Cadence’s Birth Story
The day before labor began, I laid mulch around the sunflower seedlings and the raspberries in the raised beds. It was chilly out, despite being late June. I felt exhausted after gardening, but also satisfied for having done something physical. I spent most of the rest of the day watching British Bakeoff. "Bit of a rough day," I wrote in my journal. "Really tired and pretty physically uncomfortable. Grateful that pregnancy is almost over." I took a bath before bed, and then Duncan and I did a Spinning Babies exercise called The Three Sisters of Balance. For a few hours, I slept well.
I went into labor at about 1:30AM on June 20th, 2023. Right on time: June 20th was exactly my due date.
I called Duncan to my room once I was sure I’d had a few strong contractions. I was feeling pretty calm, but I was also shaking off and on. I wanted him to hold my hand.
I’ve heard that shaking is a common response to labor hormones. It was a big part of the labor experience for me, especially in early labor. The contractions that were accompanied by shaking felt like “hormone dumps” to me, and I described them that way to Duncan. They were more satisfying than the other contractions. I didn't like the shaking; it's difficult to relax through a contraction when you can't control your muscles. But I did like the psychological changes that went with it. I felt like I was moving into a different state of mind, like I’d taken a drug.
What state of mind did they move me into? Words I associate with the state include: Raw, toppled, stripped away, naked, open, riding, receptive, internal, trembling, alive, real, body-focused, quiet, present, and timeless. In that state, I wanted to be near the ground, to touch the floor with my hands and feel its stability. Everything outside of me became dim in my awareness as I let myself be taken by the waves. I barely felt time passing; there was only what was happening inside of me right then. I've never been more acutely aware of my animal instincts.
I felt a little bit like I’d been poisoned, but I wasn’t scared. I felt ready for it.
I asked Duncan to call our doula, Shalin, after about an hour and a half. She’d said it might take her an hour to get to our house, and I thought if things continued to progress as they had been, I’d probably want her support and guidance after another hour. She arrived at 3:50AM.
I used several positions early that morning. Some Shalin suggested, some were inspired by her suggestions, and some were spontaneous responses to what I was feeling. I spent time on hands and knees, sometimes tilting my pelvis or moving my torso in big circles. Sometimes I sat on the toilet, usually with a robe worn backward to keep me warm. For a while I sat on an exercise ball while leaning forward over my desk. I walked up and down the stairs sideways a few times, did a little bit of lunging in place with one foot up on the ottoman, walked around doing abdominal lift-and-tucks during contractions, and danced to music in my bedroom. But I think I spent the majority of my time kneeling and leaning forward over either an exercise ball, the ottoman, or a bean bag.
My focus was mainly on staying relaxed and integrating the sensations. I especially kept my hands, jaw, face, and pelvic floor relaxed. I breathed deeply and moaned to release the tension. Rain and thunder sounds usually calm me, so I kept those on in the background when I wasn’t playing music. I used mantras and visualization to guide my mind in the direction my physiology seemed to suggest. Aided by the endorphins and hormones, I deliberately put myself into a hypnotic state, moving deeper or nearer the surface as circumstances required, and I stayed that way for all 18hrs of labor.
I threw up at 5:37. It was quite a lot of liquid.
As the sun rose, my contractions started to space out. They had been about four minutes apart, lasting for one minute, but then they spread out to about eight minutes apart. I started to get a little worried that labor was going to stop again, like it had a week and a half before. I’d been through a lot already, and I would have found that pretty discouraging. There was still no bloody show when I went to the bathroom, and very little mucus. I was also feeling more “normal”, not so deep in labor space.
Shalin texted my midwife, Mackenzie, who suggested I take 50mg of benadryl and get some rest if possible. I took the benadryl and tried to rest, but lying on my side made contractions feel much more intense.
By 8AM I was shaking again, throwing up more, and losing a lot of mucus plug. Maybe this is really happening after all, I thought. I went for a short walk outside on the deck, where I paused a few times to lean against a wall or railing during a contraction. Duncan and Shalin walked beside me, ready to offer physical support, or a barf bag, if I needed help.
By 9:20 I’d thrown up again. Duncan kept me well supplied with coconut water, juice, and bone broth, but I couldn’t seem to keep much liquid down at all. Mackenzie decided to come over a bit early to rehydrate me with IV fluids.
I’d been paying a lot of attention to Cadence’s movements; they tended to move quite a bit just after contractions, as though they were stretching or shoving themselves around. I said multiple times during labor that I thought Cadence was doing most of the work. At 10:12 I had a contraction that I said felt “different”. I don’t remember this in detail, but I told Shalin that it felt like Cadence was “pushing through”. I think I felt them move to a different position this time, and there was more downward pressure for the rest of labor after this contraction.
Mackenzie arrived around 10:30. She listened to Cadence’s heartbeat with a doppler, and said they sounded good. She checked my blood pressure, temperature, and heart rate, and told me all of those readings were fine as well. I was feeling pretty ragged and depleted by this point, though.
She waited for the end of a contraction, then placed the IV while I was leaning forward over the ottoman. The IV itself wasn’t a major part of my experience, though it was occasionally a little inconvenient. She ran a second bag of IV fluids at 11:52, and by that time I was feeling much better. I definitely prefer to labor while hydrated. Being dehydrated felt sharp and strained. Being hydrated felt plump and expansive. I was stronger after the IV fluids.
At 12:25, Mackenzie asked if I wanted a cervical exam. I was still struggling with the possibility that this was not “real labor”—I didn't know how to orient to the experience, and it's hard for me to let go while disoriented—so I said yes. To my surprise, the exam didn't hurt at all. I was 7cm dilated and 90% effaced, and Cadence was at +1 station. I found that really encouraging! Sure sounded like real labor to me.
At 1PM, we decided it was time to start filling the birthing tub. We planned to set it up in my bedroom, so I moved to the living room while Mackenzie’s assistant Jaime began to inflate it.
I remember Shalin saying, “This is transition,” while Jaime was inflating the tub. The contraction sensations were intense, but they felt totally continuous with the earlier parts of labor. I had a harder time integrating them while the tub was inflating, because the sound of the air pump was pretty awful for me. Almost like a leaf blower. I didn’t consider it to be “too much” from within my tranced-out state, though, and told Duncan and Shalin that I was fine. But Duncan brought me ear muffs anyway, and things really were a lot easier after that.
The second bag of IV fluids finished running around 2PM, and it was time to go to the tub. Shalin and Mackenzie wanted me to use the bathroom first, but getting to and sitting on the toilet did not sound any good at all to me. I asked if I could just pee in the birth tub, and they said yes, people do that all the time and it’s fine. So I crawled on hands and knees toward the tub, pausing in the middle to ride through a contraction in child’s pose.
The support of the water was an immense relief. I felt far more comfortable with half of my body floating. I think it made an especially big difference between contractions. I found it easier to rest and relax in the water.
I spent a while leaning forward over the side of the tub, often holding Duncan’s hand. It was comfortable for me, but during a fetal heart rate check, Mackenzie told me that it was not comfortable for Cadence. The birth tub included a little seat on the other side, so I crawled over to it and sat upright. In the new position, Cadence sounded fine. I made the seat my new home base for the rest of labor.
Around 3:30PM, something started to shift for me. I don’t know what sensations tipped me off, but emotionally, I began to orient to the experience differently: Rather than completely surrendering into the timeless space of endurance, I think I recognized that I was entering “the home stretch”. I wanted to mark the shift, and perhaps to communicate with Cadence about it as well, so I asked Duncan to play Cadence’s birthday song: “Come Alive” from The Greatest Showman.
I rarely felt very connected to Cadence as a proto-person when they were in the womb. I was not in love with them already, the way many gestational parents are during pregnancy. But at some point in second trimester, I was listening to “Come Alive”, and it hit me hard that this is how I feel about the fetus, that this is what I want for them and why I was drawn to creating a human in the first place.
It’s what I want for everyone. It’s the kind of love that I feel for everyone. It’s the impact I want to have. I want people to somehow move beyond whatever obstacles prevent them from fully experiencing all the awesome things that constantly surround them. To be their full selves in intimate contact with the world. The ability to experience is why I care so much about humanity.
Come alive, come alive
Go and light your light, let it burn so bright
Reaching up to the sky
And it’s open wide, you’re electrified
And the world becomes a fantasy
And you’re more than you could ever be
’Cause you’re dreaming with your eyes wide open
And you know you can’t go back again
To the world that you were living in
’Cause you’re dreaming with your eyes wide open
So that’s how I wanted to welcome Cadence to Earth: with a prayer that when they left the darkness and safety of the womb, they would begin a life of unbridled wonder.
I felt all of that in the song as I listened to it, and as, between contractions, I was able to sing along.
The contractions were so intense, and even in the tub, the pain of them never completely let up in between. I felt a little bit betrayed; multiple books and videos about labor had led me to believe that the discomfort would stop between the contractions.
That sense of betrayal conflicted with my meditative strategies. For a few minutes, I was more aware of time, and I started to worry. I thought to myself, I can’t keep doing this.
Fortunately I’d prepared for exactly that thought. I recognized it as a sign of transition while it was happening, and I told my support team about it. “It was just a thought,” I said, trying to reassure them that it had been fleeting, and I was all right. Letting go of it moved me back toward the calm and relaxed state of labor space.
My body began to push spontaneously at about 4:30PM. Mackenzie said she heard it in my voice: Mixed in with the moans, I started making a sound that was more like a growl.
By 5:30, my contractions had spaced out again. They were eight minutes apart. I still felt the pushing when they happened, but the times in between had become comfortable, and I was really enjoying my rest.
Mackenzie alerted me that things might not be moving in the direction I wanted. She offered me a couple options: I could take a cotton root tincture, which might increase the pace of the contractions on its own. Or, I could get out of the tub, maybe go for a short walk on the deck, to try to pick things back up again.
I definitely did not want to get out of the tub, so I asked for the cotton root tincture. However, by the time the tincture was ready, I’d changed my mind. I wanted to try stimulating contractions myself without leaving the tub, just by moving around differently. I used several tactics, including alternating lunges, pelvic tilts, and lifting my body out of the water. Basically, I just needed to make myself the right kind of uncomfortable as soon as I felt ready.
It worked! I rested for what felt like “just as much time as I needed” after each contraction, and then I began moving again to bring on another. Although the contractions seemed to begin as a result of my own decisions, Mackenzie said my pace was just perfect not long afterward.
I used my hand to touch inside my vagina, to see what I could feel. What I felt was a taut little water balloon very close to the opening: The amniotic sac was still intact. I re-checked after every couple contractions, to see if I could perceive any progress, but I could not.
I began to feel frustrated. I was working so hard, but as far as I could tell, nothing much was happening. I didn’t feel Cadence moving as much as they had earlier in labor, either. I really wanted my water to break.
This period of yearning for change was probably the most uncomfortable part of labor for me. The raw physical sensations weren't any more extreme, but emotionally, I felt almost as if I were in an argument with my body. Perhaps if I put more energy into pushing, I thought, then my water will finally break, and things will move again. But it didn't break, not then. I felt a little stuck.
At 6:02, Mackenzie asked whether I felt like I was pushing against my body, or with it. I told her I thought I was pushing with my body, but I wasn’t completely sure, because the sensations were all new to me, and I was frustrated. I asked for another cervical exam. I wondered if I might be pushing against my cervix, in which case perhaps I should try to hold off.
But Mackenzie confirmed that I was completely dilated. To me, that meant that everything was fine, and I just needed to be patient.
I began speaking then to Cadence, and a little bit to myself. Not always in words, and usually not out loud. I reminded myself that birth happens when both of us are ready, that I had no interest in rushing them, and that we’re safe to continue like this for a long time if we need to. “It’s ok to take your time,” I murmured. “Take all the time you need. I’ll be here when you’re ready.” It helped me so much. After that, I felt calm and patient again.
But I wanted to encourage them as well, to invite them out. I told them the thing that’s kept me moving through the roughest patches in my own life: “It’s hard out here,” I said, “but it’s worth it.” There are fireflies out here, and thunderstorms, and poetry. Even though it hurts, you have to live to see them.
At 6:34PM, my water broke as I pushed. It felt like a little pop, like squeezing a water balloon until it burst. I could feel Cadence helping out again after that, moving themselves around and down after every contraction.
My pushes felt clearly productive for the rest of labor. Cadence moved back up a little after each contraction, but each contraction brought them farther down than the last. I could feel their head with my hand at 6:43.
Duncan, who had been awake and almost constantly attentive to me for many hours, was napping on the bed near the tub. I noticed, while vocalizing quite loudly through a contraction, that he was snoring. “How is he sleeping through this?” I asked in the trough of the wave. I was actually a little worried he might miss the moment of birth! He raised his head and mumbled something in response. Apparently Duncan can sleep through anything but people talking about him.
I was able to push two or three times with every wave, two or three exhalations. Mackenzie suggested that I maintain downward pressure between pushes as I inhaled, which I found effortful but intuitive. I kept my pelvic floor open and imagined my breath pooling at the bottom, rather than flowing all the way out.
I felt burning and stinging sensations around my vaginal opening, but they were not nearly as intense as reading about “the ring of fire” had led me to expect. On top of all the endorphins, it was a kind of pain I find pretty easy to tolerate. I was surprised to learn afterward that I had labial lacerations. It really wasn’t so bad while it happened.
Cadence’s head was 13 inches around. I got it out in three pushes, over the course of one contraction. I felt their body turn sideways shortly after their head emerged. I asked for a mirror to find out what it looked like: A furry softball sticking out of my vagina. Just as I’d expected, but fascinating anyway. Not a sight I was likely to see again, or at least not any time soon.
The rest of their body came out on the next contraction. Even though their chest was larger than their head (15 inches! Great big ribcage!), the whole thing seemed to slide out easily once the shoulders were through. At 7:22PM, Cadence was born into the tub, and Mackenzie caught them.
As I held Cadence to my chest, I said to them, “Hi! Hello! …You’re a little person!?” It seemed pretty wild to me that they had a whole human body full of rigid bones, that they were so large, and that all of that had somehow been inside of my abdomen. I rubbed their back to help them breathe while Mackenzie listened to their heart and lungs. Duncan came over to hold both of us.
Then I sang to them, the chorus from their birthday song, and Duncan joined me. I felt so relieved, and so pleased that I’d accomplished this, and that they were all right.
I was excited for the life they would have. I cried a little as I sang, and my voice wavered. I’m glad it’s one of the first things they heard on the outside. I sincerely meant it, and I always will.
Q&A
Big Picture
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As I understand it, the term “natural childbirth” usually refers to birth without routine medical interventions (such as anesthetics, pitocin, episiotomies, and forceps).
My birth was not entirely unmedicated: I took benadryl in early labor, and I received a saline solution via IV. Afterward, I took misoprostol for minor hemorrhaging, I received lidocaine injections before getting some tares stitched up, and I took naproxen to take the edge off the cramps while my uterus gradually returned to its pre-pregnancy size. But I didn’t take anything to control pain during labor or delivery, or to speed up the process.
I think I actually mean to communicate something a little more than that, though, when I describe this as “natural childbirth”. I think it would have been a completely different kind of experience in a hospital, even if I succeeded in preventing people from doing stuff to me that I didn't want.
"Natural" has a lot of baggage that makes me a little hesitant to use the term, but it just feels to me like it fits so well. I could have had the baby outside if I’d wanted to, no problem; people would have just followed me and caught them for me. I was supported by others, but I was not managed. By “natural birth”, I really mean "birth where people leave you the fuck alone and you do it however your body tells you".That’s definitely not the right way to go for some birthers. “Natural” isn’t necessarily better. Sometimes high-tech, efficient, and most importantly safe is what matters. But for me, natural birth was perfect.
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My support team was my husband Duncan Sabien, our midwife Mackenzie Rose Leeke, her assistant Jaime, and our doula Shalin Butterworth.
Shalin took most of the photos and videos on this site, and she also took notes that helped me put together Cadence’s birth story.They were all amazing, both during the birth and in the prenatal care leading up to it. I highly recommend both Mackenzie and Shalin, especially to anybody who’s either queer or neurodivergent.
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I felt totally at peace with my choice the whole time. In fact, I thought several times, "I'm so glad nothing is interfering with this particular balance of oxytocin and endorphins right now."
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Absolutely. I feel like I had an excellent birth. I consider it to be one of the most valuable experiences of my life so far.
The Pain Of Childbirth
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(This will only mean anything to people with uteruses, but) to me, they felt exactly like period cramps, except about five times as intense, and happening in a uterus that took up most of my torso. More of the pain was in my lower back compared to period cramps, but I don’t think there was anything fundamentally different about it.
It felt as though I’d been practicing ever since puberty using a little baby version of a uterus, and now I had a great big full-grown big boss uterus and this is what it was really meant for. If that makes it sound like contractions almost sort of felt good—they actually did! Hurt a bunch, but it was also kind of satisfying, especially once pushing started.
For those of you without that point of reference: It’s a lot like a charley horse. (Is that a regional colloquialism?) It’s a lot like a muscle spasm in your calf that makes your calf muscle contract harder and for longer than you’ve told it to. It’s a tight sensation that’s a little reminiscent of aching, with some burning mixed in. The feeling was concentrated in the lower front part of my abdomen, but it also involved my lower back, and everything from my pelvis to my ribs.
The pushing contractions involved an additional element that felt physically like sit ups, but emotionally like weighted squats or deadlifts.
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I find this question a little tricky
Sometimes people claim that "painful things hurt more when you're scared". I'm not sure I’ve found that to be true, but something very similar to it certainly is: I experience painful things as more bad when I'm scared. Pain can be great in quantity, and it can separately be bad in valence. More intense pain is not necessarily worse pain.
It can be hard to separate the simple physiological pain sensations from my overall impression of a painful experience. Maintaining the distinction is difficult both when storing an experience in memory, and when re-interpreting the memory upon retrieval.
So there are at least two questions here: 1) "How much was the pain, compared to past experiences?" and 2) "How bad was the pain, compared to past experiences?"
I do not trust my ability to separate those two questions in my memory of most of the labor experience. I think I was so far away from an evaluation-type headspace that I probably stored the memories as a single summary that emphasized 2 over 1: I remember how bad the pain was more vividly than I remember how much pain there was. My guess is that the amount of pain was a whole lot more than the apparent badness of it. It was probably more pain than I remember, because the pain wasn't all that bad.
But if I just pretend that my memories are accurate, this is what they have to say:
The most painful parts were about as painful as minute 3 of holding my hand in ice water. They were about a quarter as painful as the time that I accidentally leaned against my grandparents' wood stove for balance while putting my shoe on. They were two thirds as painful as having an IUD inserted. They were about twice as painful as a strong hit from a heavy flogger. They were around as painful as a solid lash from a dragon tail whip. They were about five times as painful as the most painful period cramp I've ever had. They were around as painful as the stabbing sensations I experienced when an ovarian cyst ruptured. They were about a third as painful as spraining my ankle.I think that experiences more painful than (uncomplicated) birth are pretty common for me. Many injuries produce more intense pain. Accidentally closing the door on my finger can be more painful than birth.
I think that what makes birth exceptional among painful experiences is that it is not fleeting. With an injury, there is usually a moment of intensity followed by relatively mild pain during recovery. In labor, the most intense moments of pain continue for a long time, and then repeat for hours, or even days.In fact in my case, I often did not get much of a break from the pain between contractions; one of my obstacles was that I was pissed off and feeling a little betrayed that my studies had led me to expect that the pain would stop between contractions. For me it did not stop hurting between most of my contractions. Though the pain certainly lessened, it almost never completely let up.
So while no one moment of pain was really exceptional compared to the rest of my painful experiences throughout life, the accumulated amount of pain was indeed unprecedented, at least in abstract. (I was in labor for about 18hrs.)
Fortunately, it did not feel to me as though the pain was concretely accumulating! With only a few exceptions, there was always only one moment happening at a time.
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It didn't really surprise me. I'd been through some prodromal labor about ten days earlier, and that had involved some nausea, so I wasn't shocked that there was more of it. Also, a huge part of my framing was "this is a drug trip", and I have experience with eg mushrooms causing nausea.
But it was for sure a lot more challenging to go through a contraction while vomiting. I have not found that multitasking goes well with contractions, especially when it's my abdominal muscles in particular that are multitasking. It was harder to deal with than most of the rest of giving birth. Still, it was like, "Gosh that was rough," not "Oh no, panic!"
However, I was surprised and concerned by the quantity of liquid I vomited. I don't think I've ever thrown up that much before. My doula sent photos to my midwife, and it concerned her as well. I felt much better after I'd been re-hydrated by IV, and I stopped throwing up.
I think by default the IV would have made things a lot harder for me. Fortunately I'd anticipated that, and practiced having an IV catheter inserted at my previous prenatal visit. The IV didn't throw me off, and ended up having barely any impact on the overall experience.
Techniques and Strategies
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My main strategy for handling the pain was the same one I always use when I’ve chosen to experience something painful: “Let it in and integrate it.”
“Wait, do you often choose to experience pain?” Yeah. As an athlete, as an autistic person who occasionally participates in society, and as someone who enjoys the occasional S/M scene, I have quite a bit of experience deliberately choosing pain.
How exactly do I “let it in and integrate it”?
When I've chosen to experience something painful, such as an ice bath for my legs after running a long way, or a really long time spent in a deep stretch as part of yin yoga, or a labor contraction, the worst thing I can do is try to run away from the sensations (which is what my mind and body do by default).
If I get into an ice bath and I'm not mentally prepared, my first impulse is to immediately jump out, as though pulling my hand away from a hot stove. If I then use force to stay in the bath, my experience the whole time is one of intense conflict: Part of me is trying to run away, and another part is holding me in place. It's incredibly exhausting and unpleasant.
So I do a couple things instead. First, I reconnect with my motivation for choosing the pain. If I'm confident that the pain does not indicate damage, I remind myself of that as well. (“Reconnecting” and "reminding myself" are kind of complicated, but this is an important step. A sort-of-shortcut is the phrase, "You are safe.")
Then I imagine the sensations as a liquid pouring into my body. Rather than trying to relegate the sensations to the one specific place they're coming from, such as the surface of my skin or the muscles of my uterus, I imagine the liquid pouring through all of my veins and seeping into every part of my body. I almost always do this on an inhale. Sometimes this goes with the words "let it in".
Once I'm full of the liquid, I imagine all of the tension in my muscles dissolving into it. Then when I exhale, I let the liquid and the tension pour out with my breath. Sometimes this goes with the words "let it go".
I repeat this over and over with every breath. I get more relaxed with each cycle, and I'm better able to integrate the sensations with each cycle. At some point, sometimes almost immediately, I stop perceiving the pain as "bad", and I'm able to take full advantage of the endorphins my body naturally releases in response to pain.
So I did this almost continuously throughout labor. Especially during contractions, but for me there was actually a lot of pain in between contractions as well, so it was a nearly continuous meditation.
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My midwife gave me a lovely card deck full of mantras/affirmations, made by my doula (they're friends). I found some of them to be a really good fit for me; I picked out my top five favorites and used all of them frequently.
The cards I picked out said:
* My body knows exactly what to do.
* Open and release.
* Soft jaw, soft hands, deep breath.
* I inhale comfort, I exhale tension.
* I honor my intuition.
I used some other words and images as well. For most of labor, my main anchor during contractions was inhaling for a count of four and exhaling for a count of six, so I was counting a lot of the time.
I never initiated this one on my own, but my midwife would sometimes say, "You are safe, and your baby is safe." I'd repeat that to myself a few times shortly after she'd say it.
I sometimes visualized the horizontal bands of muscles in the lower part of my uterus as blue ribbons with the consistency of plumber's tape, and I imagined them stretching out and dissolving. (This is one I picked up from a hypnobirthing book.) I didn't use it a ton, but I did occasionally find it helpful to have a very specific visual image through which to interpret the physical sensations.
During the pushing phase, I imagined my breath going through my body in the shape of an upside-down J: I inhaled up into my head, then exhaled down through my torso and all the way out my pelvic floor. At the very end when I needed to maintain downward pressure while inhaling, I imagined the first breath pooled at the bottom of the J, and took in an additional J to add to it.
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One of the top suggestions I ran into while studying for labor was to "trust your intuition" or "get your brain out of the way". I mostly interpreted that as "listen to your body". The labor hormones were clearly inclining me in that direction anyway, so accomplishing it was mostly a matter of not fighting against it. I just kept my attention turned inward, put as little effort as possible into intellectual activities like evaluation or problem-solving, and followed every impulse I became aware of.
While I was listening to my body, I could feel how Cadence was physically responding to my various motions and other tactics. I felt that they were doing most of the work for most of the time, and my main job was just to make way for them to do their thing.
I could tell when I needed to rest, when it was time to deliberately stimulate another contraction, and which movements were likely to result in that. (They were not always the ones other people suggested.) I could tell when it was time to dance, and what kind of dancing I should do (asymmetric hip movements from bellydance, mainly). I could tell when I needed higher energy music, calmer ambient sounds, or a song that had a specific emotional meaning for me. At one point I even noticed that my body was asking for sexual stimulation, so I did that for a while (yes, right in front of everybody, and I felt safe and body-focused enough that I did not care). Except when deferring to the experts when I was uncertain, I completely put my body's instincts in charge.There was a point when I'd been in the tub for a while and my contractions had spaced out a lot. Rather than getting out of the tub or taking a cotton root tincture to speed them up, I decided to try to stimulate contractions on my own by moving differently in the water. With a goal of stimulating contractions as soon as I felt I'd had enough rest, I was able to dramatically increase the frequency of contractions very quickly, and when I checked in with my midwife about whether she was satisfied with the results of this strategy, she told me that my pacing was beautiful.
This was a pretty interesting and surprising-to-me part of the experience. It really seemed like I needed to create each contraction myself for a while, and that they would not happen for a long time otherwise; but also, doing so felt completely fine, and I had no problem at all figuring out how to do it. There was just a certain kind of uncomfortable I needed to become, and it was easy to feel my way toward that discomfort.
My body is biologically female. It knows how to birth. There's an incredible amount of information in there that I did not have to learn; I just needed to get out of its way. -
Early in pregnancy, I read that the hormones and endorphins of unmedicated labor can take the birthing person into a different state of mind. It’s often called “labor space”, and people sometimes compare it to psilocybin or other psychoactive drugs.
I don’t use recreational drugs frequently, but I’ve had a few experiences with psychedelics.Before taking a certain psychedelic for the first time, I spent a while learning about trips and how to be prepared for them. I learned that a small handful of things can have an enormous impact on the overall quality of your trip.
The main one is "set and setting": It matters what mindset you're in at the start, and it matters where you are and what's going on around you. This was actually a major consideration in my decision not to birth at a hospital: Given my particular sensitivities, hospitals are one of the most stressful kinds of environments I’ve ever encountered. I would never begin a drug trip at a hospital unless I specifically wanted to be traumatized. So if labor is a kind of drug trip, then I probably shouldn’t give birth at a hospital either, if I can at all help it!
Instead, I turned my bedroom into a “labor cave” by anticipating the sensory experiences I’d likely find comforting. I covered the bookshelf with a sheet, to reduce visual chaos. I strung up fairy lights, and I covered the windows and part of the ceiling with tapestries, to soften the space and make it feel like a blanket fort. I laid a think folded blanket across the floor so it would be comfortable to kneel or lie down on. I set up a speaker, and picked out several audioscapes and songs to play during different moods. And I selected some scent experiences to have on hand, including a candle and some essential oils. I brought some labor props into the room, including an exercise ball, a rebozo, and a bean bag. My labor cave helped me feel safe and comfortable during labor.
There are a few other general trip tips I attended to as well, all of which came into play for me during labor:
* If you're running from it, let it in.
* If you're spiraling, try changing contexts.
* If you're scared to think it, say it out loud.
I also chose a mantra for that first psychedelic trip, which was, "I joyfully welcome whatever arises." I modified that slightly for birth, but otherwise I wrote all of these down on my blackboard where I'd be able to see them from my labor cave.
I went into labor thinking of it as a combination of drug trip, intense physical exercise, and an S/M scene. At least in my case, I was absolutely right on every count, so all of my strategies for psychedelics transferred beautifully.
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Part of how I “kept my brain out of the way” was by relating to thoughts as an observer. Instead of getting wrapped up in my thoughts and perceptions about what was happening, I tried to just notice them, and to leave them alone.
For example, at one point I thought something like, "I can't keep doing this." Several things happened in response. First, I noticed I was having the thought. Then, I noticed I was running from it (so I let it in). Then, I noticed I was afraid of it (so I said it out loud).
But actually the version I said out loud was, "I've just had the thought 'I can't keep doing this,'" because I remembered reading that many people have that kind of thought when they've reached the transition stage of labor, and I specifically wanted to communicate to my birth team that I was likely in transition. “It’s just a thought,” I added.
As (probably) a result, the perception that "I can't keep doing this" never overwhelmed me. In fact it was quite a light-weight, fleeting part of my experience. It was like, "Ah yes, that perception is a part of my experience at the moment." And then the next moment began, and I moved on.
Preparations
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My main goal was to go through the experience without suffering.
I think that suffering happens when a person is in the role of object rather than subject, so while preparing for birth, I did everything I could to make sure I stayed firmly in a subject role.
I think that suffering happens when a person thinks/feels/believes that something bad is happening to them. I emphasize the "to" in that sentence, and contrast it with "for": A different thing than suffering goes on when something happens for a person, as a deliberately chosen consequence that is part of their strategy for satisfying their values.
I think this is probably what other people are talking about when they describe themselves as "empowered". I think empowered means that although you might experience a great deal of pain and difficulty, you're able to do so on purpose, because you have chosen it, because for some reason you personally consider it to be worthwhile—and not because your circumstances or the people around you have forced you to experience it.
It seems to me that people tend to suffer from experiences that happen to them when they are trapped or coerced. Sometimes they suffer a lot, and even end up with long-term trauma, from what would otherwise be negligible discomforts. And sometimes people do not suffer, or even value the experience, when they have chosen experiences for themselves that are apparently unbearably unpleasant.
I knew that birth would be painful and challenging, and I wanted to go through that without suffering. So when making any decision at all about pregnancy or birth, I asked myself something like, "What do I want for me?" (where "me" here includes my values that range over all of the people and things I care about).
I chose a care provider I thought would honor my choices without trying to pressure or coerce me into anything they thought I was supposed to want. I chose an environment where I had a ton of control over external sensory stimuli, because I know how big of an impact that can have on me. I did a lot of research to understand various standard practices and recommendations when the plausible consequences seemed large enough (such as GBS treatment—I went with a mixed risk-based approach, which isn't standard in the US), so I could weigh the costs and benefits according to my own preferences. I talked for a long time with my doula about my birth preferences; we discussed the kind of experience I wanted as well as which treatments or interventions I might want under various circumstances, at home or at a hospital. (If I ended up at a hospital, for example, I wanted nitrous oxide available.)
So when the time came to give birth, I was firmly grounded in my values, and very much on the same page as the people around me that I was not an object helplessly trapped in an experience I did not want, but instead the subject of an experience I had not only chosen but carefully crafted with their assistance.
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I avoided reclining during third trimester. This was more because I found it horribly uncomfortable to recline than because I was preparing for birth, but it is one of the main Spinning Babies recommendations. When I wasn’t standing, I was almost always either kneeling and leaning forward over something, or lying on my side. I can’t know whether this actually mattered, but Cadence was in the ideal position for birth by week 37, and they stayed that way until labor began.
I did some perineal massage to reduce the risk of major perineal tearing. I didn’t like having someone else help, so I bought a special device that let me do it myself. (It’s called a “PeriMom”.) Again, I can’t know for sure whether this helped, but I didn’t end up with any perineal tearing. (I did have significant labial tearing, though.)
I ate a lot of dates. I really have no idea whether this mattered. I kind of doubt it. I just saw a little bit of evidence that it might reduce the time spent in active labor by helping my cervix ripen, and since I love dates anyway, I figured it wouldn’t hurt.
I stayed active throughout third trimester. Nearly every day, I either walked or gardened. Honestly it’s difficult to get me to sit still for long no matter what’s happening to me, so this wasn’t a very deliberate intervention. But nearly every pregnancy resource I’ve encountered strongly recommends this, so I think it probably helped.
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I did not take a birth class, but I did study for labor.
My main resource for birth itself was my doula. She actually teaches birth classes, and though I didn’t participate in a live version, I did get to read through the course materials. She helped me learn about comfort measures during labor, possible medical interventions, and how I would like people to support me.I tried several books on labor specifically, but honestly I couldn’t get very far with them. I’m not quite sure why. In at least some of the cases, it was a gender dysphoria thing for me. I felt intensely alienated, not just by the language but by the assumptions the authors made about how I relate to my pregnancy, my fetus, my body, parenthood, and just… information in general.
There were a couple exceptions. To start with, I read Expecting Better by Emily Oster before I even got pregnant. It remains my favorite book on pregnancy, and it has stuff about birth as well. Oster is an economist, and she treats decisions, evidence, and reasoning in a way I find comfortable. The vast majority of authors writing about pregnancy just don’t. I do wish Oster’s book were less gender-y, but at least it’s only gender-y in its language, rather than in spirit.
A similar exception is the website Evidence Based Birth.
My period tracking app, Clue, has a pregnancy mode that gave me info about what’s going on my body each week. It cites its sources, doesn’t make a lot of uncomfortable assumptions about the user or their mind, and is even trans-friendly. It doesn’t have much in the way of tips for labor, though.
For that, I had the most luck with Youtube videos, for some reason. The channel I found most useful was Bridget Teyler’s. She really likes to call the viewer “mama”, but she also has a lot of practical tips for unmedicated labor, and I found her whole “built to birth” perspective to be exactly what I needed.Watching a variety of home birth videos also helped.
This is an exercise I made up rather than a resource, but it was certainly part of “studying for birth”: In the weeks leading up to birth, I sometimes held my hands and feet in ice water. I’d done this before to treat muscle and joint problems, but this time I did it just to practice pain tolerance strategies.
I definitely recommend this one to anybody who’s drawn to it. As long as you don’t exceed 15 minutes, chilling your body parts in ice water is a safe way to practice with pain that for me, at least, is comparable in intensity to strong labor contractions.
Contractions don’t last more than two minutes, and the peak of the ice water pain usually happens around minute three. If you can find a way to be comfortable through minutes two and three of an ice water soak, I think there’s a good chance that you’re well prepared for the intensity of uncomplicated labor.
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I asked myself a lot of questions and tried a lot of prompts; I didn't know at the time which ones would turn out to really matter. In retrospect, it's very obvious that the most important one was, "Imagine how you would like to feel during birth."
Nearly every resource on natural birth that I've encountered says something like, "Natural birth is far more psychological than physical."
That matches my experience of this birth very well. What goes on in your mind will determine what kind of birth you have. It’s not the only factor, but it will probably be the main one. It will determine how you cope with unexpected circumstances, with challenges you weren't prepared for, and with how much value you're able to derive from whatever happens.
So figure out what kind of person you want to be while giving birth, and imagine what it feels like from the inside to be that person going through an intense experience. Imagine how you want to feel during birth. Once you know that, you can use it as a compass to navigate through all your other preparations. You can begin to create whatever support structure will help you be the person you want to be the whole time, whatever goes down.
And hey, it's possible that your answers will lead you to discover that birthing in a hospital by default makes more sense for you! I don't think this approach is only good for unmedicated home births.
My own answer was, "I want to feel confident and powerful. I want to feel grounded. I want to feel supported and taken care of. I want to feel that it's right for me to focus on my own mind and body, and that I can trust my support team to take care of everything else."From there, I started asking myself what tends to lead me to feel each of those things, and what obstacles to feeling them I currently foresee when I imagine birth.
So for example, I chose to add a doula to my care team, in addition to a midwife, because 1) a doula will advocate for me at a hospital, should I end up in one, which frees me to focus on my own mind and body in the midst of riskier birth, rather than on trying to negotiate with doctors and nurses I may never have met, and 2) a doula's primary job is to help me feel supported and taken care of, while a midwife will at least sometimes need to focus exclusively on ensuring the physical health of me and my baby.
Afterward
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Nope! Not as of three weeks postpartum, anyway.
I'm pretty relieved about it, actually. I generally do not like having my emotions yanked around by hormones.
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So first of all, I'm so fucking relieved not to be pregnant anymore. I hated pregnancy. I like Cadence much better on the outside.
The very first thing I felt about them on the outside was that they're ENORMOUS.
Some time in early pregnancy, I had a nightmare that a queen termite had burrowed into my abdomen, and I couldn't get it out. I think I had sort of continued to imagine them as an ever larger termite-esque shape that grew, but still remained of a reasonable size to fit in my abdomen.
They're not actually enormous for a baby, though they certainly aren't small either (8lbs 15.5oz when they came out, with a ribcage that's wider than their head). But they certainly are enormous for a termite, or for any reasonable sort of abdominal contents, or for an object that goes in a vagina.
The first thing I said to them after "Hi!" and "Hello!" was "You're a little person!?" And what I meant by that was, "Jesus christ, you have an entire human body, what the actual fuck?!" And that's also still some of what I'm feeling.
I gave birth three weeks ago, and mostly, I feel open curiosity and affection toward Cadence.It feels very much as though someone has brought their pet to live with us, and their pet is a species I've never encountered before. Some sort of variation on a fox, maybe. Clearly a mammal, but I've never even heard of one, whatever they are.
The fox-thing is kind of cute, usually isn't causing me any large or immediate problems, and appears to have an awful lot of interesting things going on in their head. They’re also obviously very incompetent in most ways and just have no idea how to operate in the world, yet they seem endearingly chill with this situation for the most part, and they’re learning fast. Recently they seemed to figure out that if they extend their digits before sucking on their paw, sometimes one of the digits will go inside of their mouth; but they can't do this consistently.
Fortunately I seem to have a lot of instinctual knowledge about how to help them cope. It's not hard for me to empathize.There's also something deeper in the affection for Cadence than "oh haha I appear to have evolved to find rooting behavior cute". This human is clearly not fully baked yet, but I know that they're in the process of becoming a full person, and eventually they will probably be someone who can be fascinated and delighted by fireflies. That kind of thought was my one way of connecting with them in the womb, and it's still present. They already seem interested in leaves and music. Watching them be aware of their surroundings is a joy for me.
I played and also sang "Come Alive" from The Greatest Showman during their birth, and it's still playing through my head now and then. It feels more like a quiet but powerful prayer than like the overwhelming love many people describe upon meeting their child.
I do love them, though, and I’ve told them so. It’s mostly a soft feeling, but they are precious to me. It feels very right and comfortable. I'm happy that these are the things I'm feeling.
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It’s been a little rough, but I have it very easy, compared to most. Because Duncan is the primary caregiver in our family, and because we’ve arranged for extensive on-site help from our community during the first three months, I have been neither sleep deprived nor overstimulated for most of my recovery so far. Cadence is eating donor milk (I don’t have breasts), so I haven’t had to figure out nursing. I even have my own separate cabin on our property, which was a precondition for my ever becoming pregnant. (We planned this before we even got engaged.) I visit the main house, but I do not sleep there, and I can go be alone any time.
At first, I was startled by the bleeding. There’s a gigantic wound in my uterus where the placenta was attached, and though it gets smaller as my uterus contracts back to its non-pregnant size, it still takes a while to heal. For the first two days, I could feel blood falling out whenever I stood up or moved around. Because I’ve been using tampons since I was a teenager, this is not a sensation I’m familiar with. Also, I passed a couple of gigantic blood clots (like fist-sized ones) while on the toilet, and that felt super weird and slithery. All of that’s totally normal, though, and most of it had stopped by the end of day three.
My main challenge has been restlessness.
All of my tissues are healing quickly, but I had some minor hemorrhaging after the placenta detached. For the first week, I couldn’t walk across more than one room without getting light headed and feeling utterly exhausted. Today I was able to walk on flat ground for twenty minutes at three miles per hour, but that was definitely my limit. I needed to lie down for a while afterward.
Being sedentary sucks a lot for me. I need motion to stay sane. I need to physically move through and engage with the world, or I start to feel like I’m some kind of lifeless zombie. It’s hard for me to sink into any sort of restful activity, like reading or watching a show, unless I’ve recently exercised pretty intensely.
So yeah. Staying put has been necessary while I rebuild my red blood cells, and also it sucks. Silver lining, I guess: If I hadn’t lost the blood, I probably would have been too active too soon and slowed the rest of the healing process.
Another big thing for me has been “baby blues”. Separately from the “I am a lifeless zombie who floats in gray bubble of pointless unreality” feelings that result from lack of exercise, the first two weeks postpartum involved some intense mood swings.
About twice a day, for one to two hours, I’d feel extremely sad, just out of nowhere. My brain would find one or two sad thoughts to focus on—such as “Perhaps I have destroyed my family by creating this child?”—and then I would sob and sob.
For the rest of the day, I’d feel… not “normal”, but better.
I actually liked the “not normal” that came with the less-sobby parts of baby blues. It was the psychological aftermath of a personally momentous event, and it felt that way. For about two weeks, I felt raw, sensitive, vulnerable. I reacted emotionally to things quickly and intensely. Just sitting quietly in my cabin thinking about stuff, I felt alive. It was an excellent mental space from which to process the birth experience, and that’s how I spent a lot of my time. I created most of the content on this page in the first week postpartum.
In fact, one of the thoughts I ended up focusing on during a sobbing session toward the end of week two was, “Soon things will be normal again, and I will not have access to this way of being anymore.” It was an awful lot like recovering from an acid trip, probably for similar reasons. Bright, complex, exposed, fragile, beautiful.
But what about my crotch, though, right?
Honestly that hasn’t been a big deal for me. I had bad enough labial tearing that I got about fifteen stitches and I… appear to mostly not have a right labia anymore, I think? But labia aren’t structurally functional the way a perineum is. There was a little bit of stinging in the second week, but nothing ibuprofen couldn’t take care of.
I have bruising in some of my internal tissues, which has sometimes made going to the bathroom uncomfortable. My rectal muscles were overly sensitive in week two, so I had cramps whenever there was gas or anything else in there to irritate them. That’s been the most annoying thing, physically, and it hasn’t completely gone a way yet. Bruising around my urethra has caused an odd sensation when I stand up quickly, but it’s more pressure than pain.
My pelvic floor seems mostly ok as long as I don’t spend too much time in the car. I can handle about fifteen minutes of car-jostling before I start to feel sore. Before I figured this out, I accompanied Duncan on a two hour car errand, and this is how I learned that halfway through week three, I am not ready for cars. That was pretty awful.
It’s also sore when I cough, laugh, or sneeze. So far I don’t seem to be leaking when those things happen, which is nice and a little surprising to me. But I’ve learned to reach down and put pressure on my crotch when I cough, which helps a lot.
I think I’m doing very well with recovery overall. But man, I sure do continue to want my body back. I love that I can eat and sleep again, but I want to move. I want to lift, and dance, and run. It’s frustrating that I’m not there yet, but I do find every bit of progress is encouraging.
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Some people describe their birth experience as "transformative" or "life-changing". I've thought for a while about what sort of impact birth has had on me. It was undeniably a monumental experience.
But was it transformative? Have I been changed?
I think it depends on what you count as "transformative". In one sense yes, because I do think something is different.
But in another sense, I think it was somehow the opposite of transformative. I've never thought about "transformative" as something that has an opposite, especially one that mirrors that concept in intensity. But that’s what happened: I was profoundly the-opposite-of-transformed. “Affirmed”, perhaps.
As I search for ways to describe this, what keeps coming to mind is Zaphod Beeblebrox in the Total Perspective Vortex. If you haven't read (or listened to) The Hitchhiker's Guide to the Galaxy, this will not help much, and it will be spoilery; I'll say more things below that don't rely on the reference. (Skip to "Unlike Zaphod".) But if you have read H2G2, I think it's quite an apt analogy for the overall impact of labor and delivery on me.
To jog your memory:
*
GARGRAVARR: You’ve been in the Vortex?!
ZAPHOD: You saw me kid.
GARGRAVARR: And you saw the whole infinity of creation?!
ZAPHOD: The lot baby - it’s a real neat place you know, heh-heh.
GARGRAVARR: And you saw yourself in relation to it all?!
ZAPHOD: Yah, yeah, yeah.
GARGRAVARR: And what did you experience?!
ZAPHOD: It just told me what I knew all the time: I’m a really great guy! Didn’t I tell ya baby, I am Zaphod Beeblebrox!!
*
So, was Zaphod changed by this experience?
Before he walked in, Zaphod certainly saw himself as THE supremely hoopy frood, and that's still how he saw himself after he walked out. Yet he also seemed apprehensive about going in: He didn't actually know what would happen, or whether he'd even survive.
But after experiencing such compelling evidence that the universe really does revolve around him, I imagine that all his secret doubts about whether he was the person he pretended to be just... dropped away. Before the Vortex, he yearned to be Zaphod Beeblebrox, whether or not he really was. After the Vortex, he knew that he was, in fact, Zaphod Beeblebrox.
(Or at least, he thought he did. Simulation shmimulation, the anology's imperfect.)
Unlike Zaphod, I have never believed or pretended that I'm the most important being in the entire universe. (Though I readily admit that I've... been through some not-so-sufferable developmental stages, and I will never be accurately described as "humble".)
However, I have aspired throughout my life to cultivate certain virtues. Over the past ten years or so, I have really honed in on which virtues I care about most in myself, and on how I'd like to embody them. I've largely figured out who I want to be.
The person I want to be is a pretty complicated mix of things, and I can't articulate all of them. But here's some of the central stuff: He is powerful, resolute, and dedicated. He is sensitive, perceptive, and curious. He is grounded, integrous, and courageous. He is agentic, generative, and playful. He is patient, open, and compassionate.
In addition to identifying those virtues, I've made at least some amount of progress toward being a person who embodies them.
How much, though?
Sure, I've often succeeded at acting dedicated. I've convinced an awful lot of people that I'm perceptive. I've done some things that seem a lot more likely in worlds where I'm courageous than in worlds where I'm not.
But is it real? What parts of it, and to what extent? It's been hard for me to know.
To me, natural birth seems a crucible. I don't think it's the sort of thing that permits you to "fake it 'til you make it". There is no room at all for anything fake.
You can't climb a mountain by being really into mountaineering. You have to actually walk a very long way, up a very steep incline, at very high altitude. When you're on the mountain, you find out for sure how you respond to altitude sickness, the threat of frostbite, or equipment malfunction. There's just no way around it.
I think it's the same with natural birth. During labor and delivery, there is nowhere to run. Nowhere to hide. No way to pause. Nothing to dull the experience. Nobody else who can do it for you. It is long, hard, and inescapable. You are naked, in front of yourself and anyone else who is watching. The person you are when you simply cannot pretend is thereby revealed.
And do you know what I see when I look back at my memories, at the videos, and at the reflections offered by the people who were there with me?
I see power, resolution, and dedication. I see sensitivity, perceptiveness, and curiosity. I see groundedness, integrity, and courage. I see agency, generativity, and playfulness. And I see patience, openness, and compassion.
I sound my barbaric yawp over the roofs of the world.
This does not mean that I am satisfied. I am rarely satisfied. Ambition is also a part of me. The more I learn, the more I can imagine; in any moment I will always yearn to be something greater than I am.
So I still strive. But I am far more certain, now, of the place from which I do so.
Am I transformed? No. I am the same.
But I'm sure of who that is, now. And I like him.
Ask A Question
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