A friend of mine is currently awaiting the birth of her fourth baby. She’s a week past her due date, and going through the special kind of hell that is prodromal labour. She’s frustrated, tired and in pain, and yet she is doing something that impresses the hell out of me: nothing.
My friend’s approach to birth is that it will happen when it happens. This is not rooted in idealism or the la-la land of the ‘trust your body’ mantra. She has had her fair share of physical and emotional challenges in life, including in pregnancy and birth, and I think her willingness to go with the physiological process is a reflection of what she has learned from her own past experiences and observations of doing anything other than just going with it.
There is no shortage of evidence supporting the value of patience at the end of pregnancy. The first of Lamaze’s healthy birth practices is to let labour begin on its own. I’m not going to get into a discussion of the medical arguments for and against induction before 42 weeks (the point at which a pregnancy is considered post-term). Obviously there are times when an induction is medically indicated. Those are not the times I’m talking about here, nor am I suggesting that induction is universally bad. Like any intervention, it has its appropriate time and place.
I’m talking about the normal pregnancies that go past 40 weeks with no evident complications, and how difficult dominant cultural norms make it for women during this time to maintain faith in the physiology of labour and birth, and connection with their bodies.
The temptation to evict a baby who overstays his or her welcome is enormous, and there is huge cultural support for it. North American culture is obsessed with rationalization, predictability and the clock. Pregnant women have a host of pressures on them as they stare down their due dates: care providers’ schedules and the desire to have a particular provider attend their birth; hospital and health care policies dictating where and how they can birth depending on the number of days past their EDD; impending maternity leaves and a wish to maximize time off with a baby actually in their arms; demands to return to work or school within a set time frame, regardless of the actual date of a baby’s birth; the exigencies of travel for family and partners who want to be part of the birth process, and so on.
More than that, by 41 weeks? Pregnancy can really freaking suck. It hurts to be that pregnant. Take all the normal pregnancy “discomforts” and multiply them by a million. That’s 41 weeks plus. Fun times. Add to that every friend and family member treating you like a watched pot (“have you had that baby yet?!”), every personal inadequacy you’ve ever felt bubbling to the surface, and care providers pushing interventions, and it’s hard to resist the urge to do whatever it takes to get labour started, from so-called natural approaches—homeopathic remedies, castor oil, pineapple, eggplant parmesan, hiking up hill, shoveling snow, acupuncture, sex, AROM, membrane sweep, and so forth—to medical induction.
I worked so hard to get my babies born that I was physically and emotionally exhausted by the time I had them in my arms. I was lucky that my first birth went well, despite finally electing a medical induction (I had no idea at the time that induction posed any risk). I was less lucky the second time, when I tried every “natural” trick in the book, and, whether or not there was a simple cause-and-effect relationship, ended up with a hypertonic uterus before I’d even hit 6 cm. In both cases, in the final days, I completely lost touch with my body, baby, and pregnancy, and instead became consumed by thoughts of getting the pregnancy over with. Both times, by 41 weeks, I was convinced that my body would never go into labour on its own, and as crazy as it sounds, that I would be pregnant forever. Of course I knew at a rational level that the latter could not possibly be true, but after being pregnant for 10 months your mind can start doing funny things. And the former was a self-fulfilling prophecy: in neither case did I give physiological labour enough of a chance.
Whether or not a woman requires an induction is a decision that only she and her health care provider can make. At the time, in both pregnancies, I was absolutely certain that induction was the right thing for me, and at 41 weeks 3 days, going ahead with a medical induction matches the protocol governing childbirth where I live. Yet even women for whom induction is indicated could benefit from a shift in attitudes and approach that honours and values the final days and weeks of pregnancy, rather than seeing them only as days of increasing statistical risk and unpredictable inconvenience. You would never take a cake out of the oven 10 minutes early just because you know it will burn if you leave it in 10 minutes too long, or because company’s coming and you just need to serve the damned cake already. Obviously that analogy can only take us so far, but it is food for thought in this context nonetheless.
So I salute my friend who is weathering the end of her long pregnancy with grace, if not patience. Given everything she’s up against, I think she’s amazing.