Compulsive childbirth

It was the morning of August 19, the day before my due date, and if this kid was anything like the last, I knew he'd be arriving the next day, right on deadline.

I was ready.
A naturally obsessive person, I had been certifiably manic since going on maternity leave just four days earlier. Nesting was in full swing: I was scrubbing baby furniture, cleaning out closets, and laundering armloads of tiny, ruffly, useless things. I had also developed my usual, uncontrollable urge to wander about a Laura Ashley store--a place that, in a normal state of mind, I would have absolutely no use for. After all, who, besides Martha Stewart, needs a frilly floral dress with matching bed pillow and lampshade?

When I'm pregnant, I think I do. My Laura Ashley fetish was so out of control with my first child that I insisted my husband take me there on the way home from the hospital--to pick up the matching lampshade, of course.

All of which is moderate behavior--compared to my second pregnancy. At the end of my ninth month, I woke up bright and early one morning with an insatiable desire to go into the backyard and hack bamboo. Which, of course, I did with great gusto until nightfall. My second daughter arrived eight days later.

This time around, when I wasn't in a closet or at the mall, I was concentrating on the themes of this third--and last--pregnancy: exercise, nutrition, pain control. I was convinced that I could achieve--through sheer will power and extreme physical fitness--the perfect, pain-free, no-fuss, natural childbirth experience that had so far eluded me in life.

Ideally--and I exaggerate only slightly here--I saw myself running around the track at my health club on my due date, flying by slower mortals, munching on one of those energy bars that tastes like ground-up tree bark, and watching the baby just--well, you know--drop out. Then I'd kind of gather things up and head over to the locker room.

Insane? Yes. But there is an explanation--of sorts. When you know you're in the last pregnancy of your life, and you're 36 years old, and you have two other rambunctious children and a full-time job and a traveling husband and no earthly idea how you're going to be able to handle it all, you live in dread of unlikely diversions--like running out of gas--a move that, after all, can absent you for many precious minutes from the productive world. The only sure way to avoid such inefficiency, I figured, was to remain fully in the game: stay focused, never skip a beat--or a morning jog--and simply incorporate the birth into my weekend workout.

Since this had always been the plan--at least since my husband convinced me that a third child was the key to a perfect life--I had engaged an exercise physiologist to help me achieve my goal. Yes, in lay terms, a personal trainer--but this happens to be a very intense one with a master's degree who finds this term inadequate, and, quite frankly, I didn't have the muscle mass (especially then) to quarrel with him.

Though he was already busy with a full slate of clients, John Ledbetter agreed to take on a newly pregnant woman with poor posture and a penchant for swearing because, he said, he enjoyed challenging situations. (He wasn't kidding. The ever-irascible Dallas City Councilman Paul Fielding was a client of Ledbetter for four years--the equivalent of one Dallas mayoral term--though, unlike the past two mayors, Ledbetter actually seems to have enjoyed the association.)

Ledbetter understood my goal: contouring and shaping a scrawny upper body, firming and de-rippling a slightly pear-shaped lower body, gradually--and imperceptibly--gaining 30 pounds during pregnancy, and developing enough stamina, self-discipline, and muscle tone to have a baby and barely notice it.

Hiring Ledbetter was the best thing I could have done. Not only did he never make fun of my idiotic goals, he created a rigorous, but never perilous, exercise program that did keep me looking trim as long as I wasn't standing sideways. I, in turn, stuck to his plan slavishly, even feeling good enough--on those days when the baby wasn't tap-dancing on my bladder--to push the envelope when he wasn't around, euphorically bashing through the outer limits of my recommended maximum 160 heart rate.

Still, on the morning of August 19, when I showed up for our last pregnancy work-out, Ledbetter--tough-guy trainer, lover of challenges, friend to Fielding--looked a bit ashen. "I really didn't think you'd come in today," he said, surveying me with enormous trepidation, as though I might, at any moment, start gushing amniotic fluid all over the Nautilus machines. "Are you sure you don't want to knock off today?"

No way, I said. If we were lucky, labor would start in the middle of our bench-press set, then build slowly through bicep curls and the pec deck. Then I'd hit the track for a few hours of light jogging and contractions. With any luck, I'd never make it to the hospital.

Ledbetter looked queasy. But I was adamant.
After all, I explained to him, the childbirth books say exercise creates stamina. Stamina allows mobility. Mobility means control over the labor experience. Control increases a woman's ability to relax. Relaxation eases pain. Pain could therefore be overcome.

Circling the track at the health club that Saturday morning, I felt strong and empowered. I would absorb the pain. I would eschew drugs. I would refuse an IV, an epidural, an episiotomy, and those ugly hospital baby portraits. I would do this. I would do natural childbirth.

"Marie," I said, panting hard, and, if memory serves me correctly, wailing like a dying beast. "I can't do this."

"Sure you can," my trusty midwife, Marie Rabinowitz, responded, though I could tell through my undulating prism of pain that she wasn't so sure. "You know you can--it's not like you haven't done this before."

Which is the point of this, actually.
How many excruciatingly painful childbirths does one person have to endure before realizing there's no such thing as a free lunch--or a painless natural childbirth? Three, I guess. (True story: a childbirth instructor once told me that something akin to orgasm was attainable during childbirth. And I suppose--if you're the kind of woman who can find pleasure in a vertical, over-the-cliff car plunge--she was right.)

What is there (and I hope the two first-time pregnant women in my office aren't reading this) is grotesque pain--the kind of pain that must come, if you stop and think about it for a minute, when you shove a watermelon out a hole made for a lemon.

I'm sorry, but anyone who tries to sell you some sugar- coated bill of goods to the contrary is simply full of mean mischief. Believe me, I've heard it all--these supposed antidotes to pain--and I've tried most of them. Heating pads. Ice packs. Tennis balls. Rolling pins. Almond oil. Ice chips. Gatorade. Orange juice. Pressure points. Popsicles. Soft stroking. Soothing music. Visualization. Aromatherapy. Deep breathing. Shallow breathing. Jogging. Walking. Reclining. Showering. Bathing. Bowling.

My two sisters-in-law--epidural experts with seven children between them--roll their eyes every time I get pregnant, knowing that I will be sitting around for months, immersed in all manner of Buddhist-esque childbirth books, plotting some elaborate, totally unrealistic L.L. Bean birth (warm argyle blankets, sheepskin-lined cradle, the midwife arriving on snow shoes carrying a plate of freshly made chocolate chip cookies).

I could have saved myself a lot of time. Because the answer, as most sane people know, is drugs--massive quantities administered as quickly as possible.

Don't misunderstand. I am not an Earth Mother, a masochist, or a Christian Scientist. I am your average wimp when it comes to pain. I am the first person to jump into my dentist's chair and beg for anesthesia the minute I feel a slight toothache coming on. I take more Tylenol than anyone else in my house.

But childbirth has always seemed different to me. Unlike headaches and sore teeth, baby-making is not an ailment, a system failure, a malady. To the contrary, it usually takes place during the peak of youthfulness and health. And if a body is functioning otherwise perfectly--save hemorrhoids, heartburn, and other joyous prenatal conditions--why treat childbirth as though it were a dire medical condition? Why jeopardize the smoothness of one of the world's most natural physical conditions by adding unnecessary chemicals to the mix--the symptoms of which can often bog down and generally muck up an otherwise problem-free birth experience?

Why subject a baby you've slavishly protected for nine months from the evils of third-hand cigarette smoke to one enormous, Timothy Leary-esque, narcotic jolt--just as the poor little thing is trying desperately to find the escape hatch somewhere past the big intestine?

(It also amazes me how, in the eyes of the hospital staff, you are no longer the healthy young woman with the glow in your cheeks; you're the triple-bypass patient well on your way to a hip replacement and a colostomy bag. "You can't go home until you've had bowel movement," the Big Nurse with the Big Clipboard told me shortly after I delivered my first child. "I've been drinking Gatorade and sucking on ice chips for 20 hours," I told her. "What bowel movement?" Big Nurse apparently didn't believe me. Twice during the night she dispatched her emissaries to my room, to wake me up from a deep sleep to give me stool softeners. Which did zip. Which caused them to prescribe more stool softeners.)

On the other hand, I will admit that epidural mothers seem to have more pleasant memories of the first time they met their children.

With my first pregnancy in 1990, I started out clueless. I took a generic birthing class given by my obstetrician's nurse. She spent most of the two-day seminar holding up a lot of needles and fetal monitors and forceps. Chagrined, I found a natural childbirth coach who taught the Bradley Method (normal breathing, fetal position, husband murmuring obsequious, unnatural things in your ear like, "Honey, let that big bag of muscles open up like a flower and push out our sweet bundle of joy.")

My husband and I practiced stupid pet tricks for months (we supposedly "stretched" the perineum--i.e. the exit wound--but I'll spare you the details). Having endured all of this and more--the childbirth coach recommended we plant my placenta in our backyard--I thought I was prepared for the big event. I was not. When I got to the hospital, barely dilated, the nurses at Presbyterian Hospital sneered wickedly at my stated desire to go natural, strapped me to a fetal monitor, and happily abandoned me and my husband in a labor room to deal with the pain ourselves.

I demanded to be taken off the fetal monitor. I paced the empty main lobby of the hospital in the pre-dawn hours, collapsing in a writhing mess on the floor or furniture with every miserable contraction. Through it all, I could not escape the enormous lobby painting of Mrs. Ross Perot. It made me a little (more) crazy.

After 10 hours of labor, I went back to the labor wing and threw myself onto a bed, sobbing from the pain. My husband fell asleep, and I finally gave up and started begging for a touch of Demerol. The nurses sat out at their desk, ignoring me, clearly enjoying my change of heart, my failure. One nurse, who my husband finally dragged into the room with us, refused to get me the drugs. "You wanted to go natural--go natural," she said.

My husband made a scene. I got a good snort of Demerol through an intravenous drip. I passed out. I woke up. The Demerol had worn off. I pushed. I was confused--I thought someone was attacking me with a machete (I'm kidding here, though I want to give you a clear picture of the pain). My doctor cut me up to Oklahoma. I realized I was not the valedictorian of my Bradley class.

With my second kid, I was smarter. I took a short Bradley refresher course and skipped the pet tricks. I decided to hire my own independent midwife and bring her with me to the Presbyterian jailhouse to hold my hand and engage in hand-to-hand combat with the Sid Vicious nurses. My doctor, sensing territorial trouble in the cat den, recommended that I introduce myself to a Presbyterian nurse named Marie Rabinowitz, who worked for years as a bona fide English midwife before moving to our fair city, the epidural capital of the world. I met Rabinowitz for coffee. She was sympathetic. She agreed to wear a beeper so that she could be contacted no matter what time I went into labor.

Miraculously, I went into labor while she was on duty. Recalling the dreaded fetal monitor, I stayed home and walked off my contractions until I was eight centimeters and wailing. My doctor, Clark Griffith, was amazingly cool about leaving Rabinowitz, my husband, and me alone to do the natural childbirth thing. The pain was horrendous. When it was time to push, I was back thinking about the machete again. The baby's head popped out. Rabinowitz put my hands on the baby as it began to emerge. I pulled it out. My husband and I were grossly happy and moved--especially me, since I was fairly confident that I'd never have to go through this again.

Two years later, when I decided to do it one last time, I figured I could repeat my second childbirth experience but with much less pain. With two births under my belt, I could get in primo physical condition and just knock it out. Though by this time my doctor--in a rare move in this town--had put a wonderful, full-time midwife on his staff, I called Rabinowitz. She was game. She told me it would be painful again. I didn't believe her.

On the evening of August 20, I sat uncomfortably on a hard, plastic bench in a Presbyterian hospital shower. I had a bag of ice on my forehead and a hot shower nozzle fixed on my stomach. Rabinowitz looked at me through tired eyes that had just spent eight hours staring at the highway stripes between here and Lubbock. (She was out of town when I went into labor but, as luck would have it, able and willing to rush to the hospital as soon as she got home.) My husband stood helplessly beside me--soaking wet from the waist down--tired of receiving conflicting, high-volume demands from his hysterical wife: "Rub my shoulders!...Don't touch me!"

Then, without any warning whatsoever, I suddenly explode brackish-looking amniotic fluid all over the plastic bench.

Though my biceps are spectacular, in a flash, an unbearable sensation comes over me--as though a tractor-trailer is backing up into my inner organs to dump a load of Chrysler minivans on my liver. The baby is coming, I start screaming with enormous agony in my voice--and there's no way I can make it to the bed in the other room.

Suffice it to say that I made it to the bed (which was not pretty). And I did give birth to a wonderfully calm, sweet, lovely baby boy--though I was far too miserable to watch his entrance this time, let alone be the one to pull him out. (His cheerful disposition is a mystery--I can't help but think he's just so happy not to be jogging anymore.)

No, those last 20 minutes in labor have convinced me, beyond a shadow of a doubt or a place in the Natural Childbirth Hall of Fame, that drugs have their rightful place in this world. It just took me a little longer than most to figure it out.

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