This blog comes from our Natal teacher Sara Bussandri, exploring the feelings, knowledge and choices which made each of her births similar and yet so different…
I have 3 children, and I was blessed with 3 fairly straightforward pregnancies, labours and births. In terms of pain relief I took varying degrees of medication during the births of my children, culminating in the drug-free home birth of my third boy.
I don’t normally go round making a big song and dance about the fact that I didn’t have any pain relief, but when I do mention that I had a home birth, it always comes up, as people often assume that no pain relief is available when birthing at home (which isn’t exactly the case, although it’s true that some forms of pain relief aren’t available). So inevitably, when I say to people that I had no drugs for my third, I always get comments like “oh, you’re so brave” or “I could never do it”, and they sadden me a bit.
And here’s why.
Having a pain relief-free birth was something that I did want for myself for the birth of my third baby – it was something that made sense to ME. It was part of my own ‘journey of discovery’ and ‘tuning into how my body births’, and it was based on what I had learnt about myself and my body in my previous labours, which are basically these 3 things:
1) My body labours quite efficiently once it gets going;
2) I’m the ultimate ‘sloucher’, so I’m an expert at making back-to-back babies, and the pain I feel on my back as a result of baby still having to turn always takes me by surprise, upsets me and overwhelms me.
3) The intensity of that back pain is something that terrified me the first time round – that pain scares me; I feel fear and panic, I slow my own labour down, and I end up prolonging my own pain!
So having learnt all of this, I had a plan to tackle it. But before I get into that, let me tell you of what other forms of pain relief I used in my previous labours…
Baby #1 and the weirdness of opiates
With my first baby, I didn’t have a huge amount of expectations about how labour and birth would all go, and, looking back, my birth plan wasn’t much of a plan at all! The only thing I knew for sure is that I didn’t want an epidural. Why, you ask? Well, because I was scared. I didn’t know much about how it works, and I wasn’t even interested in finding out – I had heard horror stories of people who had epidurals which had ‘gone wrong’ and ended up having back pain for the rest of their lives, and that was enough for me. I didn’t even look into it to check whether there were real stories or stats to back this up. I just knew, point blank, that I didn’t want an epidural. And *that* is pretty much what my birth plan said!
So you won’t be too surprised when I tell you that when my midwife offered me an injection of diamorphine, 1) I didn’t even know what it was, and 2) I just said yes because all that mattered was that I wasn’t being offered an epidural! I took an injection of diamorphine after my midwife had informed me that I was experiencing a back-to-back labour (i.e. the back of my baby’s head was basically pushing down my spine and tailbone, causing that awful back pain that made me think that ‘something was wrong’) and, in his words, it was “the longest and most painful labour” there was, so I needed to take something or “I wouldn’t have lasted”. You’ll probably agree that perhaps those weren’t the most encouraging words he could have picked, especially considering how terrified and shocked by the pain I was, but all that I chose to hear at the time was that he was offering me a ‘way out’ from that pain, and I took it.
Luckily the rest of my labour progressed quite quickly (to mine and my midwife’s surprise), and my first little boy was born just over 5 hour after I took that injection, which had given me some sort of weird (hallucinating) relief for about 4 hours. (I won’t go into the details of how I could hear myself snoring in between contractions or the stories that I heard myself telling, when I knew, as I was telling them, that they weren’t true. Weirdest. Experience. Ever).
Anyway, I was feeling great after the birth of my son and extremely proud of myself. The fact that I took pain relief in the form of a strong opioid did and does not make me any less proud or less happy about the experience I had. I don’t regret the choice I made because I made it based on the information I had at the time, BUT it wasn’t an informed choice. It was mainly based on ignorance and fear, and those are never good prerequisites to make decisions really. I might have ended up making the same choice had I known that diamorphine crosses the placenta and has the potential to affect baby’s breathing or feeding if given too close to the birth, but maybe not. The point is, I didn’t know any of this, and more surprisingly (to me anyway) is that it didn’t even occur to me to ask! So, an amazing experience after all, but with some learnings to take away for next time. Noted.
Baby #2 and the panic of nearly having a baby with no pain relief
So, fast forward 3 years, I’m in the same hospital, in the same midwife-led centre and in the same room as I was with my first son, about to give birth to my second son. My birth plan is slightly better than the previous one, and it still features the “I do not want an epidural” line, as well as the new “Please do not offer me diamorphine” line. I had managed a lot better at home this time (as I knew that the back pain was part of the package and was not going to kill me), and despite a horrible trip to the hospital and a walk from the car park to the labour room that I won’t forget, it turns out that I had really done quite well at home as, according to midwife Amanda, when I got there, I was ready to push.
And that’s where I panicked: “What do you mean? We’re pushing? Now? What, just like that? I can’t do this now, not yet. I’m not ready!” I had never decided or written down or said that I wanted to have this baby with no pain relief! So I panicked. The beauty of it all is that I was probably in transition, and I maybe I just needed someone to be a bit firm and tell me that, but when Amanda offered me gas and air (Entonox), it almost felt like she was reading my mind. So I happily took my gas and air, which at least calmed me down and helped to restore my breathing… BUT, it all still felt like too much hard work and pressure on my back, so I had to tell someone (namely the poor Amanda and the poor husband), and when the urge to talk and complain became stronger than the urge to breathe on the gas, well, I knew it was time to give it back as I didn’t really need it.
And that’s really when the penny dropped for me. I can only describe the birth of my second son as very ‘primal’. My body took over – it was doing things of its own accord, ‘guiding’ me through it; it felt like my body KNEW what to do and when to do it. Don’t get me wrong, labour still felt very painful to me, and it was most definitely hard work, but at the same time it all ‘made sense’, and I was left feeling amazing and proud, once again, about the whole experience.
Baby #3 and going into it with confidence
Fast forward another (almost) 3 years, and I was very excited and so looking forward to the birth. I knew my body could do it – it had done it before and fairly well too, so I had the confidence that it could do it again. I just needed my mind to be prepared and ‘work with it’, so the plan this time was to use the best pain killer of all – my mind. I needed my conscious mind to help me focus, stay calm, and avoid panic and fear as much as possible to allow my body to take over again. My pain relief this time would come from within – from my state of mind, from the belief that my body had the power to ‘just do it’. All I had to do was to try and LET my body take over, without my conscious mind interfering too much with the process.
And as well as my mind, I didn’t want ‘other things’ that had caused me discomfort in the past to interfere, so on my ‘birth preferences’ (which had replaced my previous ‘birth plans’, which weren’t really very good plans at all), I asked my midwives NOT to offer me any pain relief, and avoid any sort of intervention (like internal exams or breaking the waters) unless strictly necessary or requested by me. Another thing I was hoping to eliminate was the drive to the hospital – giving birth at home would have got rid of that for me altogether, but in case I had to go in for some reason, at least the drive was only half a mile this time and not six. Good.
So, did I feel any pain? Oh yes I did. The pain in my lower back was as insane as it had been with my other labours. This time I had eliminated a lot of the factors that had caused me to panic in the past, but involuntarily I had added others. I was at home, with a fast-progressing labour, it was 7am, and my children and parents, who ideally would have been out of the house when I was giving birth, were still fast asleep and had yet to get up, have breakfast and get ready to leave the house. Being the control freak that I am meant that I couldn’t switch my conscious mind off because of all of this and really let go until they left. Frustration and fear kicked in again, and as I became stressed adrenalin flooded my system, which meant more time, more pain and more fear, and the more I was trying to understand why and ‘fix it’, the more I was getting myself ‘stuck in that cycle’. This may sound very dramatic and like it added hours and hours to my labour, but in reality it probably delayed the birth by an hour or two. Luckily, given some privacy from the midwives, I got out of the adrenalin / fear cycle, and things were super quick from there on. Baby and body took over again, and it was overwhelmingly amazing.
I am not a hero and it’s not just for me
So as you can see, I’m not that brave, I don’t have a particularly high pain threshold, I’m not crazy (well, some people will say that that’s debatable), and I don’t enjoy feeling pain!
It wasn’t about being brave – it was about having had the chance to get to know myself in labour and having ‘a plan’ for myself for the things I wanted to work on. It made sense FOR ME, and the fact that I did feel pain doesn’t make me regret my choice because I knew what the pain was for, and I was more scared of the fact that numbing that pain would have interfered with my body ‘doing its thing’ in the way it knows how to, so well.
As for those who say that they could never do the same, I’m not here to say they can or should. I didn’t have a drug-free birth so I can tell everyone else that they should do the same. Everyone’s different, and their circumstances are different too. I can’t say to anyone that what worked for me will work for them too. I can only share my story and just encourage mums-to-be to invest the time to prepare for the birth of their babies (mentally and physically), so they can make the best choices that are right for them and their babies and families, and I’d encourage them to make INFORMED choices and not ones that are based on lack of information or fear, like my obsession with not having epidurals!
We are so busy being terrified and ‘in denial’ about giving birth that sometimes I think we forget how amazing birth can be, and how incredible our bodies can be if we let them.
Sara is a mum of three and part of The Natal Family as a BabyNatal teacher for West London. Find out more about Sara’s classes here.