The RA Pregnancy Chronicles: Birth Positions
The RA Pregnancy Chronicles is a series of posts that share my experiences being pregnant while living with RA. This post was written during Week 34 of my second pregnancy.
With the weeks remaining in this pregnancy now in the lower single digits, it is time to start thinking about the inevitable end to the pregnancy chronicles: childbirth. Everyone will agree that childbirth is extremely hard on your body - even if you are an Olympic athlete in the best shape of your life! So if you are an ordinary woman who also has to deal with rheumatoid arthritis, like me, the prospect of labor and childbirth can seem quite daunting.
When I was pregnant for the first time, my husband and I took a childbirth class to try to gain some perspective about the birth process. We were happy to learn about breathing techniques for staying calm and distracting me from pain. My husband practiced some massage and acupressure techniques to help me. We also talked about music and other relaxation techniques, and we were very excited to discover that every room in the hospital where we would be delivering had a hydrotherapy tub for pain relief during labor.
The instructor also spent a lot of time talking about birth positions. She emphasized how important it is not to just lay on your back like you see in the movies. Instead she said you ought to change positions often and focus as much as you can on positions where gravity is on your side. And while this information made a lot of sense to us it was at that point we discovered the limitations my arthritis might place on the birth process.
Unfortunately, in order to get into a position where gravity is on your side, you also end up supporting a lot of your own weight. As we attempted to practice the various positions it quickly became apparent that a lot of the positions just weren’t going to be options for me. Almost all of the kneeling and squatting positions put too much strain on my hips and knees. Despite pillows, props, pads, and my husband attempting to hold as much of my body weight as he could, I had considerable difficulty staying in most of those positions for more than a few minutes. I felt like a lot of the positions would only increase the overall pain in my body and tire me out more quickly rather than helping me deal with the pain of contractions.
It was pretty discouraging at first. The instructor kept talking about “using what nature provides” to make the birth process easier, and I couldn’t stop thinking about how unfair it was that nature had provided me with a bunch of inflamed joints and the ability to get fatigued more easily than other women, which wasn’t going to make the birth process any easier! I kept looking at the posters of the birth positions around the room – not to mention the five other couples successfully enacting these positions – and feeling very overwhelmed.
But then I took a few deep breaths (see? That breathing stuff came in handy!) and my husband and I ignored the rest of the room, disregarded the posters, and got creative to come up with positions that I could actually handle. We discovered that there were lots of options for standing/walking, mostly with me leaning on my husband, which would be a good way to keep gravity on our side without overtaxing my knees and hips. And, with the use of a birthing ball, we actually managed to find a couple of kneeling and squatting positions I could handle. We even came up with a position on our own (me squat/sitting with my back against the birthing ball, my husband with his back against the other side of the ball for support, and our heads resting on each other’s shoulders, cheek to cheek). The instructor liked our position so much she pointed it out to the whole class.
In the end my first son turned out to be breech, so I had to have a C-section anyways. But if things continue to go well this time around I am planning to try for a VBAC (vaginal birth after cesarean) and so I wanted to review everything I learned the first time around. While our experience in birth class made it painfully obvious (quite literally for me) that my arthritis will most likely make the birth process more challenging, we also realized that if we stay calm, work together, and get creative we will be able to get through it!
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