Monday, April 16, 2007

Thinking (too much) for two

My six-almost-seventh month checkup at the hospital was last week. As usual, I felt as if most of it could have been taken care of by filling out a web form: no, I'm not experiencing this symptom and that symptom; yes, I feel the baby moving. Spending an hour at the hospital hardly seemed worth it for a simple blood pressure test, urine check and pelvic exam, and the quick 30-second listen to baby's heartbeat. I supposed it's just that a normal pregnancy is so routine to the hospital staff that it's difficult to do anything but hurry this sort of simple checkup along. Of course for me everything is new, and I feel like an hour-long in-depth discussion of everything from my pregnancy Pilates workout to where and when the baby is kicking wouldn't be out of place. As it is, I manage to wring out five to ten minutes at the end of the visit with a few well-planned questions, and always leave feeling there's something important I'd wanted to say but forgot.

My biggest concern last week was whether I would be able to make the pain management choices I wanted during labor. I have never been particularly frightened of labor -- I keep repeating that it's the twenty years that follow that really have me worried! -- but I kept wondering if the fear would catch up with me. Before I was pregnant, I figured that finding out that I was would make me realize that I'd put something into motion that would end in this strange, scary, unplannable event. But no, even after getting the news I wasn't worried. I thought perhaps it was simply too far away to seem real at the beginning, but even now, with only three months to go, I'm honestly not much more anxious. I'm just convinced that this is something my body is designed to do, and beyond preparing and informing myself as much as possible, I simply have to trust my body and the hospital staff to do their jobs. The most important thing I can do is stay calm.

I liken it to preparing for the Paris Marathon, which I ran two years ago: I'll prepare, I'll ask as many people as I can for advice, and I'll remember that mental preparation is at least as important as physical preparation. I know that I'll very likely feel pain at some point, but it will be the kind of exhilarating pain that is quickly forgotten: it will all be so worth it at the end. I also suspect there's much I simply can't prepare for, and all the advice, all the anticipation, will mean little as the experience takes its own course.

I also can't help thinking, I'm tough, I'm fit, I can run 42 kilometers, bring it on!

[Skeptics in the audience are kindly asked to keep any comments to themselves.]

The problem is, I think this is a fairly unusual approach to childbirth. I've been trying to find myself somewhere in the two prevailing philosophies, and failing. You see, I find people are of one of two schools of thought:

The majority seem to think that all the tools of modern medicine are necessary for a tolerable, if far from pain-free, delivery. Many people ask if I plan on having an epidural. No, I'd rather avoid it, I say, for they are not without risks, and the idea of giving myself and my baby a non-negligable dose of opiates at the moment they come into the world depresses me. Perhaps I'm being silly, but I like to imagine my child first opening his eyes to the world outside with a clear head, and I'd prefer to have an unfoggy memory of the event myself. "What, no epidural?" is the response, "But it will hurt... you can't imagine..." and then I see them mentally write me off as a wacko.

The minority, including a dear friend of mine, think that natural childbirth is not only possible but preferable. I started reading a book she recommended about a preparation method based on self-hypnosis. It's seductive, and largely convincing. The key idea is that childbirth is natural, that women's bodies are designed for it, and most of the pain conventionally accepted as inevitable comes from the unnecessary fear childbirth inspires. Control the fear, plus practice the breathing exercises and visualizations, and you'll have one of the picture-perfect, pain-free births described in the numerous letters published in the book. The only problem is that reading between the lines I've gathered (and perhaps I'm reading too much) that if you don't have a perfect birth you weren't zen enough, you didn't empty your head of negative emotions, you didn't properly breathe: in other words, you failed. I'm all for empowerment, but I believe that one of the most important steps is understanding that not everything is under your control.

Where's the middle ground, then? It's difficult for me to find. My biggest concern at the moment is that the hospital staff accept my somewhat unconventional approach. I talked about epidurals with my (British) gynecologist at the hospital, and she said that whether I'd be able to avoid one depended in large part on which midwife I ended up with. Some of them are willing to work with you, but as "this is France, and birth is overmedicalized," I should be aware that I might be so hooked up to monitoring equipment that I'd have trouble moving around and working through my labor.

I know they can't and wouldn't force me to have an epidural against my will, but I imagine some bossy midwife explaining to me, "but madame, of course you are in pain, but it was your choice," with more self-righteousness than compassion.

I realized that for now all this must fall into the realm of things I can't control, and my fears should be at least somewhat addressed when I'm on my pre-maternity leave at the end of next month and can finally attend some childbirth classes. In the meantime, I'll try and keep in mind my mother-in-law's advice, one of the only women who seems to share my point of view on the whole thing. She showed me some breathing techniques (easier for her that for me, with her background as a professional opera singer), described matter-of-factly her two, largely painless labors, and said "De toute façon, don't listen to what I or anyone else has to say about it, since every labor is different. And all those women, they exaggerate. It isn't such a big deal."

Or my British gynecologist's favorite phrase: "Just get on with it!"

Yeah. That's my way of thinking.

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