A Wise Birth
by Penny Armstrong & Sheryl Feldman
My friend Penny, who is a nurse-midwife, assists Amish women having babies at home, and sometimes I go out with her. I remember one woman particularly. Rachel1 was young, unformed, and vastly uncertain. She was so shy, in fact, that she scuttled beetle-like across the open spaces of her very own kitchen, one of those Amish girls whose experience of the outside world was limited to what she heard from her more adventurous friends, ones who had, in fact, walked through a shopping mall.
Of course Rachel wanted to do her best with her birth, but she hadn’t any idea of what was entailed, so we were out to her house several times on false alarms. The minute Penny cut the engine of the car, the screen door would bang and Sam, Rachel’s husband, would lope out of the house to greet us. Each time, he’d lead us indoors to Rachel, who would be seated in the recesses of her couch, crocheting intently on an ever-lengthening afghan. Sam stood next to her protectively. Penny would ask Rachel questions and she would answer in muffled responses, as if from the inside of her stitches.
“You were having more pains then, Rachel,” Penny would say.
“There were quite a lot this morning.”
“How long did they last?”
“There was one forty-five seconds, wasn’t there, Sam?” she’d say.
And Penny would say, “That’s good. You’re doing just fine,” and she would sit down beside Rachel. She used words meant for a woman with an eighth-grade education and farmyard experience. “Your body’s getting some of its work done ahead of time. It’s turning the soil.” Penny would pick up a stretch of afghan and admire it. “You won’t be getting your baby until the contractions are regular and lasting. You’ll feel the difference.”
Rachel would nod and hook.
“Are you drinking your red raspberry tea?” Penny would ask, referring to an herb that softens the opening of the uterus.
“We make sure to do that,” her boy-husband might announce. His married man’s beard, only ten months in the growing, was struggling to cover his jaw.
When the final call came late on a Sunday night, the afghan was lapping around Rachel’s ankles. She dropped her hook as we came into the kitchen, closed her eyes, sucked in her lower lip, and vanished into a contraction. Penny told Sam he might fit us up with some light and soon we were following a lantern into the bedroom, where Penny examined Rachel. The news was good.
“We thought maybe this time was different,” Sam said, gleaming.
“We’ll be needing the big red suitcase in the back of the car,” Penny told him. “It’ll be heavy enough for you.” He set directly off.
When he brought it in, I straightened the rubber gloves, syringes, suction equipment, and suture packs. I unlatched the black box that held the oxygen tank. While I worked, Sam brought a plastic bucket to the bedroom, found the homestitched pads for spreading on the bed, threw back the covers, smoothed the sheet, and set out the pad himself. Then he went into the kitchen where, from the sounds, I knew he was balancing a cookie sheet on a kitchen scale – a makeshift device for weighing the new baby.
Rachel labored for several hours, sometimes walking, sometimes with Sam rubbing her back. After a while she took a position in the tight alley between her bed and chest of drawers, apparently buying resistance against pain by pressing her back on the bottom bureau drawer. None of us spoke much during that time. Later she got back up on the bed and not too long afterward we smelled the burst of sweat that marks the beginning of the pushing phase of labor.
She threw the force of her contractions against the bone of her pelvis. Her groans came not from her throat but from the cave parts of her body. As the baby traveled, Rachel’s bones and muscles gave way. The ligaments and tendons, warmed by the vigor of labor and pressured by waves from the contracting uterus, eased out, and eventually we could make out the dark ridges on the top of the baby’s head. It should have been two, three contractions before she emerged, but the baby snagged on the last notch of her mother’s tailbone. For six or seven pushes, the baby rocked forward infinitesimally and retreated, but Rachel, too absorbed in her labor to notice, did not complain.
Penny guided Rachel onto her knees. “Sam,” Penny said, “when the next contraction comes, I want you to push here,” and she took his hand and placed it on his wife’s back. Without a word, he climbed on the bed, and when the next wave came, the heel of his hand rode down with it.
Three contractions clapped down, and then the baby’s head was ringed by a tight halo of Rachel’s perineum. It spread and a head slid out. Penny’s fingers went to the baby’s neck, where she found a cord and unlooped it. We waited while the head pivoted and then there was another contraction and a baby girl, tossing us reassuring cries, was landed by her mother’s knees.
Rachel, timid and tentative, authoritative about nothing more than beating mashed potatoes smooth and hanging clothes in order on the line, had borne her cord-noosed, backbone-snagged child. In the process, she experienced the power that accompanies motherhood.
There is power that comes to women when they give birth. They don’t ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying a child with it. Penny and I have both known it. Penny, one hand on a woman’s knee, has seen it steal into a lackluster labor and radiate a child out. I felt it erupting in me when I had my children. It sounds in our bodies. Contractions creep up, seizing ever stronger until they make a mockery of all the work we have ever done on our own. Birth can silence our ego and, for the moment, we feel ourselves overcome by a larger life pounding through our own.
The experience of power is an appropriate introduction to parenthood, which also explodes in our guts. “You’ll see,” many of our mothers said to us when we were growing up. “Just wait until you have children of your own.” And they were right, we have to wait, because we can’t imagine the bolt that comes. Not only does parenthood expand our physical and psychological endurance, but it also invades every character trait we’ve got. So desperately do we want to make patience, generosity, tolerance, compassion, commitment, affection, common sense, courage, and humor flow that we suffer cruelly when we find our resources too small. One trouble with having children is that they reveal who we are; what makes it worse, we care. We care overwhelmingly. “The deep, deep love,” a new mother and editor at National Geographic said. “I knew that wild animals would defend their babies. I know now that I would kill for mine.” So fierce are mothers.
When you see the power flowing uninterrupted, as we did in Rachel’s birth, it seems as predetermined as that mother’s fierce love. As absolute, as single-minded, as disregarding of human affairs as weather. Sometimes, as an assistant, you are pulled in by it and you lose your capacity to think about it; at other times you watch it, as if through a living room window, and find yourself feeling like a child, disarmed by the universe and all the amazing forces that dwell in it. In these moments, you think it can’t be stopped.
But for all its mythic force, the power is vulnerable. It can be undercut. It can and will stall, wallow, and punish. It can and will be capricious, vengeful, and sulky. It can and will retreat, grow taciturn, withold. It can take a child’s life. Sometimes it seems like God in the Old Testament, giving a woman a bad time for no reason that we humans can make out. As a result, it’s hard to be sanguine about birth.
So women prepare, plan, and protect themselves for nature’s eventualities. They bring experts into their lives when they are with child, trusting that these people have some familiarity with the mercurial maneuvers of nature. They read, they make arrangements and informed decisions. They think how to cope with the pain. We hope to trim birth down to size, hoping that she’ll behave herself in our ordinary, nonmythical lives.
Penny and I go about listening to women’s birth stories. We make arrangements to talk to Leslie, a professional woman and the mother of six-month-old Nathan. It’s midafternoon in an eastern city in November and we’re looking chilly, so she gives us coffee and almond cookies before she starts with her story.
“You get what a friend of mine calls ‘baby lust,’” she said. “My husband had it too.” Not sure if it was professionally convenient for them to have baby lust, they had it anyway and got pregnant. (As luck would have it, the baby’s due date coincided with the end of a major project Leslie had been working on.) They found a doctor who was “young and not paternalistic. He didn’t say tummy or bottom and all that. He was very frank and open.” He recommended a couple of books and Leslie and her husband, Craig, attended childbirth classes at the hospital. They thought it would be helpful to “learn their procedures.” By the time the classes were completed, Leslie understood the choices she would be making during her labor and delivery. She felt that if she wanted to give birth without drugs, she could. Her question was whether she wanted to.
Cool-headed and casual, Leslie was clearly accustomed to making decisions. Her organizational skills were apparent in her home which, despite the encroachment of baby paraphernalia, was ordered. Before we left, we would be tortured by the aroma of chicken and curry, which had begun to cook itself in timely fashion.
The idea of avoiding anesthetics for the sake of “some ideal” didn’t wash with her. “Sometimes,” she said, breaking a cookie and popping half of it into her mouth, “you hear people obsessed with prepared childbirth say, ‘The pain is good to feel.’ If men said that, we’d say it was incredibly sexist.”
That’s for sure, we said.
Then she leaned over her cup, which meant that her magnificent black hair, cut like Cleopatra’s, closed over her face and that we lost sight of her green eyes. “I had had an abortion . . .’ she said, securing her hands on her coffee cup. “It was a terrible, terrible experience. . . . With each contraction in the abortion, I had a terrific wave of nausea and at the end I was literally paralyzed. . . . I couldn’t open my eyes . . . I thought I was dying.
“The doctor,” she proceeded, “just kept telling me it didn’t hurt. . . . He screamed at me when I called him the next day.” Head down, fingertips drumming, she was snapping events together efficiently, as if they had been jacket closings. “I was really afraid my labor would be the same way, that I would be paralyzed. I had no idea what caused it because the doctor wouldn’t discuss it with me. . . . I thought it was emotional, that it was maybe anxiety. So I thought, if you have to take something to dull the pain to avoid that, well just do it.
“I told my obstetrician [about the paralysis] and he said, ‘I won’t promise you something like that won’t happen, but I don’t think it will.’” Her head came up then and her eyes rejoined us.
With the ambivalence about her body in her mind, she carried her baby to term and went into labor near her due date. “People had described labor contractions as like an earthquake wracking your whole body. It was totally unlike that. It was all very, very contained like in this little belt,” she said, adding that she’d sustained herself by sitting on the hospital bed and resting her head on her husband’s shoulder. When nausea hit, “I said to myself, you can take something and you don’t have to feel this pain anymore.” She spoke to the nurse, who offered an epidural, to numb the lower body, but the doctor ordered Demerol, an analgesic. They may have gotten her on her back then, cinched the strap of the fetal monitor2 around her belly, and switched the monitor on.
With the Demerol in her veins, Leslie fell into a sludgy sleep. “I didn’t want to breathe,” she said. “My husband tried to wake me to tell me to breathe. I said, ‘Why should I breathe when I can sleep?’” While she slumbered, her body labored on, and when it came time to push the doctor insisted that she come to.
Unenthusiastic about being awake, not feeling the drive to push, she pushed for two hours, and then the baby banked on her tailbone, its heartbeat dropped, the doctor cut an episiotomy and pulled the baby out with forceps. The cord, he said, had been around the baby’s neck. “It took them about a minute to get him to breathe, but Nathan was fine.”
“Anyway,” she said, casually dropping her lush head to her hand, “it took the doctor and the resident forty minutes to stitch up the episiotomy.”
“Forty?” one of us gasped.
She nodded and went on to say that her mouth had been dry as sand and her legs quivering the whole time they stitched. She must have seen us shaking our heads, because she tackled us with a cynical remark. “You know how after the baby’s delivered everybody forgets about you.”
“Uhmm,” we said.
While she was in the hospital, she went on to say, she had a “kind of distant feeling” toward Nathan. It was “nice” to nurse him, but she felt no extraordinary surge of emotion; besides, her mouth was incredibly dry and all she could think of was drinking water. She brought Nathan home and for the first day was in a daze. On the second day she went to check on him while he slept and, hovering over the rail of the crib, she fell helplessly in love with him. Seeing him from this new perspective, she began to attack herself for giving him a stressful birth.
We went on talking after that, about Leslie’s career plans, her baby-sitting problems, and the mothering decisions she was faced with, but as soon as Penny and I hit the sidewalk, the first words out of our mouths were something like: Darn right it was stressful. Stressful for the baby who got hung up in the birth canal, who had to be dragged out by forceps, who had to be poked and prodded to breathe. Stressful for Leslie, who literally toughed her way through, past perceived inadequacies, into and out of complex decisions, pushed when her body wanted to sleep, and ended up cut. What’s more, she’d done it without the accompaniment of much power. Slovenly thing, it did not appear and wash Nathan out into the doctors’ hands. It left Leslie to muscle the child out, as if she were an athlete in a competition. As if life can come about without the assistance of nature.
But Leslie, who had reported so many terrible experiences to us so matter-of-factly, had made but one bitter comment: “. . . everybody forgets about you.” Sitting on the bus, we returned to those words. It was true, we said, they had. Amidst doctors, nurses, childbirth educators, hospital staff, sensitive machinery, sophisticated knowledge, all focused on successful outcome, the woman with the black hair and the baby lust, the human in whom life had re-created itself, had been ignored.
Not just at the end, although that’s what she said, but all the way through. There was the abortionist who concealed information from her; the doctor who gave her casual comfort when she was worrying about whether her body, her baby’s life source, might not sabotage her and him; the nurse who failed to explain to her that a bolt of nausea meant not paralysis, but a vigorous and active labor; the books that did not tell her that her baby would travel better on her undrugged strength; the people who, apparently afraid that she might move as women move – wide-hipped, rhythmic, and yielding – had made her hips lie still, straight, and narrow on a hard table, no place for making love or giving birth.
We knew Leslie’s birth was not exceptional. Indeed, among the women we talked to and in the society at large, such births are typical. Each woman may be an individual, each birth may be different, but what is constant is the supplanting of the formidable undulation of muscles, hormones, and bones by needles, wires, tubes, chemicals, and metal objects. What is routine is the diminution of power. What is common is the absence of respect. What lasts is the sense of failure.
Out of instinct and desire, we make children. Dependent on the genius of our bodies, we grow them in our wombs. If and when we defer to that same genius during birth, if and when we invite and cultivate its power, we find that women can give birth 85 to 90 percent of the time without complication and without unreasonable bravery. Seeing birth work well, seeing that women generously attended abide its pain and rejoice in its fruition, we remember that nature wants her young. We find that the power that comes to woman at birth is not, after all, as inconstant as it might seem. It can be derailed, diminished, even paralyzed, but that’s often our doing. It is like the women who carry it, becoming silent only when it is not respected. It is most painful when it is not understood.
We ignore the power foolishly, for the knowledge of nature wanting her young is our ally in birth. Not only does it carry our children out, but it follows us into our work as parents, which is formidable. It is we, after all, who must protect our babies while they are so desperately vulnerable. We who must root and ground them as they grow. We who must see their gifts and nourish them. We who must teach them to believe in themselves even when they experience failure. We who must love them enough so that they can endure hate. We who must make them thrive.
Given the responsibilities of the mother, it is odd that we cripple the power that comes with birth. It is curious that we do not give human warmth, which attenuates pain. It is strange that we mute a woman’s physical and emotional responses when, well nurtured, they can give her strength. It is unthinkable that we, wanting human life to go on, cut, wound, sap, and scar the women who do the work for us.
Yet we employ these procedures routinely, regularly, even ritualistically. And send women like Leslie home to work out how it came to be. What is wrong with her that her body had to be cut, she must wonder. Why wasn’t she very interested in her baby those first couple of days, she must ask. Does every woman resent the slowly healing wounds on which she sits while learning to nurse? Leslie stands alone over the baby’s crib and faults herself for her baby’s birth stress.
She does not accuse us – those of us who failed to be generous to her, to name her strengths, to nourish her, to give to her, to support her in the huge piece of work she is undertaking for herself, for her child, and ultimately for humankind. She does not notice the absence of humility, awe, and caring among us; instead, she absorbs the neglect, the nonanswers, the damage, and the responsibility. She criticizes herself. She suspects that her child has been hurt and she grieves. She lives with the memory of the experience and the judgment she makes of herself as a mother for the rest of her life.
© Penny Armstrong & Sheryl Feldman. All rights reserved.
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