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Are You Woman Enough to Take It Lying Down?

We were a battalion of weebles accompanied by hovering guards, and we invaded the 11th floor of Roosevelt Hospital not too long ago. “You may hear some weird noises,” our guide said. “There are some women in labor right now.”

Couple by couple we checked out the maternity ward: the modern Labor, Delivery & Recovery (LDR), on one floor, and the Birthing Center, the natural-birth alternative on the 11th. Dr. Awesome and I filed into one after another birthing center room, all of them nearly identical. Each was like a roomy hotel suite with a full-size bed, a small jacuzzi, a few chairs, a TV, natural wood furniture—even a lovely view of the Hudson River.

“Wow, this is really nice,” I said to Dr. Awesome. “Now can we just add drugs?”

Choosing how to give birth is a decision fraught with more complications than you would imagine. For most of history, of course, it wasn’t an issue. You got knocked up, you realized it after a few months, and several months after that you got on with it. A good portion of the time you lived and the baby lived, but frequently enough one or both of you died.

Now—at least for a woman like me, with health insurance, living in NYC—there are lots of options.

What’s interesting is the hand-wringing and moral-wrangling now attached to how one gives birth. Yes, modern human females have been giving birth vaginally, largely without pain relief, for at least 160,000 years. But that doesn’t mean they haven’t tried; various potions and remedies—many of which, like hemlock, are seriously poisonous—have been used by cultures all over the world throughout history to attempt to relieve the pain of labor.

There are lots of other natural events requiring some medical assistance that aren’t yoked by morality. Skulls have been found dating to the Stone Age that show clear evidence of trepanation—the cutting of a hole in the skull to relieve pressure on a swelling brain (or, perhaps, to release malevolent spirits—who knows the motivation, but the effect on the brain was the same). Would anyone today expect you to have a section of your skull cut out without anaesthesia purely because it had been done that way in the past? Or to have a tooth removed without even the minor relief of Novacaine?

Of course, pregnancy is not a disease; in fact, its treatment as a weird malady of the lady parts by male doctors during the past several hundred years, particularly in Europe and America, is one of the main reasons so many women today are reflexively suspicious of the “medicalized” birth. For sheer physics alone, lying on your back in labor—a position that does nothing but give birth attendants a better view—makes no sense: gravity can’t help, and there’s nothing to push against. Rushing the process of labor can lead to (oh god stop my brain from even thinking about it) episiotomies and increased cesarian births. Epidurals can slow down labor and make it difficult for a woman to know when to push.

As recently as the 1950s, laboring women in the U.S. were given general anaesthesia; while they were under, the baby was simply removed like any other excessive growth—like a tumor. Countless women (and their frustrated partners) tell horror stories about feeling helpless as they were shunted around the maternity ward like pieces of howling meat, with little attention paid to their preferences for labor or the level of medical intervention they want. We are all scared shitless by the endless images of laboring women in movies and TV screaming their heads off—while lying down, of course. For years, every time I’ve seen some scene of labor, I’ve crossed my legs and squeeeeezed hard. Because the message is: Labor is trauma. It is pain. It is terror and emergency and the unknown. And only by having the experience tightly controlled by the professionals can you and the baby get through it.

But there is also a romanticizing of childbirth by many natural-birth advocates that is equally not based in reality. First of all, let’s take this concept of “natural.” Here are some perfectly natural elements of the world: Cancer. Cavities. Getting eaten by something faster and stronger than you. Flesh-eating bacteria, macular degeneration, fungus, great white sharks. And, of course, dying in childbirth.

Mother nature has been picking us off during childbirth for forever. It’s a risky proposition for many women and babies around the world even today, from those suffering from malnutrition and disease to girls who give birth too young, before their pelvises have fully developed—often as a result of stunted growth from said malnutrition or disease. There’s a veritable epidemic in Africa of teenage girls who get fistulas during labor. Their bodies literally rip open with holes. Afterward they suffer from constant incontinence and are then shunned by their husbands and communities.

The operation to fix a fistula costs about $450, by the way. You can donate here.

Fistulas used to be common enough in developed countries even in the 19th century, and it was doubtless common across the world for millennia. And that’s one of the better examples of what can go wrong in childbirth, because at least both mother and child live. You want a macho pregnancy? Try undergoing a cesarian birth without anaesthesia, which also has happened throughout history. (Though the story that Julius Caesar himself was delivered by this method is surely apocryphal.)

The idea that if those evil men hadn’t gotten involved in pregnancy (beyond conception), then every birth would be a profound, if difficult, experience bathed in a golden glow of Natural, is doubtful.

And keep in mind that in Judeo-Christian cultures, the idea that women are being continually punished for Eve’s transgression in the Garden of Eden is a durable thread that persists to this day. If you’re all down with natural womanhood and against the patriarchy, make sure you’re not falling into the trap of thinking that fate of woman is to suffer, and that in fact you must suffer if you’re going to be a good mother—labor being your first test.

My goal has been to find some sort of middle ground between the two extremes—the pregnancy-as-disease mindset, and the strangely macho Mother Earth birth.

I had to make some kind of decision while I was still in the single-digit weeks of pregnancy, when the idea of this person growing inside me, let alone the idea of giving birth to said person, was still utterly surreal. I had no idea how I might feel about labor come the Big Day, but I knew I wanted to leave my options open.

For that reason, I chose an obstetrician who has midwives on staff, and a hospital that has both a natural birthing center and a standard hospital LDR ward. (Incidentally, and hilariously, in the pamphlets Roosevelt Hospital hands out to expectant parents, giving birth in the LDR ward is called having “the traditional birth experience.” So I’ll be squatting in a mud hut while the nurse hooks me up to a fetal monitor, right?)

I knew a few things. First of all, I wanted to give birth in a way that made sense. A strange criterion, maybe, but there it is. No help from gravity and pushing against nothing make no sense. An inability to switch labor positions makes no sense. Neither does it make sense to needlessly suffer from pain just to prove I’m a hard ass. (I know I’m a hard ass. C’mere so I can punch you!)

Secondly, I knew that I like drugs. Drugs are my friend! I’m not a crazy pill popper—I rarely take even cold medicine or Tylenol—but the drugs that I’ve come to know and love I, well, know and love. Give me a Xanax on an intercontinental flight. Let me pop an Ambien when insomnia has me near insane with unsatisfied exhaustion.

Lastly, I wanted to participate in the birth, neither so doped up I can’t feel anything nor so frantic with pain that I’d plead with someone to knock me out with a hammer just to put me out of my misery.

Is there a way to have pain relief and yet some mobility? Is there a way to have an experience couched by a) the safety and security of a modern medical facility and b) patience and assurance from someone who knows that, despite the rocky record, this is indeed a process for which my body is not particularly well designed (thanks, no-master-plan evolution!) but that it mostly can handle?

There may be. Roosevelt gives something called a “walking epidural,” which is essentially a lower dose of anaesthesia; it will provide pain relief but may—the midwife was a bit doubtful—allow me to switch positions in bed; I plan to do my squatting above the floor of the mud hut, thanks. Right now the plan is to deliver in the LDR area, attended by the midwife I’ve been seeing for months (I’ve only seen the obstetrician once). I may enter the ward hollering for drugs, or I may not. Who knows. I do know, though, that I’m going to do whatever feels right at the time.

On April 23, Dr. Awesome and I begin a five-week childbirth education class. Think cring-inducing birth films and breathing techniques. The class I chose offers pain-coping methods, some of which are already going to be familiar to me from yoga and meditation, but it also fully covers pain-relief options, i.e. drugs.

Whatever happens, I’m sure that the experience will turn out to be much as Dr. Awesome predicted after we wrapped up the maternity-ward tour. As we walked back to Columbus Circle to catch the A train, he dragged on his cigarette and said, “Everytime we went into a new room I thought, ‘Is this where I’m going to get my mind fucking blown? Or is this? Or is this?‘”

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Moderation, Metaphysical Hangovers and the Modern Mom

This entry is less about pregnancy than about bitching—and not, actually, bitching about pregnancy. I’m really tired of that freaking word.

Anyway.

The latest installment of the NYT’s Proof, a blog ostensibly about drinking (more on why I qualify it later), is called Moderation and the Modern Mom.  Anna Fricke writes about how after years of downing shots with 23-year-olds and being escorted out of the side doors of establishments by her husband, she completely gave up the sauce when they began to try to conceive. Even before he was pregnant, she entirely stopped drinking (and eating sushi—evil, evil sushi! Oh, I had some the other night, by the way).

In response, she says,

I felt maternal, wise and frankly relieved. I had worried for years that the alcoholism that ran in my New England stock had snuck into my veins and it was good to know that I could painlessly, easily, give up alcohol when necessary. And so, for 13 months, I didn’t touch a drop. And then I had a baby.

While I’m not abstaining entirely, I do understand why she felt relieved; alcoholism runs through my family’s veins too, and it has worried me that this tendency might, like a tumor, metastasize one day, and that would be the end of me as a sober, functioning member of society. It’s unlikely, though. I have always been the type of drinker who has fun and fun and fun until it gets late and I get tired and I suddenly realize that I am ruining my entire life. The next day, I don’t just wake up with a hangover. I arise to greet an existential crisis.

Writer and committed boozehound Kingsley Amis called it the “metaphysical hangover”:

When that ineffable compound of depression, sadness (these two are not the same), anxiety, self-hatred, sense of failure and fear for the future begins to steal over you, start telling yourself that what you have is a hangover … you are not all that bad at your job, your family and friends are not leagued in a conspiracy of barely maintained silence about what a shit you are, you have not come at last to see life as it really is.

Yep. It’s pretty much exactly like that. I don’t even need to drink much to feel this way; from what Fricke relates, I couldn’t have kept up with her. Still, this metaphysical hangover has served as a painful but effective check on excess.

So I understand where she’s coming from and where she goes with it. Once she felt like she had her mothering skills down and the baby was a bit older, she says:

I started to revel in taking a little of myself back. At night, after she was soundly asleep, I would cook my husband and myself dinner and pour a luxurious glass of wine. I sautéed, I sipped. It was just like the good old days. Except that it wasn’t. Because in the good old days, I would have had at least half a bottle by myself and would have started slurring non-sequiturs to my husband in the middle of “Damages.” And as much as I wanted to celebrate my newfound nighttime independence by getting pleasingly sloshed, I discovered that this was an impossibility.

I too have had a similar realization: that my drinking life has been irrevocably altered. I will not tie one on for a long, long while. I feel some relief about this, too. Because like Amis, I hate dwelling the next day on the conspiracy of silence you all keep about what a shit I am.

But! The point of this posting is: That’s just me. (Well, and Fricke.)  What I want to bitch about is this column, Proof, which every week features yet another entry about the woes and vagaries suffered by yet another ex-boozehound and how complex but ultimately satisfying it is to live the sober life.

I am so calling bullshit.

One of the things pregnancy has taught me so far is that sobriety can be seriously tedious. Unless you’re a master of the universe deciding the fate of nations or a bone fide Zen master, endless sobriety is, well, fucking endless. How I would love, just for a few hours, for reality to have the softened edges it has after you’ve had a couple glasses of wine or finished the last sip of an icy, tawny, sweetly biting Manhattan. How I would love for conversation to have that lubricated effortlessness, for the social bond to put on its fabricated but nonetheless pretty mask.

But if you read Proof every week, you’d think that our alcohol use—which archaeologists have physical evidence for going back at least 8,000 years—never offered these sweet reprieves. You’d think only misery, dysfunction and trauma were responsible for our tippling. It’s absurd, irritating and moralizing.

Why for the NYT is it the people who are unskilled at drinking, who suck at it, who fucked up its venerable traditions so royally that they had to give it up entirely, get to define it for the rest of us?

Bullshit, I say.

Sure, I’m grateful pregnancy has forced me to avoid the metaphysical hangover for the past nearly six months. But that doesn’t mean I don’t envy you your postwork drink. One of my cousins had a baby several months ago and many of her Facebook status updates mention her early evening wine. Ohhh, I can’t wait. I suppose I should be grateful for this as well—that after The Kid is born, maybe I’ll get to have my cake and eat it too: a couple of drinks but no next-day trauma.

But the rest of you: you should drink the hell on. Par-tee.

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Can't Tell Nobody Nothin'

After sciatica and hemorrhoids, unsolicited advice may be the pregnant woman’s biggest pain in the ass.

That’s because you can’t tell nobody nothin’, least of all me.

If you think you don’t like people telling you what to do, well, meet me. If you tell me that hitting myself in the head with a hammer is a bad idea, I might grab one in each hand and start banging away at my temples just to be contrary. Part of me is still a surly 13 year old who think she knows everything until confronted with the clear and unavoidable evidence that she doesn’t. And then the fury starts, because how dare you point that out, you heartless bastard?

Charming, right? Poor Dr. Awesome.

Because of this tendency, I think I’ve been pretty restrained so far when dealing with the comments that are starting to roll in as predictably as my belly is beginning to grow out. Everybody’s an amateur going into parenting, but everybody’s also a goddamned expert afterward.

Most people are just being friendly; the bump is compelling, for whatever reason. (Personally I find it more comical than anything else. I hope I can maintain that perspective the more I resemble an egg on legs.) And I’m being perfectly pleasant in return. Generally that involves a lot of noncommittal nodding and polite noises. (“Hmm.” Oh yeah?” “Wow.”)

But sometimes it’s intrusive. Take the livery cab driver who gave me a ride home recently. Having put in a 10-hour day at the magazine, I was yawning away in the backseat as we zoomed along the East River heading toward that amazing stretch of the FDR Drive that puts the skyline, the Manhattan and Brooklyn bridges and the harbor on a glittering display of light and reflection and height. I always think then that NYC looks like a dragon languorously sprawled across a horde of gold and jewels.

Two weeks before, his daughter had given birth to a girl at Maimonides Hospital in Brooklyn, so he was on the baby tip big time. In short order, I learned four incontrovertible facts about the world: girls only want to talk about hair and clothes; it’s “weird” that Dr. Awesome had initially hoped for a girl, because all men want a boy; epidurals are for the weak-willed and selfish; and male obs-gyns are infinitely better than female ones.

Take your pick as to which one of these assertions you would have been most annoyed by. I went with the final one. I wanted to slap the back of his head, but instead I said I had only ever chosen female ob-gyns (and here I considered how weird it was to discuss Intimate Fun with the Speculum with some random Israeli man my father’s age), and that they had been perfectly good doctors. Finally I ventured to ask, “Why would you say this, that men are better than women?”

He shrugged. “This is just the way it is. The truth.”

I rolled my eyes. “Look, would you take your car to a mechanic who didn’t drive one?”

“I don’t think that’s a good metaphor,” he said seriously.

And then there was the waitress at the diner a few weeks ago. That Sunday morning I awoke and decided that there was nothing I wanted more than some big honking breakfast involving pancakes and meat and eggs and coffee, and I wanted to be reading the Sunday Times while someone delivered it to me. Thus the diner.

As coffee jacks me up like a cracked-out gerbil, I rarely drink it. But that morning I figured the “lumberjack breakfast” before me—three pancakes, two eggs, bacon, sausage and ham—would soak up the jitters. The enormous platter did a fine job of keeping my blood sugar’s response to the coffee minimal, so I happily requested another cuppa joe.

As the waitress refilled my cup, she said, “You’re not supposed to have this, Mami,” and nodded at my belly.

“Really, it’s fine.”

She shook her head. “No, coffee’s no good when you’re pregnant.”

“No, really, it’s fine. You can have coffee. You just have to keep it to a minimum. People are so hysterical. And you can have a drink once in a while too. Oh, and I had a glass of wine last night. You’d better call child protective services.”

“Oh no, that’s fine,” she said dismissively. Booze in, coffee out. Noted.

She leaned companionably against the next table. “The doctor told me I couldn’t have children, so when I got pregnant I didn’t even know it,” she said. “The only sign I got was I had big boobs. My friends were like, ‘Did you get a boob job, Mami?”’

We both laughed. “I know, they get huge.”

“So I didn’t even know I was pregnant. And I was eating and drinking things I shouldn’t have and at five months I lost the baby.”

I winced. Jesus Christ. “Oh, I’m so sorry.” I was just about five months myself then.

“No, it’s okay, it’s okay. Because now I know that I can get pregnant. So next time I’ll do it right.”

I didn’t quite finish that second cup of coffee.

Most of the time the conversation is neither as macho as Mr. Men are Better or as unexpectedly personal as Ms. Mami. I apparently “look” like I’m carrying a boy for various reasons—because I’ve gained no weight in my face, because I’m carrying somewhat low, because I don’t resemble the speaker’s memory of herself (or of his partner) when she was pregnant with a girl. I’ve been advised to do stomach exercises. I’ve been advised to avoid stomach exercises at all costs. I should breastfeed til The Kid applies to college, or I should swap out the tit for the bottle ASAP. I’m clearly insane if I’m considering going for natural childbirth, or I’m clearly insane if I want to be as drugged up with painkillers as is medically safe. (For the record: I haven’t decided yet.) To my endless consternation, the first thing many people mention is the baby’s astrological sign, which, I have been well informed, will be Gemini—and which means fuck-all to me or to Dr. Awesome.

Still, people are being quite kind. In the same way we reflexively say I’m sorry to the bereaved, most default to saying Congratulations and You look great to the knocked-up. Which is lovely and sweet, even if mere form.

It’s winter. I imagine that as the weather grows warmer and I grow larger, so too will the number of comments expand. I’ll have to handle them as they come. But at least I know exactly what I’m going to say the next time someone questions my cup of coffee. “Oh, don’t worry,” I’ll assure them. “It’s just scotch.“

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Bill Proposes Mandatory Drug and Alcohol Testing of Suspicious Pregnant Women in Tennessee

A bill was just introduced to the Tennessee state legislature that would mandate drug and alcohol testing for certain pregnant women. And not only that—any such woman who then failed to show up to two subsequent prenatal exams would be reported to the department of children’s services. You can find the full text of the bill at the link above, or find it pasted here, on the informative website Women’s Health News.

According to the proposed bill, which behaviors signal that you are a pregnant woman of interest who can be forced to have drug or alcohol testing? The following:

(1) No prenatal care;
(2) Late prenatal care after twenty-four (24) weeks gestation;
(3) Incomplete prenatal care;
(4) Abruptio placentae;
(5) Intrauterine fetal death;
(6) Preterm labor of no obvious cause;
(7) Intrauterine growth retardation of no obvious cause;
(8) Previously known alcohol or drug abuse; or
(9) Unexplained congenital anomalies.

Where this list is vaguest is also where it’s most alarming. What exactly is “incomplete prenatal care”? Who defines it? And who, after all, goes without prenatal care? Often, it’s poor women, marginalized women (perhaps immigrant, illegal, or lacking English skills) and uninsured women.

I suppose it’s no surprise that merely being poor means you are, by default, of dubious character in our by-the-bootstraps culture, which often promotes the idea that if you’re poor, you must deserve to be. All women should have prenatal care. But is assuming that women who don’t get prenatal care are substance abusers the way to do it?

To continue with the troubling vagueness: There isn’t always an explanation for preterm labor, nor for every congenital anomaly. According to the National Institutes of Health, intrauterine growth retardation is associated with heart disesase, high altitudes, carrying multiples and having preeclampsia, poor nutrition, infections such as rubella and toxoplasmosis—and substance abuse. Abruptio placentae, which means the premature separation of the placenta from the uterus, has been tied to the use of cigarettes and crack—but also to such risk factors as high blood pressure or diabetes, suffering trauma (say, from being in a car accident), being over 35 or carrying a male fetus.

I’m 36 and carrying a boy. If I were in Tennessee and were unlucky enough to suffer abruptio placentae—and survive it, since it can kill both mother and child—I could then be subjected to a mandatory drug test. Because how can a doctor know for sure that my age is the cause without eliminating the possibility of substance abuse? It just doesn’t add up. And the bill doesn’t require doctors to test for all of these other causes before asking a woman to pee in a cup.

So say a woman tests positive for alcohol or drugs. What happens next, according to this proposal?

Every physician, surgeon or other person permitted by law to attend a pregnant woman during gestation shall report each woman who refuses to seek treatment for an alcohol-related or drug-related problem or who misses two (2) or more appointments to the department of children’s services.

What happens after that is left unexplained. Are they brought up on criminal charges? Do they lose their children upon giving birth to them?

This law would seem to open up the possibility of sweeping up a whole bunch of people who aren’t substance abusers. It’s ironic that the only way some of these Tennessee women are going to get prenatal care is by being considered a potential threat to their own unborn children.

We can all agree that substance abusers are endangering their unborn children. But a violation of many women’s civil rights doesn’t seem to me the way to intervene.

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I Think Steve Albini Mixed "The Prego Shuffle"

Courtesy of our friend Clay, who posted this to my Facebook profile.

Consider the Albini-esque loud/soft sound mechanics of this excerpt from a 1980s pregnancy exercise video.

Or just sing along!

Hey I dig my waddle

it’s okay with me

cause every day’s a new center of gravity!