On birthing


I'm trying to book a flight in January, back to Chicago for my baby shower.  As I was shopping for a decent fare, which is hard to find at my small local airport, I realized I had better check on the airlines' policy on pregnant women flying.

I can understand that the airline doesn't want some woman going into labor and the pilots having to divert.  But … how often does that really happen?  A quick Google search yielded breathless news coverage of a premature baby born on a Korean Air flight in June and not much else.

The thing that gets me all amped up is that the act of giving birth seems to be frozen in time.  Obviously there are many innovations in the way that doctors intervene in birth, probably new epidurals and shinier stirrups and God knows what else.  But the conversations I find myself having about birth, most people's attitudes towards it, their understanding of it, make me feel like I've stumbled into Old-Fashioned Land, where doctors know everything, women are helpless, and having a baby is a serious medical emergency that springs up, full-blown, without warning.

This is hard to get used to, partly because it sucks, and partly because the medical world of getting me pregnant was so different, and seemed to be much more up-to-date. 

Anyway.  Should I decide to travel less than a month before my due date, United Airlines requires that I present a letter from an obstetrician saying what my due date is (perhaps this is too hard for me to remember?) and that I am "fit to travel."  At first glance this cracked me up – fit to travel?  Do have to be fit to slump in my seat and say no thanks to the peanuts?  but that's because I'm not familiar with some of the complications many women live with due to diabetes, preeclampsia etc.  I'm ignorant because I don't have any drama and I thank God for that.  So I suppose some women with complicated pregnancies are deciding to fly and the airlines want to prevent that. 

Part of my dangerously cavalier attitude about flying is that it's a 90 minute flight.  Were I going to New Zealand or something, I'd probably be a little more concerned about the blood clots and all that.  But this is one of those where you ascend, they turn off the seat belt sign, they give you a drink, you get 10 pages into Skymall and it's time to descend.  Now, if they make the plane sit on the runway for 4 hours so they can call it an on-time flight, making announcements every half hour that we'll be "wheels up in just a few minutes," not letting me use my DVD player because it's a "prohibited electronic device," why then I will make every effort to have the baby RIGHT THERE because that sitting-on-the-runway thing is just too, too much.

As you can imagine, the thing that has me all riled up is the "obstetrician" part.  What would happen if United Airlines required any passenger over 40 with cholesterol over 220 to present a note from a cardiologist, because those passengers might have a heart attack?  Setting aside the uproar that would result from inconveniencing, uh, MEN in this way – but why couldn't these ticking time bombs bring a note from any old doctor?

I fired off an email to United, asking if I could use a note from a board-certified midwife, and received this response:

I regret to learn your disappointment with our policy to present an obstetrician's certificate while traveling. I understand that you would like to present board-certified midwife's medical letter to travel. But, please understand that as per our United policy we only require the certificate which states that the obstetrician has examined the passenger and found her to be physically fit for travel by air from place/to on date, and state the estimated due date of the baby.

Sigh.  Setting aside the odd wording which makes me wonder if my initial inquiry was even understood, and the usual customer-service technique of reiterating the policy without really answering the question, this just infuriates me.  I don't have an obstetrician, I don't plan to get one, and the idea that a midwife isn't qualified to ascertain my "fitness for flying," let alone catch my baby, is insulting.

Midwives, you have my respect and my sympathy.  To be in such a worthy profession that is so disregarded and disrespected by most of this country is to live your work life in Old Fashioned Land and that must be really hard.

If I can get past the OB requirement, and I can't, I'm also infuriated by the old-fashioned idea that a pregnant women is a ticking time bomb.  I bet countless women have gotten a few hours of early labor out of the way on a plane and didn't think it necessary to "warn the cabin crew" before heading off to their destination.  In Old Fashioned Land, apparently they think babies will just plop themselves out without warning, yet it's still a dangerous medical emergency.  I understand that second and third babies do this, but I think second and third-time mamas have a much better sense of what rumblings to look for.  I certainly hope for a shorter labor but I don't expect one.

There was an essay in the New York Times a few weeks ago. A man wrote about how his wife's baby came so fast that he was still on the phone with 911 when she caught her own baby and called out to him from the bathroom: "it's a girl."  Instead of celebrating his daughter's birth and his wife's incredibly short and easy labor, the father was traumatized, and haunted by what he calls his own "irrelevance." 

Is this why we as a culture cling to the idea that childbirth should be harrowing, and traumatic, and dangerous?  So that our men can feel important, and have something to do?  I think that's sad.

It would be oh so much more sensible if United, and Northwest which has the same policy, would only apply it to flights over a certain number of hours, and obviously they should accept a midwife's note.

I'm actually just one day clear of their stupid requirement.  I will be traveling on January 12th, and my guess date is February 13th, so I'm not quite traveling a month before. 

By the way, did you know that less than 5% of babies are born on their due dates?  I hate due dates and I'm trying to forget mine so that my baby isn't labeled as "late" or "early."

It seems like it would be so easy to just lie about my due date – what are they going to do, check my cervix?  But luckily I don't have to. 

We had a great midwife appointment last Thursday.  My weight gain is steady at 10 lbs as I enter week 26, BP still low, fetal heartrate rock steady.  I was prepared for the glucose test to be horrendous, as I have had the 3-hour test before and I assumed the one-hour test would be as bad.  But it was a breeze… I was told to eat a protein-rich breakfast, drink the sugary stuff and show up.  I figured there would be multiple blood draws and urine tests but it was just one blood draw and done.  While waiting for the blood draw and the hemoglobin check I had fun perusing the huge wall of baby pics, Christmas cards and announcements.  My husband and I are stuck for a name but these types of displays are no help, since we abhor 1) overused names and 2) newfangled names, and that is of course all we can see.  Instead of being inspired we find ourselves chortling or stiffening in horror at photos like one labeled "The X-Men," featuring three boys and their unrepentant parents, said boys labeled "Rex", "Jax" and "Dex." 

Who does that?

Anyway, I was feeling moderately nauseated that morning but the sugary stuff went down just fine.  I thought I'd feel horrible afterwards, hungry & shaky etc., but felt "normal" which for me was just, still, moderately  nauseated and tired, but not so much that we couldn't go to Baby Megastore and start our registry. 

I'm thinking, now, that maybe that's a bad sign if the glucose test didn't make me feel bad when it was over.  But I'm trying to stay positive and I'm visualizing my pancreas as a muscly little tough guy superhero, letting all that glucose just bounce off his tiny yet inflated chest.

Staying positive is a new thing and I like it.  For so long I tended to inoculate myself with the what-if, just in case I was taking a good result for granted.  HA.  I carry the "what-if" gene, for goshsakes.  I do not need more "what-if."  I'm trying to catch myself in those "what-if" thoughts and I'm noticing that they ring in my head in the stern voice of some parental figure.  "There may not be a baby, even after all this," says one.  "I just don't want you to get your hopes up."

Ugh.  Isn't that horrible?  Aren't there some things for which we should "get our hopes up?" 

I need a lot of help in this staying-positive area, and I am getting it from Hypnobabies.  Hypnobabies is the self-hypnosis home study course we're taking to help with our unmedicated birth.  The main point of Hypnobabies and other hypnosis strategies is that childbirth doesn't have to hurt. 

If that statement makes you giggle, watch this old Dateline story about some hypnosis births.  I'll wait.

(Edited to add): Check out another article about hypnosis in today's NY Times.

Obviously the first step in trying to learn self-hypnosis is a whole lot of brainwashing about the no-pain part, and the home study course has lots of CDs and techniques to help me do that.  One is a series of "pregnancy affirmations" like "my baby is healthy and strong inside me now," and "I am imagining everything going right" and boy do I need that.

Yes, it's brainwashing, and why not?  How many times have we been brainwashed the other way?  How many births have we seen on TV and in movies where there is yelling, agony, needles, doctors, and the woman is flat on her back looking helpless?

Sorry.  I was yelling.  Deep breath:

Self-hypnosis home study is great.  I'm instructed to get comfy, relax and listen to a half hour recording of someone who has a masters' degree in soothing, telling me how wonderful my birth is going to be.  If I fall asleep during these recordings, which I often do, that's fine: "my inner mind is always listening."

And, you know what?  It is.  I am really getting used to the idea of everything going right, which is why I'm scoffing at the idea of my glucose test coming back with anything but an A at the top.  It's probably helping me re-frame never-ending nausea as a gift from God, since it is helping me not to pig out.  And it is helping me with the fibroid.

The fibroid, yes.  It's one of my old friends, the monkey on my uterus' back.  It has been considerate enough not to grow through the wall of my uterus, but it's been there for years and some doctors think it caused problems in conceiving for me, and some doctors think it's just furniture.

When I had my one and only OB visit, because I haaaad to have an ultrasound before we got to TN and got in the granola groove with the midwives, the fibroid came up.  The doc said it could be a complication if it grew in such a way as to get in the way of the dilating cervix.  We'll have to watch it, he said.

So the seed was planted.  My husband and I had many conversations about how we could strive for the natural birth but we mustn't be disappointed if this fibroid thing derailed it.  It's out of our hands, we said.

Which it certainly is.  But…

After re-viewing "The Business of Being Born," I thought again about the OB perspective, which is surgical.  I certainly think a lot of other things that OBs and doctors suggest, to minimize risk, are unnecessary or alarmist. 

I remember when I showed my dermatologist a big lumpy cyst thing on my back, and he offered to "take care of it" surgically right there in his office.  I said "will it cause me any problems if I just leave it?"  I'm not exactly a back model or anything.  The doc said no, except that "it might rupture."  Hmmm, wouldn't that be what we wanted?  And isn't a "cyst" just a big old zit with an attitude, anyway?

So I asked Dr. Google about fibroids crowding cervixes (cervices?) and it seems to be exceedingly rare.  I thought more about the mighty engine that is a woman's body.  If the uterus is so tough that a kicking, wiggling 8-pound baby can't punch through it (despite his best efforts), if the cervix (which is part of that tough miracle of musculature) expands to many times its original diameter to help push the baby out, if my very bones soften and move to let the baby out, do I really think a 6 centimeter fibroid is going to be in the way?  Right now the baby is squeezing far more crucial things like bladder, stomach, and heaven knows what else, out of his way.  I think he is wearing my diaphragm like a cowboy hat.

I understand that things can go wrong but I also know that I am fearfully and wonderfully made, and I'm going to trust that.

I asked the midwife and she said, yes, it didn't sound likely.  I said "Maybe the cervix will just push it out of the way," and she said, "Yes.  I want you to visualize that happening."

And, of course, we will get some extra ultrasounds just to be sure.