Guest post by Susan Peterson
I was pregnant with my first child through my senior year in college. As soon as I announced my pregnancy, a faculty wife gave me the La Leche League manual and Niles Newton’s Family Book of Child Care. She also called up the local Lamaze teacher and registered me for a class, saying she would take care of the fee. I went to the OB group suggested by the Lamaze teacher as her personal preference. I thought I was lucky to have someone point me in the right direction and that I would be well prepared.
I was busy with college and was not aware that there was a whole world of knowledge about birth which I did not have.
I rejoiced in what my body was doing; I was really overjoyed that I was finally going to get to have a baby. I had had two abortions that I did not want, one to please my parents and one to please my then boyfriend (now my husband and very sorry about this). So I was thrilled to be having a baby. I threw up every day for four months, and was basically glad that it meant I was having a baby; I only worried if the baby was getting enough nourishment. When I got stretch marks, I only thought, Wow, my belly is really growing, there’s a baby in there!
About the birth I had two contradictory sets of feelings. On the one hand, I trusted “science” and medical authority figures. On the other hand, I had a very strong dislike of the idea of going to the hospital to have my baby. I expected it to hurt a lot; I thought maybe I would yell and scream. And I thought it would be much better to do that in private, in my own bedroom. I fantasized about just not telling anyone when I went into labor. I wondered if the local black people had an old granny midwife, and I asked some of them, only to find that they thought that was terribly old fashioned, what their grandmothers had to endure because they were poor, and that they all went to the hospital and had as much pain medication as they could get. I even asked the Lamaze teacher kind of shamefacedly, and as if I was only asking theoretically, if there were any old granny midwives left. She denied knowing anything about it. I found out later that there was a midwife, not a granny, but one who actually forced the state of Maryland to certify her under its old granny midwife law, and who actually got to sign a book as a midwife next to the names of the old grannies, the first person to sign it for decades. After that, they repealed the law, and I am sad to say that the nurse midwives were the biggest proponents of repealing it. The Lamaze teacher knew about this woman and didn’t tell me about her. I suppose she needed to have a good relationship with local doctors and couldn’t be known as someone who sent women to a medically untrained person to give birth at home. But I wish she had told me. I didn’t know anyone else to ask, and I thought that this was probably only fantasy anyway.
Prenatal care in those days was weights, blood pressures, measuring the height of the fundus, and peeing in a cup to see if you were spilling sugar or protein. There were no sonograms. There were no tests for Downs or spina bifida. Only woman who were suspected of diabetes had a glucose tolerance test; it was not routine.
The Lamaze class included basic information about the physiology of birth, information about the practices at the local hospital, and training in Lamaze breathing, relaxation exercises, and how to push. For the breathing, the teacher went around and pinched our legs hard and we were supposed to remain relaxed and go on with our breathing.
For pushing, we were trained to take two cleansing breaths and then push as hard as we could. We all brought pillows and practiced in a semi-sit (really a semi-lie) position. The teacher drilled us, “Contraction begins! Cleansing breath! Cleansing breath! Push! Push-push-push-push-push. Cleansing breath! Push! Push-Push-Push-Push-Push!”
We were strictly instructed that we must NOT push until we were examined and told we were 10cms dilated, and taught how to “pant like a puppy dog” to keep from pushing. I wondered a little how this worked out when women just gave birth at home and no one had heard of centimeters. I also wondered why it was always the same number for every woman; weren’t babies’ heads different sizes? But I kept these thoughts to myself. One thing we learned which was valuable was Kegel exercises, with the idea that we would increase awareness of tension in the perineum and be able to relax to let the baby out. I am not sure it ever worked for that, but it is sure good for not becoming incontinent!
We were told that at the local hospital we would not be allowed to eat or drink, but the “liberal” OB’s would allow ice chips. We mustn’t swallow the water in the bottom of the ice chip cup. In order to be in the delivery room with us our husbands would have to take both this class and the hospital tour. We also had to take this class to be permitted not to have our hands strapped down in the delivery room, since we would have learned in the class the importance of not touching the sterile field. We would want to touch our baby when they put it on our stomach on the sterile field, but we must not do that! If we forgot, and contaminated the sterile field, the hospital might start requiring all women to have their hands strapped again.
We had to make sure we had our certificate from the class with us when we went to the hospital as well as making sure it was in our chart at the OB’s office. At that time, once one was fully dilated one was taken to the delivery room, which was really an OR, one’s feet were put in stirrups, and the standard practice was to strap down the hands, but we were to be released from that. When we got a contraction, our husbands would help raise our upper body off the table to help us push. When we went on the hospital tour some older woman on the tour— she might have been all of 30— asked if all woman were required to give birth with their legs in stirrups, and I was actually embarrassed by her and for her. I knew this was a displeasing and improper question and marked her as some kind of a nut. I also thought it very whiny to make an issue over what position one’s body would be in. I must have thought that one gave birth with one’s head!
There were mixed messages about “accepting pain medication.” The only medication in use at the local hospital was Demerol. Some woman had a spinal for the birth, but the Lamaze teacher pointed out that they didn’t do that until you were pushing, and that usually that felt wonderful, unless you had back labor. And once they did it, someone had to feel for the contractions and tell you to push, because you couldn’t feel when to push. (No fetal monitors/contraction monitors in that hospital at that point.) Sometimes they didn’t do it until just before the birth, and at that point, what was the point? But as for Demerol, on the one hand, Lamaze techniques were supposed to keep us from needing it, and it sometimes just caused one to lose control without taking away the pain. But if we needed it, we weren’t to consider ourselves failures. I, of course, was not going to have any Demerol.
The Lamaze teacher told us that the c-section rate at the local hospital was 20%. I know that is much higher than the statistics for that year on this blog, but that is what I remember. There were five or six couples in the class, and she said that statistically, one of us would have a c-section. I wondered which one of them it would be. A few days before the birth, standing on the sidewalk in front of church, one of the old ladies said to me that her daughter who was my age had just had a baby, and had had a c-section. I thought—I hope I didn’t say—“I’m having natural childbirth.”
I had a prenatal visit on my due date, which I think was June 30. The doctor, the nice fatherly one that I liked, Dr. Riley, examined me, said, “I know this is your due date, but your cervix is very green.” He saw I looked puzzled and said, “You know, its not ripe, it’s not ready, it is still long and hard.” He told me not to expect labor for probably three more weeks. There was no great worry back then about being overdue. Due dates were figured from the last menstrual period, without regard for the actual length of a woman’s cycle, and there were no sonograms to check on them, so they really were a rough approximation.
That night, or maybe the next night, my water started leaking, and I had a few contractions, which even were fairly regular for a while, though not really strong. I called the doctor, my favorite again, and he said, “Babies are always making liars out of us. But call me again when you get some that curl your toes.” I remember thinking that a properly relaxed Lamaze woman would not curl her toes, but also that the doctor might well have better information about this, and I said nothing. The contractions stopped.
I went in the next day, was put in a gown and sat on the examining table, and then the doctor (Dr. Chitterling, less of a favorite) ran off to deliver a baby. I sat in that room on that table for two hours. When he came back, he used nitrazine paper and said my water was not broken. I thought of telling him that if I pushed I could make some come down, but I said nothing. At the end of that week I had my regular weekly visit, and they tested again, and the nitrazine paper was positive. I could tell the doctor was very anxious. He wanted me to proceed directly to the hospital without going home. He was afraid my water had been broken for a week, a spectre of infection.
I insisted on going home, to get my bag and my husband. I waited for him to come home from work. Then we set out walking to the hospital, which was only about two blocks from my house. My neighbor asked as I went by, “Is you sick?” “Sick” was what the older black folks called being in labor. I didn’t like this and said loudly, “No, I am not IN LABOR but they are going to induce me, bring my labor on because my water is broken.” My husband though I was rude and was angry with me. I was afraid for a minute that he would leave me to go to the hospital alone. But we continued to the hospital.
At the hospital they took me for an x-ray; before they started pitocin they were going to make sure my pelvis was adequate. Yes, they used to x-ray babies and pelvises at the end of pregnancy. We waited a long time for the x-ray, and a long time for the result. Then the doctor came in to the room saying “Your pelvis is huge! You could drive a truck through it. You’ve got a big baby in there, but no problem getting it through that pelvis.” I was excited. I was going to have my baby. And the doctor had just promised me my pelvis was big enough for my baby.
The next thing I remember is sitting in the bed in the tiny labor room, listening to two nurses out in the hall arguing about how to mix up the pitocin. I was pretty sure that the more assertive, self confident one, who triumphed in the discussion, was in error about where that decimal point went. The results tend to bear this out. The pitocin gave me piddly little contractions, hardly more than Braxton Hicks. My husband kept sneaking and turning up the drip, which wasn’t on a pump, just a count the drops sort of thing, and I would have a few more contractions, but nothing to speak of, and then the nurse would come in and adjust the flow back down again. I think it was about 6:00 in the evening when they started the drip.
At six in the morning the doctor came in and said, “We’ve given you enough pitocin to induce an elephant and it isn’t working; we have to get that baby out of there; the risk of infection soars after 24 hours of ruptured membranes and yours may have been broken for days.” I think they had only given me enough for a tenth of an elephant, and tried to say something about this, but nobody seemed to hear me. I remember asking plaintively if I would still be able to nurse my baby. I knew the answer to that, but at that moment I didn’t trust anything and felt everything was being taken away from me. I was reassured on that point. I asked if this meant I would always have to have c-sections. The doctor said that if I came in fully dilated they wouldn’t race me with the knife, but otherwise, yes. I think I had already been shaved when I came in, as everyone having a baby got a shave and an enema, but now they had to shave more, and put Betadine on me. Dr. Chitterling told me that my friend Dr. Riley was coming in to do the surgery. How did he know I preferred Dr. Riley? I wondered, and felt guilty if I had made him feel less liked.
I said a tearful goodbye to my husband and was rolled up to a hall type area outside the OR doors. Then I was told there would be a delay; the hospital had no AB negative blood and wouldn’t do non-emergency surgery without having type specific blood on hand. They had to send up to Baltimore to Johns Hopkins for it. Apparently no one thought that maybe my husband and I might want to be together for the two and a half hours it took to get that blood. I lay on the stretcher mostly alone. Occasionally someone walked by, but mostly I was alone.
I thought that I was going to be someone who was forever dependent on surgery to get her babies out of her. I thought that probably ten years before they would not have done a c-section for this reason, and maybe ten years later they wouldn’t either. (Little did I know that 37 years later they would be doing c-sections for a whole lot of reasons which hadn’t even been dreamed of yet.) I thought I was the victim of an obstetrical fad. I wanted to leave the hospital and go home and just wait until I went into labor. I actually looked around to see if I could see where the people coming and going were getting their scrubs. I calculated my chances of escaping from the hospital. But… I was barefoot. And, ultimately, I was just too obedient.
It was the Fourth of July. The baby whose mother had her c-section right before mine was named “Sparkle.” I later babysat for her a couple of times. So then I was finally wheeled into the OR and had my spinal. The heaviness settled into my legs and I felt that they were bent in an uncomfortable position. I begged to have them pulled straight, and although she thought it was unnecessary, the anesthetist went around and pulled them straight for me, and it was a great relief. I thanked her profusely. She said, “You couldn’t do it without me.”
I started telling her a story I had heard about a woman who had had a c-section without any anesthesia until the baby was out. She said this was impossible. Dr. Riley, said, no, this was true, and he had done the surgery. The woman had serious spinal problems and they were afraid the spinal might paralyze her. But her baby was in serious distress and general anesthesia would depress him further. She asked how long it would take and he gave her an estimate of a few minutes. She said she could stand anything for that long, and just do it. He still knew to the second how long it had taken him to get that baby out. I wish I remembered the number.
I was also asked the question at some point if I would be wearing a bikini again. “With all these stretch marks?” I said, “No, I don’t think so.” But they didn’t tell me why they were asking that. So I have an incision right down the middle on the outside. But the uterus is cut low cervical. They hung a curtain so I couldn’t see, except a bit reflected in the light. When my son was out they showed him to me for a few seconds, then he was handed to the pediatrician. Before the took him to the nursery they again hung him next to me for me to see, and I tried to turn my hand in the strap to reach for his foot, but could not reach it. He was certainly strong looking and crying vigorously, and I had some interest in him, but it was not intense at that point really. He left the room in a covered incubator painted bright yellow. I don’t remember when I found out that he weight 9lbs, 6 oz.
After a while I was in “recovery” which was really the hall outside the labor rooms, on a stretcher. They let me talk to my husband on the telephone, and he said, “Susan, he’s beautiful.” I was very moved by the emotion in his voice, more I think, than by the actual baby at that point. Then I was taken to the maternity floor. And there I stared to feel pain. It felt as if my uterus was contracting, but in an uncoordinated way, pulling in several directions at once. I begged for pain meds, had 75 of Demerol, and went to sleep.
When I woke up, there was still that awful uncoordinated contracting, and I begged for pain meds, had another 75 of Demerol, and went back to sleep. I think this happened a third time. I am still ashamed that I never even thought about my baby for all that time.
The baby was… I couldn’t say born… taken out of me, at 9 am. At 9 pm, I finally woke up feeling a little better, and said to a nurse, “Will they let me see my baby tomorrow?” She smiled and said, “Let me see,” disappeared, and came back with my baby in some kind of bed on wheels. She picked him up, and he was bumping his head against her. She said, “I think this baby’s hungry.” I said, “Well?” She said, “Oh, no, c-section babies can’t be fed for 24 hours.” She laid him in my arms and went away.
He was turning his head toward me and rooting. I had never even ever seen a baby nurse in my life, but it was clear what he wanted. It hurt to lift up my arms to untie the hospital gown, but I finally got it undone and got my son to my breast. He knew exactly what to do. All pain immediately left me. That uncoordinated clamping down immediately stopped, and all I had was something like regular afterbirth cramps. I never needed any more pain medication. I managed to nurse on both sides. When a different nurse came back and saw me, she was very angry and yelled at me, and took my baby away quite roughly. I cried. Another nurse came in later and said, don’t worry, it means you will be a good nursing couple. I told her I would tell the doctor when he came. The next morning when the pediatrician came, he said “The earlier the better.” “So why did the nurse yell at me?” “Well, this hospital has a policy that c-section babies can’t be fed for 24 hours.” I never did find out what the reason for that policy could possibly have been.
Then there was the sugar water issue. For some reason, babies had to have sugar water, and they would bring it out to the mothers to give them, in little glass bottles with these huge protuberant nipples on them. My baby didn’t like it. I just nursed him and ignored the water. There was a tall, redheaded nurse who complained that I hadn’t fed the sugar water to him. I said that he didn’t like it, and if she wanted him to have it she could give it to him.
She was furious, slammed the baby back in the little bed, banging his head on the edge. I complained to the next nurse, who told me that that nurse had problems at home. I didn’t really think that was a good enough reason to bang my baby’s head. It wasn’t until years later when I was a nurse myself that I understood that this was a time issue. She would have to feed the sugar water herself, and that took time, time away from all the other tasks she had to accomplish on her shift. Once I was able to get out of bed, I just dumped all the sugar water they brought me down the sink.
Getting out of bed. The day I had the section, I was told strictly not to try to get out of bed, which I hadn’t even considered, since even moving in bed or lifting my arms hurt. But the next morning a nurse told me to get up. “I had a c-section” I said. “So?” she said. She put down the side rail and said, “Now, get up!” There was no pre-surgical education about early ambulation; just the prohibition and then the command. I tried to get up and thought I would never walk again; I couldn’t stand up straight. But I made it a few steps.
They were also going to run some IV med or fluids on me the next day. An IV team came, started an IV in my hand, put a board under my hand and wrapped the board to my hand. (Wouldn’t I have had one for the section? Did they take it out? Didn’t they have heplocks/saline locks back then?) I said, after this was all done, “How will I hold my baby with my hand like this?” “Oh, you won’t get your baby while you have this.” “How long will I have it?” The answer was something outrageously long; it might even have been 24 hours. “Oh, no,” I said, “I am going to have my baby. Take it out and put it in somewhere else.” They made faces, but they did it.
Once a nurse ran in all distraught and said “Are you sure you have enough milk?” Apparently my determined baby was crying so hard in the nursery it was disturbing them all. I showed her all the tissues soaked with milk that had leaked out of the other side while I nursed. She couldn’t argue with that. I told her to bring the baby to me if he cried, and I could tell she wanted to, but she wasn’t sure it was allowed.
Oh, and then there was the aide who told me when she saw me nursing, “Babies don’t like that nasty stuff.”
At one point I had a fever. I was told that meant I couldn’t have my baby. “The last nurse dropped that thermometer,” I said. The nurse smiled at me and went to get another. While she was gone, I gulped ice water. No temperature. I got my baby.
I was terribly worried that I couldn’t heal on the ridiculous lack of food they were giving me. A day of clear liquids. One person, I suppose it must have been an aide, told me that green jello was very nutritious, it had iron in it. I had my vitamins and brewers yeast and desiccated liver in my hospital bag. I mixed the brewer’s yeast in the clear liquids when no one was looking. The next day it was full liquid and I drank desiccated liver in my tomato juice. But once I made the mistake of putting desiccated liver in the oatmeal. I had to wash it down the sink.
On the fifth day I got to go home, which was one day early. As we were getting ready to go, they remembered the baby wasn’t circumcised yet. We had like so many, decided the baby should look like his father. So they took him to do it. When they brought him back to me, the tension in his little body was terrible. The whole way he felt in my arms, the way he held himself, was rigid. And when I saw his penis, with the little plastic ring on it, part of it missing, I knew right away we had done a terrible thing. I knew we would never do that again. It took days before he lost that awful tenseness.
So I went home, with my poor circumcised baby. Both of us had been cut. But, the next day I was able to carry laundry down stairs. I was fine. And I was in love with my baby. He ate and slept well. I wasn’t miserable, and I wasn’t angry yet, but I was plotting already for the next time, how to make sure I showed up fully dilated so they wouldn’t race me with the knife. How would I know? A few months later, I read a book, I think it was the “Boston Women’s and Children’s Hospital Book of Pregnancy and Childbirth” or something like that. It said that in Europe, doctors did not all believe in the maxim of “Once a c-section, always a c-section” and a few doctors here were beginning to experiment with allowing a trial of labor after a c-section.
It was possible then. And I was determined I was going to do it.
Stay tuned for the next chapter of Susan’s stories. Coming soon whenever Susan feels inspired to write more.