Barbara's Birth Story: Fear of Forceps
This mom learned to stay flexible during a trying time.
A few months before our son was born, my husband and I sat down to write our birth plan. This was a list of things that we did and did not want during our child's delivery. The "want" list included a drug-free birth. Though I'd never experienced severe pain -- or, perhaps because of that -- I assumed I had a high pain threshold and wouldn't need pain relief. And I wanted to avoid certain things that sometimes went along with pain meds: catheters, monitors...
Right at the top of our "don't want" list was a forceps delivery. I'd read that forceps could, in very rare cases, cause head fractures, and we didn't want to take any chances. I was hoping we wouldn't have a cesarean, either, but a cesarean seemed a safer bet for the baby if the vaginal route didn't work. "If vaginal delivery doesn't work, I don't mind a cesarean, but I'd like to avoid a forceps delivery no matter what," I told our doctor, as we regally presented him with our plan.
"Well, I can't promise you we can avoid that," said our obstetrician, a 20-year veteran who went on to explain that while forceps deliveries did carry slight risks, so did cesareans. And depending on the position of the baby, how exhausted I might be, and other factors, a forceps delivery could be safer.
I didn't like hearing that. Still, I knew the statistics were on my side -- only a small percentage of births involved forceps. We probably wouldn't have one, I reassured myself. I stopped worrying about it.
Several weeks later, I started having contractions at night. The first few nights, I was sure the baby's arrival was imminent. It wasn't. Nocturnal contractions became part of my nightly routine, which now included 16 or 17 trips to the bathroom and leg pains that made me suspect an irascible mule was surreptitiously joining us in bed. I stopped worrying about the contractions, too.
The Contractions Worsen
Then, one unusually warm November morning, the contractions continued after I'd gotten up to take a shower. John and I were talking through the shower curtain and, at one point, I had to stop. "Wow, I needed a break to catch my breath," I explained, gasping, after a pause. "These contractions are really rough." As soon as I'd said it, we realized something was happening. We called our doctor, who told us to come to his office for a look.
On the ride over, the contractions got increasingly painful. I could barely sit still by the time we reached the waiting room. I felt the pain primarily in my back. Someone in stiletto heels was doing the flamenco on my spine. Rat-tat-tat-tat-tat, rat--tat-tat-tat. Pause before the next contraction. Then on again with the not-so-fascinating rhythm. After a quick check to see how dilated I was, the doctor said there was no hurry; it would be hours before the baby arrived. He suggested we stop at a movie theater two blocks away, about halfway between his office and the hospital.
I could barely walk the two blocks. The stiletto-heeled flamenco dancer was with me every step of the way, and she'd brought friends. "Have to go straight to hospital. Can't stand this!" I croaked, stopping every few feet to grab John by the shoulders and brace myself against the onslaught.
Complications in the Delivery Room
By the time we reached the maternity ward, a whole troupe of dancers was rattling along my backbone, and I was begging for an epidural. As much as I'd wanted a drug-free birth, I knew I couldn't hold up under the pain and still have the energy I needed for the delivery. While we waited for the anesthesiologist, the nurse suggested I get down on all fours, to shift the baby's weight off my spine. It didn't help. Neither did the breathing exercises we'd learned in childbirth class. Finally, the anesthesiologist arrived.
The epidural was, in a word, magical. After a few minutes, no pain! Truly miraculous. I settled down in the bed in a comfy daze. Someone had turned on the TV in the delivery room and, by sheer luck, an old Cary Grant movie was playing. What could be nicer?
I was still trying to figure out the plot line when the nurse told me -- I have no idea how much later, since I'd lost track of time -- that we were almost ready to start pushing. "What about transition?" I asked. I was shocked to hear I'd already been through it. I hadn't felt it. In fact, I felt nothing. No pain. No urge to push.
"No problem," the nurse said. She'd tell me when to push. So, standing at the foot of the bed, she announced "Push" periodically, like a dry-docked coxswain. And I'd pushed. And pushed. And pushed. I couldn't tell what was happening, because I still couldn't feel much. Apparently, the baby was making very slow progress. And then none. In fact, he seemed stuck. Push, push, push. Nothing. Push, push. Nothing.
The doctor looked grim. He asked the nurse to turn off the stereo, which was quietly playing classical music. I pushed some more. He looked grimmer. What happened next had the foggy feel of that intermediate stage between wakefulness and sleep. I remember the nurse asking my blood type. After that, my husband tells me, the room filled with people. I didn't notice them.
"We're going to need to use forceps," our doctor said. (Evidently, all the people crowding the room were there in case the forceps didn't work and we needed a cesarean after all.)
"Is that the safest thing for the baby?" I asked, worried.
"Yes, it is," he said.
So there it was. Precisely what John and I had wanted to avoid. But I wasn't going to argue. I knew there was a chance the baby wouldn't get the oxygen he needed if he stayed stuck. I clung to the word safest.
Facing My Fears
"Safest, safest," I told myself, over and over, as the doctor did a quick episiotomy and began fitting together what appeared to be two oversized silver salad spoons. The forceps. Shiny, they looked improbably decorative, out of place in a hospital room -- more like something that belonged in a model kitchen in a Williams-Sonoma catalog. After a bit of fidgeting with the things, the doctor was ready. "Okay," he said.
And then I screamed. I don't know how that scream got out of me. I'm not the type to scream -- not because I'm brave, but because I'm inhibited. The pain was brief, but far, far more intense than anything I'd ever been through before -- including the time my sister and her friend decided to play jump rope with a metal chain, and insisted I try jumping in first. (I still have a lump on my head from that one.) The epidural was wearing off.
One more "Okay." One more burst of pain. Then I felt my son's legs shimmy through the birth canal.
I couldn't take in what happened next because I was still trying to grasp what had just happened. John tells me that the doctor quickly cut the cord and then a crew of pediatricians scooped up Malcolm -- we'd decided on the name months earlier, but he didn't seem ready for it until his arrival -- to check his vital signs. I just lay on the bed, reviewing the last few minutes, so different from anything I'd planned. Then I turned my head and caught sight of our son, surrounded by his own retinue of doctors. The first thing I saw was his ear. A beautiful, little, wet, red ear with a funny little pixie-ish point near the top.
Despite our worries about the effects of the forceps, Malcolm was fine. The bruises on his face faded by the second day. There were no fractures. Nothing was amiss. Today, almost three years to the day since his birth, he's a bright, loving, funny, silly, and -- I have to say -- stubborn little guy, who questions any rule that doesn't sit well with him. Often, the rule stays on the books. But not always. Malcolm makes us ask ourselves, "Do I need to be more flexible here?"
I'm convinced this is a good thing. The hardest and most important lesson I've had to learn -- and relearn, over and over -- since becoming a parent is to be more flexible. And my crash course in the importance of being flexible started the day Malcolm was born. There's no predicting what a child's birth, or journey through life, will be like. "Stay flexible," I remind myself. Daily.
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