Giving Birth, Feeling Powerful - Shilpa Phadke

I was having the time of my life. Nothing had prepared me for this possibility. At best I had hoped to cope well and to retain my sense of equanimity through the process. At the most I had hoped to have a sense of control over my own body. At the least I’d wished to retain a sense of self through the process. But this – this was something else!

I had never felt more keenly the power of my own body – not when I hiked up steep trails, not when I danced the night away, and not even when I successfully managed a difficult yogic pose. As I sat on a birth-stool I knew this was the most visceral thing I had ever done in my life and the most visceral thing I would ever do.

I had done the exercises and the yoga and practiced the breathing. I was eating better than I had ever done in my adult life. I had read many books and visited dozens of internet sites on the subject. I had heard the stories and been to the ante-natal classes. Each person told me their truth of giving birth. Some said it was the most painful thing they’d done. My mother told me her dislocated elbow had hurt more than childbirth. One friend told me that it was the loneliest thing she’d done – eventually it was just she and the baby. Most said that the best thing about it was that eventually the pain would end.

There I was, sitting on a birth-stool, my mother on one side of me and my midwife on the other side, feeling my baby inch her way out of my body, to begin her life as an independent being. It was 6.30 a.m. in the morning and I was in an alien nursing home environment with an unknown obstetrician. This was not how I had planned my baby’s birth.

I’d had an incredibly happy pregnancy, marked by lots of delicious sleep in the first trimester, travel in the second and incredible pampering from my husband, family and friends in the third. This included my very enjoyable visits to the obstetrician which were marked much more by teasing camaraderie and discussions on art (my husband, Abhay edits ART India and my OB an art lover) rather than anything to do with my pregnancy. My doctor treated my pregnancy as an everyday non-event and never ever mentioned that I was on the wrong side of the magic figure before which women “ought” to reproduce. This also included the hour-long conversations I could have at my meetings with my midwife, as also my ante-natal classes with my childbirth educator where my over-informed questions were welcomed rather than shushed. My thrice-weekly yoga class with kept the endorphins flowing. Further, a Craniosacral Therapist had even managed to cure my sinus, a condition I had lived with for over a decade!

I knew that my baby in the last few weeks had descended and was in the Left Occiput Anterior (LOA) position, one of the most facilitative for her birth. I had a midwife I trusted and an obstetrician I felt comfortable with. I was ready and it looked like my baby was ready too. The evening before my daughter was born my husband, a friend and I had been on a longish walk and then sat around drinking herbal tea until almost midnight. As we talked and laughed, I wondered how many days of such leisurely teatime we had left.

It was 3.30 am in the morning when I woke up wanting to use the loo – a completely unremarkable occurrence in late pregnancy. It had only been about ten days since the weight of my tummy had become an obstacle and so I got out of bed in my newly unwieldy fashion only to feel a trickle of water and thought, ah it’s starting, the labour is starting. I was then nearly 39 weeks pregnant. I imagined from all that I had read that I would get back into bed, sleep for a few more hours, call my midwife in the morning and then figure out when to head for the hospital. And then within fifteen minutes I found myself in the middle of what seemed to be the most excruciating contractions. These made me rather anxious since everything I’d learnt had suggested that the onset of labour was slow and the contractions mild at the beginning.

I woke up Abhay who woke up my mum. By 4.30 a.m. My midwife arrived and tried to time my rather erratic contractions. “I really feel like pushing”, I said feeling rather confused for pushing was supposed to come later, much later! My midwife was unfazed and said she’d better check how far the cervix had dilated. Two minutes later she looked up and uttered the most terrifying words – “Your baby is ready to be born,” she said. “It’s two inches from crowning. We need to find a hospital close by.”

Apparently I was not going to get to my chosen hospital and more importantly for me, I wasn’t going to have my OB present at the birth. Not wanting to be in an alien hospital with unknown doctors, I suggested to my midwife that we do this at home given that my baby was ready. She said she didn't have anything with her and our best bet was to ask my OB to recommend someone close by. I was trying to deal with the idea that I would have to give birth without the reassuring presence of my doctor whose high fives and teasing humour I had counted on to make my birth easier.

And so it was that I found myself in an unfamiliar nursing home, in the labour room, where one other woman was already labouring – which meant that Abhay couldn’t come in as there was another woman about to give birth too. A resident doctor confirmed what we already knew – my baby was ready to be born. Now it was her and me in this life’s momentous journey. I asked my midwife, desperate for some measure of control, if we could use the birthing stool and before anyone could figure what we were talking about, my midwife had calmly set it up on the labour room table and I was already sitting on it by the time My OB’s obstetrician friend, came in.

None of us want to be faced with a stranger when it’s finally time to actually birth the baby but having been put in this unenviable position, I couldn’t have asked for a better emergency obstetrician even if I’d taken time out to interview for the job! He smiled at us reassuringly even when my midwife produced my birth plan which she’d very wisely asked me to get my original doctor to sign – I of course hadn’t thought to keep it so close at hand so was very grateful for my midwifes foresight. He read through the plan carefully and said – we’ll try and do as much as we can the way you want. And he was as good as his word.

He was completely unobtrusive and let my midwife lead and for that I can’t thank him enough! Flanked by my midwife and my mother, I would hold both their hands through each contraction. As I sat on the birthing stool I discovered that this new unknown doctor went to school with my brother, was a consultant gynecologist to one of my best friends, and went to medical school with my childbirth class instructor. He joked that it was foretold that I would have him attending my daughter’s birth! Even as we spoke I was struck that it was possible to have a coherent and even mildly amusing conversation while giving birth.

Through it all my midwife used warm compresses on my perineum to help it stretch more easily. I'd read in a hypno-birthing book that I could breathe my baby out. This sounded like a plan. Also elsewhere I'd read that if the baby was born slowly it gave the vagina and perineum time to stretch so it wouldn't tear. So I went slow, not pushing too hard. The contractions felt more like intense pressure than pain and strangely I felt able to control how hard I pushed. Between contractions my midwife used a doppler to measure my baby's heartbeat and each time I'd ask, “ Is it ok? and feel a sense of relief when she confirmed that my baby was indeed holding up well.

By this time my midwife figured out I was in no hurry. In an earlier conversation days before the birth I'd confided that my greatest fears, medically speaking were a c-section and in a vaginal birth, tearing. She figured rightly that I was going to take this very slow. So she gave me a push – she suggested that if my baby wasn't born soon, I might have to move off the oh-so-comfortable birth-stool and perhaps (horror of horrors) lie on my back (at this point I was of course too far inside myself to recognise a bluff!). But her bluff worked – no way was anyone going to get me off that stool. In two pushes my baby was out. The actual crowning felt like someone was smashing a giant cannonball against my vagina, it felt like the ring of fire I'd read about. But it was mercifully short and in what seemed like seconds my baby was in my arms, her umbilical cord still attached, my/her placenta still inside me.

But most importantly, even in the throes of that intense pain I felt in charge, I was controlling that pain – I was pushing my daughter’s head out into the world, it was my stage and I was performing. My body felt ready to do this – to take on this challenge. My worst fears of childbirth had always been of loss of control rather than of pain and here I felt completely in control. I was the subject, never the object. If there was pain, it was something my body seemed to understand what to do with.

A few minutes later, the doctor asked if he could cut the chord. I asked if it had stopped pulsating. He said it hadn’t and he would wait until it did. Eventually it was my midwife who cut the chord! He asked if I would place a tablet under my tongue to help the uterus to contract faster. I looked at my midwife who nodded. At that point I think both she and I were too grateful for what had been a dream birth to protest at this apparently mild intervention. I took it. In a few minutes I was looking at the beautiful whole placenta and fragments of the amniotic sac. I looked at it in awe while my midwife examined it to ensure it was complete. I had torn only very slightly. I had two stitches which later felt alien but gave me no trouble.

Hours later in the hospital at least three of the nursing staff visited me separately to check out this unusual creature, a woman on the wrong side of thirty-five who had given birth to her first child without any medication. None of them had ever seen such an event!

A few days later I looked up precipitate labour on the net while my baby slept. Reading about it was oddly pretty scary, quite different from living it had been. For many women, the roller-coaster of precipitate labour means dramatic changes in the way they intended to give birth – sometimes too short a labour is as much of a problem as too long a one. Women didn't get to the places they planned to be, babies were born on the road, women ended up with unfamiliar people in their birth rooms, the outcomes were not always comfortable for the women.

For me, luckily my precipitate labour and the four-hour from start to finish labour and birth was a wonderous experience, one that inspired awe in my body. For me it was self affirmingand joyous and a little bit like an unexpected gift – I expected labour, that is, hours of work and effort and I received this almost blissful experience that made me feel more a person with free will and agency not less. Giving birth was a high like no other I've experienced. Within hours I honestly felt, “I can do this again!”.Of course in a day the hormones and with it the high all come crashing down but that's another story!

Sometimes I wonder what it was. Perhaps a mix of things.Sheer serendipity. Genes (my mother had me in six hours start to finish). My brilliance (without false modesty) in knowing I needed a midwife to help me birth. (For without a midwife I would most certainly have had a very different birth story). My conversations with my daughter about a month before her birth where I'd tell her how she and I had to work together to help her be born, that we were a team and we could do it together. My disciplined yoga, breathing and exercise regimen (and never ever before or after so far in my life). An obstetrician who never ever mentioned the words elderly primipara and who assumed that I would have an easy pregnancy and birth. The can't-say-how-wonderful-it-was-enough birth stool which gave me a sense of control and power.

If I think back and analyse it, because I ended up in an unfamiliar space with an unfamiliar obstetrician, my midwife became de facto my primary caregiver. My birth plan listed my initial doctor as my primary caregiver and the others –the midwife, Abhay and my mother as supporting cast. Perhaps in an odd way this helped allow her to assume a more active role in my labour than she might otherwise have.

For hours after my birth, my mother and I looked at each other in awed bewilderment – “What was that?,” we asked each other. Having heard stories of my own birth, where my mother walked around almost until it was time for me to be born, I had imagined that I would have a fairly good birth but this short, beautiful, completely non-medicated and fully-in-my-control birth is something even I could not have dreamed of.

If I had to do it again, I would change only one thing. I would have had my baby at home.