- A Tale of Two Labors
My pregnancies are the best of times, and the worst of times.
I am a planner and worrier. So, when my husband and I saw the much–desired second blue line on the little white stick for the first time, my joy was matched by my fear. I had far more questions than answers, and I knew my best bet was to find a doctor I could trust. When appointment day finally arrived, I was filled with anticipation, but the visit culminated with the words, “no heartbeat.” Instead of a baby, I would have a procedure.
So, when I entered my second pregnancy in a new town, with a new doctor, I had little optimism. When spotting from a sub–chorionic hemorrhage began, I was crushed. I stayed in bed for two weeks, praying for better than I thought I would receive. I understood that I had precious little influence over the outcome, but I would do anything asked of me that might help.
Mercifully, this time there was still a growing baby. As time went on, I would be diagnosed with placenta previa, and then with gestational diabetes. I hoped, but I also had a constant sense of dread that a bad outcome was one test or mistake away. I did my utmost to follow doctor’s orders, eat as I was told, and test my blood glucose until the tips of my fingers felt bruised.
Many aspects of her own pregnancy are not meaningfully within a woman’s control. The child may gestate in her womb, and grow from a mingling of her genetic material with that of another human being that she, one hopes, chose for the role, but the best diet, exercise, home environment, and medical care in the world can only improve odds where there is hope to begin with. There’s no fixing an extra set of chromosomes or other intractable defects, as I had learned the hard way. Still, I wanted a say where it was possible, so I made a lengthy, careful birth plan. I wanted labor to be as intervention–free as possible. I wanted everything explained to me to assuage my anxiety, and I wanted to make treatment choices when possible. In short, I wanted to be a respected partner in my care and wanted to feel that I retained autonomy and identity.
I sat across a cluttered desk from my obstetrician at 38 weeks of gestation. He pointed to a graph and said, “We know he is okay now. We should take him out while that is true. Outcomes are best at 39 weeks, and you are a good candidate. Do you want to schedule an induction?” I mentally crossed off the first item in my birth plan. I could not live with the implication of his words: that waiting for [End Page 185] spontaneous labor could mean my much–longed–for full–term baby didn’t survive or thrive.
Looking back, I had more of a choice in that moment than I had realized. Medically, odds were worse for us than for some, but there were no markers of concrete, immediate peril. My fear and my doctor’s trust in medical data drove that first decision, which set up the dominoes that would fall.
In my ideal world, I would labor naturally at home—trusting my body and the skill of an experienced midwife to handle the unexpected in time for medical intervention. In my real world I learned fairly quickly that my birth plan—the last vestige of my autonomy—was a barrier to getting the job done. My opinions and questions and instincts were inconvenient at best, and dangerous at worst. I had rolled onto an assembly line and my individual needs and personality were subsumed by data, protocol, statistics, efficiency, documentation, best practices, and liability–reduction. The only space for personality was occupied by doctors. There was no room for me.
I was attached to an IV and consigned to a bed. I tried to get used to the idea that I wouldn’t see much of my doctor. Instead, the kindly stranger busily scribbling on my chart...