Falling Forward, Falling Back: What Nobody Wants to Talk About

“The Women’s Health Initiative found that more than 34% of women in the U.S. with a uterus had significant cystocele (bladder prolapse). The figure of 50% of all women who have given birth (experiencing some form of prolapse) is published widely in gynecologic literature. These statistics show that prolapse occurs far more often than any other women’s health disorder.” – Christine Kent

Let’s put it right out there: I have a postpartum bladder prolapse. Three vaginal births and a 14 inch head coming down the birth canal last month did the trick. A month-long chronic cough also helped pave the way back in January. Don’t get me wrong: Life is good, nonetheless. I’m one of the lucky women with no symptoms and a positive prognosis for healing. And, there have been challenges. The chronic, debilitating cough. The whole family sick again right after birth (including my four-day old newborn). Then there was the stomach bug (mine) in postpartum week three. Then there was another cold this past week (week four). Oh, and of course there was the high blood pressure news delivered up by my midwife alongside the newly acquired retroverted (tipped) uterus revelation. (Perhaps that is why those afterbirth pains were so excruciating?) Oh, and yes, the bladder prolapse. Did I mention the bladder prolapse?

Wow. Did you say prolapse? Yes: “a slipping forward or down of one of the parts or organs of the body.” (Although it actually isn’t a falling forward but rather a falling backwards). WHAT? There was dismay. Confusion. Distress. Even despair. I cried. Was my body failing me? There was worry. My husband tried to reassure me (based on the midwives’ assessment) that prolapse after a third birth is ‘normal.’ (But really, death and disease are ‘normal’ too and that doesn’t make it any easier, right?). Luckily, my midwife handed up sound advice: “Worrying is the worst thing you can do. You are sending negative energy to the very part of the body you are trying to heal.”

But wait: Why hadn’t I heard of this? Why was nobody talking about this? I vaguely recall hearing of prolapse occurring in older women. But 50% of all postpartum women? Me? According to the NAFC, one in five women will go through prolapse surgery in her lifetime. One in five?! NAFC also estimates that the number of women undergoing surgery to treat pelvic organ prolapse will increase by 48 percent between 2010 and 2050. Furthermore, 27 percent will have repeat surgery. And so it appears I’ve stumbled upon a quintessential women’s issue. A motherhood issue.

The emotions accompanying the reality of this experience swing all over the map. Two things I know as a constant truth: This is hard. And, this merits practice. This is about my body, our bodies. This is about shedding light on what wants to remain in the dark: personally and culturally. This is the very literal expression of depth, right here in the organs at the base of the body. First, there is the uncomfortable process of acceptance. Then, there is the confusion about what to do. There is the conflicting information. The surprising revelations. “Kegels are the only thing that will make it better,” my midwife says. But wait! The kegel actually might not work? In fact, it can make prolapse worse? But wait! What do you mean the field of gynaecology is based on a faulty 500-year-old understanding of female anatomy? Wait! Squatting regularly like our ancestors did helps? Oh, and carrying heavy loads on our heads like indigenous women serves the feminine lumbar spinal curve which keeps organs in their proper place? Oh, sitting on couches can make our pelvic muscles weak?

After several weeks of mulling, inner work, research and a trip to a physical therapist, I come away with several insights that I hope will serve the women and mothers reading:

1. Knowing our own bodies is essential. This shift in my body has elucidated how little I really know, and how much I take for granted. Each woman’s body is different. We need to find out for ourselves what is true of our own experiences. Believing everything we are told about our bodies doesn’t always serve us. Cultural patterns of disconnection and dissociation from the base of our bodies fuels bodily complications.

2. It is important to tend to the deeper emotions embedded in bodily experience. Our bodies are home to long-held psycho-emotional patterns and habits, either our own or inherited genetically. Birth too comes with its own imprints and associated bodily ‘traumas,’ even for peaceful, non-complicated births. Prolapse has pointed me to the ways in which my own body has been adversely affected as a result of my three births: pelvic bones out of alignment, tailbone tipped to the side, tissues rubbery from stress…

3. Self-reliance and trying to “hold it all together” is a bust. Tucking the tailbone, sucking in the stomach muscles, overly contracting the pelvic floor and trying to “hold it all together” doesn’t work. One vein of research addressing prolapse points me to the practice of softening the belly, deepening the breath, loosening the tailbone, and reconnecting with the natural feminine curve of the lumbar spine. Apparently the force of our deep breath coupled with good posture serves to maintain the proper position of our organs. As Christine Kent says, “Part of the graceful curvature that makes us women is the pronounced curvature of our lumbar or lower back spine. It is this curvature that allows our organs to stay to the front.” Instead of trying to “pull in,” stay “strong,” or “hold it together,” we can instead let the belly relax (postpartum pooch and all), be okay with ‘softness,’ and let go of trying to overly control situations in our lives. We can practice a relaxed trust in the female body’s natural alignment, even when that alignment is out of balance and things are asunder.

4. “Letting go” is key. My physical therapist tells me to ditch the kegels. “You don’t need more strength here. If you contract the pelvic floor muscles too much you will shorten them and eventually weaken them.” And – you guessed it: this can tip our organs out of place. “What you need is release.” We need to remember lengthening, letting go, releasing and relaxing, just as much as we are told to practice the contracting strengthening exercises. (Of course!) Kara sums it up well: “It’s easy to see how we heard Dr. Kegel telling us to squeeze, but we ignored that bit about releasing…who among us has an easy time “letting go?” That, right there, is what childbirth is all about: letting our body open up and let go. Open up and let go? Huh, what? No, letting go just doesn’t come naturally to us in our society. We can clench and squeeze and get nice and tightly wound, but ask us to let go?…The exercise of letting go is always a good one to practice in any aspect of life.” 

The experience has ultimately led me to ask essential questions about my body and my broader existence. What is true of my own body and experience? What habits need tending so that I can be healthy into my later years? What do I need? Where do I need more support? Where do I need more strength? What is out of alignment? Where do I need to let go?

Once again, motherhood and birth deliver life-altering challenges that ultimately move me to new perspectives and make it impossible to ignore or dismiss the deeper layers of my human condition.

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The Other Side: Paying Homage to Life

The moments after birth: I call it ‘being on the other side.’ Giving birth is one of those moments in life when there is a clear before and after – the continuum of life as it is known is profoundly interrupted. There is a giant pause in the experience of time’s passage just after. Time slows down. Priorities shift. A new normal slowly emerges that can’t fully be imagined before. There is the anticipation, the waiting and wondering, the anxious uncertainly (for me) about labor’s when and how… And then, all of a sudden, you are on the other side. Birth happens. Baby is here. A mystery in the form of a new child has come into the light. And, despite my wish for time to stop just for a moment, life moves on.

There is a lesson herein for me about savoring and acknowledging life’s great transitional moments. Something dramatic has happened. A new life has come into the world and I am changed by it. For these days and weeks immediately following baby’s arrival, I am steeped in a slow wonderment. Life is centered around this tiny being and my immediate present moment home, yet at the same time there is the largeness of a full lifetime perspective. Memories of my own childhood flash. Family stories come to the fore. My mother tells me of my own birth. I feel the presence of old friends. I look at my children and wonder about their future.

The lesson of this particular time has to do with a practiced awareness that there is only this one lifetime in this body and that there is no repeating any moment. Birth has happened and there is no repeating it. Baby and children grow. My son will only be a newborn for this short, precious time. We age. We change. The trouble is that life can sweep us up in a flow so fast that we can forget the sacred markers of being alive. Like signposts on a journey, they are there to be greeted and tended to, but too often the pace of life prevents us from fully slowing down to steep ourselves in awe and gratitude at the passage of time and the blessings bestowed. So how to mark this time? Savor. Acknowledge life’s great transitions.

The experience of pregnancy and birth offers the opportunity to mark a threshold for both baby and mother (and family). Crossing from one side to another in any life transition offers the opportunity to pause, reflect and wonder. We can pay homage to what has been while also gracefully entering into the newness of what is becoming. Most importantly, we can pay homage to life itself…

Birth: Entrance into This Crazy World of Light

A slow, uneventful early labor leaves me wondering whether he really is coming. I clean, burn sage, take a walk, make dinner, call my mom and tell her to come, help with bedtime (all between mild contractions). I roll into active labor at 7:25 pm with back to back contractions, dipping into the timeless realm of touch and go pain, blurred vision, doubling over, calling for help, shaking wondering and awe. I roll into the realm of surrendering control and I hear myself say how much I hate it. Modesty slowly goes out the window. The midwives have arrived and now I’m fully in the dance of dilation. Not “contracting” but rather expanding – and I try to meditate on the star-gazer lilies I’ve bought for this moment. “All you have to do is float…” says the midwife. “You don’t have to do anything…” But there is no floating, only the shaky handing over of myself to one moment and then the next. There is no floating, only the raw practice of trusting a process that is greater than myself.

I move to the tub for relief and finally feel the urge to push. Has it been one hour or five? I have no idea. I only know that I don’t want to be alone and I don’t care anymore about words. Chris tells me to “stay with it” and I hear myself say “I have no choice but to stay with it.” There is no getting out. No escaping. No distraction. “The only way out is in,” I hear my yoga teacher’s voice as a fuzzy line of background noise. The only way out is in.

It is one of those moments in life where the rawness of physical pain and discomfort serves as an edge upon which I serve myself up to a force greater than myself. I’m terrified of I know not what – except perhaps the searing truth that this passage of bringing new life is really happening and I’m responsible somehow for overcoming exhaustion and doubt and mustering the strength and wilfulness to push a baby down and out. Its true: “you don’t have to do anything…” All you have to do is trust that your body was made for this – AND: you can’t just ‘give up’ either. At the very least the moment requires presence. At the least, the moment requires a square confrontation with the reality of what is arising, particularly when the reality doesn’t match up with one’s preferences…

I’m so, so tired and its one wave of pressure after another. I have no idea where to go or how even to move with a head like a bowling ball two centimeters away from crowning. All I know is I have to get him out. I’m dripping sweat now and standing over my bed. I see stars and beg for rest, even though I know that the final moment of reckoning is upon me like a pressure cooker. This is when I have to dig deep and find a reservoir of strength that I’ve only tapped into twice before with my other births: A woman’s gritty wilfulness to make something happen that feels impossible. For me, this is no easy birth. It is raw, uncomfortable, painful. There is no bliss, no rest, no peaceful hypnobirthing place to relax into. For me, birth is a series of deep, wild screams of disbelief coupled with absolute, unfiltered awe in the face of great mystery. How the hell does all this work? How the hell do women do it? So normal, no big deal – and so literally transfiguring at the same time.

And then: he’s out – blue, sticky body on my chest, loud cries and the midwife comforts him by saying “You only have to do this part once…” And in that moment I feel again my own birth – squeezing into life through a narrow passage, “contracting” into form… And I simultaneously feel my death, which perhaps will take me into the opposite realm of expansion. And I feel back to the burst of my waters breaking earlier – a crackling preparation for baby’s entrance – and I wonder if somehow we come via darkness and water into this crazy world of light and go too from this world into a different light?

All this passes through me as we welcome my son – and really all that matters now is the skin touching skin, and the awe-filled reminder that being in this body is a blessing unlike any other. Sensation! Touch! Love! Pain and pleasure blur into one of the most glorious moments of Grace…

A Poem for Birth

Birth Blessing: A Poem by Natalie Evans – shared at my sister-in-law’s Blessingway last weekend

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Close your eyes and breathe deep

Breathe in peace, breathe out pain

Imagine your feet

Toes curling into dirt

Think of yourself as rooted

Think of your place in the earth

How did you come to be here?

Through generations of women named-

A maternal lineage that brought you to this place

Think of their birth stories

What you know, what you believe to be true

Realize that their births carry deep wisdom

Some may carry the memory of joy and transcendence

Each birth is a powerful experience

Each birth traces down to you.

Just as you pass this knowledge on to your baby,

Understand that your birth is your own.

It will be different from all others

Like the swirls in your thumb

Your birth will have a unique pattern

Unfolding with each contraction

Rising and falling like a newborn’s chest

This birth belongs to you

This birth is an opening

This birth is the end and a beginning…

Tree of Life

Braeden’s Placenta Print, May 24th, 2012

“She gives birth to a baby who is born attached to… something else. This something is a part of her baby, but completely different. She looks at it, and sees in its shape the same roots that burrow into the ground and grow into strong trees. She sees the roots in the veins on its surface, the trunk of the tree in its umbilical cord, and the life-giving fruit in her newborn infant.

Is it now so difficult to imagine how she would see a connection with new life in the image of the tree?”

– Jodi Selander

The Gift of Waiting

Written May 23rd, the day before my son’s birth.

Waiting. Still waiting. Almost 42 weeks pregnant and still waiting. The days tick by and I try to wait as if it’s “No Big Deal.” I recite mantras like “This is all normal. Waiting isn’t a problem. Baby is fine. Women the world over go “overdue” and there’s nothing to worry about.” Birth is life and it happens in millions of ways every day: so what’s the hang up? Why all the angst and impatience and anxiety? What’s the big deal?

A friend wrote to me that “Birth is everywhere, it is like breath…” and I begin to settle in to the lessons being served up in these late stage moments of pregnancy. I even have time to look up the etymology of the word pregnant and find it fascinating that before pregnant meant ‘with child’ it actually meant something akin to “full of meaning” (c. 1400). With this in mind I feel the “Big Deal” aspect of this journey, being blown over by how taken to my edges this process of gestation allows and invites. Simultaneously full of meaning and also so normal, pregnancy and birth is as integrated to life as breath is. Yet just when I thought I’d crossed into the realm of the Stoic, Patient Waiter, new layers of complaint emerge. My feet! My back! But But But… Really? Another day of this exhaustion? Just when I think I can’t handle one more day, five more days pass. It is a continual re-frame of what feels possible to withhold.

And then: A call from a friend who just gave birth reminds me to savor the experience. She shares her unexpected grief at the letting go of this phase and encourages me to “Cherish this.” “Savor this.” “Remember this.” – and I’m thinking “are you kidding?” But the deeper layer is “Of course!” While its true I feel done, over-cooked, hot, big, ready to move through an impending transition, ready for a great release, I also feel the lesson of savoring and cherishing what just IS. I have the rest of my life to be not pregnant. I’m reminded of slowing down, appreciating the phase of life I’m in, and remembering the great truth of impermanence. So why not enjoy what’s being served up?

Nonetheless, I still feel ready to be on the other side. I feel the futility of all my efforts to speed up a process beyond my control. Here I enter into my resistance to the unknown. I’m ushered into the mystery of this process, as well as my desire to probe and know. I feel the ever-present themes of invitation to surrender, let go of control, trust… An invitation to practice gratitude for the gifts embedded in liminal spaces, the gift of waiting for something and the vast spaces opened up if you can stay with the waiting without freaking out (which I have done, by the way – freaking out, that is).

Just when I think my practice in waiting is only about cultivating patience, deepening in my capacity to trust, staying rooted in the present moment (and waiting on the biology of labor to kick in), the final days usher me into a realm where I know I’m being worked on in mysterious ways. Things begin to look different. Time slows down. It strikes me that readiness for birth isn’t confined to having the diapers stacked and the baby clothes washed. Instead, this baby offers us a gift in the wait. The dust is kicked up. Routines are disrupted. There are new things to consider. Perhaps baby knows there is yet work to be done, and not the nesting kind – but rather the existential kind. All of the sudden my partner and I are made aware of old cobwebs that need to be cleared, and this week of eternity transforms into a daily unfolding of revelations about self and past. New limits are revealed. Buried memories resurface. Birth stories are told and re-told. Our own family experiences are closer in our awareness and we consider our own experiences of being first-born and second born. We feel ourselves in a long line of emotional and genetic ancestral patterning, generational knots to be untied or left alone. What do we want to do differently this time? What patterns do we need to shift? What growth is required of us in order to foster deep peace, health, sanity and love? We consider our own preparedness to parent again. Are we really ready? What does ready mean? The waiting offers a lull in the rush of routine, a brief dip into a valley where we can see the big picture of our lifetimes from new vantage points.

All of this passes before us as we sort out old karma in preparation for a new life.  Each day affords an eternity of possibilities. This time reminds us that while birth is indeed as ordinary as breath, it is also a reflection of unique and precious human life, each with an intricate weaving of story and history.  This is the gift of waiting. Birth impending. Pregnant. Full of meaning, if we are available to it.

And Now: Enter the Birth Terrors

How ironic that I write this on the heels of my last post, where I found myself in a place of acceptance amidst the uncertainties of Birth. And now, enter the Birth Terrors. It is the second night where I am awake and restless at the 4 o’clock hour. Passing through a veil of crankiness, exhaustion, irritability, profound restlessness, agitation, frustration, I think “I’m just tired” as I thrash my way into sleep. Today’s wake up ushers me directly into the unexpected jaws of terror: a literal cold sweat, shortness of breath, vice clamp around my heart and I can’t seem to get out. My body is shaking and I enter into a giant ‘HOLY SHIT’ moment when I feel acutely how much fear I have yet to metabolize about Birth. In the same vein there is gratitude that I’m feeling this at all (and an understanding that this is one of the threads that needs to be experienced and metabolized before baby will come).

All of this utterly blindsides me. Out of nowhere, and yet obviously living in the deep crevices of my body lies the trauma and fear from the last time I gave birth (and perhaps too the trauma and fear from my own 42 hour labor entrance into the world when I was stuck in my own mother’s birth canal). What if I get STUCK again? What if I can’t get the baby out? Intense claustrophobia propels me to run to the open window in search of space. I trip outside at 4:50am thinking “why don’t people tell you all this is wound up in Birth? Why don’t more people talk about these things?” I do laps, shaking, around my neighborhood block, crescent moon trying to shine through into my awareness. Thank God for the birds singing. They call me away from my terror as I catch my breath.

I didn’t know this lived in me. I didn’t know this fear of stuckness and claustrophobia was still alive in my experience. How fascinating that these forces of emotion and cellular memory go underground until they are triggered again.

Returning to the status quo of my baseline sanity: I’m reminded that all I have to do is just feel my way through this. We feel what we are letting go of. Feeling equals metabolizing. Burning up. Will this memory of stuckness serve me? Yes, if I feel into it again, awful as it is, and move through it.

I find myself wondering why on earth I’ve chosen to do this again? 40 plus weeks pregnant ushers in my first moments of doubt and dread. All of this feels normal and yet all of this feels vastly under attended to somehow (Meaning: there are so many emotional, physical, and psychological thresholds we as women bump up against and move through around Birth and perhaps there is too little weight placed here. Do we fully acknowledge the vast spectrum of emotions that can emerge? Do we talk enough about it?) All of the sudden we are in it, past it, forgetting the intensity of it…until we walk into an unexpected pocket of remembrance.

40 Weeks Pregnant: A Thin Veil Between Worlds

After the birth of my first son, my midwife said to me, “Don’t you think ushering new life is going to bring you to your knees? It brings me to my knees every time…

We’d been talking about my struggle for several hours to push Rowan out into the world, and how the pain literally brought me to my knees, over and over again for four hours of pushing in the middle of the night. Those brutal hours from 1:30 to 5:30am were unlike any other: A threshold, a portal, an unmistakable glimpse into the vast power of the mystery that is life – beyond my control, vexing yet awe-inspiring, bringing me to my knees in a gesture of humility so all-consuming it took my breath away again and again. There was no way out but in. No turning away or back. The threshold had to be crossed.

And here I am again: standing at the gateway to Birth, which is akin to inhabiting a thin veil between worlds. The word ‘liminal’ comes to mind: Of or relating to a transitional or initial stage of a process, occupying a position at, or on both sides of, a boundary or threshold. The space in between. I rest in this liminal realm where I’m called this time to lay down the desire to know what ultimately can’t be known. Already I’m being taken to my knees: reminded by the powers that be that there is nothing to do other than trust a process far greater than oneself. All I have to do is be available, surrender… And yet, here I am, spinning conjectures and betting odds on when and how baby will come…

It strikes me that instead of inhabiting the familiar world of intellectual odd-betting and grasping for what is “known,” being 40 plus weeks pregnant is a time to settle into the mystery of liminality. We can choose to hang in the spaces in between. We can swing freely in the balance of the inner and outer, the inside world and outside…much like the womb contrasted by the vast space of everything else. We can walk the thin lines between darkness and light, mystery and the known, fullness and release, contraction and expansion. Even if not pregnant with new life, perhaps there is a lesson here that we can all access, for the womb is our origin and we have all made this journey from breathing water to breathing air, most of us having hung upside down in our mothers even as the rest of the world was so-called “right side up.”

For this brief moment in time, a pregnant woman holds the sublime reminder of a passageway between worlds. She is the circle of yin and yang holding a small universe of life inside. Herein lies a blueprint for living: remember the mystery from which you sprang and to which you will return. Learn to bask in the not-knowing. Trust forces at work beyond your control and let yourself be humbled by what it can take to bring new life onto this Earth. Relinquish all desires to know and control. Only then, resting gracefully in the liminal realm of mystery, will you enter into the fertile plains of free-flowing unbridled creative synergy: that which truly does propel forth new life and make the world go ’round…