what should I say to my friend?

[Slackermom]

I have a friend, P, who is due the same day I am. Her first son, who is six months older than my DD, weighed almost 11 lbs when he was born. That's not surprising -- P and her partner are both very large people, as is everyone in their families. With her DS, P was induced at 42 weeks, and the labour was very fast -- just three hours from 1cm to delivery. She ended up with 4th degree tears, and needed surgery to reconstruct things. The doula they'd hired wasn't able to do much to help, given the circumstances (P hooked up to every monitor imaginable, in bed, with a big bag of pitocin). I ended up having DD by "emergency" c-section (which, of course, wasn't so much an emergency at all), P's partner (who will compete about anything) kept going on and on about how P had this wonderful, "natural" birth. I guess -- if you consider pitocin, monitors, and birthing flat on your back to be "natural". P didn't say much about it, at all.

P is really having a hard time with this pregnancy. Everything is fine, but the baby is measuring even bigger than her first DS did, and that has her scared. She was really traumatized by her DS's birth, the surgery that followed, and the impact it had on her sex life. Her partner claims that she's measuring 6 weeks ahead, but I don't know if that's the uterus or the baby. If it's the baby, that seems like a pretty big discrepency. If it's her, it's not as surprising. I mean, I'm a very small person, and my babe is measuring five days or so ahead (according to a 20 wk ultrasound), but my fundal height is measuring three weeks ahead. I'm not convinced these measurements are a reliable indicator of anything. I just worry that she's reading too much into it, panicking, and looking for an easy way out.

Yesterday, she emailed me that she's asked her dr to schedule a c-section, or to induce her as early as possible , because she's so scared of the labour and tearing again. Unfortunatley, drs here are far too happy to perform c-sections (it's up to a third of all deliveries at our maternity hosptial). I don't think anyone in the medical community is really going to talk her through the options, or reassure her about a vaginal birth. She seems to think a c-section will be like magic, no pain, no suffering. I didn't have a bad time recovering from mine, but I certainly don't want another one -- things will be very different trying to keep a toddler off an incision, not being able to pick up the toddler, etc. It's just not the easy answer P is looking for.

I'm wondering how I can help her discuss her fears about vaginal birth without seeming like a big buttinsky. I'm worried for her. Last time, she had a doula and was committed to an unmedicated birth. This time, she all but wants to be knocked out, and her fears about the delivery really seem to be negatively influencing how she feels about the pregnancy. She's pretty unhappy.

Any thoughts on how I might be able to help her? I should add, in case you haven't already guessed, that her partner is a bit of an unsupportive @ss.

[KKmama]

I dunno... to be honest, if I had 4th degree tearing and reconstructive surgery, I think I'd be thinking about a C, also. And I've had one (it was necessary, but I wasn't too pleased about it) and have had a VBAC. I suffered for the better part of a year from an anal fissure (tore into the muscle after a bad bout of food poisoning), and just *that* was awful. I just can't the healing process for 4th degree tearing. It may very well be worse than the healing process from a cesarean.

Personally, I don't think 8 or 9 lb. babies are that large. I *do* think 11 pounders are pretty big, though, and it sounds like there's a good possibility that she'll have another *big* baby. I don't think her concerns are unreasonable.

If her labor was so fast, why was there pitocin?

Why are you getting all the info about the 2nd pregnancy (and the 1st birth) from her husband? Why can't you talk directly to her about it?

To be honest... I think there's more to this than just your friend's pregnancy. It sounds like you have regrets and sadness about your own cesarean--and I understand that... I certainly did not get the birth I wanted or was preparing for with my my first child. Neither did you, and *neither did your friend*. Like it or not, these personal experiences then go on to inform and influence our own feelings and decisions about subsequent births. I don't think you have fully understood how painful and traumatic your friend's experiences were for her; you're a little dismissive, and I feel like you're blaming her a bit, too.

It sounds like the 2 of you should get together and talk (and listen) honestly about each others birth experiences. You need to here what happened with (and after) her 1st birth and what her recovery was like. And then you will have the opportunity to share your cesarean experience. If nothing else, it will help prepare her for that so it goes more smoothly.

[stafl]

I would probably get her a copy of Ina May's Guide to Childbirth, and maybe Dr. Sears Birth Book, and then try to stay out of it. Ultimately it is her decision to make. You can give her the reasons you made *your* decisions, but she's the one has to live with what happens the rest of her life. If she's afraid, she isn't very likely to have a positive natural hospital birth anyway, might as well just go along with what the doctors want to do...

Traumatic births aren't always cesareans. It sounds like she had a very traumatic first experience, and is afraid of a repeat, and rightly so if she has the same care provider and is planning to birth at the same hospital. Different people respond to such trauma in different ways. Some of us fight tooth and nail to have a different experience the next time around, and others decide to not fight it at all so they won't be disappointed if it happens again. There are resources online for women who have had traumatic birth experiences. I don't have my bookmarks anymore, but you can google and find some really good websites. :rainbow

[Slackermom]

Thanks for setting me straight mamas. I was wrong.

[dancindoula]

:Hug to you, mama, and :hug to your friend. I would reccomend the book "Birthing From Within" to BOTH of you. It deals a lot with birth trauma and finding strength and grace to heal with the next birth (regardless of the birthing method). If your friend wants to talk about it then there is no reason not to be available to debrief from both of your last experiences and examine resources/options for the future. If she is determined, however, that a scheduled c/s is what she wants then the best you can do is continue to support and love her the way you already are.

If it turns out that she is open to other methods of avoiding a repeat of her last birth, that would be the time to talk about options like changing care providers, NO augmentation (at all, at all), upright positions, self-directed pushing, perennial support, etc.

You sound to me like a normal caring friend who doesn't want her to be hurt any further, in any fashion. Keep listening to your heart, and to her's - you'll know what to do.

Blessings,
Aron

[MamaTaraX]

Maybe you could get her Birthing From Within as well? And you could read it too and thenyou two could talk, together.

Namaste, Tara
mama to Doodle (7), Butterfly (2), and Rythm (due at home 1/06)

[TurboClaudia]

do you have a local ICAN chapter near you? www.ican-online.org you could ask her to go with you to be your support for processing your previous birth experience... and who knows? she might get some good information about giving birth by cesarean...???

:hug

~claudia

[Slackermom]

Thanks again for your replies. I've read Birthing From Within, and Ina May's Guide to Childbirth, and many other great books, too. Actually, I've been in therapy for quite awhile -- not because of my birth experience, per se, but because of PTSD from a sexual assault that contributed to the way my birth experience went. It's been helpful for me to process it and work through things, especially in light of my upcoming new baby. I'm also a MSW, but I find it hard to apply what I know about counselling to friends! However, most of you think I'm butting in and transferring my own feelings onto her, which wasn't my intention. I will just let her make her own choices, and will keep my opinions to myself.

As Forrest Gump would say, that's all I have to say about that.

[KKmama]

Jellyfishy, :hug. I was probably a little too grumpy in my reply (I'm pregnant and have super bad m/s and I'm pretty cranky these days).