I wanted to have a home birth, not only to bring my baby into the world gently, but also to avoid the hospital. I would be forever grateful to modern medicine for saving my life, but I didn’t want the lingering scent of sterility and pain in a hospital to be a part of my birth experience. Home births weren’t covered by our insurance, however, and Mark was nervous about possible complications that could require medical intervention. So we compromised: I found a nurse-midwife who worked in the hospital. She espoused the midwife philosophy—that each woman has the right to a natural birth—and she was also armed with all the interventions of allopathic medicine, including an MD. If anything came up, all she had to do was contact the doctor who was on call. During the course of pregnancy, she and I had talked about my birth plan, and I felt strongly that I didn’t want to use any drugs.
A few years ago, not long after I started working with Lynn, she had suggested I visit Catherine, a naturopath, to help deal with the phantom pain I had experienced ever since I lost my leg. During the course of the six months I saw the naturopath, she prescribed a variety of herbal remedies. She would start off each session by asking questions about any differences I felt as a result of the remedy I was currently taking, and by reviewing any changes in physical symptoms and how I felt emotionally. No matter how casually I mentioned a topic, she’d investigate each one, leaving no stone unturned. From her perspective, everything was intertwined; she was a firm believer in the mind–body connection. Her matter-of-fact demeanor would instantly shift to a warm and fuzzy one the second she sensed any emotion coming from me. During one session, through my shame, I confessed to her that I smoked. Without judgment, she asked me some questions. I explained I’d started smoking a few months after my accident and that I particularly craved cigarettes when I was upset.
She asked permission to talk me through a guided meditation. I had used guided imagery frequently in my twenties during my quest for deeper spiritual understanding, so I quickly agreed. I lay on her exam table, and after a few minutes of relaxing and deep breathing, Catherine asked me to move backward in time until I reached my earliest memory. I was two years old, holding on to my father’s hand as we ascended the thirteen steps in our new house. Then she asked me to go back even further and further still, until I was back in my mother’s womb.
I felt myself, small and scrunched up, floating in a dark, liquid world. I heard the whooshing of my mother’s blood surrounding me. In the distance, I heard Catherine’s voice telling me I was ready to leave my mother’s womb.
I felt the contractions. My body, forced to shift and move, was squeezed into new positions. I was confused and didn’t know what was happening. I sensed time passing, and the contractions became stronger. I panicked and felt afraid: I didn’t want to leave my home. Then a sudden feeling washed through me, and I felt different: somewhat agitated, but I didn’t feel afraid anymore. I moved through the birth canal and saw my mother’s beautiful face and heard her familiar voice.
Catherine explained to me that the drugs they used during my mother’s labor were my first introduction to the concept of using a drug during stress to relieve fear and grief. Given what I experienced in Catherine’s office, I vowed to avoid planting that same seed of a crutch in my own children, if I could help it.
Thus, my choice to forego drugs during childbirth wasn’t merely ethical; it was driven by a deeper concern for my child. It was a decision I’d made even before Mark and I had known one another.
During the last month of pregnancy, I saw Nancy, my midwife, every week so she could measure the baby and determine if my cervix was starting to open. Once we hit the two-weeks-overdue date, she decided to gently induce labor using Pitocin, a synthetic form of the naturally occurring hormone oxytocin, which stimulates contractions. Nancy assured me no harm would come to my baby. I knew my baby was getting big, and if he didn’t come out soon, I might require a C-section. I desperately wanted to have my baby naturally, so I agreed to the Pitocin. Mark and I went to the hospital in the morning, and I was hooked up to the IV drip. After an hour, Nancy sent us home with instructions to have a good lunch for strength and to take a walk around the block to help induce labor.
On the way home, Mark and I had Greek food for lunch, a choice I would later regret as I spewed my heavily laden garlic breath throughout the hospital room. After we returned home, I felt small cramps, but having never been through labor before, I had a hard time deciphering if they were labor’s beginning, a bad reaction to lunch, or nerves. We decided to do whatever we could to help the baby along, so we took Nancy’s prescribed walk.
I crossed the threshold of my front door and looked down the four steps leading to the sidewalk and then down the interminably long block. In the six months Mark and I had lived in our new house, I had never explored my own neighborhood on foot. Though I’d driven past the park three blocks away, I never stopped to see where my child would one day play. I had no idea how important that park would become to us once our little one was old enough to walk. And right then, on the precipice of labor, three blocks to me might as well have been a walk to the moon. But I wanted to do as Nancy had said, so I hobbled down the stairs and, with Mark next to me, began to limp down the road.
We didn’t know the gender of our baby, and I was busting with excitement to meet the creature who had turned my life upside down. So there I was, walking down the sidewalk, seeing front yards and houses I’d never noticed as I’d driven by them on my way to work each day. The houses were all vintage 1920s bungalows, and old, soggy leaves littered the yards. While the earth was in the depths of autumn’s decay, I was ready to bring forth new life. As we were nearing the dark time of the year, I could sense a new light coming into my life.
I walked slowly, leaning heavily on my crutches, fearful of inducing labor and yet desperate to do so. Mark walked quietly beside me, feeling his own fear and excitement. Pain was my constant companion now. My relationship with it was complicated, but familiar. As a way of preparing myself for what was to come, I kept telling myself the pain in my leg was likely small peanuts compared to the pain of labor. My midwife had every confidence that I could manage it, even when I voiced my fears to her.
“Do you think I can do natural childbirth with just one leg?”
“Colleen, the part of your body that will deliver a baby is intact. Childbirth is childbirth. Your body will know what to do. I’ll be there to help if there are any complications, but the loss of your leg won’t be the cause of them.”
That was reassuring, but how did I know she really understood my situation. “Have you ever worked with an amputee before?” I’d challenged her.
“No, but I don’t really see it as an issue.” She had delivered many babies and had seen many situations. In fact, she seemed surer of me than I was of myself. I had lost some of my fly-down-the-mountain-with-wind-whipping-through-my-hair self-confidence over the last nine months and was dubious about her confidence in my abilities. In any new activity I learned, I usually needed to teach my teachers how to help me. Except for my skiing and soccer coaches, I’d rarely encountered a teacher or coach who had taught an amputee before. I wanted to believe the loss of my leg wouldn’t make my birth experience harder, but how could I—or Nancy—know if that would be the case?
I had walked only two blocks down the road before my whole stump began throbbing. I was sweating from the exertion. It was on the tip of my tongue to ask Mark to go get the car and take me home. But I knew this walk might help me get the labor started, so instead, I just signaled to Mark to hold still for a moment so I could lean against him, close my eyes, and breathe through the worst of it. The tight knot in my stomach resisting the pain was loosened as I heard my old physical therapist’s voice in my head, spurring me on: “Atta girl, you can do it!” Okay, yes, I can do this, I thought. This wasn’t as hard as taking my first steps in the hospital. I took a deep breath and felt Mark’s gentle presence beside me. I opened my eyes, transferred my weight back onto my crutches, and
kept walking.
The walk worked. Labor began in earnest, and I spent the next ten hours watching a movie, preparing Christmas gifts, and taking a bath to soothe the cramps. Mark lit candles all over the bathroom and sat on the toilet as I soaked, my belly protruding like a barren island. Then, finally, it was time.
Labor was in full swing shortly after we settled into the hospital room. I changed into a nightgown, unstrapped the six-inch neoprene belt attached to my prosthetic leg, and removed it. I landed on the bed like a beached whale. The fifty pounds I’d gained during pregnancy had stripped away all my grace and finesse, but I’d made it here. And I was as ready as I could be.
After another hour of labor, and a long time of trying to reposition myself on the bed to help alleviate the searing pain of the contractions, my old nemesis, fear, crept in. The absence of my second leg and how it impaired my movements was glaringly obvious. Without the leverage of my other leg, readjusting my position was difficult, and turning onto my side on my own was nearly impossible. I was limited to one position: lying on my back. Am I really going to be able to do this? I fretted.
After a few hours of watching me struggle, Nancy drew me a warm bath in a deep tub. Transferring me from the bed to the wheelchair in the midst of my pain was a Herculean effort on everyone’s part. Just sitting me up took the three of us; Mark straddled me from behind, pushing me forward, while the midwife pulled my arms from in front. Once I was upright, I stopped to allow another contraction to pass and then turned my body and slid my leg over the bed, near the wheelchair. Mark was right next to me, guiding me as I stood up, pivoted my body, and plopped into the chair. Anyone who says birth contractions happen in the uterus is telling lies. I felt my whole body contracting.
While the labor was agonizing, I had an odd relief in feeling a new kind of pain, a productive pain. The pain during pregnancy had only worn me down; this pain I felt I could transcend. My only job was to deal with the pain and do what the midwife told me. I didn’t have to walk; I didn’t have to focus on anything or take care of anyone. All I had to do was get through each contraction.
Mark stayed in the hospital room while I soaked in the warmth of the bath. The lights were low, and Nancy sat quietly beside the tub. It was two a.m. I floated, exhausted, in and out of ethereal consciousness until the next contraction plunged my awareness back into the tub. Nancy gently coached me through each one, and then when it passed, I slipped away again. Images of women washed over me in my hazy dream state; an infinite procession of women, chanting softly, formed a ribbon of support and guidance around my body. I sensed these women were everlasting, from the beginning of time. They infused me with the confidence and wisdom inherent in a woman’s body. I relaxed in the understanding that my missing leg truly didn’t matter, not now. Not here. Just as Nancy had promised, my body knew what to do.
But then suddenly it did matter. Suddenly I was yanked out of my gentle reverie. The ribbon of support disappeared, and my left leg started to cramp hard due to its bent position in the small Japanese-style tub. Nancy grew concerned and called a nurse to help haul me out of the bath, into the wheelchair, and back into my room. After measuring my cervix, Nancy determined the warm water had slowed down my dilation.
I watched her face and could see her trying to hide her worry. I was gripped with fear when I realized I had to stay in bed and deal with labor outside of the water that had been so comforting only moments ago. The intensity of my contractions now doubled without the water’s soothing effects. I closed my eyes and tried to conjure up the image of my flotilla of women, but they were gone. Doubt surfaced again. Can I really do this?
There are times in our lives when we fear we are not up to the tasks required of us—moments when feel we are not made of enough toughness to face our circumstances. In this moment, I felt weak and small. I just wanted this all to stop.
But from somewhere inside of me, perhaps from a mother’s fierce protective instinct for her child, my resolve surfaced. My decision was still clear. I wouldn’t use drugs. I opened the file drawers in my mind and pulled out images of strength from my past: my first backpacking trip after the accident, playing soccer on one leg, my five-mile backpacking trip, snowshoeing, kayaking in five-foot swells on the Pacific. I had been physically challenged before, and I’d always been faced with doubt about whether or not I could really do it. But I never failed. Yes, I can do this.
I retreated into my own dark world behind my closed eyes, managing the pain in my leg, moving beyond the ache to a place of calm. I conjured up images of the mountains, the sea, places that brought me comfort. The dead weight of pain in my leg never left, but I stayed with it. A few hours passed. I was unaware of the clock or anything outside of my body except for Mark wiping the sweat from my brow now and again.
The midwife measured my cervix again. “Colleen, if you’d like to get back into a tub, you’re far enough along. We have a bigger tub, so you can stretch your leg.”
The second bath didn’t bring reprieve from the pain like the first bath did. I was too far along in labor. The intensity and frequency of my contractions increased dramatically. Light was streaming into the dark bathroom from the open door. I was distantly aware that staff or other patients might see me, but I couldn’t muster the energy to care. I had to continue my focus inward, had to attend to the pain and to muster strength the best I could. Nancy kept measuring my cervix, which meant I had to frequently lift my pelvis out of the water. Every movement hurt. Up to this point, I hadn’t vocalized during contractions. I was so inwardly focused on getting through each one. What started off with a low groan turned into a full-fledged howl. I was on a rollercoaster of pain; up, down, all around me was pain. I tried to open my eyes, but they were so heavy.
One more contraction and I lost my breath and my pinpointed concentration. Suddenly I couldn’t help myself. “When is the point of no return?” I managed to say. “Am I beyond having some drugs to help with the pain?”
“It’s never too late, Colleen.”
Damn it. I don’t want this choice, I told myself. I wanted her to tell me it was too late so I wouldn’t have to make the decision not to accept help from medication. But even in my near delirium I knew that life was all about making choices for oneself. I knew that a person never really gets to pawn her choices off on someone else. I had to decide something. The best I could do was to decide to wait until after the next contraction. I would have to go moment to moment on this.
Then, up the pain rollercoaster I went again. “Oh, I can’t do this.”
Did I really just say that? I asked myself. After everything I’d been through in my life, did I really, in the truest part of my heart, believe I could NOT do this?
No. Feeling I couldn’t do this was just that: a feeling. And feelings come and go just like contractions. Ride it out, I told myself.
With the next contraction, something was different. Something was coming out of me. “Oh, what’s happening?” I instinctively started to push. Was the baby coming?
“Oh don’t worry, dear, just a little poop. I think you’re body wants to push.” No one had told me about this. I was embarrassed; mortified actually. I’d never pooped in front of my husband before. But I coached myself through it: Embarrassment is just a feeling. Ride it out. Nancy put on a clean plastic glove, and without hesitation, scooped my little turd from the tub and dropped it into the toilet behind her in one fell swoop. Clearly this wasn’t new to her.
“Colleen, you need to change your breathing. Open your eyes, Colleen.”
Nancy was right in front of me, her breath stale, and her first two fingers standing at attention in front of my face. “Okay, Colleen, you’re not dilated enough to push yet, so I want you to pretend my fingers are a candle and you’re trying to blow out the flame. Like this: who, whoo, whooooo.”
I mimicked her breathing breath for breath. My body wanted to push so badly, it was nearly impossible to resist the urge. Nancy kept breathing with me, and I focused directly
on her fingers, as if I were really blowing out a candle.
“Lift up your pelvis again, Colleen. Let’s see how far along you are.” I wanted this to stop. I just wanted it all to stop. Ride it out. I grabbed the sides of the tub, lifted my pelvis, and allowed Nancy to stick her fingers into my cervix. “Okay, let’s go.” She turned to Mark and the student midwife and said, “Help me get her out of the tub. We need to get you to bed to start pushing. Are you ready to have a baby?” The air instantly cooled as I heard her words, and I swore I could see sparkles all over the dark bathroom. I’m going to have a baby.
Once back in bed, pushing felt right, like what I was made to do. I could only lie on my back, so with every push, I brought my leg and stump up to my chest and gave it my all. This was a full-body experience; even the muscles behind my ears were involved. After nearly an hour of pushing, the persistent ache in my leg and nerve pain in my stump made it difficult to lift them to my chest on my own. Mark straddled me from behind, lifting my torso and bringing my stump up to my chest while the student midwife stood on my right maneuvering my leg. With each push, Nancy voiced her encouragement. “That was a good one!” “You’re stretching nicely.” “Oh, I see some hair.” “Give me another one just like that.” My leg pain was nearly unbearable. It felt made of glass, and each time the student lifted it to my chest, it felt like it was going to snap off at the hip. But I knew I wouldn’t snap. Ride it out, I told myself. At the end of this there would be a baby. The contractions offered relief from my leg pain, not because the pain stopped, but simply because the contractions were more intense. I would take what relief I could get.
A Leg to Stand On Page 16