A Heart Stronger Than Fragile

Several blog entries ago, I wrote about our struggles in making a decision as to how to deliver. Born with several congenital heart defects, most of which are corrected now, I am automatically lumped into the "high-risk" pregnancy" category, and we are followed closely by a high-risk perinatal clinic. Half of the practitioners and much of what I've read has told us that our safest route is to deliver via C-section, to avoid the physicial demands of labor on my heart. The other half have recommended going for a vaginal delivery, citing surgical risks of a C-section including infection and major fluid-shifts, which can also pose as a danger to my heart. Michael and I were burdened with the decision that was left for us to make. We are medically-educated people, but first and foremost we are a couple seeking guidance for a delicate situation. What is the safest route for me and our baby?

My cardiologist, Dr Singh, has follwed me since I was two weeks old. If you do the math, that means he has known me inside and out for 30 years. We trust him with our lives, quite literally. When we met with him around week 22 of the pregnancy, we asked him what to do. He wore a thoughtful face and told us what we already knew, that there is no right or wrong answer, and that whatever we chose would be the right thing to do. We nodded, and acknowledged that while he was not an OB, he knows me best. "But what do you think we should do?" Michael asked again. "Because we want to do whatever you think is the best route. We trust you."

Dr. Singh guided us through a plan, one that we have come to feel comfortable with. We will attempt to deliver vaginally, with a very dense epidural placed early to avoid stress of contractions on my heart. We wait and let the uterus do its thing. I will do very little pushing, which will probably necessitate the need for a foreceps and/or vacuum assist. That part I'm not fond of, but it's part of the package deal. If stage-two labor lasts long, we will go in for a C-section at that point. Dr Singh then turned to me. "Don't be a martyr," he said in his thick Indian accent. "I don't want you to get to the point of exhaustion." He gave us and idea of a timeline of when a C-section might take place, and explained that I would likely get exhausted faster than other (heart-healthy) women.

We nodded, agreed with the plan, and shook Dr Singh's hand. As the door closed after him, I started to cry. I wasn't quite sure why at the time, but looking back, I realize it was because of something that has always bothered me: being different. I was always the slowest in gym class, and could never keep up in a game of tag. When I was little, I even became anxious over a game of Duck-Duck-Grey-Duck, where I obsessed with the worry of always being stuck sitting in the middle of the circle. I hate group sports, even hiking with groups of friends...anything that requires me to keep up with others. It didn't occur to me that my endurance in labor would be different from others, too.

There is a lot of pride in being able to give birth. Women tease men that they get off easy, and that it is their fault we are in pain ("you did this to me!"). But we also quick to acknowledge our amazonian skills for being able to endure contractions and the delivery of a 7-9 pound little human out of a very, very small hole, like a seriously misjudged puzzle piece. Before being pregnant, I never did quite understand why women would get so upset at needing a C-section. Surgery's not an awesome experience, but it's not horrible, and in relation to the painful venture of vaginal delivery it actually sounds pretty appealing. But as an expectant mother, I am understanding a bit more of the psychology behind it. Women are built to give birth. We've been doing it since the beginning of time. The thought of needing a C-section, for some women, can feel like a failure of sorts.

And so it was difficult for me to envision actually being able to speak up and say that I'm exhausted. I understand that Dr Singh has given me parameters and very clear instructions not to tough it out, for the purpose of avoiding stress to my heart. If I need to go in for a C-section, it's because of medical direction. But I would be lying if I said that I wouldn't still feel like I failed. That I gave up early, wimped out. That I'm not as strong as other women.

I shared these raw feelings with my mother, who has a beautiful gift of putting things in perspecitve and bringing me immense comfort. She responded with something that I will be holding onto during labor and delivery. "When I think of all of the things you've accomplished and all of the things that you can do, nobody can light a candle to you!" she said She recalled a conversation that she and my father had with Dr Singh when I was a baby, when they were asking about realistic expectations for the life I would lead. Dr. Singh was very positive about the things I would be able to do, with very little limitations. To put things in perspective, he clarified, "Well, she won't be able to be in the Olympics." "But then," my Mom said to me, "you were in the Olympics!" Tears came to my eyes again as I understood what she meant. In the fifth grade, I won a creative writing contest, with the prize being that I got to carry the Olympic Torch out of my hometown during the celebration of the Summer Games. There was a huge city gathering, a presentation by the mayor, and then me, being handed the Olympic torch. I walked it out of the town guizebo and jogged it down to road to pass it on. It was a very proud and profound moment.

As my Mom mentioned this in our conversation, I knew it was more than a neat follow-through story to Dr. Singh's expectations for my life. I understand and need to remember that I am still strong, in my own ways, in my own time. I could never run the mile in gym class, but I can do it now, at my own stride. I cannot keep up with friends swimming laps, but at my own pace, I can swim non-stop for over two hours. I do okay on my own. I am stronger than what's wrong with my heart. God has blessed me with so much that has made it right, and we have more evidence of that coming in a week or two.