Deconstructing "natural" redux

Waaaay back at 15 weeks gestation, I wrote about how annoyed I get with the word "natural" because it's subtly judgmental.

We hired a doula, and so, obviously, the word "natural" is going to come up. One doula that we met with and decided against kept using the phrase "committed to a natural birth" which immediately turned me off.

I mentioned to the doula that we hired when we first met that I preferred "unmedicated" to "natural" and why. She heard me, and she seemed to be down with our more pragmatic orientation. I brought it up the other night, though, when we met again because she used that same maddening phrase the other one had: "committed to a natural birth."

It really set me off that day, because for about a week now I've been having A LOT of pelvic ligament pain. It seems to be "symphysis pubis dysfunction"; big-time pain right where the two sides of the pelvis come together in the pubic bone. I feel it mostly as overall pelvic achiness (though not in my back) and as something like a searing groin pull. It hurts a lot to lift one leg (like when putting pants on), to walk, or to go from one side to the other when laying down. The crappiest part is that when it's bad, there is no pain-free position to lay down in. It takes a lot of micro-adjustment to search for a pain-free position and sometimes there just isn't one.

The other day (a few hours before the doula came over), I was reduced to tears because I desperately wanted a nap, but I just couldn't find a pain-free position. I was so afraid that I was going to have this disabling pain and no sleep for the next 3-5 weeks leading up to labor. It also seemed like a lot of the non-medical strategies I had in mind for labor and delivery (swaying movement, frequent position changes, squatting with my knees out) just weren't going to be possible. Then it occurred to me that pushing a (big) baby out through a compromised pelvic ring could seriously jack me up. Some women with severe SPD actually come apart there, and it's not easily fixed.

So, when the doula used the phrase "committed to a natural birth" I explained all this and said that I would prefer to not have an IV in my arm, a tube in my back, and a catheter in my urethra, but if my non-medical bag of tricks is limited (and I haven't slept well for weeks), then I will not hesitate to request medicine or anesthesia and breathe fire on anyone who interferes. I think she heard me. J also thinks she's gotten an accurate picture of where I'm at, and he shares my impression that she's sincerely committed to helping us have the experience we want. And she gave me some good advice for how to find a pain-free position in bed.

The SPD pain has gotten a lot better. I found a great article from a physical therapy journal that explained some exercises and everyday techniques that were shown to help. It's mostly about engaging the muscles around the pelvic girdle, like lower abs, kegels, and glutes. I've been doing the exercises and using the techniques for a couple days now, and I feel worlds better. Walking is now an exercise in mindfulness, because I consciously flex my lower abs and kegels when I do it. It's still hard to find a comfortable laying-down position, and I can only do it so many hours at a stretch. No more reading in bed. I don't lay down until I'm on the cusp of sleeping, and I get up as soon as I wake up. I'm also letting J do most of the housework.

I'm hopeful that I'll get good sleep for this final stretch and that I'll have normal or near-normal mobility for labor and delivery. I know which movements and positions to avoid. I now know from my reading that my case is late (a lot of women start with this around 20 weeks gestation) and relatively mild (most have major back pain too, and some women have to use crutches), so I'm less worried about having this long-term, especially now that I'm almost completely pain-free from using the techniques.

It's a drag not being able to do my yoga or pilates DVDs or to tackle physical tasks around the house. And I hope my OB doesn't burst my optimistic bubble when I tell her about all this at my next appointment. But, hell, if this means I need a scheduled c-section, then I couldn't give a (perfectly natural) shit.