Monday, March 15, 2010

A Midwife’s Experience of Birth (and Life)

Most of the instructions given to pregnant women are inadequate – not least because they encourage women to focus on the little things related to their pregnancy and miss the big picture. For example, early in my career as a midwife I was surprised by how many times women called me thinking they were in labor, not because they were having contractions, but because they lost their mucus plug. Then I picked up What to Expect When You’re Expecting and saw that it was listed as one of the common symptoms of early labor.

When I’m in clinic, I spend most of my time disabusing pregnant women of misconceptions like these. And I also try to give them a bigger message: pregnancy is the “new normal.” When you’re not pregnant it’s not normal to feel nauseated, dizzy, and most of all, in pain. But when you’re pregnant it often is. That’s the bottom line, and it’s unlikely to change. Notice that I said pain and not something else, like discomfort. I remember when I was pregnant thinking that if I hadn’t known that such multifaceted pain was normal, I would have gone to the ER and presented my complaints with a hope for a cure. But there is no cure.

There is simply the will to bear it. You either have the will to dig in and prepare for more or not. That may sound frightening, but what I mean is that women are strong, incredibly strong. And yet even in a world full of amazing women athletes, entrepreneurs, and even astronauts, most of us don’t know how strong we are until we gestate another human being. Maybe if more of us knew our strength ahead of time, we would prepare more and become even stronger. We should behave like we are in training, like Olympic athletes, or serious applicants for the space program. And yet, even for those who have trained for years — performing - whether in a stadium or on the space shuttle — remains the ultimate challenge, achieved under unique and unpredictable circumstances. There are as many experiences of labor and birth as there are women and no “correct” way to do them.

My first piece of advice for any pregnant woman is to find a provider you trust. And my second piece of advice is to go into birth with a clear vision of how you want things to go. I chose to have a homebirth with my midwife, a dear friend, attending me. As we talked about preparing for the birth she asked me what my greatest fear was. I told her that I was haunted by the story of one of my fellow students in midwifery school: She too had planned a homebirth with a midwife, but after many hours of labor at home she ended up in the hospital with an epidural and forceps delivery.

Long after the birth I asked my friend about her birth experience. She offered that if she could have changed anything it would have been to listen to her midwife more. She remembers having been almost paralyzed by the pain of labor and only able to sit and rock on the floor as her midwife implored her to move and try other positions. I told my midwife, with my husband and doula and best friend in attendance, that I was afraid I would also suffer the same fate. However, since there is a lot of anecdotal evidence to suggest that the more a woman states what she does not want in child birth, the more likely it is to happen, I kept my birth plan simple. “I know what I want. My support team knows what I want. I will do what my midwife says.” That was it.

Was it any surprise that I came up against my greatest fear? After a fairly short labor (12 hours) I was fully dilated, but I didn’t make much progress after pushing strenuously for two hours. I had been experiencing a lot of pain in my lower back, and the only thing that seemed to help was lying on my side while my husband or doula pressed against my sacrum with all their might. So far everything had gone according to plan, but absent any more progress I knew I would soon be taking that ride to the hospital. At this point my midwife told me to get into a squatting position. In my exhaustion, I told her, “After the next contraction.” When the next contraction came and I said that again, I glanced up just at the moment when all of my support people looked at each other as if to say, “Here it is: the thing she feared.”

And then the vision I had for my homebirth, the one they had supported me in, took hold. In the next moment they had taken me in their arms to support me in a squat. I found the position better for pushing, and although it took another hour, my baby was finally born. Instead of fearing the pain and running from it I and the team I had put together heard what it was telling me—this way isn’t working—and shifted. Enduring pain does not make one a better person: I’m all for pain medicine if the woman wants it, and I’m convinced that gestating and giving birth to another human being brings meaning and joy whether it happens with or without medical intervention. But if your mind and body are prepared, the pain you feel in labor—and the effort to embrace it, move toward it, and work with it—can be transmuted into a gift that informs the rest of your life.

Labor and birth are intensely spiritual and physical all at once. As such, they are also apt metaphors for life. To stay open and willing to receive the messages in pain—whether that pain is physical or spiritual—is one of life’s greatest challenges, and running away from it is one of life’s greatest temptations. It takes enormous courage to stay with the pain long enough to hear what it has to say. And yet, working with pain and developing the ability to rise above it to reach our vision allows us to tap into something profound and magical that can remind us of our true power. And that will serve us well for the rest of our lives.

Stacey Curnow works as a certified nurse-midwife in North Carolina, and over more than 15 years her career has taken her from western Indian reservations to a center-city Bronx hospital to the mountains of southwestern Mexico. She has been an enthusiastic student of positive psychology for years and applies it to her midwifery and life coaching practices (link to with great success. She is the creator of a thriving blog (link to and many of her articles have been published in print magazines and online. She lives in Asheville, NC with her husband, young son, and Ruby the wonder chicken.

*top photo is of Ginger with her second son

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