Another Way To Think About Choice

I didn’t have a birth plan. I thought the whole idea of a birth plan was stupid to be perfectly honest. I didn’t have any romantic notions that this would be a blissful or supernatural experience. It was going to be messy and it was going to be painful. My birth plan was “get the baby out.”

This wasn’t my first pregnancy. I’d given birth once before and it wasn’t nearly as difficult or painful as I’d imagined, though people kept telling me that “every pregnancy is different.”

I still think it’s just a silly gimmick to convince you that you have some control over the process. They encourage you to plan out little things, like your preferred hospital or favorite snacks or drug choices. But none of this intricate planning is realistic when you work until your due date and you have no idea when the baby is going to come.

I remember researching which hospitals were in walking distance of the office, just in case my water broke and I couldn’t make it to the car that was parked on the other side of downtown. Maybe if we had better paid parental leave policies something other than convenience would have driven my decisions, but I wasn’t interested in spending my limited FMLA time sitting at home and hoping I went into labor early. I worked up until the very end.

I hated being pregnant. Not simply because of the havoc it wreaks on your body ― the swelling and the hormones and the vomiting. I also hated pregnancy because people standing next to you in line at the grocery store would ask you stupid questions about your birth plan.

“Are you going to have a natural birth?”

No one ever asks you if you’re going to have a natural appendectomy. Apparently when you become a mother people expect you to endure spectacular amounts of pain for no good reason. I believe that modern medicine is a gift. We’ve come so far, in fact, that people have apparently forgotten that childbirth is dangerous. I wasn’t interested in water births or doulas or any of that hippie crap that was trending. I just wanted to get the thing out.

Of course, the first time I gave birth I was so anxious to “get the thing out” and so numb from the pain meds that I tore straight into the muscle. I was determined to avoid that the second time around, which was really the only reason I was considering refusing the epidural.

My husband never said anything about hospitals or epidurals or any of that. Hell, I was lucky if I could get him to weigh in on baby names. He would say things like, “Whatever you come up with will be fine,” and then follow up with something like “I know that’s not helpful.” His career was finally taking him where he wanted to be. He was traveling a lot and there was a possibility he would be out of town when the baby came (we had our moments over how we might handle that). Obviously, neither of us wanted him to miss the birth, but we also had a strange way of glossing over the seriousness of what was happening with my body - since we’d been through it once before. And ultimately this was something I had to do. He could be in the room and hold my hand and talk me through the experience, but I’d be the one on the hospital bed. I’d be the one bleeding and contracting and pushing and tearing. All he could do is sit on the sidelines and watch.

My water broke at 2 a.m. My husband had fallen asleep in the next room ― putting our 2-year-old to bed. I crept through the dark and tapped him on the shoulder to tell him it was time. I threw a bag together while he carried our sleeping son out to the car. On the way, I called my parents and asked them to meet us at the hospital. Roughly 20 minutes later, I said goodbye to my exhausted little boy – already hurting for him and how this new baby was going to shake up his world.

Within the first few hours, I knew that something was wrong. Everything was taking longer than it should. The contractions were harder than I remembered, far more painful and less effective. The nurses would occasionally come in and check my cervix, always disappointed at how little progress I’d made. They would say ridiculous things like “I can feel his head,” and “He has a lot of hair.” One of them even asked me if I’d like to feel it.

“No thanks, I trust you.” (My actual words.)

But every pregnancy is different, right? Maybe this baby was more painful because I was older? Maybe because I’d had less sleep? My heart sank a little when I finally asked for the epidural. I didn’t understand why my body wasn’t responding to the pain the way it had before. But I comforted myself with knowing that I would be fresh and alert when the baby came. I convinced myself that I would just have to take it easy when it came time to push.

My husband helped me laugh it off, even though I knew that nothing about this was right. We went back and forth over potential baby names like Ivan or Oscar. I fixated on the fact that no one liked Ivan and tried to figure out if I should care.

The nurses kept asking if I felt the pressure of the baby’s head yet. I felt nothing. No pain. No pressure. The last time I gave birth I could feel the kid’s head making his way into this world. Even with the pain meds, I knew I should’ve felt something. I was so god-damn comfortable it was alarming.

But I didn’t argue when they told me to push. I didn’t care if everything about this seemed twisted and out of sorts, I just wanted to get the thing out. I had no reason not to believe them when they started in with a chorus of “It’s coming now, I can see the head.”

Until the doctor mumbled something that plunged the room into a murky silence. There was a long and awkward pause followed by close and quiet mumbling at the foot of the bed. AlI heard was “That’s the baby’s scrotum.” That’s right, scrotum. The baby was flipped, and suddenly my plan to “get the thing out” became a whole lot more complicated.

I don’t really know if there’s a way to describe how frightening it is, to be laying on a hospital bed after hours of slow and intense labor only to realize that there’s no clear path for your baby to come out. That he’s turned the wrong way and one or both of you are in serious trouble. I was lucky that the doctor didn’t give me much time to dwell on it. She spoke firmly and slowly and gave me a clear choice. They could push the baby back up the birth canal and perform an emergency C-section, or they could attempt a vaginal extraction. She didn’t mince words. “A C-section is safer for the baby. The extraction is safer for you.”

I felt suspended just above something resembling delirium. I couldn’t cry or panic because I had to keep my composure long enough to get us through this. For almost 12 hours I’d been fighting pain and exhaustion and a miserable feeling that something wasn’t right. And in this desperate state, I was asked to make a decision that could haunt me for the rest of my life. I knew that I didn’t want them to cut me open. We were too close to the end. I gave her permission to go ahead with the extraction. “Just get him out.”

It was agonizing. I watched the doctors pull his wet limbs until his head became lodged in my cervix. I don’t remember having difficulty breathing, but someone strapped an oxygen mask over my mouth and nose. It constricted my view, but I still saw the forceps. I still knew what was happening when they reached up inside me to wrestle my baby’s tiny head out and into the open. He was blue and limp when he came out. For a moment, I thought he was dead. And if not dead, then severely compromised. In that moment I thought I might ask myself forever if I’d made the right choice. If it was selfish and short-sighted to do what was safer for me, and put all of the risk on an innocent baby.

They took him to the NICU for two hours. In time, his color came back. His Apgar scores improved. I started to breathe and recover. At the time of this writing, it’s been a full 4 months since that awful moment. To this day, I’m watching and waiting for some deficiency to manifest itself. They tell me he’s perfect. That I made the right decision. That the doctor wouldn’t have performed the extraction if I hadn’t stayed calm and kept him safe.

Some of you may be wondering, at this point, about my husband. What he wanted or what his role was in all of this? But the truth is, I never consulted him. I didn’t look in his direction for approval or reassurance. It didn’t even occur to me to do so until long after the decision had been made. This was his son, too. But it was my life and my body. It was my decision.

To this day, I don’t know what he would have chosen. If he would have preferred to put my safety at risk for the sake of protecting his unborn son. From what I know of my husband, I don’t suspect that he would have. When I think about that day I feel terrible that he was sitting on the sidelines, helplessly watching the whole thing take place with no outlet or agency. I felt for him, but not to the point that I was willing to give him a say in how much I had to suffer. Because I was the one on the bed. I was the one bleeding and pushing and tearing my body apart.

It’s hard for me to envision that anyone would think otherwise. That someone might attempt to take away my choice of emergency medical procedure because they felt that my baby’s safety trumped my own – or that it trumped the well-being of the 2-year-old boy at Grandma’s house who was waiting for his mommy to come home.

I don’t doubt that there are readers out there who will think I’m terrible for not putting my child first. I’m sure there are plenty of women who would have chosen differently. But that’s what makes it a choice. The very thing that allows us some control over our own fate, rather than turning us into an instrument of someone else’s theology or personal beliefs. It’s not the sort of choice that I ever want to make again, but I’d be a less free person if anyone were to take it from me.