The paradox of control in birth is that we must internally surrender to our bodies while externally exercising consent for what’s done to our bodies. On one hand, the physiological process requires us to relinquish control and allow the primal brain to take over in order to move labor forward. On the other hand, participating in a medical context means it’s critical to exercise control by being active, informed consumers.
When I became pregnant for the first time, I abruptly realized how little I knew. I knew that my mom was very proud of her natural birth (at 42-1/2 weeks). Her precedent had long ago normalized a spontaneous, drug-free birth for me. I had always assumed that that would be my experience as well. But I knew nothing about the path to get there.
Being the amateur researcher that I am, I spent the first two trimesters knee-deep in books and the web. I was committed to approaching every prenatal routine as an informed consumer, but suddenly there were so many options to weigh. So many polarized camps of opinion, so much contradictory evidence, so many decisions and so many huge consequences. By the time forty weeks came (and went), my head was a whirlwind of resolute determination and anxiety. I never could have guessed how critical one’s emotional state is when awaiting the onset of labor.
When I was still pregnant at 42-1/2 weeks, my midwife recommended scheduling an induction. I was in tears. I didn’t want to be that storied woman who gets led into induction then turns around to find herself having an emergency Cesarean with all that it means for risk, recovery and future births. I feared the “cascade of interventions” and was convinced that acceding to induced labor was turning over control of my baby’s birth. As if I had ever had control to begin with.
The paradox of control in birth is that we must internally surrender to our bodies while externally exercising consent for what’s done to our bodies. On one hand, the physiological process requires us to relinquish control and allow the primal brain to take over in order to move labor forward. Clinging to specific ideals of a birth experience often works against us and serves only to close our bodies, divert our focus and raise our anxiety levels. Anxiety creates adrenaline. And adrenaline can impede the onset or progression of early labor.
On the other hand, participating in a medical context means it’s critical to exercise control by being active, informed consumers. Generalized protocol is frequently designed to mold textbook cases and often prioritizes averaged results, efficiency and liability protection over individualized needs and circumstances. Health decisions are best made in partnership with care providers and so it is our responsibility to be conscious, inquiring advocates for ourselves, our bodies and our children. We must be active participants, ask questions and weigh options.
In other words, think about your choices, but don’t get in the way of your body. Take a laissez-faire approach with your body, but not your surroundings. It can be a tough juggling act to maintain, especially for a first-time mom who may not have a gauge of what’s “normal”.
When I was post-dates, I could (and did) point fingers at everyone else for creating the pressure cooker around me, from passersby asking casually about my due date to the faceless writers of obstetric protocol with its looming deadlines and statistics. But the fact is that the only actions we can control are our own. I didn’t know how to surrender to the process occurring in my body and I thought that digging in my heels was expressing strength and self-determination over my body. The non-stress tests and ultrasounds showed that my daughter was fine, but my head was a jumble. My body and my baby were readying themselves, but I was impeding their progress.
My midwife had the experience and objectivity to see that I needed someone to take the reins. With both apprehension and relief, my husband and I consented to the induction and went to the hospital. I was fortunate to have a medical team that respected my preferences and kept my Pitocin level as low as possible, which enabled me to labor without an epidural.
I didn’t fall down the mountain of interventions. Pitocin was used to augment my labor rather than steer it. My care providers made decisions with me based on my individual progress. And, with no other choice, I let go.
The next morning, with the support of my husband, a team of fantastic nurses, my midwife and a dear friend, my daughter was born. Nearly eight years later, I recognize that induction was the wisest decision at that moment. Not only because protocol restricted my midwives’ ability to continue to care for me much longer, but also because it was the only thing that enabled me to let go of the illusion of control.
Often in birth, relinquishing the pretense of control is how we show strength.
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