Wednesday, July 20, 2011

Happy Birthday: a fat queer birth story

Editor's Note: this piece was originally posted May 20th 2011)

(content notice for discussions of pain and medical interventions)

My dad is a labor and delivery nurse, and he likes to say that the more strict someone's birth plan is, the more likely it is that their plan is going to go horribly awry. For my child's birth, nothing went to plan. Well, that's not entirely true. My only set plan was to have a baby, and that zie would be able to survive outside of me. And I had very little confidence in that plan, to be honest.

I spent most of my pregnancy being fairly hermit-like, both on and off-line, because I was waiting for something to go wrong. After the struggle to conceive and carry a pregnancy, I was fairly well convinced that my body was little more than a death trap for any new life. I spent years being checked for conditions like poly cystic ovaries that can cause infertility, and being told that obesity caused them. I really internalized the idea that being fat meant I had destroyed my chances of reproducing. So when I finally did manage a pregnancy, I was absolutely convinced that my body would kill it somewhere along the way. I was so scared of this that I couldn't discuss anything about it with anyone. I felt like I was getting everyone's hopes up for no reason, since clearly there was no way that a fatty like me would be able to carry a pregnancy to term or give birth to a live child.

I had also spent a good deal of my pregnancy delving into my gender identity. Trying to find that space between queer identity, internalized fat hatred and how quickly my body was changing in ways that are coded very femininely and as "good" fatness.

So when my water broke 4 weeks early, while I was preparing for a maternity photo shoot, I was a little surprised. Partially because it was early and partially because a substantial part of me was convinced that I would not get that far. Then again, I had been having a constant back ache for the last two days, and added pressure on my cervix so it wasn't a complete shock.

I went right to the bathroom, and called my birth coach upstairs just to be sure. At that moment, my spouse and my photographer got to the house. They found me standing pantsless and cursing a blue streak in the bathtub as amniotic fluid gushed down my legs. I called my midwives, and because I was early they told me to go to the Perinatal Evaluation and Treatment Unit (PETU) at their associated hospital as soon as possible.

My original plan was to try and labor with as little intervention as possible. I was flexible, however. Having a family member that does nothing but help birth babies gave me a unique perspective on the reality of giving birth. For the most part, intervention is unneeded, but when it is, accepting small interventions can prevent larger ones. There were only a few interventions that I wanted to avoid at all costs, namely episiotomy (cutting into the flesh from the vaginal opening towards the anus to widen the vaginal opening) and a c-section. Episiotomies generally lead to worse tearing than just pushing, and the outcomes for c-sections tend to be not so hot.

Being 4 weeks before my due date made avoiding all intervention impossible. I ended up in the PETU on external fetal monitors for an hour. The midwife on call was concerned about the possible reasons why I had ruptured so early. Most reasons were not too big of a deal but the possibility of infection was a concern. So we discussed artificially ripening my cervix, and I was left in the PETU to labor so we could see if that would be necessary.

I went into labor on a ridiculously busy night, so it took 6 hours before they could move me to a delivery room. I basically spent all of early labor and part of active labor in a tiny space designed for triage. Not fun. I consented to a heparin lock, so I would be able to get hooked to an IV relatively quickly if need be.6 hours, pacing a small space, with my spouse applying pressure to my lower back once my contractions got so bad that I couldn't talk through them.

12 hours after I ruptured, the midwife came in with a look on her face that did not inspire confidence. She told me that with the fear of infection and the fact that I had only dilated 3 centimeters, she thought it best to try a bit of enhancement. She suggested what my dad calls "a sniff of Pit." A small dose of Pitocin, with some Benadryl and a pain medication so I could rest before the birthing stage. Her biggest concerns were 1) getting the baby out before we hit the 24 hour mark, and 2) making sure that I had the energy to push once I was ready.

I went for it. Not two minutes after they attached my IV and injected the pain meds, I was passing out. I managed to sleep for about three hours before the contractions woke me up again. I tried to get up and move to deal with the pain, but the external fetal monitor severely limited my movement. Every time I tried to squat to deal with the pain, the monitor slipped and they lost the baby's heartbeat. I moved into the bed, and we tried to manage the contraction pain with massage. My spouse climbed into the bed next to me, and held me until the contractions started. Every time the pain began, zie'd massage my lower back and apply counter pressure until I relaxed.

over the next hour, I dilated from 4 cm to 10 cm. The pain spiked so quickly that I went into a full panic. I couldn't move during the contractions, and all of my coping techniques up to that point simply didn't cut the mustard. I was screaming and punching the bed through each one. If I could have moved, I'd have run away. My spouse was terrified that I was going to hurt myself and kept trying to comfort me in any way zie could. There honestly wasn't much comfort to be had. the pain had me in complete instinct mode. Anything vaguely resembling self-consciousness was gone. My birth coach was livid that I was left to scream that way, and was getting ready to find someone to come and care for me when the nurse and the midwife came in.

They checked me, and got me set up to push with a knotted sheet for me to hold onto. As I pushed, I was to pull myself up using the sheet. I was pushing for less than an hour when I began crowning. I could feel ears and a nose on the sides of the head, and seconds later Shai's head was out. The rest of her body slipped from me in a rush and suddenly I had a tiny, struggling, goo covered baby on my chest. My spouse was beside me, in tears, telling me how much zie loved me and how amazing I was. I was in utter shock. All I could say was "oh baby. Its a baby!" and run my hands over hir. I held hir while I was being stitched up and until zie had to be bathed.

Its funny.

I had so many fears about this whole thing. All of them are gone now. Every time I look at my Shai's little face, smell hir breath, feel hir tiny heartbeat while zie sleeps on my chest.

This is the most mundane and amazing thing I have ever done. and even with all the pain and frustration, I'd do it again in a heartbeat.

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