Ask Aunt Dorcas: When Birth is Traumatic and It's Not Ok to Say So

 

Aunt Dorcas, Amy, and Ben--1993
in the hospital, soon after Ben was born.

Dear Aunt Dorcas,

  I gave birth to a beautiful baby boy about two years ago. Prior to his birth, I heard many women share their birth stories both online and in person. Their comments about the pain level ranged from "I would describe it more as pressure than pain" and "It was intense but definitely manageable" to the occasional "Labor was incredibly painful." I averaged all these comments and decided that the birth process must be fairly painful but not terrible.

  I found labor to be shockingly painful and transition felt almost unbearable.

  I have two questions about this.

   (1) Why is it so common for women to downplay the pain of childbirth? I realize that so many factors play into the intensity level and I believe there are some women who truly don't find it to be that painful. But I don't understand how someone can experience the level of pain I did (or worse, in some situations) and consider it "uncomfortable but definitely manageable."

  I want to view birth as the beautiful experience it is, and I agree that we as Christian women should be among the most positive voices when it comes to talking about babies and birth. What does it look like to be honest about the hard aspects of birth while fully appreciating the beauty of it and the miracle of new life?

  (2) I've heard many conversations about the practical aspects of childbirth but very few about the emotional impact of birthing a child into the world. One of the factors that plays into many events that are considered traumatic is the powerlessness to stop the unpleasant event (in abuse, an accident, etc.) While labor is different from those incidents in the sense that there is a purpose for it and it is expected, it still feels as though there can be something traumatic about the very nature of contractions- wave after wave of intense pain that you are powerless to stop or escape from. I've never really heard anyone talk about this so I'm not sure if this is a real thing or if the only trauma that can come from birth is from complications such as emergency c-sections, hemorrhaging etc. I had a fairly short and straightforward labor so I struggle with feeling like I don't own the right to be traumatized by my experience.

--Lydia

Dear Lydia,

Yesterday my daughter was talking to a new mom about her baby’s birth. She said she figured she’d be fine having her husband with her as the only non-professional support. However, she soon realized that when you’re having a baby, you want someone with you who’s also had a baby.

In her case, that was quickly arranged, luckily for her.

Paul said, “As the husband, you take all the classes and you think you know what to do. Then it turns out not to be what your wife wants you to do.”

In our case, he had perched eagerly beside the bed while I was gasping in mortal pain, leaned over me, and said cheerfully, “Ok, breathe! Come on, breathe!”

I said, “YOU JUST BE QUIET!”

Can you imagine me yelling at him like that? Probably not. But labor brings out what you didn’t know was there. Local legend has it that one of the sweetest young women in Oregon threw a washcloth at the nurse during labor.

Labor is an experience that takes you to the edge of reality. For many of us, it is a tunnel of pain and overwhelm that feels like the valley of the shadow. Lost in waves of pain and pressure that we are powerless to stop, we lose track of who we are, what is going on, who is with us, and why we are doing this. We become someone else, a wild woman with no filters or tact, both weak and strong, fighting and conquered.

With a couple of my five births, I completely forgot I was having a baby or that this would not last forever.

Of course it’s traumatic.

And then, in an instant, we are taken from the depths of agony to the heights of joy. There’s nothing in the universe to compare. One second, we are bearing down in the middle of the hundredth contraction, lost to reality. The next, the pain is instantly and entirely gone, and there is a baby! A new little person, come from heaven, red and slippery, the most wondrous creature you have ever seen. If you’re like me, you think, “Oh that’s right!! This was all about a baby! I forgot there was a baby! And there she is!” You feel a joy that is surely a glimpse of Heaven and feel like the veil between is sheer as an organdy curtain and the light is shining through.

If you’ve been through it, tasting the worst and best, you have a story to tell. Childbirth and stories are connected like salt and pepper, like thunder and lightning, like frogs and puddles.

Eve didn’t have women to be with her or to talk to afterwards when she birthed those first babies, poor thing, but ever since then, women have supported each other in labor, and they have told each other their birth stories.

My mother used to repeat the stories of how the six of us were born. “Oh, girls, it’s just the most TEEEEEEERRRRRIBLE pain! Oh, you just can’t imagine. Oooooh, I can’t even describe it, it hurts so bad.”

My sister Rebecca and I found out, years later, that in large groups of people we both used to look around wide-eyed and think, “For every one of these people, some poor woman went through the most unearthly, unthinkable pain.”

However, as I got older I realized my mom’s stories didn’t really make sense. She also told of having a chemicalled cloth laid on her nose and being completely unconscious when she gave birth and also presumably during the worst stages of labor. How did that compute with the insane pain?

By the time I had my first baby, times had changed. We went to a little hospital one night a week for probably two months and learned all about pelvises, dilation, contractions, exercises, and Lamaze breathing. We ladies lay on the floor and breathed long slow breaths in our noses and exhaled out our mouths with earnest hoo hoo hoos and ha ha ha’s while the hovering husbands coached us.

We were taught that the perception of pain changes when we are informed and prepared, when we have support, and when we feel that we have choices and volition.

That, I was convinced, was why Mom’s births were so agonizing. She was completely at the mercy of the medical system and especially Dr. Sattler, a sadistic man who scoffed at weak American women because, as a refugee in Germany, he had marched with a flood of desperate people and had seen women drop out of the line to give birth and then get back on their feet to keep going.

[Edit--That was what I remembered from Mom's stories, but I saw an article online that indicated Dr. Sattler may have been with the American military and observed refugees in Europe, rather than being one of them.]

When Mom was 8 months pregnant with her first child, Dr. Sattler decided the baby was breech and needed to be turned. He called in a helper, and the two of them pushed on Mom’s stomach as hard as they could. The pain was unbearable. That didn’t stop them.

The baby didn’t move for 24 hours, and then Mom went into labor and was taken to the hospital.

She woke up all alone in a room. No husband, no nurse, no baby.

She thought, I must have had my baby, and it died.

After a while, a nurse came in with a bundle. “Would you like to see your baby?”

Oh! She had a baby? And it was alive?

Well, yes.

No wonder Mom was traumatized. I feel like her daughters were maybe not the best audience for her tales, but I hope we bore witness to her hellish experience. Certainly, we wanted something better for ourselves.

As I see it, there are three factors to a good outcome with childbirth.

1.      Skilled care: someone present who knows how to deliver a normal birth and who has resources when things go south—breech, bleeding, and a hundred other complications.

2.      Volition: a sense of choice, control, power, and ownership for the mom. She gets to choose place, position, people, interventions. She can make requests and they are granted.

3.      Support: people who are there for the care and keeping of the birthing woman, who listen to her and grant her wishes. Also, people who will listen to her story afterwards and validate it all. And people who will care for her in practical ways.

We are always trying to find the perfect combination of these three ingredients, and we are always reacting to the generations before.

In the late 1890’s, when my grandmothers were born, women gave birth at home, in familiar surroundings, and had support from other women. New moms stayed in bed for six weeks, fed and cared for by others.

However, many of them lacked skilled care, and every family has stories of women who died in childbirth. We still see this in places that don’t have access to medical care.

The reaction to that was to maximize hospital care and completely minimize the mother’s choices over what happened to her, as well as the support from others. By the 1950’s, doctors called all the shots, women had no options, and husbands were relegated to waiting rooms and ushered in when Mom was all cleaned up and tucked in bed with clean sheets. I’m told my father-in-law was always skeptical of his wife’s descriptions of childbirth because, after all, she looked pretty good when he finally got to see her. Some of us are still annoyed at him for that.

In that era, women like my mom survived births that might have killed them in earlier days, but they had lasting emotional scars from the inhumane methods of the medical world.

Maybe my generation had the best combination. We were allowed to put together the birth plans we wanted, we could have husbands and moms and friends in the delivery room, and we could tell our stories to other women and be affirmed and believed. I’ve been at many women’s gatherings when the conversation wandered into childbirth and we all told our stories, while the rest of us laughed or gasped by turns.

We recognized that every woman’s experience is different. I have a sister-in-law who just “loved that feeling of puuuuusssshhhing the baby out!” Others of us, in great contrast, were ripped from stem to stern pushing the baby out and didn’t know if we’d ever have a normal bowel movement again.

It was all valid and validated.

When I was having babies, there was already a trend to minimize the danger of childbirth and maximize the normality of it. “Your body is made for this,” those midwives said. “Welcome the pain. Breathe through it. We are here for you.” This was far better than what my mom endured, but had its own pitfalls.

My impression is that that movement has expanded in the 25 years since then, accelerated by Instagram and a young-mom peer pressure that is unlike anything I’ve ever seen. My guess is that the pressure to minimize the pain of childbirth is a wish to maximize a sense of control over the process. This is your body, your choice, your quest, and you are strong and brave and you can do this amazing thing.

Unfortunately, this can cut off the other two legs of the stool. An unrealistic perception of your control of the process often means not making contingency plans for medical emergencies.

It also means, as Lydia said, that women downplay the pain, presumably because if you had a hard time, that means you “did it wrong.” So stories aren’t told, heard, or validated, and the trauma isn’t healed or processed. It wasn’t supposed to be more than discomfort and pressure, so the unbelievable pain must be their own fault. If all the other ladies in the hot tub felt empowered and strong all through labor, how can you admit you were asking for a knife to kill yourself? [True story of someone I love.]

We all make birth decisions based on the stories of sisters and friends. Maybe we choose their midwife, doctor, or hospital. Or we take castor oil to get the process underway when we’re overdue, as my one sister-in-law swore by.

I had heard glowing reports from friends about the wonder of giving birth in a tub of water. “I hardly felt anything,” said one.

What a gift that would be! So I planned on a water birth at home for my fifth baby. We placed a new stock tank in the dining room and filled it with warm water. Paul was there along with three professional midwives.

It was horrible.

The pain was beyond all endurance, and then when it was time to push I didn’t feel the slightest urge, and I was so far gone mentally that I couldn’t think which muscles to activate and how to make it happen. Things got a bit desperate and dicey for all of us, with Paul and the midwives leaning over and practically yelling at me to push, before Jenny was finally born.

So the water birth was a bust, but I felt good about the home birth, the midwives, and all that. My friend Rita Baker came over soon afterward with a pot of chicken soup, and a few hours later Paul went and fetched the other children at his parents’ house, and we all snuggled that amazing baby.

I had made my birth plan based on real people, reading, and my own experiences with previous births.

What’s troubling is when pregnant women make high-stakes choices about childbirth based on persuasive social media characters and online information with no connection to real life, such as a young missionary overseas making a birth plan based on advice from Instagrammers in the US.

Here’s my advice to women having babies:
1. Acknowledge the high stakes of childbirth. Yes, it’s amazing and life-affirming. It’s also dangerous. It can be traumatic. It can be the highest and lowest points of your life. Be honest about this.

2. Seek a balance of skilled care, personal choice, and support from others, in your birth plan and afterwards. Be aware of the risks of every approach.

3. Get information on preeclampsia and stretch marks online, but learn about birth options from real people. Sisters, friends, aunts, midwives, doctors. They know how far it is to the hospital and what the weather might be like around your due date and whether or not your husband will make a good coach. They can also tell you real experiences with birth centers, midwives, and epidurals.

4.Own your own story. Choices, mistakes, feeling empowered or guilty or defeated. It’s yours, it’s real. You don’t need to change it to sound good.

5.  Listen to each other’s stories and affirm and validate every one. Every woman is different, every child is different, every birth is different. Each deserves affirmation. Ask young moms questions and listen to the answers. Don’t say everything you might think. Affirm their story even if, like one memorable young woman, they say giving birth was really awful, and no, actually, they can’t say that it hurt, but it was terribly miserable because it was just so much pressure. [True story. To my eternal credit I didn’t slap this woman but nodded and listened and affirmed her experience without telling her about mine WHICH HURT LIKE BLAZES, JUST SO YOU KNOW! “Just so much PRESSURE!” WHAT EVEN???]

Sometimes women keep talking about experiences that don’t sound that traumatic on paper but seem to have left a lasting, haunting, impression. Listen, make sympathetic noises, and, if the woman seems stuck there for a long time, refer her to a professional. Any part of the process can be traumatic, whether it’s the lack of control over the process, complications, medical interventions, or an unmet need for support. Sometimes we need extra help.

I wish my mom could have seen a therapist to talk through her birth trauma.

We are strong women, and we can do this unearthly task of bringing a new human being into the world.

Let’s erase the expectations and gather around and support and affirm. Most of us in Mennonite communities have the best possible combination of medical care, plenty of information, community support, and the means to choose what works best for us. Let’s celebrate these resources and not complicate an already complicated process with expectations that most of us can’t meet.

Birth can be traumatic for many reasons. We can bring healing by supporting other women and allowing them to share their stories.