What does your magic crystal ball say?

I actually emailed the question in the title to my therapist today, which goes to show what a rough day it is 'cause a) I don't email her much except to coordinate appointments during this crazy bi-urban time and b) I really actually emotionally sort of want her to be able to say.

The issue at hand is seeing the psychiatrist (Dr. Y.) on June 7. When I first set up this plan with my nurse and ob I was all about the birth-plan-team-yay-go-team aspects of it. But after some thought and perhaps more to the point dealing with Dr. Y's office, which is a very bureaucratic sounding place, now I've gotten into the headspace of the closeted multiple. Which I'm not, really - my parents are not informed but most everyone else in my life is about whom I care, including my boss.

Still I don't want my hospital file red-flagged with Dissociative all over it, because I am prejudiced beyond all get-out. First of all, psychiatry was a threat held over pretty well all of us as children by various people - as explicitly as "if you ever told anyone that, they would /know/ you are crazy and lock you up!" And frankly, that is true enough in my experience, that kids who act out often (or were often, when we were growing up) end up drugged and in restraints.

And even in my adult brain, I believe that many (no, not all, but many) psychiatrists became doctors because they like labels (diagnoses) and pills and solutions more than listening and questioning. Otherwise they would have become something else entirely.

Now in this context - sort of pregnancy loss/difficulty/infertility, which is what this floor specializes in - there are some mitigating factors, like they probably deal with grief a lot and there isn't really a grief pill, etc. etc. But the fear switch has been flipped and I am questioning how to handle this and even if we should handle it. My fear, at the root, is that we will get a red flag all over our file - crazy person - and then we won't be listened to or respected or something like that.

(For those of you who read this blog who aren't multiple, suffice it to say that most people (maybe you) who hear that, even within the therapeutic industry never mind just your garden-variety obstetrician, tend to liken it to someone saying "oh and I'm concerned about my prior alien abduction and the reptilian child I bore at that time, too." It can bring everything else to a halt.)

I had some of the same concerns going into our first delivery. It was a big question with our obstetrician - do we disclose our history of childhood sexual abuse, and beyond that, do we disclose that we're multiple.

In that previous case we compromised: I put on our forms that we have a history of childhood sexual abuse and that we had some post-traumatic stress disorder symptoms that we had received treatment for. That, I figured, was enough of a flag that if we, or Carl, had to say during labour that it was just too difficult, we would have given enough information for people to react appropriately. I thought it was an excellent compromise.

That was before we went through labour, of course. Now that we have I have to say that I am one hundred times more concerned - both with people being aware of the dissociation so that they can ask the right questions, but also with what the consequences of providing that information could be. (Which probably means I'll end up saying the same thing, but doesn't prevent me from worrying about it.)

And that's the thing. We weren't tv-style-spectacularliciously crazy. No one abreacted a rape (that's where someone thinks they are being raped regardless of what's really going on, a flashback on acid). But looking back I think we probably were too calm and too compliant and too shut down (that's the less spectacular, probably more common form of dissociation: gee, as a 6 year old we could be quiet during all kind of shit). I know we were when we started to ask for a c-section. I know what came out of my mouth was a teary voiced "I really want a c-section now" rather than "get the fucking doctor in here to do a c-section because I am not fucking pushing anymore!!"

And part* of that was because, to be blunt with you all my dear audience, some of us have been carefully trained over years to be calm and compliant in very awful situations particularly physical pain in the genital region. And those people were around. And where staff might expect the person they'd been talking to a few hours before about an epidural to be able to say "hey this is not going well," they weren't precisely speaking to the exact same person.

Too calm, that is, up until Emily's heart monitor went dead, which is when all fucking hell broke loose in almost every way and probably completely appropriately. I tend to focus in my memory on the consequences of that, but in fact it was just 15 minutes of hell all around because that was when the adrenaline got us to where we stretched the umbilical cord out enough to get her out, and that last 'out' is really fucking painful. Really. And eerily like certain forms of abuse as a kid, if you think about it (but don't).

So the thing is, if you get people who understand what it really is to be dissociated or multiple, they could really use that information in a very good way. Like that the harder things get, the more calm and detached we tend to get, or that abrupt silences are not necessarily concentration, or that just reminding us that we're having a baby is a good thing.

But if you get people who don't, they tend to wait for the screaming and wailing and bouncing off the walls to begin, and completely miss what's really going on - even more so than perhaps an uninformed person might. They assume that if you've been raped you'll go bugfuck, not go quiet. A little cultural mythology at work.

Add to this that the really lousy, shitty, fucking hospital staff at East General in fact followed through on the worst nightmare - my baby was dying, her tracing showed she was dying, and they did nothing, the big zero, zippo, nada, just kept telling us to push and stay with the pain and that we shouldn't be tired out or freaked out or anything. Don't even get me started on how like the abuse aspects of our childhood this is.

Remind me why I'm going for a vaginal birth again? Oh right, it's nominally better than major surgery.

Anyways so if we're going to discuss what the reality is in order to make a helpful birth plan, all this is our reality. Well that plus what you would guess from just looking at the outside of our labour experience - that we were pushing and that was killing our daughter, that we had bad advice and negligent care, that the small wee person who came out was grey and blue and it was all needles and resuscitation and monitors and trauma from there.

It doesn't seem to me to make a whole lot of sense to make a birth plan that doesn't at least mildly touch on some of this stuff.

On the other hand, it's an option. We already know what some of the hard core elements will be. Fetal heart variability? C-section, regardless of whether it's the good or the bad kind. Any failure of the baby to descent at a decent rate? C-section. Pushing for more than a half hour? C-section. Parents decide they can't handle it? C-section. Parents decide the day before they can't handle it? C-section. If the default in so many ways is c-section, is it worth opening up the can o'worms of dissociation, or should we just go with the flow?

That's what I need advice on & since I'm not seeing my therapist before the appointment I had to *gasp* email her.

But really I just want to know that it'll be okay, hence the magic crystal ball.

Shandra

* The other part is the natural birth movement, and this is the part that may be interesting to more normal people so why I've moved it down here is beyond me, except that I've mentioned it before.

But here it is: I took weeks of pre-natal classes and read tons of stuff about labour, pain management, and it was heavily propagandized towards natural delivery, or at least vaginal delivery. I had tons of information about birthing balls, music, jacuzzi tubs, colostrum, and narcotics.

In all that time no one ever mentioned the very real risks of vaginal delivery - that cerebral palsy is often caused by a lack of oxygen at birth, and that c-sections are pretty much the big tool in the toolbox to prevent that kind of damage to your child. Because it was never really about the child that much. It was about the birth experience.

There are arguments for the child, and some of these convince me that a vaginal birth is worth going for: the way the lungs are massaged, the faster recovery meaning better post-natal care by the mother, etc. etc. But these were blown way the fuck out of proportion, and I mean totally. Not just in the pre-labour propaganda, either. During the labour. I was discouraged from getting an epidural; I was encouraged to keep pushing long, long after there should have been an intervention.

The very strong message was that A Real Woman will recognize that millions and billions of children have been born through force of will, basically lying in the dirt biting on a piece of leather, and that her essential womanhood will see her through the rite of passage of this natural process. And that doctors who want to go for more sterile, medical solutions, are really a part of the patriarchy that fails to recognize the power of woman.

And frankly, I bought into that to a large extent, despite also knowing about infant (and mother) mortality rates, etc. I truly believe that if I had been better informed I would have been more forceful earlier about getting a doctor in the room. And I read so much information that I really believe there was a prejudice in the information itself.

Natural does not equal safe.