“My husband and I, we took a Bradley Method childbirth class,” Stewart says, “which is a 12-week class, pretty in-depth, and we decided we wanted to do natural, unmedicated labor.”
When she first mentioned this to her doctor, Stewart says the doctor told her to “keep an open mind” and not to “fixate on any particular way of labor and delivery.” At the time, Stewart thought the doctor didn’t want her to be disappointed if natural birth didn’t work out, but now she speculates that the doctor was always leaning toward a C-section.
At 36 weeks, the doctor suggested they induce her at 38 weeks. Stewart refused.
“From what I can tell,” she says, “it’s just common that it’s more manageable to have twins at 38 weeks because of size. Sometimes they’re concerned about size. But [my girls] were normal-sized.”
The doctor suggested 39 weeks, then 40. Finally, Stewart agreed to induce at 41 weeks if she hadn’t gone into labor by then. But it was unnecessary. At 40 weeks, three days short of her original due date, Stewart went into labor.
Stewart chose Mary Birch because it had everything she was looking for. Originally, she’d wanted to deliver at Best Start Birth Center in Hillcrest, but they don’t accept women who are pregnant with twins. Mary Birch, she says, seemed like the next best thing.
“It had the facilities, doctors on hand, and all these different classes — prenatal yoga — and since I was diagnosed high-risk because I had the twins and since I was over 35,” she says, “I just thought their whole entire focus is for women and newborns, so I’ll probably get the best care because they’ve got all the resources for that.”
Stewart had heard about other women going into the hospital prematurely and getting “strapped down” immediately. But in her natural childbirth class she’d learned that mobility helps with labor. So she and her husband didn’t go in right away.
Once they did arrive at the hospital, Stewart was four centimeters dilated. She gave the nursing staff her birth plan, which stated that she did not want any mention of pain medication.
“Thankfully, they did not offer medication. They were respectful of that. The contractions were intense,” she says, pulling her feet up onto the chair and hugging her knees. I was slowly dilating in a normal time frame. They were telling me that was normal. My doctor still was not present. She did not actually arrive until about 10:00 p.m. So up until that time, it was the labor nurse who was in communication with my doctor over the phone.”
The nurse who’d been assigned to her provided juice, watched the fetal monitors, and kept the doctor informed about any changes. But otherwise, Stewart received no help from her.
“She was there, I guess, as a resource, but she wasn’t active or in any way involved in the labor process itself,” Stewart says. “Everyone knew we were doing nonmedicated birth, but I think we just felt like if that’s the decision we made, we were just on our own. There was just no assistance getting through it.”
While it may be true that doctors call the shots, doula Dawn Thompson believes that the nurses’ lack of training in unmedicated births plays a large role as well in whether a woman gets a C-section.
“Nurses have a lot of power, and the reason they have a lot of power is because the doctors aren’t present,” Thompson says. “The nurse is the one calling the doctor to give them an update. So if the nurse is inexperienced, she might say, ‘She hasn’t changed dilation in two hours.’ She might constantly be giving the doctor a negative report. Or she might say, ‘She’s doing great. Just a little bit of change.’ In that case, then the doctor might say, ‘Okay, call me when she’s ready to push.’ The nurse absolutely has a lot of control.”
Christine Stewart believes that the main reason she ended up having a C-section was that her nurses had no training in natural childbirth.
“Ultimately, the outcome was because there was no one in the labor room who had the experience to help get the babies in position to be delivered,” she says.
By the time the doctor arrived, Stewart was fully dilated. She knew her babies were healthy, that they were both head down, in a good position, face forward. Her blood pressure was not elevated, she had no fever, and she’d been in labor for less than 24 hours. Everything was normal except that the babies were wedged in, each trying to get out first.
“There were a couple of things they asked me to try,” Stewart says, “but I never really felt like there was any truly proactive measures to say, ‘Okay, can we move the babies around? Let’s see if we can move this one up so the other one can move down.’ There was nothing hands-on.”
At 2:00 a.m., the doctor came in and said, “It’s time to meet your girls.”
“There was kind of an emotional appeal going on. I just said, ‘Okay, fine.’ It was a disappointing moment. I kind of resigned myself, like, ‘If this is what we have to do, this is what we have to do.’ I felt like crying because it just went against everything I had hoped for, everything I had planned and practiced for.”
The twins run past us now and into the room behind us, where an air mattress sits in the middle of the floor. They leap onto it and begin to jump. Stewart watches them for a moment and then turns back to me.
“I think the hospital has some standard protocols, and I think that if you don’t follow their standard protocols, they just don’t know what to do with you,” she says. “And a C-section is manageable. They know exactly how to do it, and I think at 2:30 in the morning it’s, ‘We can manage this, and then we can all go home.’”