Friday, April 8, 2011

Birth guilt

It may seem odd that I'm writing about this now, seeing as my youngest - and LAST - child was born almost 3 years ago. I'm done having kids, so why is birth still such a big deal to me? Beats me, but I am. I am a proud, loud advocate for natural childbirth, attachment parenting, breastfeeding, home birthing (although I never did, and never would, do one myself....but that's another story) and a whole slew of other "granola" things about pregnancy, birth, and parenting. And once I know something valuable, I usually become passionate about it, and from there the advocacy and vocalization flows.

I have been trying to compose a blog in my head for a while now. For years, it has bothered me that so many women whine, complain, moan, and groan about the aches, pains, and discomforts of late pregnancy. I've been there and done that. I agree, late pregnancy is miserable. However, there are many young, first-time moms who want to have their baby born preterm because they are "tired of being pregnant." Its sick and sad. I have a friend, and this is the synopsis of her experiences with prematurity (and yes, I have her permission to share):

Marisa would have turned 9 yesterday. She was born at 22 weeks gestation; barely past the halfway point of the ideal 40 weeks. She was the length of a Barbie doll, and barely over a pound in weight. Marisa lived for 45 mins and died in her mother's arms. I have seen pictures of Marisa. I have seen her urn. I have seen her mother's tears. I cannot even imagine what heartache the loss of a baby is.

Morgan is Marisa's little sister, born at 24 weeks. Morgan was under 2 lbs at birth, and stopped breathing multiple times a days for months. She was in the NICU for over 3 1/2 months. Her dad had to perform CPR on her the first night she was home from the hospital. She has many lasting health and developmental/social issues. (Make no doubt about it though, she is one SMART kid!) She defied all the odds, but its still been a very rocky road in her short life.

I posted my feelings about the irritating women who think prematurity is "no big deal" on my Facebook feed the other day, asking for stories from my friends with preemies. Many of them spoke of regrets and sadness. Many of them replayed the fear and uncertainty in their minds. And those who didn't have preemies expressed their relief and gratitude over having a healthy, full-term baby. It was a heavy thread, but I am grateful I have friends who are gutsy enough to share their stories, even if they are painful and sorrowful to remember.

Yesterday, ironically, this post popped up on my wall. Again, it induced comments both of zealous agreement and irritation over this ridiculous school of thought, and of regret and sadness.

As I reflected on the comments made, it made me a bit melancholy. My heart goes out to the women who, because of circumstances out of their control, have not just regrets, but guilt, over their premature deliveries and/or less-than-ideal birth experiences. I find that really sad.

Pregnancy, birth, and motherhood is something women spend a lot of time thinking about. From the moment the line pops up on the stick, we begin "planning," dreaming, wondering, and wishing. We know what we want, and we expect it to happen. And when it doesn't, it can be heartbreaking.

My son was born just shy of 37 weeks (which is what is considered the dividing line between preterm and full-term). I went in on Monday, November 26th for a routine OB check. My due date was December 20th. My elevated blood pressure was now full-blown pre-eclampsia, and my blood sugar levels were too high due to the gestational diabetes, and I was sent straight to the hospital, and told I wasn't going home without him.. I came to find out years later that I was also quite anemic. I was sick, and getting sicker, and the best thing was to induce me. Everything happened so fast, I didn't really digest it til later.

After I got to the hospital, I was hooked up to IV's, monitors, and had my blood drawn a bazillion times. It seemed that anything they could monitor, they did. All I wanted was a healthy baby, so I went along with it all and just trusted my midwife and the nurses had it all under control. They began preliminary induction methods on Tuesday morning. 24 hours later, absolutely nothing had happened. Not even contractions. Wednesday morning, November 28th, around 9AM, they ruptured my membranes, started me on magnesium sulfate, and put in a catheter to monitor my kidneys for potential organ failure if I was to seize from the pre-eclampsia. (Which was FAR more painful than any of the contractions!) Then as the contractions picked up, I had some Stadol, and between that and the mag sulfate, that is where my memory of the rest of his birth gets hazy. And that makes me sad. I remember every detail of my girls' births vividly, but there are "chapters" of my son's that I wasn't present for. He was my first child. I am "supposed" to remember it all. But I don't. Nine and half years later, I still have friends and relatives telling me things about it that I don't have any recollection about. That is a hard pill to swallow, even now.

At birth, he was a decent size for his gestation - 6 lbs, 10 oz and 19 1/2" - but he was small by full-term standards. When he was born, he wasn't screaming. He was groggy and quiet from the cocktail of meds I was administered. Still, he was pink and adorable. Shortly after birth, his core temperature and his blood sugar both took a dip, and it was scary. Not to a level of panic, but it was scary. All I knew was that something was wrong with my baby boy. Not scary wrong, but still not right. As soon as that was under control, the jaundice set in. And one night, I couldn't wake him to nurse, and paged the nurse in sobs. On Saturday morning, his bilirubin was still too high, so after they discharged me, they informed me they wouldn't be discharging him. Fortunately, my midwife is a force to be reckoned with, put the pediatrician in her place, and got her hands on a bili blanket we could take home. The jaundice was in the "safe zone" after a few days, but it lingered for a month or more.

A few weeks after birth, he contracted RSV. Then, about once every 2-3 weeks, he'd be back at the ER or the pediatrician's office with another bout of bronchiolitis, RSV, bronchitis, or pneumonia. We ended up purchasing a nebulizer after about the 4th time we rented it because it was cheaper in the long run, and a lot less hassle. And the respiratory issues went on til he was about 18 months. He also didn't walk til he was 19 1/2 months. And we found out he had undescended testicles that caused multiple hernias.

The older and more educated I get, the more I wrestle with the "what if's." What if I had been able to carry him a few more weeks? Babies' lungs aren't fully developed until somewhere around 38 weeks. Could all the respiratory issues have been prevented if I had just "done more right" and been able to carry him even a week or two longer? A boy's intestines and testicles all live inside the same abdominal cavity until the end when the testicles drop and the abdominal cavity closes around the intestines. (His intestines dropped into the area where the testicles are supposed to go, which blocked the testicles from descending, and caused the hernias.) If I'd been able to carry him longer, would his body have closed correctly and prevented the hernias from forming? And without the hernias, would he have walked sooner? If I could have prevented my elevated blood pressure from developing into pre-eclampsia, could I have avoided the magnesium sulfate that caused me to be so out of it that I don't remember half of his birth? These are the questions I am plagued with. I don't think about them all the time, but when I do, its overwhelming, and it causes regrets and guilt over not being able to carry him longer. Because I know it would have made a difference.

And for those with preemies - especially micro-preemies - its a lot worse. The guilt must be so much heavier.

But for just about every mother, for just about every birth, there is some guilt. And oftentimes, its because of things we cannot control. Its over circumstances that we never saw coming and couldn't do anything about. We build up our hopes, dreams, and expectations, and when it doesn't work out, its sad. Its a let-down. Its a huge blow. And instead of just accepting it as doing the best we could with what we were dealt, we feel remorse, and then guilt. We always feel like, this is my child, and it was my job to do everything right so that it would all turn out alright. If breastfeeding didn't work out, there is guilt. If a woman ended up with a c-section, there is guilt. If her baby isn't born at full-term, there is guilt. If anything the mother built up in her mind doesn't happen as according to plan, there is guilt. It breaks my heart. It really does.

I don't know what the answer is. Usually I offer some sort of advice or encouragement at the end of my blogs, but I feel like this one may not be quite as full-circle as my other ones. But here is what helps me work through it all.

I look at my son. I remember everything we've been through (which he doesn't even remember). I realize that, through all of it, I have done everything I could possibly do for him. I fought for him. I cried for him. I worked hard to make things right for him. I can't change the past, but in the end, it doesn't really matter. My son is handsome. He's smart. He's funny, and courageous, and sweet, and most importantly, he's healthy and happy. And he's mine. He is mine! I love him, and he loves me, and nothing else really matters.


Anonymous said...

I suppose I have a different type of guilt, I feel like I can't give CJ enough of... I don't know... everything? Sometimes I feel like I chose medication over breastfeeding, even though the pediatrician I had for 21 years (amazing woman I completely trust) said that "a stable mother is more important than breast milk." I see my sister giving my nephew all the natural stuff - organic, cloth diapers, home-made baby food, the whole bit. Sometimes I wish I could do that. As a single parent I can't afford organic stuff, so I do what I can to get the best lunch meat I can, and then splurge a bit on hard salami from the deli.
So my guilt is different.
CJ also has Asperger's, and I felt horribly guilty that I was so angry at his situation... there's a post in the blog somewhere, but I can't remember where, it's been a while.

Every good parent has guilt about something. We want to give our kids everything, and want them to succeed. It hurts us when something bad happens, and we work hard to get them ready for the world (or try to change the world for the better).

All we can do is prepare our kids for the future, the rest is up to them.

Megan said...

I completely agree with you! The guilt doesn't just start and end with pregnancy and birth, and compared to many people, I've got it pretty easy with my kids. Still, I cried when I heard my son needed supplementary help at school with math (he is way below grade level), and there is something (or many things) on a daily basis that make me question and feel like I'm just not doing enough. But at the end of the day, we can only do what is in our realm to do. Some circumstances are simply out of our hands, and we have to make the best with what we've got. I think questioning and striving are healthy, questioning to the point of beating ourselves up isn't.