My OB said WHAT?!?

Where to start. Hoo boy. For quite a while, I've been following the site My OB Said WHAT?!?, which features outrageous (but true) things said by pregnancy and birth care providers. In April 2010, I submitted my own quotation from the OB attending my first child's birth in 2002, then forgot about it. I received an email recently alerting me that my submission had been published, here.

Yes, my OB *actually said* "I bet you wish you had gotten that epidural now," while she was stitching my second degree tear. To be more specific, it wasn't *said* so much as it was *sneered*. I've been wanting to write the backstory to the birth and it has felt too overwhelming. How much to include? I'll try to make a long story short.

I was pregnant with our first child back in 2002, in the days of dial-up internet. Before I had heard of Google. Before I had even heard of Henci Goer or Ina May Gaskin. I've always been an eager learner, but apparently during my entire pregnancy, I didn't run across a single birth junkie or mom who was really self-educated on birth or even a doula. Everyone told me that I *had* to go buy What to Expect When You're Expecting as soon as I found out I was expecting. (I plan on writing a blog on that soon, too. Just wait.) I *thought* I was educated on birth since I read WTEWYE and the free parenting magazines that they send when you get on mailing lists. (I plan on writing a blog on those, too.)

I wanted an unmedicated birth for the simple fact of not wanting to put my baby at any risks that could have been prevented. I thought that making up my mind to have said drug-free birth was enough. I couldn't have been more wrong. I was really blessed that the hospital where I had my first baby was more hands-off and consumer-oriented than the competition, but it could have turned badly at any point had my birth and breastfeeding experience not been textbook.

My labor was straightforward and the nurses left me alone for the most part, thankfully. I remained mobile and active in different positions until it got very intense and I started feeling rectal pressure. I got up repeatedly to go to the bathroom but couldn't produce any more. I didn't know that this was the sensation of my daughter descending and pressing the nerves in my rectal area. I did, however, feel that my contractions were so intense that I thought it might be time soon for the baby to come, and asked her whether she would call the doctor in. (The doctor was at home, asleep, since it was 2 a.m.)

The nurse was sweet but condescending. "Oh no, sweetie, I just checked you at (whatever time) and you were only at (however many cm). You're nowhere near time to push yet. Besides, for a first time mom, you'll probably be pushing around 2-3 hours." Famous last words. I should probably submit that quote to MyOBsaidWHAT.com as well.

I had been in the bed for this intense period for no reason other than believing that it was what I was supposed to do. I didn't realize that there is NO WORSE POSITION than on your back in a bed for laboring and pushing. Live and learn. No, really. Learn. Please. From my mistakes. So you can keep your perineum intact.

By the time the urge to push came upon me, it was as involuntary and irresistible as the urge to vomit. Telling a woman who has the urge to push "Don't push yet! The doctor isn't here yet!" is truly akin to telling someone "Don't vomit yet! We don't have a bucket ready!" Seriously. The time frame is a blur, but pushing felt like it couldn't have been more than 10 minutes. The nurse believed me when she saw my baby's hair and decided that maybe she *should* call and wake up the OB.

The OB lived in an apartment building right next to the hospital and arrived there very quickly, just in time to put on gloves and catch. Meanwhile, I was scared because the baby's heart tones were dipping, most likely because I was on my back the way they told me to lie. It makes no sense to have a mother push lying in a position that compresses the artery that supplies blood to the lower half of her body, potentially causing lower oxygenation for baby and heart decels. They turned me somewhat on my left side and thrust an oxygen mask on my face. I didn't know what was happening, but I wanted reassurance and didn't receive it. I didn't understand what was going on that all of a sudden my baby wasn't getting enough oxygen.

They kept telling me not to push yet, but like I said, yeah right. My husband describes the delivery thusly: "Imagine you took the cap off a brand new tube of toothpaste, then set the tube on the floor. Then you stomped on it." *That* was why I tore. Why didn't someone explain to me that the rectal pressure I had mentioned for the past 45 minutes meant the baby was descending, that it was progress, and that I needed her to descend slowly so that she could stretch my tissues gently so I wouldn't tear? Why didn't someone encourage me to get in ANY position other than on my back, for my baby's health and my own? (I know the answer to that, but that's another blog.) Why didn't anyone at all tell me that if I worked *with* my body's cues, I could ease my baby out and keep my perineum in one piece?

Not only did I suffer what I was told was a 2nd degree tear, but I also broke my tailbone in the delivery. That's another casualty of delivering on one's back. It's more common than I realized. Dumb stranded-beetle-position.

I was so wrapped up in wanting to hold my baby that I didn't even hear the OB say her snide little comment. My husband and friend/doula told me about it afterward. I must have been in a baby haze/ pain stupor. It hurt so much as she stitched me that I thought I had not received local anesthetic. My husband and friend/doula confirmed that I did indeed receive a shot of local anesthetic. I'm not sure whether the local anesthesia didn't take or whether she took so long stitching me that the anesthetic wore off.

What a kick in the gut. "I bet you wish you had gotten that epidural now." After all I sacrificed to ensure the safest delivery possible for my baby? After all that work, that long and tiresome yet rewarding work? Really? "I bet you wish you had gotten that epidural now." I wish I *had* heard her say it at the time, so I could have retorted with... I don't know, some witty and snide comeback. Who am I kidding? I wouldn't have come up with any comeback at the time. I guess it was better this way.

What's most offensive is that there's no factual basis at all to her statement! Epidurals are well known to be the cause of perineal tears, both in number and in their severity. When a mother is numbed, it's not uncommon for her to be unable or less able to push effectively, resulting in more intense tearing. Since there would have been no benefit to having had an epidural, I guess what the OB really meant was, "You shouldn't have woken me up at 2 a.m."

Epilogue:

I suffered from intense pain recovering from the 2nd degree tear. For months, I was basically out of commission. It hurt so bad that I had to hold on to the walls to walk, hunched over. I cried every time I thought about how bad it hurt, with that recovery. I was glad that I delivered med-free and proud of that accomplishment for the sake of protecting my baby, but I hurt so much that I dreaded giving birth ever again for fear of tearing.

I hurt so much with the recovery that I had a hard time enjoying my precious newborn. I remember thinking to myself how wonderful it would be to become a grandparent and be able to enjoy and love a baby without being in pain. It hurt to sit up. It hurt to lie down. It hurt to move. It hurt to hold still. (It was so unnecessary and preventable! How tragic!)

A year after that birth, I visited my dear friend Denise at the same hospital where I delivered my first baby. Less than 24 hours after this, her first birth, Denise felt great! She had a drug-free birth like I did, but did not tear at all. She was bopping around, moving at a normal pace, and could even sit in normal chairs. (I needed to sit on a donut or Boppy for weeks after that first birth.) When I asked her how she managed to move around so well and she explained that she felt fine and normal since she didn't tear, that's when my gears started turning. I got to thinking, "Maybe what happened to me WASN'T normal and expected." This began my quest for birth info, especially when I found out a month later that I was pregnant with baby #2.

Once I discovered that tearing is NOT the norm and does not necessarily have to happen, I wanted to do everything I could do to prevent it. I never wanted to go through that again.

Babies # 2, 3, and 4 were born at home in water, with midwives attending. I didn't tear at all with any of my subsequent births due to spontaneous pushing encouraged by my midwives, as well as self-support for my perineum and, of course, the benefit of waterbirth for preventing a tear.

Baby #1, 2002: 7 lb. 3 oz. 2nd degree tear.

Baby #2, 2004: 7 lb. 3 oz. Perineum intact.

Baby #3, 2006: 8 lb. 2 oz. Perineum intact.

Baby #4, 2008: 9 lb. 1 oz. (after she pooped twice.) Small surface tear that did not require any stitches. I couldn't tell it was there.

Epilogue posted here: OB office manager's reply to MyOBsaidWHAT.com submission