by KMom
Copyright © 2000-2009 KMom@Vireday.Com. All rights reserved.
This FAQ last updated: June 2009
DISCLAIMER: The information on this website is not intended and should not be construed as medical advice. Consult your health provider.
BBW Birth Story Pages
BBW Birth Stories: C-Section Stories
CONTENTS
Over the years, many women have requested a section for birth stories of plus-sized moms.
Women of size often come into pregnancy with so many fears imposed on them by others that it's important to have reassurance that other large women have indeed done this before.
Pregnancy books and most websites do not fulfill this need; mostly they are filled with warnings about "obesity" and pregnancy, admonitions not to get pregnant until you lose weight, dire predictions of disastrous pregnancies filled with complications, or horror stories designed to scare you into weight loss compliance.
Although there are many birth stories online, most are of women of average-size. While these are also helpful to read, many women of size have longed for a collection of stories of just plus-sized pregnancy----birth in all its beauty, and birth in all its variety in women of size. It is so important for us to see that many of our fat sisters have traveled this journey before us.
This is a collection of BBW (Big Beautiful Women) Birth Stories collected by Kmom over the years. Stories have been separated into various categories (vaginal birth, c-sections, twins, VBACs, etc.). Because some stories fit more than one category, many will repeat on different pages. Some stories are already up on the web in a more complete form elsewhere; with the mother's permission, Kmom has linked to these sites and urges readers to click on the link and read the more complete story.
Unless specifically requested, all identifying information has been removed or changed to protect the privacy of the participants.
All stories are copyrighted; none may be used elsewhere without specific written permission from both Kmom and the mother involved.
This particular FAQ presents the stories of the cesarean births many women of size have experienced.
Big moms do have a higher cesarean rate, though many are probably unnecessary. For some large women, a cesarean is no big deal, for others it is unwanted but endurable, and for still others it is a horror story, full of fat-phobic treatment or intense trauma. How women of size experience cesareans is as varied as women are.
Since big moms are often not given the chance to pursue Vaginal Birth After Cesarean (VBAC), Kmom has also made a point of adding a section showing that many fat women HAVE turned their cesarean births into vaginal births as well. Giving birth by cesarean does not mean that you always have to give birth that way; fat women DO have VBACs too.
However, the point of this FAQ is not to promote one particular style of birth, but to show the wide spectrum of births that women of size have experienced, and this includes cesareans, repeat cesareans, and VBACs. All of these are represented in this FAQ.
More stories will be added over time, so keep checking back if you are interested in reading further stories. If you are interested in sharing your birth story, click here for more information, birth story format, and submission guidelines.
New birth stories are always welcome; Kmom updates the birth stories FAQs about once a year so be patient for your story to show up. If you do submit your story, please carefully follow the format and directions given in order to shorten the amount of work involved for Kmom. Kmom's family will thank you!
C-Sections: Different Meanings for Different Women
Do Large Women Have a Higher Rate of C-Sections?
In general, larger women DO have higher rates of c-sections, for many reasons. They tend to have somewhat higher rates of complicating conditions that often result in c-sections (pre-eclampsia, gd, PCOS which often results in pre-eclampsia or gd, etc.). In addition, although it's not true for all fat women by any means, some fat women are out-of-shape and don't eat properly or exercise, which also tends to increase the rate of complications in pregnancy. Unfortunately, medical studies rarely differentiate between large women who take excellent care of themselves and those who do not, making the risks seem to apply equally based on size alone. Therefore, many providers apply interventions equally to all women of size, when only a few may actually need them.
Large women also suffer size prejudice; there are OBs that force their fat patients to sign elective c/s permission forms early in pregnancy long before it could possibly be justified as 'necessary', who berate their fat patients over any pound gained or tell them to lose 40 lbs. while pregnant, or tell their fat patients they will have a heart attack and die during labor (yes, these are true stories!). Or the size prejudice can be somewhat subtle, from doctors expecting that you WILL develop complications (often a self-fulfilling prophecy), to treating you as ultra high-risk or telling you that you'll probably not deliver vaginally anyway, etc.
Or the size prejudice can be extremely subtle, such as the very common practice of inducing large women early so the babies will be smaller (a practice shown in medical research to actually increase the c/s rate instead of decreasing it). Studies show that large women are induced at much higher rates than average-sized women, and often are not given the same chances at Vaginal Birth After Cesarean that average-sized women may get, resulting in more repeat c-sections. All of this increases the c/s rate, but is mostly due to patterns of provider bias rather than problems inherent to being heavy.
Another example of this is the recent news release which trumpeted the high rate of c/s of fat women at a certain hospital and then suggested that large women should have an epidural put in place early in labor so that if a c/s is needed she is all ready. Since a number of studies and meta-analyses have found that epidurals (especially in the beginning of labor) result in higher rates of c/s, and these doctors have already been told to expect fat women to 'need' a c/s, the number of fat women having a c/s at this hospital is likely to remain high. Is it the fat causing the high c/s rates, the patterns of provider treatment and expectations, or both?
In addition, there are often subtle psychological battles for large women to combat as well. Many fat women have been programmed all their lives to believe their bodies are 'defective', incapable of performing normally, and often have very significant body trust issues that tend to come out during pregnancy and birth. They are often disempowered by the people around them, who may make them feel like they should apologize for even 'daring' to be pregnant at a larger size. They often face a world hostile to the idea of larger women having romance, let alone having sex or giving birth! Most childbirth books are full of dire warnings about being pregnant at a larger size, and these horror stories and warnings tend to lead large women not to expect a normal birth. Some research also suggests that larger women have a higher rate of being abused (especially sexually) which could also easily increase the c/s rate as well.
So although larger women tend to have higher rates of c-sections than average-sized women, it is unclear how much is due to problems from size and health concerns, how much is due to provider bias and patterns of expectations, and how much is due to deeply-placed body trust and empowerment issues. However, it's worth noting that many 'alternative' birth attendants note that with proactive attention to health, nutrition, exercise, and empowerment issues, they have found that even very large women usually have excellent birth outcomes.
Although larger women currently DO have higher c/s rates, it is NOT a given that a large women must have a c/s. In fact, midwifery studies show that even with bias and emotional baggage and complications, the MAJORITY OF LARGE WOMEN STILL HAVE NORMAL VAGINAL BIRTHS MOST OF THE TIME.
Research from the 50s, 60s, and 70s shows that cesarean rates in women of size used to be much lower. If fat were truly an intractable cause of cesareans, these low cesarean rates would not have been possible even back then. In fact, many studies then showed that fat women had no higher cesarean rates than other women. It is practice patterns and expectations that have changed the cesarean rate in women of size, not size itself.
Now, many OBs and even midwives believe that having a cesarean is a logical consequence of being fat; that fat women cannot birth normally. But we know from history and the many fat women today who choose alternative births that this is not true. Fat women could birth normally in the past, and today they can STILL birth vaginally.
With truly supportive and unbiased care providers, a proactive attitude towards nutrition and exercise, and an empowered and informed approach to birth, the c/s rate for fat women can almost certainly be reduced greatly. Unfortunately, the biggest obstacle is sometimes getting people to believe that this is possible, or even to care that it happen. But together, we can act to change this indifference. Women, fat or thin, do NOT all need to be cut open in order to have a baby.
Here are two articles that discuss why women of size have high cesarean rates and give concrete ideas for lowering your risk for an unnecessary cesarean:
Women Who Love Their C-Sections and Women Who Hate Them
In our current societal climate, it is true that a significant percentage of larger women do have c-sections. Some then go on to have subsequent vaginal births (VBACs), some try to have vaginal births but end up with repeat c-sections, and some are happy to choose another c-section and bypass vaginal births altogether. In fact, as in average-sized society, there are occasionally even women who actually prefer to have a c-section from the very beginning and are relieved if they develop a condition which necessitates one.
C-sections can be a very political issue. It is very important that we all understand that a c-section means different things to different women, and to RESPECT our differences of opinion over that fact. For some women, a c-section experience can be almost akin to rape or assault, yet for others it can be a perfectly normal or even gratifying experience. There is a great deal of bad feeling generated on email lists between those who 'love' their c-sections and those who do not. The key is to try to understand and empathize with the other person's feelings and recognize their right to have a different opinion.
To a woman who has had a c-section and is not happy with it, it is insulting to be told that the important thing is that the baby is healthy and it doesn't really matter how the baby gets there. Of course the most important thing is a healthy baby, but for many women it does matter how the baby arrives. To have a disappointing or disempowering birth experience DOES matter; to have that experience dismissed as unimportant or insignificant is tremendously frustrating. The mother matters too.
In some cases, a c-section truly is life-saving and the mom can be grateful it was there to help. While some women feel only gladness and relief over a life-saving cesarean, it is completely understandable and normal that some women might still feel upset after a frightening or less-than-ideal birth experience. Even when a cesarean is truly necessary, women can have ambivalent or even negative feelings about it.
However, many c-sections are not necessary, or only become necessary after a great deal of intervention and questionable management. Some studies estimate that almost 50% of c-sections in the U.S. are not truly necessary! Imagine the bitterness of moms who must face not only their disappointment in having a c-section, but also to know that it was probably an unnecessary one. That's a tremendously bitter pill to swallow, and it has long-lasting implications for any subsequent pregnancies and births.
Women who are disappointed in their births need and deserve to grieve that experience, despite being thrilled to have a baby in their arms. Yet few moms with disappointing births are allowed that space to grieve. They are often told to 'just get over it' or to 'move on' with their lives, or 'just be grateful' they have a baby. But although most women valiantly try to move on, it is very difficult to move on until the original experience has been fully grieved, and there is very little understanding of this in our society in general. A c-section is simply thought of as 'no big deal' and just a 'different way' to give birth. Women who feel differently are rarely given validation or space for their feelings, but it is possible to love your baby deeply yet still have ambivalent feelings about how they arrived.
On the other hand, some women 'love' their c-sections and would never choose any other way to give birth. Some women have histories of sexual abuse and are uncomfortable with feelings 'down there' and may find a c/s less threatening. Some women truly fear labor pain or the uncertainty and messiness of labor, and a c/s can feel like a relief, a 'way out' of emotionally threatening circumstances. Some women fear episiotomy or tearing more than major abdominal surgery, and to them, a c/s may feel less threatening.
Some women have had prior long hard labors (often induced), full of pain and difficulty coping; in this circumstance a cesarean can feel like a dream come true, a 'rescue' from an unending cycle of pain and exhaustion. Some women who have experienced traumatic labors choose a planned cesarean in a future birth in order to avoid any repeat of the same difficult scenario; they see it as a way to protect themselves from experiencing that trauma all over again, and as a way of "controlling" the experience and making it more predictable.
For some women, a c-section was a truly necessary intervention and they only feel deeply grateful it was available. It might not be how they would ideally have given birth, but they have come to a place of peace with how the baby arrived and are thankful
Some women simply don't see a c/s as 'any big deal' and don't really care how the baby comes out. Some women are relieved to simply schedule their birth and remove all the unknowns; the enticement of a known and familiar outcome is less threatening than the uncertainty of not knowing what the outcome will be.
There are as many reasons for 'loving a c/s' as there are flowers under the sun; no one should be made to feel bad or 'less than a woman' for having had a c/s.
Women who are not disappointed in their births also need and deserve to treasure that experience, even if it doesn't meet someone else's expectations of a 'good birth'. No one should have the right to make someone else feel bad about their birthing experience. Although our society is currently mostly supportive of women who have had c-sections and liked them, occasionally you will find people who may try to tell you that you are 'less of a woman' for having birthed differently, or that you 'wimped out' when you chose the c/s, or that you are 'defective' for having needed a c/s. Not so!
Nor should women who did not love their c-section be made to feel like they are ungrateful wretches who place their own selfish experience above the baby's well-being, or that they are emotionally stunted because they are still working through negative feelings about the cesarean. Their feelings are just as valid, and they deserve the space to mourn that experience and those feelings too.
In the end, most women who undergo a c/s do it because at the time they feel it is best for their babies and/or themselves. To undergo major surgery for another person is an act of love, no matter the circumstances.
It is VITALLY important that we understand that as women we all come to our c/s experiences with different expectations, needs, fears, and 'emotional stacks' (previous experiences that color our interpretation of a new experience). For some women, a c/s can be a disappointment, a hurtful experience, or even a trauma beyond measuring. For other women, it is simply no big deal, a tremendous relief, or a treasured and beautiful memory.
We need to understand and RESPECT that our feelings and reactions may not apply to someone else's experience, and to allow them the space to have different feelings than our own.
About This Cesarean Stories FAQ
In this FAQ, all kinds of c/s stories are told. Some cesareans herein clearly saved the lives of the baby and/or mother, some cesareans were questionable, and some cesarean experiences were clearly horror stories. Some women were delighted to have a c/s, while some women, far from being delighted, likened the experience to being raped.
This FAQ is a kaleidoscope of all different kinds of cesarean stories and reactions. Readers are urged to understand and respect all the varying perspectives on c/s herein.
Bias Disclaimer: Kmom has had 2 c-sections, one a truly horrible experience and one a relatively good and loving experience. Thereafter, she also had 2 VBACs (Vaginal Birth After Cesarean). Although she has not personally voluntarily chosen a c/s, she fully understands the lure and appeal of it, and she does not judge women who make an educated decision for a c/s. Please do not read that into this FAQ.
However, Kmom's personal opinion is that as a society far too many women (and especially fat women) are being cut unnecessarily, and that this has deep public health implications that should not be ignored. Cesareans are NOT simply 'another way to give birth' because they DO have significant health risks and implications for future births. You will find this opinion reflected in Kmom's commentary. However, this is in NO way a judgment about any woman who is happy with her c-section or who chooses further c-sections in the future. For some women, a c/s can be a wonderful experience or a truly unimportant way of getting the baby into the world. Although Kmom does not feel that a c/s should be a commonplace method for birth as a society, she does not judge individuals' decisions.
Most moms will recognize most of these terms, but women new to reading about childbirth may be puzzled by some of the terms and abbreviations used in these stories. This section briefly defines some of these in order to help women understand the stories better.
Shawn's Story (c/s, posterior)
Kmom's Notes: The circumstances of the labor suggests that this baby might have been posterior and gotten 'stuck'. Shawn confirms that her baby was indeed 'sunny side up' but that this was not noted in her medical records. This is not unusual; many doctors don't see posterior position as relevant and fail to note it in records or mention it to parents, yet many other providers feel that it is the cause of many c-sections. Positioning often helps facilitate rotation, but Shawn was not able to try these.
Also, although the midwife felt that rupturing the bag of waters more fully would help dilation by bringing baby farther down, doing this tends to fix baby in its poor position and make a normal vaginal birth difficult to impossible. Breaking the bag of waters is the last thing that should be done if baby is in a poor position for birth.
Birth Story
When I went to see my OB about fertility treatments, I remember one of her first comments being, "You really should try to lose some weight prior to beginning treatment...but I have had patients close to your size who have conceived." "Whatever," I thought, "just give me the prescription." After the first cycle of Clomid, we conceived and we were both surprised and elated. MY OB was skeptical, however, and ran at least 3 progesterone tests and two ultrasounds before she was convinced.
My physician had not been derogatory in our visits, but I was concerned about her pessimistic approach to my care. After my second U/S the technician was able to see the baby's heartbeat. What a sigh of relief! Prior to seeing the U/S the doctor kind of walked back and forth past me as though she was preparing to give me bad news. When the U/S Technician finally put the report in the doctor's box she appeared amazed that it turned out so well and then stuttered over the words "Have you rescheduled your OB appointment yet?" Of course I hadn't because a week prior, she had told my to wait to schedule the appointment until after the U/S (as if to say if it's bad there will be no NEED for an OB appointment) So much for positive thinking!
After a great 'start OB care' appointment the doctor commented, "Things look really good, but because of your low progesterone I don't want you to get your hopes up until after the first trimester." I thought I would never get the green light that my pregnancy was fine. Although the pregnancy had been progressing fine and all signs were good, she was treating me as though the pregnancy was a risky one. Her attitude when I visited her was usually apathetic. I remember feeling that she just couldn't believe that someone my size was having such a healthy pregnancy. Nine UNEVENTFUL months later...to the day (my original due date had been 11/20, but was changed to 11/13 after my third U/S), I began my birthing journey:
Wednesday: False labor pains begin at 2:00 AM and continue on and off throughout the morning and afternoon. About 3:00PM I lost the first of what would be several parts of my mucous plug followed by general crampiness for the rest of the day and evening.
Thursday, 12:00 AM: Contractions begin at 7-10 minutes apart. I figured it was more false labor pains since I had not had a bloody show (but ultimately learned that these were in fact the real thing). I called my midwife when the office opened at 9:00. She thought I may be right in assessing the pain as false labor. I had not slept all night from the pain and she prescribed a sleeping pill. She said, "If it's false labor, the pills will stop them and you'll sleep, but if it's the real thing, you won't be able to sleep through the contractions." I decided not to take the pill just in case. I didn't want to be in pain AND groggy!
At 2:00 PM my water broke (although it wasn't as much water as I had expected) and the midwife asked me to come in to be checked. Once there, she confirmed that it in fact my water had broken and then informed me that the fluid was stained with meconium. She also stated that I was only 1 cm dilated and at this point I had been in labor for over 13 hours. She recommended pitocin to get things going. I'd learned that those moms induced with pitocin had very hard labor pains and my midwife confirmed that this may be the case. I told her that I wanted to try it without an epidural and knowing the c/s rate for overweight women, reminded her how important it was to me to wait as long as possible before a C-section was considered. We then left for the hospital.
4:30 PM Contractions still irregular and topping off between 70 and 80. I am confined to bed with external fetal monitor. I am told that I may be able to walk the length of the bed if the baby responds okay to the contractions. So far so good.
8:00 PM After 18 hours of labor, the pain is more than I can handle. I admit defeat and request the epidural.
10:00 PM According to the monitor, contractions are double and triple peaking at 100. I breath a sigh of relief that I can't feel anything but pressure. Midwife checks and I'm still only dilated 3 cm. She waits for a contraction and stretches the cervix another 3 cm to 6!
Friday,12:00 AM: Midwife tells me there have been a few drops in the baby's heartbeat and asks to insert an internal monitor for more accurate readings. Realizing this would confine me to the bed but wanting to do what was best for the baby, I reluctantly agreed. Midwife discovers that my bag of waters had not completely ruptured and may have been delaying the baby's drop into the pelvis. She breaks the sack and the baby moves to -1 station. (NOTE: looking back, I realize that if we had know this back at the office, I may have avoided using the pitocin altogether since the unruptured sac was preventing the baby from moving down into the pelvis, thus stimulating more productive contractions.)
3:00 AM Dilated 6-7 cm. I am exhausted and disappointed, but ask to be given more time before considering a C-section.
4:30 The midwife brings in the doctor-on-call to evaluate. The baby had several heartbeat decelerations after contractions and she was concerned. I am dilated 8 cm and he tells me to push although I have not yet felt the urge. It is unproductive and a C-section is recommended. I begin to cry from the exhaustion and disappointment, but after 28.5 hours, I agree.
5:10 AM Our darling daughter is born. We had chosen not to learn the sex of the baby and although we both wanted a girl, we felt very strongly it was a boy. When the doctor announced "IT'S A GIRL" I cried and cried and cried. She was suctioned well and the meconium had minimal effects on her. Apgars 8 and 9. My husband left to go video the baby for me and I was whisked off to recovery.
I invested a lot of time developing my birth plan and although this is the farthest from my dream birth, my daughter far surpasses any hopes I had for my baby. There were times during the months following her birth when I thought I could have done something differently to lessen the need for the c/s, but in time I have learned to focus less on the way she arrived, and more the sheer joy she brings me and my husband now that she is HERE! I wish all of you the best in your pregnancies and pray that each of you have an uneventful labor and delivery.
akp's CS Story (induction for macrosomia, botched cesarean, surgical complications)
Kmom's Notes: Her c/s story is a good lesson in all the things that can go wrong during a c/s and afterwards, and why inducing for a "big baby" is usually a bad idea. Things were bad; fortunately they didn't turn out even worse.
Birth Story
In 2001, my husband and I were told that I had almost zero chance of becoming pregnant (we had been trying for over a year) and that if we did get pregnant, that I had almost zero chance of carrying to term. The reasoning given for my inability to get pregnant were: polycystic ovaries, hypothyroidism, a tipped uterus, twisted fallopian tube and I am overweight (270s at the time). I realize now how ridiculous most of these reasons are, but I had doctor worship issues at the time. So, we decided to start saving to adopt.
In 2002, I found myself pregnant. At the first visit (7 weeks), the doctor sent me straight to a perinatologist because I was too high risk. The peri couldn't find a heart beat, so he told me that I most likely was going to miscarry and to schedule the D&C as soon as possible. I was heartbroken, but I believed him. However, I didn't schedule because I needed to hold onto hope for this blessing in our lives. At 8 weeks, I went to the ER with major abdominal cramping--thinking I probably was miscarrying. They did an ultrasound and again, couldn't get a good heart beat, but said everything looked normal and that there wasn't any bleeding. So, they looked around and found a large cyst forming on one of my ovaries. I was told again that I should abort b/c the cyst would most likely interfere, if not burst while pregnant, causing an infection to me at a minimum--death all around at worst.
Hubby and I just could not wrap our heads around why we would be given such a blessing, only to have it taken away. So, we decided to wait and see. At 10 weeks, we saw the Peri again - he did another ultrasound and finally found a good heart beat. Yay. Of course, he also saw the cyst and a fibroid on top of the uterus. The cyst had grown since the ER visit, but the fibroid was small. Again, he recommended abortion b/c we were "running out of time" and it was unlikely I'd carry to term anyway.
(Grrr.)
At 11 weeks, my cyst burst and caused excruciating pain. I was afraid to go to the doctor at this point as I didn't want to hear abortion again. At the 12 week visit, I had a 102 fever and major abdominal pain. The peri did an ultrasound and saw the fluid around the ovary (assumption that the cyst burst as it was no longer there). I clearly had an infection, so he put me on antibiotics. I can't remember which one, but it was a class C I believe. I also had a UTI, so it would take care of both (said the peri). Anyway, he said again that I should abort as he couldn't say whether the antibiotic would hurt the baby or not "better safe than sorry-right." Again, hubby and I chose to wait it out.
At 16 weeks, the peri did an ultrasound that showed everything seemed to be going okay. Baby looked "normal" and my infection was gone. I was reminded that it didn't mean everything was fine and that I should be getting the AFP and so on very soon to see. I also was sent to do a glucose test since I was overweight. I had lost weight so far, but since I was fat, obviously I had to have GD--grrrrr.
At 18 weeks, I decided I had had enough of the abortion talk and can't carry to term stuff, so I switched to a regular OB with a different practice. She ordered the 20 week ultrasound and changed my due date to 4/22/03. We hadn't talked about it much with the old practice since they didn't believe I would "produce" a baby anyway. I believe her due date was 4/26 by LMP. I was happy to have an earlier due date though--I wanted to get this pregnancy over with (so sad I thought this way) and see if she would be healthy. At the 24 week visit, I was told that everything looked good (including no fibroid growth), but after examination, my pelvis would not do well with a large baby. Large baby, by that OBs definition, was anything over 7 & 1/2 lbs. Yep, even being a very large woman, I clearly couldn't birth a baby of normal size. And the cesarean talk started.......
At 26 weeks, I went into mild pre-term labor (I say mild b/c I think now it was BH rather than labor). I was a good patient and went straight to the ER where the contractions measured just enough to call it
pre-term labor. Fortunately, I had a great nurse who sheltered me from all the interventionists (I had told her about my experience so far) and she helped tremendously. She put me in a quiet, dark room. Soothing music and lots of water. Had me lay down for two hours and then re-checked. Contractions had reduced to what they considered safe and she got me sent home.
By 36 weeks, the OB had me do another ultrasound for size. Baby girl measured in at 7 & 1/2 lbs. I believed them. More cesarean talk and my relief at having "what appears to be a normal baby" was replaced with the destruction of my wish to have a vaginal birth. For so many of the wrong reasons, at 38 weeks we scheduled my "induction" for the due date. To the OBs credit, she did say that I was not a good candidate for induction--she told me I would end up with a cesarean. I believed all of it. Induction, however, was my last ditch effort at a vaginal birth as I was having this monstrous 10 lb baby and was just high risk (I thought). I'm so sad for my lack of knowledge and for what I put my poor baby through as I let the hospital manage my birth.
On 4/22, I checked myself into the hospital and gave up all rights to my body. I was contracting when I arrived, so they waited two hours before starting with the cervical softener and pit (doh, I wish someone had told me that I could go home at this point. I wish I had thought of it. I wish.....). I was hooked up to machines, given a blanket to put between my legs and told to not move, but try to go to sleep. Huh--I've got monitors,
Vaginal Exams, pit and Cytotec (I believe) being administered. There was no way I could sleep. 10 hours later, I was only dilated to one and the pit was getting hard to handle. I was only 25% effaced. The OB on call came in and told me that she could break my water, but it would hurt. "It should start labor though." Great, since I was "failing" in my labor, I'd do anything to get things moving.
So, at 1cm dilated and 25% effaced, I agreed to AROM. Gushing, gushing fluid and way more pain. 5 hours later--yup, still only dilated to 2 and 50% effaced. At this point, the pit had been going strong for over half a day, being turned up every couple hours and I was in a lot of pain. My OB came in as she was starting her shift and told me that I was not progressing and should expect a cesarean. If I wanted to keep trying, she'd "let me go longer." She also said I could have an epidural since the pain level was getting so high and there was no way I was going to dilate fully anyway.......... I got the epidural around 22 hours after pit started. At about 11:00 pm, after being at the hospital for 25 hours, I couldn't take it any more. I needed sleep. I needed food. I needed the constant negativity to end. The monitors showed slight dips in baby's heart rate with some contractions and I signed the paperwork to get my cesarean.
I was broken. I thought I probably had a baby with major problems and I was in pain with constant fluid running all over the place from AROM. I gave up. At 11:45. I was wheeled into the OR. I weighed too much, so I had to help the nurses move me from bed to operating table (just the beginning of the too fat punishment). My arms were strapped down and the anesthesiologist started the numbing process. My BP dropped drastically and I tried to throw up, so they started administering several medications (not sure which ones) to help with that. I was "re-stabilized" and forced to breath through an oxygen mask as I was so numb, I was having trouble breathing. I know my BP dropped several times as the nurse kept telling the doctor that my BP was too low again and medications were administered. More anti-puking meds were given each time as I kept feeling like throwing up.
At 12:07 a.m., my baby girl was surgically removed from me. They held her up over the screen for like 2 seconds and then brought her over to the warmer table where the
pediatricians worked on her. She didn't make a sound for what felt like an eternity, probably 2 full minutes, but then we heard her and felt relief. At least she was okay for the moment. Elizabeth's apgar scores were 6 and 9. All of the constant interventions had caused some distress, but she was okay. A healthy 9lb, 12 oz baby girl.
I began swelling immediately afterwards, even though I had almost no swelling in pregnancy. I was also in a lot of pain. I kept asking for more pain medication and received a lot of percocet. Nothing seemed to help with the pain though. It was searing, burning pain.
And Elizabeth wouldn't nurse. She had been heavily medicated via my induction and then was given formula while I recovered--the staff had told hubby that Elizabeth was hungry and since I was in recovery with no visitors, he would have to feed Elizabeth formula (grrr again). About 4 hours after the surgery, my mother and husband came to see me. Where's Elizabeth? She's with my sister and brother-in-law, bonding with everyone but me. So, my sister finally brought her in and I got to see my baby. I was still too numb to lift my arms, so everyone had to pass her around and hold her so I could look at her.
Finally, about 45 minutes later, I could move my arms enough to hold her. She wasn't interested in nursing and began her extended sleeping regimen. Nursing never worked out well. 18 hours later, the nurse came and pulled out my cath and told me I had to go on my own. She wouldn't help me out of bed b/c I was too big and I'd hurt her (why was she a nurse then? Why didn't she get help?), so I developed tendonitis in my shoulder getting in and out of bed over my four day hospital stay. Elizabeth lost a full pound and was taken to the nursery where she was given formula again w/o permission.
Finally, I decided I couldn't take it any more and asked to go home. I was released with a prescription for vicodin and went home. At my 8 week checkup, I still complained of being in pain and was told that I was too overweight and out of shape. If I'd work on exercising more, then I'd heal faster. Of course, the OB did find a strange bulge in my abdomen and ordered an ultrasound. Ultrasound showed nothing, so I never heard from the OBs office again.
16 months later, I felt a cyst growing in my abdomen and thought it was probably a very large ovarian cyst. At 17 months post partum, I went to my PCP because I was getting uncomfortable and the cyst was too big to be an ovarian cyst. He felt it and told me I probably had cancer. Basically, he said that 17 months out from having a clear abdomen, it didn't look good and that I should start making plans for my death. He sent me to get panels of tests for cancer and another ultrasound. Everything came back negative (no cancer and no baby). By 18 months Post partum, the cyst had grown to the size of a 20 week fetus. All the tests kept coming back negative, so I was sent for a cat scan.
The cat scan showed that there was a lap sponge and surgical tape with something that looked like metal strings. Apparently, the nurses did not bother to do the sponge count and no one saw the surgical tape and metallic edging that is supposed to help keep this from happening during/after my cesarean surgery. For months after my cesarean, I was told that I was just fat and had no tolerance for pain because, of course, there couldn't actually be something wrong with what the OB or staff did during the cesarean. For almost two months, I thought I was going to die and leave my 1 year old with no mother. All of that because I believed the doctors from before I even got pregnant that I was broken.
18 months post-partum, surgery was scheduled to remove the damaged tissue, lap sponge, tape and so on from the botched cesarean. Everyone was still thinking it was no big deal, so a laparoscopy was performed. That failed. There was too much damage and the "foreign objects" were too big. So, I then had open abdominal surgery. There was a ton of scar tissue, of course. I was told that it would be highly unlikely that I could get pregnant, but if I did to at least wait a year or more to ensure my abdomen could handle such a high-risk thing. There was no additional scarring to my uterus, but I'm "just so high-risk now."
Six weeks after the open surgery, I got pregnant with my second baby. Most OBs had heard of my case and didn't want to see me as a patient. I interviewed 3 and found one that I thought was going to be VBAC friendly and sympathetic to my history. By 20 weeks pregnant, I had decided to go the homebirth route and so begins my VBAC story............
Kmom Note: akp's VBAC story can be found in the BBW VBAC FAQ.
Stacy's Story (3 pregnancies; gd + ketones with 3rd; 3 c/s)
Kmom's Notes: Stacy's extreme problems with ketones in gd are unusual. So was the level of calories she needed to have normal levels. Most gd moms are given around 2000-2200 calories; some docs restrict obese gd moms to 1500-1800 calories but this raises the danger of ketones and brings up whether the mother is adequately nourished at that level. However, Stacy ended up with the highest caloric totals I've ever seen for a gd mom---2800 calories! She also had to stop exercising to stop the ketones; this is very unusual. However, her ketones had probably become so out of whack previously in the pregnancy that such drastic measures were needed to stop them. Fortunately, her providers did measure them regularly (not all do) and experimented till they found what worked best for her. They didn't simply apply a uniform protocol, which helped a great deal.
Birth Story
I was diagnosed with GD at 28 weeks. With my other two pregnancies I had failed the 1 hour glucose test, but passed the 3 hour one. Not this time. My fear for the health of the baby and being absolutely terrified of blood tests, wreaked havoc on my emotions. I was determined to do everything possible to avoid insulin injections, even though I knew that it may be inevitable.
First, a little history. This was my 3rd pregnancy. My first baby was born when I was 29 years old. I was a dress size 20 when I became pregnant with him and gained less than 5 lbs during the pregnancy. (Not because I was trying to not gain weight, I ate very normally. My body simply didn't gain weight.) At 32 weeks gestation I noticed that he had become suddenly a lot less active. (Thank God for the doctor recommending counting kicks early on.) I went in to see my OB and was put on a fetal monitor immediately (non-stress test). The baby was having dips in his heart rate. They rushed me to a local hospital that had a more advanced neonatal ICU. As soon as we arrived there, his heart rate took a drastic plunge and he was born by emergency C-Sec. within minutes. He is now a perfect, simply amazing, brilliant little 6 yr. old.
Baby number 2 was born 14 months later. My dress size was still a 20 but I had gained about 10 lbs since the first pregnancy. Again, with this pregnancy I gained little weight. I was not diagnosed with G/D but once again I had failed the 1 hour blood glucose tolerance test and then passed the 3 hour test. On his due date, after 14 hours of labor, the baby went into fetal distress and was also born by an emergency C-Sec. His situation was totally unrelated to his brother's. He was born with a rare skull bone abnormality, that was corrected by surgery when he was 2 months old. But because of that problem, his head was simply unable to pass through the birth canal. He is now a perfect, hilarious, brilliant little 5 yr. old.
Ok, now back to baby number 3. With this pregnancy I was 35 years old and had again gained about 10 lbs since the last pregnancy I was now a size 22. At the beginning of the pregnancy, after much discussion with my OB, I decided to have a planned C-Sec. this time. Once I made that decision, I was completely relaxed about the rest of the pregnancy. We also decided at that time, that this third child would be our last, so I planned to have a tubal ligation at the same time. The decision was made long before the GD diagnosis.
After being diagnosed at 28 weeks, I began the diet and exercise program given to me by the doctor and registered dietitian. I stuck to it to the letter, but something wasn't working right. My ketone levels were registering "high" everyday. I had been very inactive due to an accident I had been in for a few months prior to and throughout my pregnancy. So, not only was I a plus size person to begin with, but my metabolism was certainly not normal either. Although, like many large women, I had gained almost no weight up to this point in my pregnancy.
Within 2 weeks of starting the diet/exercise program I had lost 8 lbs. At first the dietitian and doctor told me to not worry about it since many people lose weight when they begin the program. My blood sugars were all fine. But then when they saw my ketone levels they decided to take action. I figured that my body was just in so much shock from actually exercising, that it just couldn't help losing weight. I cut the exercising down to 5 minutes after meals.....and they raised my caloric intake to first 2500 calories.....then to 2800 calories.....and then finally to 3000 calories per day. Finally my ketone levels went down to "small" and "trace" readings, but I was still losing weight. With the agreement of the dietitian, I stopped exercising altogether. In my case, that worked. I stopped losing weight, had no ketones, and by just lowering my calories back down to 2800, my blood sugars stayed within normal range. I was able to control everything without insulin injections. Yippppeeeeee!!!
At 38 1/2 weeks my daughter was born by C-Sec., healthy, weighing 7lbs 5oz.and was 19 inches long. A planned cesarean is a LOT more relaxing than an emergency one. (Although, due to my fear of blood tests, as mentioned above, I was MUCH more fearful of getting an IV than the surgery itself. Go figure.) Everything went as planned to the letter. It was almost comical, shaking the doc's hand and saying "OK, now go get my baby." It was incredible, magical, wonderful. I was given a spinal block and had no ill side effects from it. For some unknown reason, the baby's blood sugar was low at birth. It registered 29 which was well below the hoped for reading of 40 or higher. My husband was handed a bottle of formula and he fed her about an ounce of it right away. Her blood sugars came up to normal and have remained that way ever since. I was a little concerned that she might not want to latch on to me after trying a bottle nipple first, but she latched on like a pro on the first try, a couple of hours later. The baby did not have any shoulder dystocia any other troubles associated with GD or anything else, for that matter.
It was a lot of work, but very much worth it, and I have a whole new understanding of my body and my metabolism. My emotions went through typical upheaval after her birth, but I think that was probably due to lack of sleep as much as due to hormonal fluctuations. I am now slowly adding exercise back into my daily routine and am amazed at the difference it is making in me both physically and emotionally. My boys like Richard Simmons better than Big Bird. Ha Ha ;)
Charlie's Story (fraternal twins, c/s)
Kmom's Notes:
Birth Story
Basically a regular pregnancy... we were a bit concerned at the beginning because of the size I was becoming (rather early). Also because of my age there were concerns that the baby would have problems (down's syndrome, spina bifida, etc) so the clinic did test for AFP.... The results came back high, which led to more concerns and we were scheduled for an ultrasound. At the ultrasound, we found out that the reason the AFP was high was because there were 2 babies, not one, which was a great relief.
The pregnancy was generally uneventful, other than the fact that I was miserable through most of it because of my size and it being a twin pregnancy. I had horrible heartburn most of the time, sciatica (which I have still)... no morning sickness to speak of, although if I got too hungry that would turn into nausea if I took too long to get around to eating and then smelled food.
The doctors initially suggested to me that if we made it through to 7 months that would be great and then we'd see how it was going, since twin pregnancies generally wind up being pre-term. However 7 months came and went and I remained pregnant and miserable. Then they suggested 8 months and they would consider induction since I was so uncomfortable... didn't happen. 9 months.... They tell me, "Well, lets just let nature take its course... " I said, "that's how I got this way to begin with!!!" They still didn't induce.
Finally (since I was going in to be seen about twice a week by then) I had been experiencing some liquid leaking for a couple of days and mentioned it, thinking it was a new kind of incontinence problem (another side-effect of the twin pregnancy), and they checked it, found out it was amniotic fluid and decided to let me go and have my babies. Originally they indicated that we would try and have them vaginally, but since the boy baby hadn't turned (as we had hoped he would) they just went ahead and did the c/s to avoid their chins possibly locking on exit.
That was 2 1/2 years ago. We think (every once in a while) about having another baby, but since the fact that we HAD twins was entirely my fault (the older you get the more predisposed to having multiples) and now I'm 38, I don't think we'll be having any more... Two is plenty and we have a boy and a girl and they keep us pretty busy. Who knows???... next time it might be triplets!!!......and then I'd really be up the creek.
Jessica H's Story (breech, PROM, c/s, spinal headache)
Kmom's Notes: Jessica's doctor felt that because the baby was large at 34 weeks and had low blood sugar, she must have had some undiagnosed GD. There is no way to know this for sure. Yes, the baby WAS large for 34 weeks and DID have very low blood sugar at birth. However, between being premature, having been exposed to brethine and steroids before birth (which raises maternal blood sugar levels, which then can make baby's blood sugar drop after birth), low blood sugar in the baby would not be an unusual finding. On the other hand, it IS possible that she could have developed some late GD between the usual 28 week test and the 34 week delivery. Progesterone levels don't peak till week 32 so it is possible, if unusual, that if she was borderline before, that progesterone peak at 32 weeks could have pushed her over into GD. Still, it is not a foregone conclusion.
Jessica also experienced a "spinal headache" with her c/s. This is one possible risk of both spinals and epidurals. Spinals are placed into the innermost space by the spinal cord, with the drugs going directly into the Cerebral Spinal Fluid. Because they are making a hole in the membrane that surrounds this fluid, sometimes that fluid will "leak" out the hole and the brain will not have as much fluid cushion as it is used to having, causing a temporary but very unpleasant headache. Although an epidural is placed in the space just outside this membrane and in theory should not cause a "spinal headache," sometimes that inner membrane is pierced anyhow and the headache occurs despite a different "space" being used for the anesthesia.
The usual treatment for a spinal headache is to give the person lots of caffeine (as they did Jessica) and to give them a blood patch. In a blood patch, a little bit of the woman's blood is injected into that space so that the blood can clot and hopefully block the "hole" and the fluid leakage. It's unknown why they did not go ahead and give Jessica a blood patch; that might have significantly eased and shortened her discomfort.
Birth Story
Saturday the 8th, following our birthing class (!) my water broke while
I was napping in our bed. I'd never felt so a large SPLOOSH in my life. I hollered for
DH, and ended up leaking even more fluid. I eventually soaked through a beach towel and the mattress by the time the
doctor called back.
When we got to the hospital, I was already at 1-2 and 80% effaced, and at 34 weeks, they didn't want to hear that. So I was put on bed rest,
brethine (asthma medication to stop contractions!) and antibiotics. The
brethine didn't work, so I was put on Magnesium Sulfate. The steroid celestone was given too to help develop the baby's lungs. Since he was
also [footling] breech (feet first), I was to be sectioned. No luck with an external version with no fluid!
So I was on bed rest, and bed pans (yich) until Monday evening when both steroid injections were on board, and I was taken off the Mag Sulfate.
The side effects from the Mag (constipation, numbness and fluid retention) were pretty severe by this time, and it was good to at least
get some circulation in my legs.
Tuesday, my contractions picked up, and I was on the external monitor still, listening to Rascal and watching the Tocometer measure
contraction strength. I did pretty well until 5 that night, and called the nurses insane for not believing I was in pain. By 9:15 that night I
couldn't think straight, and was crying. The doctor checked me on a fluke (don't want to check someone with ruptured waters often) and I was
at 7-8 cm fully effaced with Rascal's feet descending down through the cervix.
I was sectioned within a half hour, and had a rough 3 sticks, 2 for a spinal and then 1 for an epidural. Rascal was lodged in my cervix, so
they took careful time to dislodge him and his head was pushing up into my diaphragm as they did so. It was hard to
breathe for a few minutes until they unstuck his legs and delivered him feet first.
I didn't hear any announcement of sex or anything, they were worried about his lungs etc... but he was a champ with Apgars of 7 and 9! Now,
he's a preemie, 34 weeks, and he weighed in at 3630 grams, or 8 pounds! He didn't require any suctioning, but his first glucose check was 12, so
there was some late developed and un-caught GD with me.
I saw him for a quick few seconds, and my husband went off to be with him during all newborn procedures (pre-planned). While they were
stitching me up, the Duramorph in the epidural was fading, and I felt the last layers of tissue and the staples being put in-- ouch!
I did get a narcotic to last me through that part, and was wheeled into my
post partum room, right across from the nursery. I did get very itchy from the
Duramorph, but wet washcloths to my face, and a drug in the IV took care of that. I had eaten dinner (they fed me!) so I was pretty
nauseous most of the recovery time. I felt tired and drugged from the narcotic, but it helped with my resting that night, and I was on Oxygen
until morning since I wasn't breathing deep enough. DH came in to tell me all the news, and update me before we went to
sleep. I developed a spinal headache and am on high-caffeine intake until it fades. This is a NASTY headache, and I don't wish it on
anyone.
So it looks like all the complications were: premature rupture of membranes, pre-term 34 week gestation labor, frank breech, undiagnosed
GD, and C-section, and spinal headache (from epidural).
Poor Gideon is still in the hospital on a monitor (rooming in with me now) for Premature infant apnea, and his colon is under developed since
he's a preemie, and we're fighting his high bilirubin levels.
On a side note: The C-section was the most relieving thing that happened to me all weekend. My recovery is perfect, wound is clean and dry and
healing well, and I'm walking as well as I was when I was waddling when pregnant.
Never feel a section isn't a real birth! To me, it was a breeze, and I wouldn't mind having to have them every time (provided I
can get a good epidural!).
Bec's Story (insulin-dependent gd, induction, c/s)
Kmom's Notes:
Birth Story
My story starts with the fact that I was trying to get pregnant for about 3.5 years. I was able to get pregnant a few times, but miscarried. After one run-in with a fat-phobic doctor, I found a doctor who was willing to help me (350+ pounds at the time) get to the root of the problem. We never got a definitive answer, but worked on the premise that I have weak ovulation leading to a luteal phase defect (the time after ovulation and before next menses was too short). With the use of 100 mgs of Clomid on days 3-9, 150 IU of Fertinex on days 10-11, hCG injection on day 14, intrauterine insemination and sex on days 15 and 16, another hCG injection for progesterone support on day 21, and finally 50 mg of progesterone twice a day through the end of 14 weeks LMP.
I had some early scares because of bleeding, but was allowed frequent ultrasounds to check the baby. I was watched carefully throughout the first trimester, having many more appointments than the average patient, because of my recurrent miscarriages. At 16 weeks I was told I was officially an average patient and no longer considered high risk. I chose to do the triple screen at 16 weeks which came back fine and a level II ultrasound at 20 weeks revealed all was well.
I was diagnosed with gestational diabetes at 27 weeks. It wasn't a big shock since I was 33 and have a family history of diabetes, but what did surprise me is that my one hour glucose test came back at 217. I opted against taking the 3-hour GTT since my one-hour test was high enough to prove glucose intolerance, but my doctor did insist on a fasting level for confirmation.
I was given the choice of trying to control my GD by diet or with insulin. My doctor felt that insulin was the best control, and I did some research and found studies indicating a lower incidence of macrosomial infants when GD was treated with insulin. I had already been pretty much following a diabetic diet, so I didn't feel there was much adjustment that would help. I saw a nutritionist who only increased my calorie intake to about 2000 and frequency of meals, not the balance of what I was eating. A diabetic counselor taught me to monitor glucose levels at home, give myself insulin injections, and discussed walking and arm exercises to help reduce blood glucose levels. Between all of these things, I had the GD in good control within a week, and perfect control (levels under 100) for the rest of my pregnancy. My insulin levels were adjusted periodically, including adding a second smaller injection when my dinner levels were a bit higher than I wanted.
I think my main issue with GD is that I felt that I was on a very rigid schedule since I was supposed to test my fasting level and 2-hour postprandials (four pin-pricks per day) and eat every 3- 4 hours. I even had to wake up at 2 a.m. to eat a small snack so I wouldn't have ketones in my urine in the morning. I exercised after breakfast and after lunch everyday, and tried to do after dinner but was often too tired by then. I figured at least I would be in good shape for labor. Even with GD, I feel I had a pretty easy pregnancy and that I felt very healthy throughout.
I switched doctors at 35 weeks to a doctor/midwife team. While my previous OB might not have induced me for another week, the new one didn't want me going past 40 weeks with GD. We knew my exact dates and I felt more comfortable not going past my due date myself; I actually would have pushed the other OB to induce me at 40 weeks! My son didn't show signs of distress, but my insulin need was dropping, something that can indicate the placenta is beginning to fail. It was hard to find good information on insulin-dependant GD . . . most of what I could find was for insulin-dependant diabetics and being extrapolated to women with GD. My original OB didn't feel that it should be, and I agree.
At 39 weeks I had a vaginal exam with the intent of stripping my membranes. I was only fingertip dilated and 30% effaced, so that didn't happen. At 39w5d I was admitted to the hospital for prostaglandin gel applications to the cervix. I had some gel in the morning, did a lot of walking trying to get things going, and then had more gel in the afternoon. I went from fingertip to a bit more than one and 70% effaced. I also started to lose my mucus plug, but had few contractions. I was sent home at 7 p.m. and told to return the next morning for pitocin.
I'm not sure why I was being optimistic about the pitocin since I know it doesn't tend to work well before someone is dilated to 3 cm, but I guess I just figured I needed to labor, needed to get the baby out soon, and somehow it would work. Even the pitocin didn't do that much for me immediately, and it was restricting my movement since I was on a monitor and it wasn't cooperating; if I moved, we would lose the heartbeat. I really didn't want to be stuck in bed and it was very uncomfortable. It was pretty clear mid-morning that my perfectly positioned baby decided to move and give me back labor. Every time I had a contraction, I would get a sharp pain in my butt and down my leg. In the early afternoon I was thinking I would be unhooked and sent home, but all of a sudden I felt something akin to a balloon expanding and then popping followed by a gush of fluid; my water broke, and there was meconium in it. I was on the clock . . . baby within 24 hours.
I was at 3 cm and the OB put an internal monitor on me, something I hadn't intended, but appreciated since it allowed me some more mobility. The pitocin and IV insulin were turned up since my blood sugar was rising. The midwife was wonderful trying to help me find more comfortable positions and massaging my back. The best position for me seemed to be sitting up in a rocking chair. In the evening, I was so exhausted I decided that the pain might be discouraging progress, so I had a small dose of narcotics to take the edge off. It worked and allowed me to sleep between contractions which were 1+ minutes on, one minute off for hours. I was rechecked late in the evening after my son showed a few decelerations. I had not made any progress and was still at 3 cm. The OB said I might just be too small (based on my tiny feet and short stature) to birth the baby and I should consider a c-section. She would let me go another hour or so and check if I wanted, or we could make the decision immediately. Since a friend of mine had recently lost a healthy full-term baby, I chose to do the c-section. My son was born at 12:44 a.m. on his due date. He weighed 7 pounds 11.5 ounces, 20.5 inches long, and apgars were 9 and 9.
My biggest regret about the c-section was that I ended up so exhausted that I didn't really get to hold my son and nurse him until he was 9-10 hours old. I know the pro-breastfeeding nurses were upset with the anesthesiologist about it, but I didn't really understand why I wasn't woken. Maybe it was the meds. I also missed my son's first bath, but I have seen most of the firsts since then and that has helped diminish the pain I had from that (which did cause some post-partum depression). My surgical wound healed easily and my blood sugars returned to normal within 48 hours. I was released 3.5 days after having the baby and my staples were removed 5 days post-partum. After a rocky start, my son is still nursing at 20 months.
Margaret's Story (malposition, c/s, severe post-surgical infection)
Kmom's Notes: Margaret experienced a very severe infection after her c/s. It is unclear why she had such a bad infection afterwards, although the use of an internal monitor is known to increase the risk for infection. Still, very few women with internal monitors experience an infection as severe as this.
Although she was not plus-sized before the pregnancy, by the end of the pregnancy she was, and could have benefited from some of the preventative measures doctors can take to reduce the risk of infection in women of size. These include doing subcutaneous stitches in the fat layer, placing a drain in the wound, prophylactic antibiotics (hopefully with weight-based dosing), etc. Eventually the doctor did order some IV antibiotics, but Margaret may have benefited from an even more aggressive approach (i.e. multiple dosing, staying in the hospital longer for monitoring, etc.). According to Margaret, "I didn't have a drain, or stitches under my skin. I just had those big staples. Afterwards though, I had no closure at all, besides the stitches in my uterus."
After going home, Margaret's wound re-opened with infectious material. She ended up back in the hospital, having the wound drained in an additional 3 hour operation, probably debrided, then packed. She was in the hospital 5 days for infection management. She then ended up with home health care 2x per day, packing and cleaning the wound for another 6 months. The wound stayed open for another 3 years before finally closing, and to this day she has numbness and sometimes pain in the area.
Never let anyone tell you that a c/s is low risk. Although most women do not experience infections as severe as this, infection is a significant risk to cesareans, and at much higher rates than after vaginal births, especially in women of size. Although there are things doctors can do to lower the risk for infection, it is never possible to lower the risk for infection to zero, and occasionally infections become so severe they require major interventions or put the woman's life at risk.
Birth Story:
Hi, I'm Margaret. I'm 28 and pregnant with my second child. I would like to share the story of my five year old daughter's birth, where I contacted an infection after a c-section. I feel not only will this story help clear my head of the trauma I experienced, but it could also help someone else at some point in time.
Before I even knew I was pregnant with my daughter, I must have gained 15 pounds. I weighed 145, the most I had ever weighed. Upon finding out about the pregnancy, I began overeating in an extreme way. I was newly married, unhappy and very depressed. I thought marriage was like the Cinderella story, no one told me about the roller coasters! My husband & I barely made it through...we actually filed for divorce when my daughter was 6 weeks old. Thankfully it never happened. We have been married for 5 1/2 years.
I had bleeding during my pregnancy that continued well into the 6th month, I was terrified I would lose the baby. I was put on bed rest and gained a lot of weight. My OB was unsympathetic and told me I would end up "being a fat woman for the rest of my life". I weighed 220 pounds at the end of my pregnancy. I have been overweight ever since.
I went to the hospital at 6:30am on November 6, 1998. I was induced and contractions followed shortly after. There were nurses in and out of the room constantly, checking my cervix and making sure I was comfortable. My water broke at about 2:00pm, and an internal monitor was used. I
dilated to 5 and was feeling pretty confident about my body's ability to give birth. A nurse made a comment about there being "no need to be a
"martyr"....I caved pretty quickly after that and received an epidural at 3:00pm. I was complete in an hour, the epidural was turned off and I began pushing. I pushed and pushed for four hours. The doctor told me I may be able to deliver the head, but if the body was unable to come through, he would have to push the head back in. I was terrified by the thought of that. I began doubting myself and wanted to give up. We prepared for a C-section.
The procedure was virtually painless, just some pulling and pressure, after about 15 minutes our daughter was born. My husband was crying and came to show me our new baby. Since my arms were bound to the table, I could only turn my head and sneak a peek. I looked at her for the first time and it was as if we had met somewhere before. I looked into her eyes and said "how weird"...she was taken to the nursery and I don't remember much. I was very tired and unable to open my eyes.
A few hours later she was brought into my room. I began nursing and loved seeing my new baby. In hindsight, rooming in would have been less stressful for me... I hated when they took her away from me. At one point they told me I could not see her because the doctor was coming to check her. I was very upset that I was told I couldn't see my own daughter.
I was given sleeping pills because I was unable to sleep due to the excitement of it all. On the second day the nurse came in to change my bandages and look at my incision. She was not very happy when she saw the area red and swollen.
But I wanted to go home, I wanted to dress and bathe my baby. I wanted to play her music and show her our home. I told the nurse my incision was red because of the tape. I must have a tape allergy. She shook her head "I have seen this before". The doctor was called and he agreed with me, it was a tape allergy! I guess he just wanted to be sure, so I was given antibiotics by IV. The doctor ordered a water filled heating pad. I placed this on my incision to help with pain.
One night I was having severe pain that the pills were not touching. My hemorrhoids were out of hand, due to pushing. I called the nurse and asked her for tucks and my heating pad. She left me for two hours because she had to "verify" this information with my doctor. Instead of giving me the damn tucks...she said "you had a c-section".
I was allowed to go home on the 4th day. I called the hospital and complained about the bitch nurse. The woman, who happened to be the head of the nursing department said "Oh yeah...I know who you are, you're the one that got the infection"...I guess she knew something I didn't.
When we arrived home, I lay on the bed and cried. My husband was shocked, I had been so happy and strong at the hospital..what was happening? I told him the pain was impossible, I needed something for the pain. He didn't know what to do for me, and I spent the first night home in agony. I continued to feed our daughter and clean the house on the second day home. I was in the kitchen washing dishes when I felt something warm near my incision. I looked down at my white shorts to see a green stain forming near the stitches. There was green/yellow fluid oozing out of my body. We headed down to the ER.
My mom came to the ER and held the baby. She started crying to be nursed, and my mom took out some formula and fed her. She wasn't used to the quick flow of a bottle and vomited all over the waiting room. I couldn't stand watching her drink from the bottle. I was supposed to be able to feed my baby. I wasn't supposed to be back at the hospital. I wasn't supposed to be in this much pain. The doctor in the ER said she needed to remove the sutures and examine the incision. I almost crawled up the ceiling at this thought. NO WAY! I demanded that they call my doctor, he arrived shortly after and I was set up for surgery.
They re-opened the incision, in order to clean it out. The operation ended up taking over 3 hours. I don't know what they did while they were in there, but the pressure seemed to be gone. I was admitted to the hospital and put on a regular nursing floor. I began pumping my milk for my husband to take home. I was determined to breastfeed. I was not going to allow this to interfere with my plans. I had to pump every 2 hours, around the clock. Because of the amount of medication in my system..I was told to pump and dump my milk. If I couldn't feed my child, I was going to keep up my milk supply. No one thought this was very important, even the doctor. "It's ok Margaret, sometimes things just don't go as planned" I ignored them. I was going to nurse my daughter.
My husband took our daughter home the first night I was admitted, he came to see me the next day looking very frazzled. He didn't know anymore than I did about babies. The little I knew came from books. He was very scared and nervous about being alone with her. She was crying, he was crying and I wanted to disappear.
A nurse appeared and said she was going to be changing my dressing. I assumed it was just a layer of gauze like it was before, with sutures underneath. She removed the first layer and then the second and then the third....then she began pulling out gauze that seemed to be rolled into a ball inside my abdomen. She pulled and pulled and pulled on the gauze...It began to stick on the inside and I started to cry, then scream, then moan. My mother in law and husband came around the curtain to see what she was doing. My mother in law started screaming at the nurse to take her hands off me. The nurse and her began a screaming match, as I lay there with dirty gauze coming out of me. The doctor was called in. After strongly medicating me they wet the gauze and removed it. It took over an hour to get it all out. There was an endless roll of gauze in my abdomen.
Until the incision had healed a little on the inside, the doctor gave orders to wet the gauze with sterile water. I still didn't realize that my incision was so deep. It went down to the muscle. The doctor recommended that I shower without the gauze and hold my abdomen open. He said it was an unsterile wound, water would do it good. I was afraid to touch it, let alone shower it. When nurses came in to change the dressing I freaked out. I was given a shot of Demerol and a vicodin a half hour before dressing changes. If they hadn't medicated me I would have ran away from the nursing staff.
My sister in law offered to take the baby for a night. She came back the next day, glowing. There was a pacifier in my daughter's carrier and she smelled like formula. My sister in law was smiling when she told me the story about a couple she met in the elevator. "They just thought she was the cutest thing..and she is, you know?" "The man couldn't get over what great shape I was in..ha ha" "I just thanked him and smiled."
I guess she missed the tears in my eyes at that point, she just kept talking about what a great eater she was..and how she loved her formula.
I grew this baby with my own body. I had loved her for 9 months, talked to her all the time. What nerve she had to take all the credit. I was so upset and pissed off at everyone. I wanted to scream.
My total stay in the hospital, the second time, was 5 days. I was sent home and visited by home health nurses twice a day. They changed my dressing and took measurements of my incision. One of the nurses wanted to take a picture of it for me. She thought I might need to document this one day. I refused. I just wanted this to be over. Hair began growing around the incision. One of the nurses recommended that I shave it, to avoid irritation. The thought of shaving that area still gives me chills.
I continued to pack and clean my incision for 6 months. It was a gaping wound, left open from the inside out. It took 3 years for the outside to close completely. I have numbness and pain sometimes when pressure is applied to the area. I can't imagine ever having that area opened up again. I lost 40 pounds after the birth of my daughter, but because of the drawn out healing process I suffered from a deep depression and ended up gaining it all back. I have been on every anti depressant in the book over the last 5 years.
I am now on disability due to depression. I don't think the infection is fully responsible for this, but I'm sure it wasn't any help either.
I am determined to have a VBAC.
Lisa L's Story (induction, c/s)
Kmom's Notes: Lisa shows classic signs of a malpositioned baby: prodromal labor for a long time (including going overdue), back labor, feeling an urge to push too early, no progress in pushing despite strong pushing for a long time. The baby was also big, which could also have been or added to the problem, but it's difficult to know for sure what happened. If the baby was indeed posterior, breaking her waters committed the baby to that position and basically ensured the c/s. In a follow-up, Kmom asked her if the baby might have been posterior. She wrote back and confirmed that "she turned during labor and was face-up which contributed to having the cesarean."
Birth Story
I was 42 weeks pregnant, very healthy, but baby did not want to come out. On the day that I went in to be induced I was 1 1/2 cm dilated and 40% effaced and had been in mild labor for two weeks. I went into the hospital on November 24 and had a cervical pill inserted to help soften my cervix which would hopefully help me dilate more. They inserted this pill 3 times at 4 hour intervals but labor got strong just an hour after the first insert (7:00pm on 11/24).
After a restless night and much back labor, accompanied by many showers and much walking, they broke my water at 7am on 11/25. By 11am I was only dilated to 2 cm and getting antsy as my contractions had been one on top of the other for 17 hours. Finally at noon I received an epidural with no complications at all. During this and throughout my pregnancy my weight was never an issue.
At 5:00 I felt the urge to have a bowel movement and when the midwife checked me I was 6 cm dilated and progressing quickly. By 6:00 I was a full 10 but only 90% effaced and I began pushing. After two hours of watching her head bob in and out with contractions and pushing they decided on a c-section because her head was too large.
D was born at 8:13 pm on 11/25/98 perfectly healthy at a whopping 10lbs 4oz. Mommy healed well and overall the birthing experience, though long, was well worth the end result. I am now due soon with a boy and hope to be writing back with a successful VBAC story!
Danie's Story (PROM, posterior, partial abruption, premature, group B strep, c/s)
Kmom's Notes:
Birth Story
The full story can be found at www.childbirth.org/articles/stories/aidan.html. A very difficult birth story; the baby and mother turned out fine in the long run, but getting there was very traumatic for them both. Below is a brief summary.
While visiting a dying aunt, Danie's water broke at about 35 weeks. She did not know it but she had group B strep (infections can cause the water to break prematurely). She had a terrific OB who was very Bradley-oriented and supportive of natural birth, but due to complications she eventually needed a c/s (a truly necessary one).
Her baby was posterior and so labor was painful and not very effective, and during labor her placenta began abrupting (pulling away from the uterine wall). The baby went into distress. When the baby was born, he got pneumonia from the group B strep, one lung was punctured by the suctioning they did, and he was eventually found to have a hole in his heart. However, they did manage to establish long-term breastfeeding despite all the barriers, and he is doing well now in the long-term.
Pam's Story (PCO, insulin-dep. gd, placenta previa, c/s)
Kmom's Notes:
Birth Story
After 2 years of trying to conceive due to PCO, we got pregnant. I had all day morning sickness for 14 weeks. At that point I was diagnosed with GD. Despite diet changes etc, I had to go on insulin at 18 weeks since my fasting sugar levels wouldn't come down. I was also diagnosed with placenta previa (low-lying placenta) and told to take it easy for the pregnancy.
By 36 weeks I was told that my GD was controlled so well (baby was not big at all) and that the placenta had shifted enough, I was going to be able to have a vaginal birth. At exactly 39 weeks I started bleeding and since the baby hadn't dropped and I wasn't dilated or soft AT ALL, it was decided that an induction would be pointless. A c-section was scheduled for 3 hours later. I was comfortable with this choice.
I had an epidural, which the doctors had NO problems putting in. I was easily shifted from my bed to the OR table, even after the section when I was totally numb and couldn't help. I was awake and conscious for the section and my DH was right next to me. Despite the fact my placenta had broken apart and was hemorrhaging, my boy was born totally healthy and fine. Apgars 8 and 10. My arms were restrained by a blood pressure cuff and the IV's, so I couldn't move much, but the nurse freed my one arm so I could touch and caress the baby while DH held him.
Baby never left my sight until DH took him across the hall where I was being taken minutes later. I tried to BF an hour after his birth (the soonest they'd let me) and he wasn't interested. He didn't nurse well at all that day and he finally got a great latch the next morning. From there on in, BFing was not a problem, even on the inverted nipple. I had trouble getting him to latch for a few days, but that was due more to my inexperience and FF breasts. Once we got the hang of it, there was no problem (as long as I used the football hold exclusively). My milk came in by gallons on day 3 and we kept it up until I weaned him at 15 months.
My pain level was easily controlled with Tylenol 3s and I was walking around in less than 24 hours (in fact at 10 hours I walked (slowly and with help) to the bathroom). The staples were taken out on day 4 when I was discharged. I never had any problems with the incision. It healed over easily. By 4 weeks postpartum I was able to run and do pretty much everything. I stopped taking extra strength Tylenol after 10 days. My GD completely disappeared immediately upon delivery, and I've been healthy and happy ever since.
Ann's Story (transverse presentation, c/s)
Kmom's Notes: Ann experienced some size-phobia and hassle from a previous provider, and decided to switch mid-way through her pregnancy. Unfortunately, her baby settled into a transverse position (shoulder/side first) and her doctors' policy was not to attempt external version. Because the baby did not change position on her own, Ann needed an elective c/s.
Birth Story
Ann's story can be read on her website at www.adairmedia.com/ann/elizabeth.htm. She had a pretty ordinary pregnancy, but had a c/s when her baby was found to be transverse. Because it was an elective c/s (no labor beforehand because of the danger of cord prolapse in a transverse presentation), the baby had some troubles breathing at first and spent quite a bit of time in the NICU (neonatal intensive care unit). Ann also had to have an unusual vertical incision due to the baby's presentation. Recovery at first was tough but all is well now. Breastfeeding got off to a rough start, but they persevered and are now breastfeeding exclusively.
JLWEEZ's Story (breech c/s; elective repeat cesarean with severe wound complications)
Kmom's Notes: This mom experienced severe wound complications after her second cesarean. It is important to remember that although cesareans are far safer than they used to be, they still can have severe complications, and that there are many risks inherent in surgical birth. While many cesareans go perfectly fine, there are many women who experience complications too; the risks of surgery should not be underestimated.
In addition, this story is a testament to the importance of listening to your intuition; if something seems "wrong," then make sure someone pays attention, even if they ignore your concerns at first. Paying attention to her intuition probably helped save this mother's life.
Finally, this is a story where the type of incision (vertical, i.e. up and down) may have had a negative effect, although of course no one knows for sure if a transverse (side to side) incision could have prevented these complications either. Vertical incisions have been shown to have a much higher risk for wound complications in plus-sized women. No one quite knows why, but it is theorized that, among other factors, the up-down vertical incision places more mechanical stress on the wound, making it easier to pull apart or heal poorly. A vertical incision also has to go down through the heaviest portion of a big mom's abdomen, which does not have as efficient a blood supply as other tissues. Thus, fluid may collect there or the wound may have difficulty coming together and healing.
Although some doctors have been taught that a vertical incision is a better incision on a plus-sized woman (thought to have a lower risk for infection), recent research has confirmed that in actuality, a vertical incision strongly increases the chances for wound complications instead.
Birth Story
Baby #1: For my 1st delivery, I had my daughter by c-section because she was breech. I did have a "version" done in an attempt to turn the baby into position. This was extremely painful. I had to do my labor breathing to get through it. The doctor was literally on top of me on all fours trying to turn the baby by pushing on the outside of my stomach. We had no success and a c-section was inevitable. They did the incision vertically. This was 6 years before the experience I will now tell you about.
Baby #2: My pregnancy was great! I was so excited to be pregnant after fearing I would never be able to again. The only difference with this pregnancy is that toward the end I had a pressure in my crotch as the baby got into position. I did not experience this with my first breech pregnancy.
Because of my history, the doctors advised that I should have my next child the same way (cesarean). They would even follow the same incision as the previous delivery. I was fine with that. My family doctor is wonderful and he was the same MD (along with 2 other doctors) that advised me to have my gallbladder out at 26 weeks. My family doctor is not a "fat phobic doctor." He has been wonderful throughout both of my pregnancies.
I had my c-section with my family doctor and an OBGYN (also not a "fat phobic doctor"), who I also highly regarded. I knew I was in good hands. All went well at this point. I had a beautiful baby boy. It seemed like it took forever for them to stitch me up. I did have to ask for more pain reducer during the end of the c/s as it was beginning to wear off and I could start to feel the stitches.
After I was totally stitched, I felt great. I stayed in the hospital for 3 nights and 4 days. It is so nice to be there because the back rest of the beds go up and this makes it so much easier to get in and out of bed. It is also helpful to have the rail by the toilet.
When I got home, the most difficult part was to get in and out of my bed. I did have myself propped up with a cushion so that I didn't have to lie flat. But you get up a lot when you have to feed a baby every 2 hours. When I had my first baby, I slept in a recliner. ( I will do that again with the next one). I knew it put a lot of strain onto my incision.
On day 5 after the surgery I noticed that there was a small amount of blood coming from the incision. I dabbed it with a kleenex and forgot about it. Within 10 minutes I was saturated in blood and there was actually a pool of blood on the floor. At this point I was a little concerned. I had a little pain.
We immediately went to the nearest emergency room. The doctor did not seem at all concerned. In fact, he said that it just must have been a pocket of blood that had come to the surface and it needed to come out. When I said I was in a little pain, he said that these were "normal" healing pains. With that, I was released from the ER and sent home.
By the time I got home (20 minutes later), the pain began. I have never experienced such pain in my entire life. This was constant pain. I couldn't walk, talk or breathe it was so bad. My husband managed to get me into the house where I changed my clothes. All I could do was moan because of the pain. After being released from the ER with an all clear, it made me second guess what I was feeling. I just knew that something was wrong. I was in more pain now than right after the surgery. This did not seem like "normal healing pain" to me. My husband was upset because he knows that I have a high pain tolerance. He decied to call my OBGYN.
My OBGYN said he wanted to see me. We drove 45 minutes to the hospital where his office was. By this time the bleeding had returned. I was again saturated in blood and the pain continued to be immense. When we got to the hospital, my husband got a wheelchair and took me in. When he examined me, he seemed concerned. He decided to pop a couple of the staples to have a look. When he looked, his eyes became like silver dollars. Now I was scared. I said "what's wrong?" He said "You have a HUGE hernia!" I asked what he meant. He then told me that all of my internal stitches had come undone.
Things instantly turned very serious. Then the urgency of the situation began to unfold. Within 45 minutes I was in emergency surgery to get this repaired. As they transferred me, he kept saying to hold onto my stomach and don't let go. I later found out that this was because he didn't want all of my internal organs to fall out.
After surgery, I was in much pain. I relied on pain relievers far more that I ever had in the past. Then they broke the news to me. He could not sew the outside back up. That's right, I was packed with gauze and had 2 retention sutures (very large heavy cord like stitches about 3 inches long) to help hold me closed. Apparently I had to heal from the inside out this time. Little did I know at the time what this would all involve. I was literally down for the count after my 2nd major surgery in 5 days. Pain level was pretty high. I did rely on the pain relievers to help me. In the mean time I am being told by family how serious this was and that I could have died. I guess it wasn't my time.
The weeks to follow would prove frustrating. I couldn't do ANYTHING! My milk supply deminished due to the trauma that my body had gone through. I had NO appetite. I would cry whenever I thought of those final moments before I went into surgery and how close I came to not seeing my son grow. My mother-in-law came to our house twice a day to change the packed gauze in my incision site and clean the open wound and re-pack it with fresh gauze. I thought I would never heal. Finally, the day came when I could get the retention stitches removed. They had begun to dig into my stomach and this hurt me. When I went that day to get them removed, I asked the doctor (OBGYN) what happened. He said that the sutures broke!! And they broke at the opposite end of the knot. Therefore his knot held strong, it was the sutures themselves that did not.
Now 17 months later, I want to have another child. My husband is a nervous wreck even though I know he wants another one too. In looking back I recognize that as a BBW, I think it is better to stay in the hospital longer. Just because the beds are so much more accommodating as far as getting in and out. I think it puts alot of strain on the abdomen to get in and out of a regular bed. Especially with the extra weight around the middle. I will have many discussions with the MDs at length with the next delivery. I will insist that they use heavy duty sutures, I will request the dreaded retention stitches and I will take as long as I need in the hospital to assure that healing is well underway. All I know is that I am blessed to be alive to see my baby grow and to tell others of my story.
ALWAYS follow your gut feeling when you think that something is wrong. It is your body and nobody knows it better that you do. My insistence that something was wrong saved my life!!!
Jen S's Story (PIH, induction, c/s)
Kmom's Notes: Some women love their c/s, some are indifferent to them, and for some women, they are a total violation. For some women, it is almost akin to a rape. Jen feels this way about her c/s, and she certainly didn't get much support or help from the staff. Her wishes were often disregarded and it's a testament to her dedication that she was able to keep breastfeeding despite all the intervention from the hospital.
Jen took a Bradley childbirth education class, which is often helpful. However, there are a few doctors and hospitals where this is viewed with great hostility and the staff may hold it against you. The doctor she had was supportive, but she did not get that doctor for the birth. Kmom also wonders about the position the baby was in and if that affected the labor. Like many women who experienced a traumatic hospital or c/s experience, Jen plans a totally different birth next time.
Birth Story
DH and I studied very hard. We read everything we could get our hands on and even some more. We were taking articles to class to share with the teacher. The classes were terrific. I really enjoyed hearing other birth stories. I couldn't wait to see what mine would turn out to be like. I was committed to a natural, drug free birth. Most of my friends thought I was insane. But I kept insisting that I was going to do it. I felt like it was best for the baby and for me. DH and I felt we had fully prepared for the birth of our first child. We took the responsibility of being parents very seriously as we learned everything we could. Our ultimate goal was to have a safe and satisfying birth, a healthy child, and a healthy nursing relationship fostered by immediate contact with mother and baby.
But I wasn't as smart as I would have liked to believe. Looking back now, I can see some major problems in my plan for a natural Bradley birth. My first problem was that I thought that because I had read and studied and knew so much that I would be in control, no matter what. My next problem was the doctor I chose. I really wanted to have a female doctor. The only one in my area had just gotten out of school. (Maybe she would have been the best choice?) And the other practice in town that all my friends went to were not only men but they belonged to my church. I couldn't go to them! So I decided to drive an hour away to see a woman doctor that I knew personally. My friend, who now lives in Oregon, was her nanny for two years. I felt like I trusted her. Besides the hospital was supposed to be one of the best. The problem with her was not really her at all, but it was the practice she was in. There were eight or nine other physicians in practice with her. So anyone could deliver my baby. How it turned out, the one doctor I never met was the one who delivered B!
DH and I wrote our birth plan and presented it to our doctor. We worked very hard on our plan and made sure that we hit all the major basics we wanted covered, being careful not to overwhelm our doctor. (This was a stupid idea we had. I now believe that a birth plan ought to be what you want it to, and if it is "too long" for your care giver to read, then you should find another care giver). I made a special appointment for DH and I to sit down with my doctor to look over our carefully designed birth plan. After presenting this to our doctor and complete discussion on every point, we felt satisfied that we were prepared for our Bradley Birth. I can remember her saying to me though, "I just hope that I am there." That should have been a clue to me that not everyone else would be so willing to let us participate in the birth of our child.
My next problem was that I was overdue. Despite every trick in the book, that baby was not ready to come out. I was eight days past my due date when my doctor decided that I should undergo several tests to see how the baby was doing. I should have canceled that appointment. My doctor decided that induction of labor was necessary due to several factors; an ultrasound found I had low amniotic fluid, my blood pressure was elevated and traces of protein were found in my urine and I had enormous swelling ankles and feet. Paul and I talked it over. I had an idea that she would want to induce me and I couldn't see a way out of it at the time. I trusted her decision and besides, I really was anxious for that baby to come. It was kind of exciting. Needless to say, my birth plan was practically thrown out the window right at the start, but I was still optimistic.
The plan was for me to come in that night and start with prostaglandin on my cervix. Twelve hours later, they would start pitocin. But Paul and I wanted to go home first (one hour away). We went home, ordered pizza, picked up some movies and I called some friends and my Bradley teacher to tell them what was going on. D's advice was to stay home for the night and get some sleep. There wasn't any real reason to go that night. I was tired from staying up the night before playing computer games and I should have listened to her. But . . . I was too excited. My plan was to go to the hospital and sleep there that night, get up early and walk the next day until the baby came. Boy, was I in a dream world! I should have listened to her and stayed home. But I really didn't want to call my doctor and explain, DH was hurrying me to get off the phone and I kind of wanted to go. So we went. By the time we got to the hospital, the doctor on call was irritated we had taken so long to get there. She wasn't interested in talking to us about the birth plan we were so proud of and determined to use. Her exact quote was, "You can stand on your damn head for all I care."
When we arrived in our room, the nurse had the bed, fetal monitor and IV all laid out for us. We refused the IV and allowed the E.F.M. for a little while. Then I was started with prostaglandins put on my cervix. Although I didn't realize it immediately, my contractions started within an hour or two. The nurse had explained to me that I might have some cramps. That's what I assumed they were. But they were my contractions. I didn't realize that they wouldn't feel like typical contractions. Right from the beginning the contractions started coming everyone to two minutes, sometimes right on top of each other. I felt them as pains in my lower back. I couldn't sleep and I couldn't rest. The nurse kept coming in the room to adjust the E.F.M. (which she said I HAD to have on if I was in bed). Within an hour of these contractions, I was lying in the bed and totally overwhelmed. They were taking my entire concentration to try and relax. When I was hooked up to the E.F.M., nothing was being picked up to suggest that I was having any contractions. I was starting to worry about what would happen when my "real" contractions were going to start. There was never the tightness in my abdomen, only severe back pain.
And since it was next in my doctor's plan and my labor did not seem to be progressing, the pitocin was started by seven the next morning. After awhile, I started asking for pain medications. An epidural was suggested but I said, "Oh no! I'm not having an epidural!" So I went on some more. The contractions kept coming but not registering on the monitor so my pitocin was turned up on a regular basis. I asked for pain meds again. I still refused the epidural but settled on stadol. This drug knocked me out. DH said I fell asleep immediately. I cannot remember much of anything, because I was in and out of consciousness. I couldn't tell what was real or what was a dream. It felt horrible! It was like a nightmare. The pitocin was still turned up again and again and when I couldn't sleep anymore, I tried to deal with the contractions (I'm not sure I even realized I was in labor yet).
After 16 hours of this, I was begging my husband for an epidural. I had changed my mind about the epidural when they told me I couldn't have any more stadol. DH tried hard to get me to relax and not have the epidural but I was tired and out of my mind and determined! So in came Dr. D and gave me the epidural I swore I'd never have. I can remember asking the nurse about how I compared to other women who requested epidurals. I wanted her to tell me that most women need one much sooner than I did and that I was really strong for waiting for so long. But she said, "oh, other women usually get an epidural about the same time you did, at a three or four." I really felt bad after that. I was felt like a failure then and I feel like one now. After all my classes and education and relaxation exercises, I couldn't get any further with a natural birth than a woman who had planned on a medicated birth her entire pregnancy! Well, after I had the epidural, I dilated from three to nine. I wonder now if I was in transition or if the epidural had just helped me to relax? I wish I had a doula or my Bradley teacher there because maybe things would have gone differently.
My real doctor (not the one on call) had come by to check on me. She asked me if I minded if they could use an internal monitor. I didn't care. I was stuck in the bed, I had an IV, blood pressure cuff, oxygen mask, E.F.M. and I can't remember what else! I figured at least I'd get some equipment off of me. This was also the time when an internal pressure catheter was put in place. My husband describes the scene as very quiet as the nurses quickly stopped the pitocin when they finally saw my contractions show on the monitor (which were still in my back every one to two minutes and still had never shown up on the E.F.M.) My contractions were out of control. My husband still worries about the pitocin being turned up and up and up. He was relieved that the pitocin was stopped because he was worried about my uterus rupturing.
Once my epidural was in place, I fell asleep again. I was told to push an hour later although I had no urge. My nice nurse was finished with her shift and I then had a not so nice nurse assigned to me. DH and I were left to push the baby out by ourselves. I pushed and pushed and slept in between contractions. I wasn't working very hard. DH would watch the monitor and tell me when the contraction would start, then I would take two breaths, and push as hard as I could. Paul watched the monitor and would tell me what number I reached. The next contraction, I would try to beat my previous record. About two hours later, the doctor on call came in and checked the baby's position. He was at a zero, maybe. The doctor told me that I would probably not be able to push the baby out and that I would need a cesarean. He gave us a long lecture on how he wouldn't be making any extra money and he wasn't trying to go home early. He said that he would be there all night anyway and so I could push for ten more hours if I wanted to but in his opinion, the baby was too big and would never come out. My choice was to try some more or hurry up and have the c/s because there was another lady who was going to have one and if I didn't go right away, I'd have to wait for them to finish up on her first.
Now this is where we NEEDED another support person there for us! I was in no condition to make any discussion. I didn't know what to do. DH wasn't in any better of a position. He didn't know what to do or say. He was looking to me for the answer. So, we agreed to the c/s. The biggest mistake of my life! I remember them giving me papers to sign before they prepped me and thinking that I wanted to say "Never mind, I don't want to do this," but feeling like it was already too late. The reason for the c/s was "failure to progress." One question I had before I was signing the papers was if I would be able to hold my baby right away. The nurses promised me that I would and told me that they try really hard for moms to have extra time with their babies when they are born via c/s. I felt satisfied with that answer and was feeling relieved that all of this would soon be over! Little did I know that the nightmare was just getting started!
My long awaited natural Bradley birth was not going to happen. Instead, my child was to be surgically removed from my body. I have heard women describe a c/s as an experience that is comparable to rape. I know that is a strong, intense and even insulting word of comparison but I have to agree. At least for me it seems to be comparable in the definition of the word. Maybe it is not for some women who truly need a c/s or for those women who really didn't care one way or the other. But for me, or for someone who expected a natural birth, it felt like a complete violation of my body that has left scars inside and outside of my body. I can never get rid of these scars, only learn to live with them. They will be with me for my entire life.
When someone has a c/s who did not want it, there are similarities to that of a rape in the feelings of violation, abuse and powerlessness. Just think, you are whisked away from your loved ones, drugged and paralyzed, forced to lie on a table with your gown pulled up over your breasts, exposing your naked body for everyone to see, your sexual organs are threatened and literally cut in a climate of total fear. You are afraid and helpless, left vulnerable and at the mercy of the total strangers around you, all the time wishing that it wasn't happening. Or in my case, just struggling to survive! I really hope that this is not taken offensively. I know it is an extreme analogy.
The c/s was the worst part of my labor. I was wheeled into the operation room (I remember it was very cold and there was music blasting, De Peche Mode, I think) and then I was made to scoot myself onto the table. The table was skinny and flat and hard! It was painful for me to lie on my back. I wanted them to hurry up so I could lay on my side again. Then I was so worried that they would not give me another epidural. I kept asking to make sure they knew that my previous one was wearing off. They hooked me up and my lower body went completely numb. My legs felt heavy and hot. My arms were not strapped down like a lot of hospitals routinely do. They were laid on little platforms and I had my IV and blood pressure cuffs in place. DH finally came in with his sterile scrubs on. Now I just laid there and waited.
When the anesthesiologist told my husband to announce the sex of our baby, I was so happy because I thought it was almost over. DH told me the baby was a boy. I was trying to see the baby but they didn't hold him up for me. I must have been losing blood or something because I felt like I was going to pass out. I felt horrible! I had to keep my eyes closed and concentrate on staying awake. I kept saying that I was going to pass out but nobody said anything to reassure me. I didn't hear the baby cry but I didn't worry. I guess I couldn't because I was busy concentrating on staying awake. Finally he cried and DH brought him over to me. I could only open one eye and peak at him. I said "Hi B.." I knew that DH was taking pictures and I could see them later. Then DH and the baby left. I was alone or at least without any one person I felt like I could really trust.
There must have been a nurse with my name because when the other doctors were giving her instructions, I couldn't understand what they were saying, I only heard my name. I kept saying "What? I don't know what you are saying to me. Huh?" It was awful to feel that way. What makes me mad now is that nobody in that room tried to treat me with any respect or dignity! They completely ignored my comments and failed to help relieve me of distress and confusion! I was still very uncomfortable and just wishing that they would hurry. Then I started to shake. I had no control over it. I was also freezing. But all my complaints and worries went unanswered. It was as if I was not there or like I was just a piece of meat lying the table and nobody cared or even wanted to listen to me. Then as they were finishing up, I felt horrible cramping. I don't know what it was exactly or how to explain it but with everything else, I couldn't handle it anymore. I started to cry and yell at them to leave me alone! I told them I was finished and to let me go! They said that they were almost finished and that I could get on the gurney and go to recovery soon. I thought that I was going to be made to lift myself off the operating table myself. This made me more hysterical. "I can't get off the table. I can't!" But they told me, "You have to, there is no choice" It was terrible! I was so upset! The anesthesiologist at my head wiped some of my tears away and finally told the nurses "That is enough." I think they were pushing on my very tender and sore, newly stapled stomach. I also believe that they might have been pushing a little bit more than necessary because they didn't like me, but that could all be in my head.
As I was being wheeled into recovery (they did lift me onto the gurney) I was finally given a blanket to help me get warm. In recovery, I was still hysterical. I think my blood pressure was extremely high and my pulse was like 200! (That was a number I saw anyway). I was still on my back but I was paralyzed and couldn't roll over no matter how much I wanted to. I cried and cried and finally asked for my husband. The nurse told me to stop my crying and that she was not going to get him unless I stopped. She said that he had been crying too and that she couldn't have both of us crying in there. This made me feel better as you could have guessed! Thankfully, DH came on his own to see me. He had tried earlier but they wouldn't let him in the OR again. Once he was with me, the nurse changed her attitude and was nice to us.
I must have had been in the recovery room for over an hour. I remember begging to leave. I feel so guilty for not asking for my baby but honestly, I can't remember even thinking about asking for him then. I guess I had all of my energy concentrated on myself right then. But now that I know what my baby was going through, I am kicking myself for not remembering to have the nurses bring him to me. We went to my own room and I had to scoot myself onto my bed. That was HARD. But once I was in my own bed, it was the most comfortable bed I had ever been in! The nurses were getting me settled and DH went to get B. When they brought him to me, it was like, "Oh yeah, I had a baby!" I felt so relieved then. I held B and I just wanted to take off all of his clothes and look at him! Dh said, "Why don't you nurse him?". And I was like "Oh yeah, I wanted to do that." So I tried. It was a little awkward at first but B did beautifully. Our first time nursing went well considering that it seemed to be filled with interruptions. I had nurses coming in and out, DH was trying to gather our things from the labor room, and our family was calling us like crazy!
Then one particular nurse came in (she was specifically assigned to B, I think). She was upset that I was trying to nurse him. She was trying to tell me that he had very low blood sugar levels (due to stress during delivery) and that my nursing him would mess up the test levels. I was very confused and I didn't know what she was talking about. She said that B had a very stressful beginning because he wasn't breathing on his own for the first two minutes after delivery. I didn't know that! I looked at Paul but he was quiet. We hadn't even been together long enough to catch up on what had happened. So I asked the nurse to explain to me more of what happened.
When B, he was not breathing. They bagged him for about two minutes and were about to put him on a respirator when he finally started breathing on his own. This must have had been why they took him to the nursery instead of leaving him with me as they had promised. And then he had low blood sugar, and to add disappointment on top of disappointment, he had been given a bottle of formula while I was in recovery to bring up his sugar levels. Paul hadn't had a chance to tell me any of this yet but while I was in recovery, he saw all of this happening and he was banging on the glass, begging them to bring the baby to me. They obviously didn't listen. They were so intent on him having that formula that he was fitted with a NG tube to force the formula because he was throwing it up.
So when I finally was able to see B, he was on their schedule of formula feedings in an attempt to bring his blood levels back to normal. I didn't know anything about it so I agreed to let him have a bottle. I was allowed to nurse for 15 more minutes and then it would be time for a bottle. I tried to feed him the formula, but he kept spitting it up. The nurse came back and took him away to the nursery, promising to bring him back when he needed to eat next.
I woke up the next morning without ever seeing my baby. And when they brought him to me, he had another NG tube in place (due to throwing up the formula). They told me that if his blood sugar didn't go up within so many hours that he would have an IV. I asked if I would be able to try and nurse and the answer I got was, only if the baby REALLY wanted to. I nursed anyway.
All of this made me so mad! Especially after the lactation consultant visited me later that day. She seemed confused as to why they didn't let me try to bring his levels up with my colostrum. I wasn't allowed to try; I was actually discouraged from nursing at all! The next time I have a baby (and if I can help it, it will not be in a hospital) things will be different!
Update: Jen S. had a VBAC! She said it was a "natural VBAC, as planned. Still can't believe it. [She was] 8 lbs., 21 inches, and bigger than brother who was 'too big to pass through my pelvis.' ".
Becky's Story (posterior, fetal distress, c/s)
Kmom's Notes: Classic malposition story. The baby's posterior position was discovered only AFTER the mom was fully dilated and pushing and the baby was firmly stuck; a posterior is difficult to turn at that point. Baby displayed some fetal distress (another possible side effect of malposition) but her Apgars were good.
Birth Story
I was scheduled for an induction on Mon. the 27th and it looked like I would get in sometime in the afternoon, but I hadn't felt any strong fetal movement since Saturday so they had me come in for a NST. The nurse said that baby's heartrate should spike up when I had a contraction or when she moved but it didn't, so they admitted me at 10:00am and by 11:00 I was hooked up to the Pitocin (I was already dilated to 4 and 80% effaced) and boy, did it work quick!!
The Doc. was in and out checking the heartrate and seemed concerned about it enough to tell me that if it didn't pick up when she moved we might need to do a c/s. So, he put me on an oxygen mask for the whole time (yuk) and attached the internal fetal monitors (I almost came off the table it hurt so bad...she was still at a -2) and finally it started to go up like it should (whew!). He was also concerned about my BP, it was very low...85/40 average.
When the contractions got too bad to handle (about 2:00pm) the Doc. said I could have an epidural, and then all was good for a while. By 5:00pm I was fully dilated and ready to push....we pushed for 2 hrs. and by the end I kept telling them that it hurt really bad on my right side, the Doc. came checked me and said that she was face up and stuck firmly in my pelvis....so a c/s was our only option. I was very scared and upset, my mom and DH were in there with me and I made them both cry (I was a baby), they had my husband change his clothes and whisked me off into an OR.
The Anesthesiologist pumped up my epidural and we were prepped and ready at about 7:15pm, it felt like my doctors were going to yank me off the table but she was wedged in there pretty tight...it took them 7 min. to get her out after they opened me up. She was born at 7:28pm she weighed 8lbs 1oz and was 21 in. long, and her Apgars were 9 & 9.
She looks like I took her to a salon to have her hair highlighted, it's auburn and red with blonde highlights in it. Everyone at the hospital told me how beautiful she is (and she is!!). Well, it wasn't the most wonderful experience but I would do it all over again if I had to. G is so sweet! Nursing is going well too, she's a pro at it....and she even started in the nursery on bottles and pacifiers, so if anyone says that you can't nurse with big breasts (mine are G cup) tell them to take a hike!
Gina Marie's Story (pre-eclampsia, induction, fat-phobic doctor, classical c/s)
Kmom's Notes: Gina Marie was induced at 37 weeks because they suspected a 'big baby'; between 8.5 and 9.5 lbs. at 37 weeks by ultrasound. Because her baby was in the wrong position her labor stalled and she had a c/s. Her consulting OB chose to use a classical incision for the operation and was very insulting about her size; her c/s and recovery were a horror story.
In most cases, ultrasounds are very inaccurate for measuring 'large' babies near term, although in this case it was accurate. Inducing early for macrosomia (big baby) is clearly shown in research to INCREASE the rate of c/s without improving outcome at all, and anecdotally, many large women's c-sections are probably caused by this common practice of inducing early. However, Gina Marie's case is complicated by her blood pressure and edema at the end of pregnancy, and the size of her baby at 37 weeks made the decision more complicated. In most cases, inducing early for 'big baby' is clearly shown to worsen outcomes, but occasionally in selected cases can be helpful.
However, her midwives did little to prepare her cervix for induction, making an induction less likely to succeed, and the induction at 37 weeks resulted in fetal distress for her baby after it was born. Also, her baby was malpositioned, which is probably why labor did not progress. It is a difficult question whether the decision to induce helped or hurt her chances at a normal birth experience. Waiting even one more week might have helped her body and her baby to be more ready, yet the concern over blood pressure and edema was a real one.
Regardless, insult was added to injury when she encountered a very fat-phobic surgeon who was very unkind and discriminatory, and did a 'classical' up-down incision unnecessarily on her. Most very large women can still have a low-transverse (side-to-side or 'bikini') incision with careful management, or they can have an up-down or slightly higher side-to-side skin incision and a low side-to-side uterine incision. The reason given for a classical incision on very large women is to prevent infection in the moisture-prone area underneath the fat fold ("apron"), yet it should be noted that this classical incision infected badly---using a different incision didn't help! It is Kmom's anecdotal observation that the large women she has seen with classical "up-down" incisions have tended to have more problems than those with the "bikini" incisions. Regardless, nursing techniques (using a cool blowdryer on the incision, plus extremely strong antibiotics for very large women) can often help avoid many cases of infection in transverse incisions, making these practical even for large women. The decision to do a classical incision on Gina Marie was dubious at best.
Furthermore, the OB pressured her strongly while in labor (which is improper) to have her tubes tied in order to prevent her from having any more children. This is unethical and unprofessional, and much of her poor treatment after that may have been from the OBs attempting to punish her when she refused to have her tubes tied. She was later told that the classical incision would make it too dangerous to attempt to have another pregnancy at all, so one wonders if the doctor tried to prevent her from having more children by using this incision and accompanying scare tactics. [By the way, it's not true that a classical incision precludes subsequent pregnancy at all. It does raise the risk of rupture somewhat and most doctors will not permit the woman to try for vaginal birth subsequently, but it does not prevent you from having more kids. Many women (including some large women--see other stories) have had subsequent kids after a classical incision. This was pure scare tactics to frighten her out of having more kids.]
Gina Marie wanted to share her difficult story so that other large women can be aware of some common pitfalls to watch out for. She says, "I didn't have a good, normal birth story. In fact, my son's birth was absolutely horrible. However, there are some important things that I learned afterwards that I think large women need to know and need to be on the lookout for, and they will be evident by the end of my story."
Birth Story
Before I went to the hospital, I had this idea of what childbirth would be like, and it definitely did not include the experiences that I have had. There is a happy ending---I am alive, in possession of all of my faculties, and I have a gorgeous healthy baby boy. But I went through hell to bring him into this world.
I started out with the local midwifery practice (five midwives) for a lot of reasons. Number one, they seemed to be the most size-accepting. Number two, they were the least expensive. Number three, they were the only all-female practice, although I learned during the birth that female doctor does not necessarily mean understanding, sympathetic doctor. During labor, I was transferred to their backup OB practice. This practice consisted of eight doctors, only two of whom have a decent bedside manner.
I had an easy pregnancy for 8 months, except for the heartburn and the initial nausea. I had no real problems until the last month or so. I gained about 6 lbs. during the entire pregnancy. I ate right and exercised and really made an effort to take care of myself. Then, in my last month, I got really bad edema in my feet and legs, so severe that I was put on bedrest for two weeks. My blood pressure started spiking occasionally---not to the dangerous imminent stroke level, but enough to be worrisome. The highest reading I remember was 150/100. I felt like a sausage. I could wear one pair of shoes---my cross trainers---and only if I put them on first thing in the morning.
At 37 weeks I had an ultrasound to determine the baby's size and position, because it was difficult for the midwife to tell through my big belly. The ultrasound technician determined that my baby was between 8.5 and 9.5 pounds. The midwives consulted with their backup OBs, and they informed me that they felt it was in my best interest to have an induced labor---that I had a lesser chance of a c/s if they induced then. They were concerned that the baby would grow too large if I was pregnant for another three weeks. I went into the hospital on a Wednesday morning, and the midwives induced labor with Cervidil [Kmom note: a prostaglandin insert]. They applied Cervidil to my closed, hard cervix around 1 p.m. and I was in active labor by 7 p.m. My water broke around 11 p.m.
Sometime the next morning, they gave me a pitocin drip. I asked for and got narcotic painkillers. Finding veins has always been an ordeal for me, and it took three different phlebotomists about 10 sticks to get an IV started. I had 3 possibles, and the veins blew. I eventually dilated to 7 cm and stopped. Because of the problems with the IVs, the put in a central line on Thursday night when I was having heavy active labor. A central line is an IV in the jugular vein. It was really traumatic. I had to have a plastic sheet over my face while they were inserting it so that the area around my jugular would be sterile, and I had to lie flat on my back, which is terribly uncomfortable for a woman in labor. So, I was on my back, I felt like I was suffocating, and I was having contractions every minute or so. I could feel myself slipping out of reality. This was the worst physical sensation of all of it.
They decided at this time that the pitocin had done all it was going to do, so they took me off of the drip. They determined that if I didn't deliver on my own by morning, it would be the best course of action to give me a c/s. They thought it would be best if I could be sectioned with only an epidural, but after inserting the damn thing right after putting in the central line, they determined I could not breathe adequately while laying flat on my back for the epidural to be effective during surgery. Still I had the epidural and the accompanying fluids all night Thursday night. Friday morning, I still had not dilated past 7 cm, even though I had been contracting every minute or so for 24 hours. I think that the epidural slowed the labor further, and it didn't really do much for the pain. The fluids that accompany the epidural to keep the blood pressure from dropping inflated my feet and legs like the Michelin tire man. By morning, I could not lift my legs.
Kmom note: One of the known risks of pitocin is to increase swelling and retention of fluids. The fluids necessary with an epidural often tend to cause significant swelling in a woman who has undergone a long induction with pitocin. This (in addition to her previous swelling) made for a severe problem.
The OB came in and told me that she felt a c/s was warranted because my contractions were of sufficient power and duration that I should have pushed out the baby if he were able to come. His heartbeat had not wavered on the fetal monitor, but he had also not moved beyond a -2 station. I think what happened is that instead of facing forward or facing the rear, he was facing my left, and his shoulders were hung up on my pelvis. I could feel his little behind right below my ribcage all the way through labor. He never dropped down.
Kmom note: A malpositioned baby could certainly have caused many of the problems she encountered---stuck at 7 cm, a high and unengaged baby that would not move down, little progress despite painful and strong contractions, etc. And being stuck in bed due to the induction meant that she could not employ other methods of turning the baby, such as position changes, etc. This is one of the potential problems with induction.
This OB was the meanest, most evil bitch I have ever met. Even though I had shopped around and shopped around for pregnancy care that was not fat-phobic and would take into account only the facts of my health and not assumptions, the OBs backing up the midwives were not nearly as enlightened as the midwives were. So when she came in to discuss my surgery, the OB sat down and asked me if I wanted my tubes tied while she was in there. I was shocked and told her no, that this was my first child, and I didn't want to make decisions like that at the moment. And she countered with a speech that boiled down to "you are too fat to have any more children, you shouldn't even be having this one, and if I had anything to do with it, you wouldn't be." Then she discussed general anesthesia, and the dangers. Granted, fat people do sometimes have problems with general anesthesia. However, it was a little heavy-handed for her to instruct me to discuss funeral arrangements with my husband before I went into surgery. She asked me if I was an organ donor, and then said it didn't really matter. (I don't know what the hell this was supposed to mean. I guess she was implying that my organs were probably not acceptable or something.)
Kmom note: It is unethical to pressure a woman to have her tubes tied while in labor. In fact, in many places it is forbidden, deemed a decision made under duress. It was *extremely* inappropriate for this OB to be pushing this decision just because of the mother's size, and especially unethical to do it while she was in labor. However, OBs have had a history of doing this to women they don't approve of having children, from welfare mothers to minority women, etc. This is supposed to be totally unacceptable now, but it is still done to some women (including fat ones) at times. The other remarks and treatment she received were extremely unprofessional. This may have been a case of the doctors 'punishing' her for not going along with them.
I was given the prognosis of 'guarded'. It was my impression that she had never dealt with a patient my size before and that she didn't like fat people to begin with. I was scheduled for a c/s for 11 a.m. on Friday. Despite being a scheduled section, the OB chose to make a high vertical incision---a "classic" c/s incision----because she was not sure about operating under my belly "apron". This kind of incision precludes a VBAC. Later I learned that a bikini incision could have been done if I'd had a more experienced doctor [i.e., more experienced with fat women]. Part of me still feels like she did this kind of incision to punish me for being such a fat pig.
Kmom note: Even very large women can usually have a bikini cut or a modified version thereof. Only rarely is a classical incision necessary, but some doctors persist in using a classical incision on fat women anyhow. The concern is for infection, but with proper nursing techniques and special attention to prevention, infection can usually be avoided even in very large women, as noted.
My legs were so swollen from the epidural fluid and the previous edema that they were worried about blood clots in my legs. They wrapped up my feet and legs in ace bandages up to my thighs. They wheeled me down to the prep area for the Operating Room and the team of anesthetists gave me an arterial line (yet another big traumatic stick). My husband was there while they were prepping me for surgery, but the poor guy was as overwhelmed by the fatigue of being awake so long and the shock of the guarded prognosis and the business about funeral plans. He was sobbing loudly and disturbing the doctors. A nurse led him away.
I could hear my baby's heartbeat on the fetal monitor until they took it out a couple of minutes before they wheeled me into the operating room. He was strong and steady and never wavered, and I was grateful for that. I was halfway convinced that I was going to die. I remember thinking that it would be all right as long as my baby was OK. While they were strapping me down for the surgery, the 15 or so people in the room introduced themselves to me. The pediatrician and her staff came over and I told them to be sure and take care of my baby, no matter what happened to me. The nurses swabbed my belly with betadine and put the anesthesia mask over my face and I went out.
When I woke up there was a greenish light over my head and people were calling my name and telling me not to cough while they removed my ventilator tube. I don't even know how long I was in surgery. I found out later that I lost 2 liters of blood during the surgery. I have a 12 inch incision down the middle of my belly, starting about 4" above and 1/2" to the left of my navel and running parallel to it. The first time I saw the stitches, I thought they had sewn my navel shut. They told me later that they were prepared to keep me on the ventilator for 12 hours after the surgery, but I was up in the operating room on the first attempt at waking me. Basically, I handled the anesthesia like a normal person would, despite their dire predictions. As soon as they took me to the recovery room, they told me that my beautiful son was born at 12:27 p.m. and that he weighed 9 lbs, 7.3 oz.,, was 21.5 inches long, and had apgars of 8 and 9 and a full head of blond hair. We named him Jacob Baruch after two of his great-grandfathers. Baruch means Blessing in Hebrew, and he is a blessing in my life.
They took me to the ICU. I couldn't see my baby for 24 hours because he was in NICU (Neonatal Intensive Care Unit). He was born in respiratory distress because of the narcotics, and he was also getting antibiotics because my water had been broken for so long. Late on Saturday afternoon, the neonatal nursing staff bent rules and rolled my boy up to see me in an isolette and let me hold him for a few minutes. I cried and cried. He had been screaming until I held him, and he immediately soothed and looked up at me. I swear he knew me. It was hard to hold him because I had wires and tubes everywhere, and so did he. I wanted so badly to breastfeed, but I couldn't because of all the stuff I was getting in my IV. A lactation consultant came and brought me a breast pump and I diligently tried to establish a milk supply, but the most I could manage was getting the inside of the breast shell wet. I was told that I would have to pump and dump for 3 days because of all the drugs in my system.
During the second day I was in ICU, I developed a fever. I was getting some very strong antibiotics through my IV, so they figured it wasn't an infection. The fever didn't go away within 24 hours. Monday morning they decided that I might have had a pulmonary embolism, and sent me to nuclear medicine for tests on that. They injected some kind of radioactive dye so they could see an embolism, and this made my hypothetical milk unusable for another 2 days. Well, I didn't have a pulmonary embolism. The OB said that I was possibly having microscopic blood clots from the surgery causing the fever. I was also having difficulty breathing when I wasn't sitting straight up. They determined my oxygen saturation level was low, and the bad OB who had been so mean to me said it was because of sleep apnea (which I had never had a problem with before or since). The next OB to come on shift after her did a blood count and determined that my hemoglobin was low, and I had a transfusion of two units of blood. I perked up immediately. This relief OB also prescribed some Lasix for me to help with the swelling, and I eliminated 6 liters of water in 24 hours. From the time I entered the hospital until I left, I lost 47 lbs. (and only 9.5 of it was my baby!).
I got up and started walking around about 3 days after the surgery, and it was incredibly difficult because of the incision and because I was so swollen. My feet were so swollen that it hurt to stand on them. I couldn't wear any shoes at all for a month after the surgery. I was released from the ICU into a regular room, and finally I was allowed to have my baby in my room with me so I could see him and feed him and care for him. I still had to sleep with oxygen and have my oxygenation level checked several times a day, but I felt like a regular patient, and I had more privacy, etc.
I kept trying to pump breastmilk for my baby, but was unsuccessful. I was also feeling horrible, could barely move, etc. and the OB said that she could give me medication that would make me feel much better and help me recover faster but it would make whatever milk I produced unusable for as long as I was on it. So I made the choice to take the medicine and feel better, since I had been unable to produce anything anyway. My breasts produced the occasional drop or two for a few weeks afterwards, but once I was out of the hospital and could safely nurse my son, he didn't want to take my nipple. This was really hard for me, because I strongly wanted to be able to breastfeed. I had been so sure that I would that I bought no bottles or pacifiers, only a breast pump and pads and a nursing bra. Because my baby and I were separated for so long, because I could not put him to my breast due to the drugs in my system, because I had undiagnosed thyroid disease at the time, and because I had traumatic blood loss during the surgery---all of these things worked against me. My son was also born with a tongue-tie, which would have hindered his latching on if I had been able to offer it to him. It seems that breastfeeding was just not in the cards for us.
Kmom note: A tongue-tie can be fixed with a small procedure and doesn't have to preclude breastfeeding. However, significant blood loss and resulting anemia is known to affect milk supply negatively, as does low thyroid. The problems she had getting any milk were probably a combination of no nursing access from the baby (a pump is not as efficient as a baby), her undiagnosed hypothyroidism, and the anemia affecting her milk supply. In addition, any medicine she took to help with the swelling may have also affected her ability to make milk.
I should mention that while I was in the hospital trying to get my blood oxygenation levels to an acceptable level and getting IV antibiotics and anti-inflammatories, every doctor in the whole evil practice came by my room to bitch at me for being fat and to talk about diets. Some were less aggressive and insulting about it than others, but they all felt it was completely important to tell me that I am too fat. "Have you ever considered dieting?" was how they all started out. Like any fat person in America could possibly get to be 30 years old without dieting at some point. Like I haven't been informed by family, friends, strangers, and doctors that I am fat fat fat fat fat and I need to diet for my entire life. As is this was a completely new discovery. I felt particularly betrayed when the lead midwife came in and gave me the speech. When I first became pregnant, I told her that I was worried about my eating habits and I wanted to take care of myself and give my baby good nutrition. I kept a food diary for two weeks and showed it to her on my next visit. It was a faithful diary. She praised me for the variety and content, told me that I was doing a good job of eating healthy low-fat foods. She suggested that I eat more protein, but otherwise did not criticize my eating habits. So it was a shock and a betrayal when she came in and told me that the best plan for my life was a really strict diet. The bitchy cruel OB got in on the act, which is hardly a surprise, and laid it on with a trowel. Not only did I need to diet, but if I did not do so, I would be dead before ten years, because women my size don't live past 40. My child would never love me because he would be so ashamed to have a fat mama. Fat women are bad mothers who can't keep up with their children, and their children suffer for it. By obstinately continuing to be fat, I would show myself to be an unfit mother.
I was so sick that I took her verbal abuse, but I am consumed with anger every time I think of it now. The nicer OB who discovered my anemia in the ICU came in and recommended Sugar Busters (which I had previously never heard of and I am still skeptical about. Steak, eggs, and cheese are great, but carrots and apples are bad for you? This was surreal advice). He was nicer about the whole deal because he said, "Let's be realistic. You're never going to get below 200 lbs. But I would like to see you considerably smaller than you are now." He then went on to ask me about my lowest weight since reaching puberty. I don't think it was the appropriate time for stern lectures, but at least he tried to take me reality and my feelings into consideration. It just gripes my ass that all of these health professionals who deal with pregnant and postpartum women every single day could not see that obstetrical complications are a risk factor for postpartum depression, and by lecturing me, they were adding to the stress level in my life. Talk about kicking a woman when she's down.
Once I got my blood oxygenation levels to an acceptable level and they were getting ready to release me, my incision opened. I had developed pockets of sero-sanguinous fluid underneath my incision, and the bottom four inches of it opened. That was a horror show. The wound oozed great gouts of syrupy fluid when it was pressed. It was 4 inches long and 2 inches deep and draining such that it soaked an abdominal pad in 3 hours. They packed it with gauze and bandaged it, and kept me in the hospital for observation for a couple of extra days to make sure that no infection would develop and that the wound would not open further.
After the doctors and nurses left from packing my wound, I was afraid to move. I was afraid if I turned over, my guts would spill out. I didn't know that people could go home with gaping holes in the belly like that, and I thought I was going to have to stay in the hospital for several more weeks. I started crying and really broke down. Did I get any expressions of sympathy or understanding? No, I got an offer of antidepressants. I prefer to get psychoactive drugs from psychiatrists, not obstetricians, so I refused. I was really angry and insulted that after all I had been through, feeling less than perky and chipper about everything was interpreted as a chemical imbalance that could be fixed with drugs.
Once I finally got home, I had home health care nurses for two solid months to help with changing my dressing, and they were terrific (both of them were BBWs). They were maternity specialists so they had seen lots of opened c/s incisions, and they assured me that skinny women got opened incisions too. My wound never opened down to the fascia layer so even though it was deep, it was not as bad as it could have been. One of the nurses gave me advice about caring for my child, and also recommended the OB/GYN I am seeing currently. My husband also helped change my dressings. I never dreamed that I would be asking such a personal task of him. It's so...unsexy and gross. My husband was such a trooper through all this. He kept joking that now he knew me inside and out. The wound eventually abscessed, but the home health care nurse caught it early so it was not as bad as it could have been. When she saw it, it was a red place the size of a quarter. By the time I got to the emergency room that afternoon, it was as big as my hand. The nurse saved my life because she acted so quickly. I was in the hospital again for two days receiving IV antibiotics.
At my postpartum appointment, I complained of being cold all the time and that I had lost my sense of smell. I could not tell when my son had a dirty diaper because I could not smell it. Eventually they discovered that I had hypothyroidism (Hashimoto's disease) which I probably had for some time but at a sub-acute level. My internist believes it was triggered into active stage by the trauma of Jacob's birth. [Kmom's note: Childbirth can trigger thyroid problems, but it's often missed by doctors. It's good that this was caught by her internist.] I also had a CAT scan to rule out a brain tumor. I saw the hateful OB for postpartum checks but not since. I saw a counselor for my postpartum depression and I described this OB as having the bedside manner of a prison guard. The counselor immediately knew which OB I was referring to. Evidently she has this reputation all over town, and it's not just me.
The new OB (recommended by the home health nurse) is wonderful. She is a recent graduate and much more size-accepting. She was shocked that I had a vertical incision. The hateful OB informed me that the kind of incision that they made in my uterus will make it incredibly dangerous for me to attempt another pregnancy. Instead of a bikini cut near the thicker bottom of the uterus, they cut along the length of it at the top where it expands more. Therefore, a subsequent pregnancy could cause the uterus to rupture and I would die horribly from a hemorrhage. Sex becomes much more ominous now. The new doctor said that although she wouldn't recommend another pregnancy for me because of all the surgical complications, it was by no means a death sentence. She said that she could manage me if I became pregnant again. [Kmom's note: As noted, a classical incision does NOT preclude future pregnancy. This may have been another attempt by the OB to keep her from having more children.]
As if I didn't have enough to deal with, the insurance company refused to pay all of my bill. We have been round and round with the insurance company over this for almost 2 years now and still owe the hospital several thousand dollars. I was laid low by postpartum depression and the Hashimoto's disease. It took me almost a year to get to my old self. But I have a gorgeous, healthy, smart little boy who is nearly 2 years old now. He is strong and beautiful, and despite the dire warnings, he does love his mother. I managed to finish my MSW degree eventually after all this too.
Warnings for other women:
Kmom's postscript: It's very important to take time to emotionally heal after a difficult birth. Most women are told to 'be grateful you had a healthy baby' as if their feelings about their labor and birth don't count. Of COURSE you are grateful to have a healthy baby, but at the same time it is perfectly fine to be less-than-thrilled about the labor or birth, while still fully loving your baby. In addition, if you have a particularly traumatic birth or poor treatment by your providers, it's extremely important to fully work through and grieve it completely. This is not a fast process, but it IS a very healing one, and is particularly helpful before moving on to another pregnancy or deciding to end your childbearing years. In order to help this process along, there is a list of books that can help on my Book Recommendations FAQ on this website. I highly recommend checking these out; healing is not an easy process but it is a vital one and it will bring growth and benefits to many facets of your life, whether or not you choose to have further children.
Dana B's Story (fraternal twins, diet-only gd, c/s)
Kmom's Notes: This mom was given an 1800 calories a day food plan, despite having twins, and told to drink Slimfast to keep down her weight gain. She had a borderline gd reading; her doctor elected to treat it as gd just in case despite it not meeting the full standard diagnostic criteria. Because her twins were not positioned well, she had a c/s. She had a lot of blood loss afterwards, which may also have affected her milk supply (see above). (Many times undiscovered or undertreated anemia after blood loss in childbirth can impact milk supply.) Being a bit undernourished in the pregnancy may also have possibly affected her milk supply and made it more difficult to rebuild her blood supplies, although it's difficult to say for sure.
Birth Story
After a year or more of trying to conceive and a couple of months considering fertility treatment options, we decided to try Serophene (which is the same or a similar chemical to Clomid). With this decision we knew we were taking a chance of having multiples, twin primarily, but we felt that it was worth the 9% risk stated in the materials. (Of course, I found out later I have *four* sets of twins in my family history so that fact certainly increased our odds.)
At my 11 week appt., my first one after getting pregnant, the OB could feel my uterus quite high---when he shouldn't be able to feel it at all yet. He sent me for my first ultrasound, where we saw two tiny sacs with beating hearts! (DH was sick that he missed this appointment!) After all the trying, waiting, and consideration, I thought I was ready for this possibility, but I was not. The nurses teased me about the look on my face for the rest of the pregnancy! I was in shock---all I could think of was double the daycare, double the clothing, braces, college---double *everything*! Dh, on the other hand, was ecstatic! "Hnnng! *I* did that!" said my caveman.
My OB works with infertility patients frequently, so has delivered many sets of twin--which has taught him to be very cautious. He leans toward intervention, which didn't bother me. I'm not much of an "au natural" kind of person; with doctors in my family, I trust them. However this OB *did* have a thing about weight, and Kmom and others were shocked when I mentioned that he recommended that I use SlimFast to avoid weight gain. I cried, and Kmom recommended that I find a new, more balanced OB, but I really trusted him when it came to the babies. I decided to ignore any weight-related comments and focus on the healthy-baby ones.
I loved being pregnant, despite the bedrest and preterm labor. I know that I crave attention, so I ate it up with a spoon during this time! I also enjoyed having a big belly that I could be proud of. I didn't have morning sickness, but "ligament stretching" is a bear! My bones and ligaments had a lot of adjusting to do to fit those two babies into my 5'3 frame!
At my 33 week appointment, I mentioned that it felt like A (on bottom) was sticking one little finger out my cervix and wiggling it, like he was trying to get out. (Yes it felt kind of weird, kind of tickly-itchy.) It was my cervix changing--I had dilated to a 2 and was 50% effaced. My OB sent us directly across the street to the hospital to check in. I had not noticed any contractions, even "false labor" ones, so this was a surprise.
Sure enough, the monitor showed some contractions, but I couldn't feel them. We were able to control the contractions with Brethene and Procardia (asthma and heart medications that soothe smooth muscle groups, like those around your uterus). A couple of time, the contractions got a little feisty, so we used injectible Brethene instead of pills, but that always worked. We never had to go to the 'hard' stuff like mag sulfate. If I had lived closer to the hospital instead of 45 minutes away, they would have sent me home. Instead, I moved in for the long haul. I was on pretty strict bedrest. I wasn't to sit up except to eat, but I could go to the restroom and take a 5-minute shower every other day. I looked forward to shower days! My parents stayed at our house during this time and visited me during the day. DH visited in the evening after work and on his days off. I didn't have much time for boredom between nurses, family, and other visitors!
At 35 1/2 weeks, my OB told me I could get out of bed! He was satisfied with the twins' development. He still wanted me to stay at the hospital, though, because A was frank breech and B was transverse---which meant I'd have a c/s (this OB doesn't like to put the second baby at risk by trying to turn one or both when they aren't in head-down position). He told us to go out to lunch and to the store to buy the babies something, then come back to the hospital like it was an apartment. (Odd arrangement, but woohoo! Sunshine! Real Food!)
I never made it--and am glad (my water would have broken in a restaurant, ugh!). While we waited for the hospital to figure out his "treat us like an apartment" order, my water broke! Once we convinced the nurse that I hadn't just wet myself, thing got exciting. I got an IV, DH got scrubs on (thank goodness he was even there!), and we wheeled down the hall to the OR, where I got scared for the very first time during the whole pregnancy. Something about that room was suddenly very intimidating. And the contractions got quite strong by that time, too. DH held me while I got an epidural (that hadn't seemed scary until that very moment--but it went fine).
Ahh...then there was no pain and not nearly so much stress. The doctor came in, a nurse turned on some rock and roll music for him, and DH watched the whole surgery from beside my head. (But he wouldn't videotape it for me....sigh). The surgery must have happened really fast, because the twins were only a minute apart, but that was a really looonnng minute, it seems! I just remember an awful lot happening between babies, and nothing seemed to occur at a frantic pace--but then, I was pretty loopy. DH took the babies to the nursery for their baths while the doctor put me back together. I decided to take a nap at this point. I woke up to go to the recovery room.
Then things got exciting again. My uterus didn't clamp down like it should, so I continued to bleed profusely where the placenta had been. My blood pressure dropped to 64/40 or something and the nurses began working quickly. They shut my parents out of the room and paged a doctor. He ordered a shot of something and the nurses pushed on my stomach to help pressure-stop the bleeding. It worked and I was stable by the time DH brought the babies back from the nursery to see me. I got to try nursing them there in recovery, but we were all pretty tired, so mostly we snuggled.
My recovery from the c/s wasn't anything to write home about, but it was okay. I didn't realize that I should have continued taking iron pills to compensate from the lost blood, so I was even more tired than I would have been already. Between that, lack of sleep, and the extra energy it takes to make milk, I was a very tired camper for the first several weeks! But we had *two* precious babies! Nope, it wasn't the birth story I expected, but it has worked out beautifully. I made it and even went back to work part-time at 5 weeks (I burned 3 weeks of leave in the hospital). And I'd say our family is now flourishing in an "all-time best" period of fun and communication...although the twins do take a toll on our ability to manage romantic encounters!
My best advice for delivering moms? Request prunes with every meal. Don't ask---just eat the prunes! :-)
Kmom's Cesarean Stories (diet-only gd, induction, traumatic c/s; no gd, posterior baby, CBAC)
Kmom's Notes: It's difficult to be objective about one's own birth experiences, but with many years behind me, I can see that this pregnancy was a call to healing. I was very scared, had no information about plus-sized pregnancy, was treated as high-risk by nearly everyone due to my size (though they were deceptively nice about it), and was undergoing major life transitions at the time. Although I did some pregnancy reading, I didn't do enough, had few resources for questioning what I was told, and behaved like a compliant 'good little girl' ought to. It took a horrendous birth experience to shake me out of that pattern. Although I cannot be glad for that experience, it certainly did set me on a different life path, started a great deal of valuable soul-searching and healing, and I can honor the learning and change that has come from it. And of course, I got the most precious baby in the world from it!
Birth Story
My first child was conceived during a period of great stress. I was very unhappy with the changes in my job, was working very long hard unhealthy hours, had too many extra activities, was deep in grief for my father who had died the year before, and was not being as healthy as usual in eating and exercise habits. To top it all off, just as we found out I was pregnant, my husband was laid off.
Although the pregnancy was a surprise, we welcomed it and were excited, if a tad worried about insurance coverage and plans. Then I began spotting, which continued off and on throughout the whole first trimester. This forced me to re-organize my life, drop my extra commitments, stop working so hard and long, and take time to just rest. It also meant no exercise. After a while, the OB agreed to do a vaginal ultrasound. This eliminated ectopic pregnancy, a significant worry, but it wasn't clear whether there was one baby or two. A further scan two weeks later showed only one baby. Thus the bleeding might have been a 'vanishing twin', low progesterone levels, or simply the random spotting that occurs in many pregnancies at first. We'll never know.
The doctor did not treat me meanly but did nothing to alleviate my fears, telling me (incorrectly) that my chances of miscarriage were 50% (they drop down once a heartbeat is seen), and was not very encouraging about my chances. She did no testing on hcg numbers or progesterone levels, which could have told us a lot more; I think she basically wrote me off as a miscarriage. But she came recommended and was one of the few accepting new patients in the area, so I didn't complain.
I experienced very significant nausea, but she told me "not to worry" if I couldn't eat; "the baby would take what it needed." The plan I was given was low on protein and very high in carbs. This set up a pattern of wildly swinging blood sugars and ketone levels that would take 7 months to straighten out, and quite possibly added into my own insulin resistance and stress levels to cause my gd. Ah, hindsight! She did send me for a one-hour gd test in the first trimester, which was borderline. I then passed the 3-hour GTT (which made me shaky and sick); no further nutritional guidance was given. I believe that had I only been given some instruction in gd food plans at that point, I probably could have avoided actual gd, but nutrition is not a high priority for most OBs.
Once I reached the second trimester, the spotting stopped, we relaxed, and I began really bonding with the baby. We took the AFP test without really understanding it, and when it came back low, we were devastated. No counseling was provided by the OB; a cold phone call from a nurse was all we got. We were sent for genetic counseling, which was terrifying because I am adopted and have no family history to fill in. It turns out that the reason the test was low was either because my cycles are long (making the baby younger than they thought), or because heavy women tend to have lower levels due to a larger circulating blood volume and they did not correct enough for that. We were pressured into an amnio, which was very painful (story in prenatal testing section). The doctor was very cold and unkind and blamed all the problems on my size (probably untrue). I experienced bleeding and cramping afterwards, and spent a horrible Xmas waiting for the results and wondering if I'd miscarry. After bonding so strongly with the baby during the bleeding scare, this was really awful.
When the results came back fine (it was a girl!), we rejoiced and thought we were home-free. Not so. My husband was transferred to another state, and we had to leave our jobs, get the house ready to sell, and find a new house VERY quickly. Talk about stress! And during all this, I had to take my next gd test. It too was borderline, so I took the 3 hour GTT again, but no one gave me any guidelines on it, so I took it while I was sick and TOTALLY stressed in my last week at work. Not surprisingly, I went over the cutoffs this time. I had to try and adjust my diet as we moved, but after moving my numbers became normal with care. I was devastated to have gd, felt like I was being put on a 'diet' again after years of freedom from dieting stupidity, and humiliated that I had a 'fat person's disease.' However, at least I managed to get it under good control quickly.
I really wanted to find a midwife practice in my new town, but was told I needed an OB due to the gd (not true but I didn't find that out till later). I chose the OB that seemed extremely personable, would not automatically induce at 38 weeks, and had a great bedside manner. The ultrasound predicted an average-sized baby at first so I was 'permitted' to go to term, but he wouldn't allow me to go beyond 40 weeks. We induced on a long hard unripe cervix, and I spent the night before writing a good-bye letter to my daughter because I had a bad feeling about it all. Sure enough, Dr. Right turned out to be Dr. Wrong in labor and the birth as a result was quite traumatic. Being "nice" does not make you a decent doctor.
We did two doses of prostaglandin gel, then started the pitocin the next morning. Labor was easy to handle, especially since I was allowed some walking and rocking until the doctor broke my waters at noon (I was 2 cm dilated and she was at a -2 station; breaking the waters when she was so high up was contraindicated and dangerous but he didn't tell us that. Fortunately for us, her cord did not prolapse, but what the doctor did was dangerous). At that point I was not allowed out of bed, and labor became excruciating. The baby was quite probably in the wrong position, which is what probably caused all the pain, but Lamaze breathing was NOT capable of handling this kind of pain! We tried IV meds before finally resorting to an epidural. In this case, the epidural was a blessing (for a while anyhow) and allowed me to finish dilating, even though it was not fully effective and had a 'window'. By about 17 hours into labor, I was fully dilated and ready to push.
We pushed for 2 hours with no progress. She stayed high (-2 station) and unengaged. Even with epidural left, I felt tremendous pain on one side of my back, another indication of position problems. We used stirrups for pushing; I asked to try squatting. But this did not budge her either; she was stuck. I was exhausted by the 'purple pushing' by then, in a lot of pain (despite the epidural) from her malposition, and requested the c/s.
The next part I will leave out most of the grisly details on, but basically I felt the surgery intensely. It was a horrendous experience, *deeply* traumatic. They tested to see if I was still numb, I told them I DID feel something but they didn't believe me and started cutting anyhow. I kept telling them to stop but they would not, and soon I started fighting. They told me they could not give me anything more until the baby was born and strapped me down. I fought, I begged, I pleaded for them to stop, but they did not. I went into shock. They gave me some meds to try and help but they didn't. They just applied a chemical gag to me so I couldn't scream anymore.
The day that was supposed to have been the best day of my life----becoming a mother for the first time-----instead became one of the worst days of my life. Instead of joy, all I felt was terror and pain and rage and violation. When they finally showed me my baby, all I could think was, "Thank God! Now I can go." Instead of rejoicing, all I wanted to do was die. This is one of the sources of greatest rage and sorrow for me. What a way for my baby to come into the world, and what a way for me to enter into motherhood.
I'll leave out the rest of the details (it was pretty gruesome for a while) but it greatly affected all of us and has taken many years to heal. The hospital staff ignored it as if it never happened. When I asked the OB about it, his only response was, "Next time you can have a spinal instead." No one apologized, no one comforted me, no one even acknowledged it even happened or that it might affect me at all.
My baby was taken to the NICU nursery, given formula even though her blood sugar was fine and they knew we were nursing, and she was given a pacifier. Although my husband tried to be with her, he wasn't sure what to do with a newborn and was concerned about me, so my baby was basically abandoned for hours, something my heart will always ache over. It was a long time before I was permitted to try nursing her, and she developed jaundice between the gd, the pitocin, and the lack of nursing (all risk factors for jaundice). However, luckily, despite the difficult birth and terrible c/s and separation, the minute I saw her, we bonded like insta-glue and were deeply connected.
That was good, because nursing was very difficult at first! Traditional positions made me very sore (only the football hold worked well), she had many bottles of formula and glucose water at the hospital, and the jaundice and drugs made her extremely sleepy and unresponsive. She narrowly avoided needing treatment with bili lights; the nurses and doctors told me to use glucose water to 'flush out the jaundice' but I have since found out that this actually increases jaundice. Between the c/s, the bottles, the lack of frequent nursing, and the severe edema I had from the pitocin and IV fluids, my milk did not come in for many days, but increasing the nursing seemed to help somewhat. Eventually we were able to slowly eliminate more of the bottles. I was too hesitant to see a lactation consultant, but eventually we managed to work out nursing despite everything. After a month and a half or so, we were fully nursing. It was very healing to finally have something work the way it was supposed to!
We had a very difficult start, from her very stressful pregnancy to her difficult birth. She developed a roaring case of diaper rash, then had 4 solid months of colic as her body struggled to cope with all the stress, drugs, formula, etc. I have since been told also that many babies that are malpositioned experience severe colic; cranial-sacral therapy is supposed to help, but it sounded too "far out" for me to try back then.
Luckily, at 4 months, a switch magically flicked and she became much easier! Nursing went well and was very healing for us both. Although I never really intended to nurse beyond 3-4 months, we mutually decided to continue for over 4 years, including through her baby brother's pregnancy. I think the nursing really went a long way to healing the difficulties of her pregnancy and birth. She eventually weaned of her own volition, and I am very glad I didn't force the issue, since she seemed to really need it. She is a very healthy, smart, and active little girl now, and I love her deeply.
The pregnancy was a tough one, but it ultimately lead to a lot of healing and changes. I lead a much less stressful life now, have worked hard on healing, have taken up exercising again, and although I do not diet I am careful again about what I eat and its timing. By being much more proactive about diet and exercise, I have been able to avoid gd in subsequent pregnancies, despite my age. I also am MUCH more careful about the health providers I select now, and am assertive about researching health care decisions. In many ways, I am a new person now, born through the fire and difficulty of this pregnancy and birth, and although I would never have chosen these experiences I can value the healing and growth that has come from them. But sometimes I do mourn the peaceful and joyful pregnancy and birth that was taken from me by circumstances and insensitive providers.
Pregnancy #2
Kmom subsequently had a baby boy 2 years later. She avoided gd in that pregnancy, although she very carefully measured her blood sugars every day anyhow, even after passing the test. Though her blood sugars were under excellent control, her second baby was larger, 9 lbs. 11 oz. and 21.5 inches long. This is apparently just genetic on her side of the family, not related to blood sugar after all. She eventually found a good set of nurse-midwives in this pregnancy and labored all-naturally---a non-induced labor is MUCH easier to deal with! She labored at home for a while with a doula, then went to the hospital, where she labored in a tub and went from 4 cm to 9.5 cm in 2 hours.
However, the baby was posterior, which went undiagnosed and unfixed, so the baby got stuck. After 5 hours of pushing, she had a repeat c/s (this time with a spinal!); as c-sections go, this was a 'good' one. The anesthesia worked fine, the staff paid close attention to her wishes, the baby was able to stay in the O.R. with them, no formula or pacifiers were given, she was able to nurse right away in recovery, and she roomed in with the baby (including co-sleeping with the baby in her hospital bed). Although not getting a VBAC was very disappointing, with a little perspective Kmom was glad to have labored instead of choosing a repeat c/s. She has since wondered if perhaps she needed a 'good' c/s to heal the trauma of the first horrid c/s.
Kmom recently had baby #3 and baby #4, this time vaginally. She avoided gd again in both pregnancies, despite being near or over 40, though she was careful to measure her blood sugar throughout as a precaution. Her third baby, induced at 38 weeks, was much smaller (7 and a half pounds, though he probably would have been close to 9 lbs if he had been allowed to go to term). However, once again, the induced labor was very difficult to deal with and she swore never again to be induced. Her fourth baby was born in the water at home, after an all-natural, totally spontaneous, NON-induced labor. It was the best birth of them all!
For Kmom's VBAC stories, see below; for a more complete version, see BBW VBAC Stories. For excruciatingly complete versions of all of her birth stories, see the section on Kmom's Birth Stories. For what it's worth, even though none of her births were easy, the VBACs were the best births of them all, and MUCH easier to recover from than a cesarean. However, each woman must choose what is right for them.
Michele's Story (triplets!, classical c/s)
Kmom's Notes: These triplets were not conceived with fertility drugs. Please note that with higher-order multiples, a classical (up-down) incision is often used, as in this case.
Birth Story
My husband and I had just gotten married when I found out I was pregnant a month later. Around Christmas time I started bleeding and called my OB's office. I hadn't seen the OB yet because he likes for his patients to be at least 10 weeks at the first office visit. When I called the OB's office he had me come in for an ultrasound. I was given a vaginal ultrasound since I was only about 8 weeks pregnant. I thought I was having a miscarriage so imagine my surprise when the u/s tech asked me if I was taking fertility drugs! I told her no, I was not, why do you ask? To which she answered, well, you are having triplets!
My first reaction was to cry (from relief that I wasn't having a miscarriage and from shock). The tech went and got my husband who came in and saw me crying and assumed the worst. After he was told our "baby" was in fact 3 babies, he screamed, "WHAT!!!!", loud enough for everyone in the waiting area to hear! The tech informed the doctor what she had seen on the u/s and we were ushered into his office for the standard speech on what could happen, such as we could lose one or all of the babies, complications, etc. I was sent home on 2 weeks bedrest with bathroom privileges only. By the end of the 2 weeks the bleeding had stopped (it was caused by me helping my husband lift the 100 lb. headboard onto our waterbed which caused a small tear in the lining of my uterus).
I worked until 20 weeks of pregnancy. I wasn't ever put on bedrest again, but my OB did advise me to take it very easy. Basically, all I did for the rest of the pregnancy was take my husband to work each morning, come home, eat, go to bed for more sleep, eat lunch, rest again, pick my husband up, eat again, and go back to bed! On weekends I went to garage sales with my mom to stock up for our soon to be larger family. I had about 15 u/s/ during my pregnancy, non-stress tests done 3x a week during the last month (during all of these I have 1 contraction), and developed pre-eclampsia. I was so swollen I couldn't wear any shoes except for velcro strap flip-flops. They would varely fasten and 2 weeks after the girls were born you could still see strap marks on my ankles!
At 34 weeks I developed a cold and couldn't sleep laying down. I tried to sleep reclining on the couch for 3 days, but that didn't work so I finally went in to the hospital ER on Saturday. I was admitted to L/D because of the protein in my urine, where they did a 24 hour urine catch. After the urine was analyzed the doctors decided to deliver my girls. My OB, the Pediatrician, and the neonatologists who were going to be there were all out of town for the 4th of July. My OB's partner, plus another OB who offered to assist, the Ped's partner, and the neonatologist's partner all were there for my delivery.
I was given an epidural and then I was taken into the OR at about 9:30 and the girls were born at 10:03, 10:04, and 10:05 a.m. I experienced a window from the epidural where I could feel it when they clamped back my bladder so as soon as all the girls were born I was given Demerol by IV. Within 2 hours of their birth the nurses got me up and took me to see my babies. I did have a spinal headache caused by the epidural, which the nurses diagnosed. I was given a blood patch to clear that up (a blood patch is when they draw blood from your arm and inject it into the back to clot the hole that was punctured in the spinal column from the epidural, which causes spinal fluid to leak, causing a spinal headache).
I was in the hospital for a total of 6 days. Two of my babies came home after 2 weeks and the third came home after 3 weeks. All three were very healthy and only needed to learn to suck and gain weight. That's my story and I'm currently pregnant with child #4 (just one this time!).
Erin's Story (classical c/s, 2 repeat low transverse c/s)
Kmom's Notes: Erin's first c/s was done with a classical (up-down) incision. Although she cannot be sure, she believes this may have been due to fat-phobia on the part of the doctor. Her subsequent doctor saw no reason to do a classical incision on her and her subsequent c/s have been done with a low transverse incision (bikini cut, horizontal just above the bikini line).
Erin's first doctor's decision to do a (probably unnecessary) classical incision took away all her future birthing choices in the eyes of the obstetrical world. She greatly desired a VBAC but because of her previous classical incision, her doctor would not agree to a trial of labor, although he was very sympathetic to her dilemma. Although some women with classical c/s have gone on to have VBACs, the rate of uterine rupture is somewhat higher with a classical scar, and it is extremely difficult to find a provider who will attend you if you try for a VBAC after a classical c/s. Although there are some who will, most will not, and Erin was not able to find a provider for this pregnancy who would try.
Birth Story
On Sunday, I spoke with my OB on the phone about refusing the c/s and he said I'd have no care from him if I did that. So Monday I started calling around but no one was interested in me at all. They all thought I was crazy. I kept taking calls until Wednesday afternoon, and though some wanted to take me, they just couldn't let me labor in good conscience. Wednesday I had a check-up with my OB. I asked if there was any way to wait until early labor to do the surgery and the answer was no. After the appointment, we waited for my best friend to get off work and then proceeded to the local Outback steakhouse. I wasn't going into that stupid surgery without a really good meal first!! I always have to wait 2 days until I can eat real food after my c/s. I had a big dinner. My friend stayed overnight to help with the kids---we had a slumber party. My DH got up early Thursday to buy me breakfast because I couldn't eat after 6 a.m.
I was in good spirits upon arrival to the hospital and they were expecting me in L&D. The nurse seemed nice enough and wanted to get a tracing on the baby's heart rate so she tried to fit the monitor belt around me which was uncomfortable (I'm quite large), but she finally got enough after 45 minutes and a wiggly baby. She said I'd had 1 contraction during that time. Guess that was supposed to make me feel better? I was very swollen so she took 2 unsuccessful tries to put my IV in. It hurt a bit but all the memories of what was going to happen to me in the next 2 days came flooding back. I was crying and she kept saying, "Does it hurt?" I was like, "No," but I couldn't really talk. Finally my husband told her I didn't want the c/s. She was pretty sympathetic and started talking about the baby. I guess I calmed a bit after that and she got another nurse who finally got the IV in. They started fluid almost immediately.
My OB was delayed. The anesthesiology team arrived; there was an older guy and a younger guy (in training). I got prepped and numbed in the site of the injection, leaning over curled. I felt at least 3 needle sticks and it was quite uncomfortable (later everyone who looked said there were 6 definite holes in my back). They were apparently having trouble getting the needle into the epidural space. This was my 3rd epidural and I'd never had a bit of trouble with the other 2. Now this! My mom said I sat rock still for over half an hour and by the time they were done there was blood running down my back. I so wished my husband had been permitted to be there; he would have insisted they stop or get another team to do it. Immediately after they put a test dose in I felt numb. So they were wondering if it was a spinal instead of an epidural! I was very numb. I was very upset and they kept talking about me in the third person. Finally I convinced them it was a spinal and I wasn't very happy about it, and the older guy keeps telling me how superior the spinal is for pain relief. At one point the young guy takes a syringe and draws fluid up from the catheter. He says it looks clear. I was like that's my spinal fluid, put it back in!!! I was thinking, well maybe this was for the best (I kept remembering the horror stories about bad epidurals). My numbness wore off before 5:30 but they wheeled me into the O.R. and I got onto the table. It was very uncomfortable and they tilted the table and had something under me.
Finally I see the doctor and of course a med student wants to observe. Great. One more person to see my baby before I do. My husband arrives with the older anesthesiologist who wants me to be brutally honest after the surgery with him about the epidural vs. spinal. The young anesthesiologist guy starts to put something into my back catheter and says "45 mg?" The older guy says "Sure." So the young guys says, "Or 100?" And the older guy says "Sure." I'm thinking, "Great."
Anyway it took immediately again and as soon as they prepped the site of incision I was ready. I remember smelling my burning flesh as they cauterized the "bleeders". I remember the doctor and assistant saying how good everything looked. Finally the baby's out! The older anesthesiologist said he'd let me hold her but he's nowhere to be seen. I'm starting to feel numbness and tingling in my hands which I know is wrong. I starting moving and shaking them (I had told them I didn't want to be taped down). They bring the baby close to me; I can't hold her because my hands are numb. She pooped when she came out (meconium) and has this muted cry, not like my others. My husband holds her and I start to feel really funny. Very uncomfortable all over and feeling like I need to run away NOW! My chest feels heavy and I don't feel like I'm breathing. They tell me they're putting my uterus back in. I say, "How much longer?" They say 15 minutes. I don't think I can take it. I feel nauseous. They young guy holds the tray next to my head and I throw up twice. I'd do it more but I can't because I'm too numb to even throw up!!! My arms are really flailing now and the young guy says if you don't be still I'm going to have to put you to sleep. I say, "No! I don't want to go to sleep." He says, "You have to calm down then." As if I can control any of this!! It's his fault! I didn't know what was happening and I really thought I was going to die then and there. My doctor asks if I'm okay, that they were almost done. I don't remember much else but my DH told me he let them give me a little something to calm me for a few minutes because I was apparently trying to get off the table and was actually moving my stomach. I know I was trying to move my feet. I kept saying, "I can't feel my feet!!!"
Finally I remember being back in my room. I told my husband to go ahead and take the baby to the nursery; she'd pooped again and he could give her a bath. I certainly was in no shape to hold her, and didn't really want to either. We'd previously decided to forego the bath so she and I could bond immediately. So much for that. Also I'd asked the doctor not to announce the sex; I wanted to find out for myself. Well, he forgot. Mom says when they brought me in I was still flailing and she was scared. I'm told they can't use the catheter that's already in place for pain relief because the dosage would be so small it wouldn't be useful. They hooked morphine up to my IV. I was already hurting. I really don't remember much here. I could move pretty soon and we went on to Maternity. By now it's about 10 p.m. and we hadn't called very many people. We figure they can wait until tomorrow. I do call the kids and tell them they have a baby sister. I don't remember when I saw the baby. I know she was beautiful. I tried to breastfeed and it seemed she was doing well considering the size of her head was about half the size of my breast!
The hospital stay was really sucky. I remember seeing the doctor the next morning and he immediately asked if I remembered anything about the surgery. He said he asked the anesthesiology team what in the world they did to me, that was not my personality! He said there was really no or nearly no scar tissue and the surgery itself went really well. I was not up to visitors at all but got plenty. I was sore and grouchy and felt so confined in that stupid room. There weren't enough nurses so my requests were ignored or put off. I was upset when they removed the morphine drip because I had to ring the nurse for pain meds. The back catheter was to stay in for 24 hours and wash with saline. The nurse wouldn't remove the urine catheter until the back came out and forget the IV. It was really impeding my ability to breastfeed comfortably because of the way the hospital gown was made (ties instead of snaps). The IV was threaded through the arm of my gown. I didn't have real food until Saturday lunch. I begged the doctor on call to let me go home. We left Saturday at 4 p.m., less than 48 hours after the surgery. I was so grateful to him! He remembered me crying to go home after I'd had one of my previous babies.
This recovery has really been a bear. I was so sore, much more so than last time, and the first time too, I think. I still have numbness right above and down to the incision site, and in the back where I sit down. The baby has been so sleepy that she doesn't latch on for very long or suck for very long. I'm pretty sure my milk came in anyway but it has since dwindled to nearly nothing because my sweet kids gave their sister a cold by kissing her in the hospital. She slept for 2 days straight when she was catching the cold. We finally got her to take a bottle and she seems to be doing fine. Still not staying latched on long enough to increase my milk supply. This is extremely depressing for me. It's like, I couldn't have anywhere near the birth I wanted and now I can't even nurse her?!
I do look at all 3 of my babies and feel so blessed that they're healthy, strong, beautiful, and smart. I really couldn't ask for more. Well, I did, but what good did that do? My experience was horrible and if anyone's looking for anymore reasons not to have an "elective" c/s, I've got plenty! I will regret this the rest of my life, but we're both fine and very healthy physically.
Kmom's Notes: External Version is not the only option for turning a breech baby, but it's the only one most OBs will even try (and some OBs won't even try this either). Moxibustion/acupressure, position changes (knee/chest or ironing board tilt position), special use of lights and music, cold stimulation, hypnosis, homeopathy, and a chiropractic technique called the "Webster In-Utero Constraint Technique" all have succeeded in turning breech babies, often even when External Version fails. Furthermore, the skill of the provider doing the Version is key; some doctors have extremely low success rates and cause the mother great discomfort in this procedure, while other doctors (and some midwives) have much better success rates and much more gentle approaches.
No one person or method is 100% successful in turning all breech babies, and sometimes there are physical reasons why a baby is stubbornly breech. However, it's too bad Liz did not get the opportunity to try any of the other methods that often work. Kmom has personally known the ironing board tilt to turn the breech baby of a very late-term mom similar to Liz. Also, it is Kmom's anecdotal observation that moms with strong sciatica pains often end up with malpositioned babies, and the Webster Technique can often help with both of these things. Regular chiropractic care may have helped prevent the sciatica and perhaps the malposition. There are no guarantees that any of these things would have turned Liz's baby, however, of course.
Birth Story
About two weeks before my due date, an ultrasound revealed that my once "heads-down and ready-to-go" baby had turned breech. The doctor told me my untested birth canal combined with the particular breech position of my baby made it especially dangerous to attempt vaginal delivery. However he was also leery of performing a c/s because of my age and physical condition, and he felt a vaginal birth would be easier for me.
He strongly urged me to have an External Version. This is a procedure where they try to manually turn the baby. He reminded me that a c/s was major surgery and he felt I should do everything possible to have the baby vaginally. So a week before my due date, my DH and I headed off to the hospital to try and turn our little dear. Once at the hospital, they hooked me up to monitor the baby's heartrate and my contractions, if any. A steady stream of nurses and residents came in to ask me questions, start an IV, explain the procedure to me, detail the risks associated with a version, and ask if I had any questions. They told me in the slim chance something went wrong, they could have me in the O.R. and the baby delivered within two minutes. When the doctor performing the procedure arrived, he did an extensive ultrasound and then he announced that he didn't think the version would work. He said there were several factors working against success:
He said it was unusual to try a version so late in pregnancy, but even with all these things working against us, we decided to give it a try. The doctor and two residents proceeded to push, pull, and push some more. But the baby just wasn't going to turn. After 3 tries, they gave up and sent me home with instructions to call my doctor as soon as possible if I should happen to go into labor over the weekend. The c/s would be scheduled for the next week.
It was a very long weekend---waiting for the surgery to be scheduled. I was scared of having surgery. I was scared of not having surgery. I was scared something would go wrong. I was scared of becoming a mommy. I was just downright scared! Monday afternoon my OB called and told me I should go to the hospital that night for blood work and my c/s would be in the morning. A sudden rush of adrenaline, excitement, and fear coursed through my veins. In 24 hours, I would be a mommy!
Tuesday morning, I got up, showered, packed my last couple of things, and we headed off to the hospital. DH and I were pretty quiet in the car. It felt like the air was very heavy and I didn't know what to say. Once at the hospital, I had a mini-panic. I had some bills that needed to be paid and I had forgotten to mail them. Overcome with a mixture of the fear, adrenalin, and excitement, I wouldn't let myself be checked into the hospital until I found a mailbox. I was a mad woman---running around the hospital looking for a mailbox.
Once checked in, they hooked me up to the monitors. The baby's heartbeat was strong and steady but there were no contractions. I was asked all the same questions they asked me on Friday. Another IV was hooked up. One last ultrasound was done to confirm the baby was still breech. Finally my OB and the anesthesiologist came in. They asked if I had any final questions, gave my chart the once-over and told DH to put on his scrubs. It was show time!
They had me walk from the intake/observation unit to the OB surgical suite. This was one of the longest walks of my life. The closer we got to the door that said "Authorized Personnel Only", the more my heart raced in my chest. There was no turning back. This was it! DH was told to wait outside the operating room while they started my spinal. I was taken into the cold operating room and told to hop up on the operating table. I needed some help for this maneuver because a short heavy pregnant lady doesn't hop anywhere. The spinal was the worst part of the whole thing. The anesthesiologist said I didn't have good landmarks (not something I wanted to hear), so it took him a few minutes to do the job. But once that was done, everything started to move really fast.
I was shaved and given a catheter and the incision was made. I asked when they would allow my husband to come in. With that, the doctor summoned him. I felt a little woozy from the tranquilizer they put in my IV but I was still present for the whole thing. The surgical lights were set up in such a way that I could watch the whole operation, if I wanted. It was a trip! There I was, lying there watching this surgery like I was watching the Discovery Channel and all of a sudden it hit me---"Hey, that's me up there!" So I stopped watching.
DH was a little overwhelmed by the blood. He said it was a good thing I stopped watching. He was making jokes and taking pictures to keep busy. The next thing I know the doctor says, "Here she comes. Here's your baby!" I look up to see him holding the most beautiful blonde baby girl. My OB gave her to the neonatologist to clean her up. He suctioned her out and the nurse took her footprint. They put ID tags on DH, the baby, and me. We all had bands with identical numbers and you had to show your band in order to get the baby once you left surgery.
While they were stitching me up, I couldn't take my eyes off of my little girl. The nurse wrapped her up in a blanket and brought her over to me. They put her across my chest and I just kept staring at her and crying. I had a little girl. My baby was here and I loved her more than I dreamed possible. All the fear, pain, and 9 months of petty annoyances were well worth it. I would have walked across hot coals for that moment with my beautiful baby.
Sherie's Story (PCOS, hypertension, PROM, induction, compound presentation, c/s)
Kmom's Notes: A short cord and baby's hand by the head
could definitely cause a long hard labor.
Birth Story:
At about 3 in the afternoon, at 37 weeks along in my first pregnancy, I started spotting. I had never had spotting or had any kind of bleeding at all during the whole pregnancy. I knew that this was most likely the mucous plug and some blood caused by the cervix beginning to dilate. I had no contractions and thought it would most likely be awhile before labor started. I went to take a shower during the shower my water broke! I called my husband to come home from work, we ate a light dinner and about 5:30 we went to the hospital.
My contractions were 2-3 minutes apart and I was dilated to a 3cm when I was checked shortly after I arrived. They put external monitors on me to track the contractions and the baby's heartbeat. The baby was moving around so much that we couldn't keep track of the heartbeat and they inserted a internal scalp electrode. They told me that I needed to be dilated to 6cm before they would give me an epidural. They said if given to early it could slow down labor. About 9 pm I was checked and had dilated to 4cm. I was having extreme pain and the nurse gave me
Stadol. After that wore off I was checked again at about 12am and was still a 4cm. The nurse had me go get into a warm water bath to try to relax. I got ice chips and more
Stadol. At 4am I was checked and was 5cm. I had nausea and threw up twice. I sat and rocked, I couldn't walk because of the extreme pain of the contractions and the nausea. My doctor came to check me at 7am and I was still 5 cm. At 9am my doctor said I could get the epidural, I was 5cm.
I had contractions all day and threw up 3 more times. I was given pitocin about 2pm because my contractions had slowed way down. At 6pm I had dilated to 7 cm and was exhausted. My doctor wanted to do a c-section because the water had been broken for more than 24 hours, I was exhausted and wasn't progressing despite the pitocin and my epidural wasn't working any longer also the baby's heartbeat showed he was stressed and needed to come out. I was so tired that I snored during the c-section, I could hardly keep my eyes open and when they showed me my baby I was so out of it I could hardly even look at him. He didn't cry much and he was so small, he didn't look like I thought he would. My husband wasn't allowed in the surgery because it was an emergency. They let my husband hold him a few minutes after he was born.
Later I found out that I had 4 large fibroids and the cord was unusually short. Also my baby had his hand up by his head and had a bruise under his eye were his hand had been. I was just glad it was over and that my baby was healthy and doing well. He had apgar scores of 7 and 9.
It was disappointing to have the c-section. It took some time to accept and come to terms with those feelings.
Danielle's Stories (elective c/s for breech, TOL c/s due to malposition)
Kmom's Notes: This mom had her hospital dispute her due date. They changed it to 3 weeks earlier than it was supposed to be. The mother and her husband are both tall, so the baby probably was bigger than average. But because ultrasound dating is based on averages, her baby's larger size made it look like the baby 'should have' been due earlier.
This had strong consequences for the mother and the baby; baby was still breech (as some still are at that point) but might have turned on its own before the due date (as many do). However, because they thought the pregnancy was farther along, they did an elective c/s for 'breech', and it turned out that it was done almost a month early. Elective c/s on its own is a risk factor for breathing problems; elective c/s plus prematurity is an even stronger risk for breathing problems. It also often impacts a baby's ability to suck effectively; it is not easy to preserve breastfeeding in the face of prematurity. Between the elective c/s, prematurity, and uncooperative nurses who kept giving the baby bottles, they were not able to preserve breastfeeding. Moral of the story: Don't allow a change of due date based on a late pregnancy ultrasound. They tend to be quite inaccurate for the purpose of either dating or estimating the baby's size.
In her second pregnancy, she wanted a VBAC. However, they induced her, which strongly reduces the chances for a VBAC. Plus her baby was large and posterior, which often makes a vaginal birth difficult. Once again, the mother is told that a 'small pelvis' is the problem when it really was a malposition problem.
Birth Story
Baby #1 (Alyssa): I was 7.5 months pregnant when I arrived from overseas to have our baby at home in New Zealand. Seeing as it was so late in my pregnancy it was hard to find a midwife, but we ended up finding one, who went halves in our care along with a local hospital. The hospital decided to do their own testing, and after yet another ultrasound they came to the conclusion that our baby was due on the 23rd of November even though my last menstrual cycle and doctors in Australia told us our baby was due around the 16th of December. Being our first pregnancy, we decided the hospital must be right and we continued with our near perfect pregnancy.
At 8.5 months it turned out our daughter was still breech; in fact the specialist said he could not turn her manually because she had descended down feet-first into my pelvis. I had an x-ray of my pelvis and another ultrasound which all concluded that she should be able to fit through (after 6 ultrasounds showing a girl, we figured that she would be a girl!). My husband (boyfriend at the time) and I talked about what we thought was best. We decided to do what we thought would be best for the baby, and having a breech vaginal birth worried me. I was scared that I would go into labour, my waters would break, and her feet would pop out. We decided the only way to ensure our baby was out safely was to have a cesarean. To me, having our baby safely was the most important thing; the caesarean itself was not a problem. I don't believe a baby has to be delivered vaginally to be a 'perfect' baby. At our next antenatal visit we told the nurse of our decision.
Wednesday the 13th of November at 8 a.m. was the date of our little baby's birth. It was a weird feeling knowing what day and at what time your baby's birthday will be. Wednesday came around slowly, each day counting down to the day our lives would change forever. Finally, we could meet our little daughter. We got up early, had a shower, took a quick photo of me outside, and walked to the hospital. A most unusual labour.
We arrived early, we were taken to a waiting room where we waited for our midwife to arrive; she arrived on time. We all waited and waited and waited. Finally a nurse came and asked me to lie on the bed in the lovely gown, where I had my temperature taken, and had my blood pressure recorded. I then had 2 nurses and a doctor attempt to insert an IV drip in my wrist. When all else failed a specialist finally managed to insert it in my hand. My husband put on the green scrubs. Then I was wheeled into the operating room. We were told before how everything worked, and were told again. So we left ourselves in the hands of the unlimited amounts of people present for our baby's birth. There were doctors, nurses, nurse's nurses, specialists, students, and somewhere in the middle was our midwife, me, my boyfriend, and my bulging belly.
I was moved onto a thin table, assured I was not going to fall off, rolled onto my side, and the spinal block was inserted into my spine. I was rolled onto my back to wait for the fluid to spread. After 10 minutes I could still feel my left hand side, so another spinal block was given. After another 5 minutes I was numb up to armpits, a catheter was inserted, a mast was put over my face to ensure the baby got enough oxygen. 5 minutes later, our beautiful baby was born at 10.15 a.m., weighing 3400g (7 lbs, 8 oz). The first thing I remember thinking the first time I saw her was, "She's not ugly, she is beautiful." I had an impression that all newborns were scrawny little shrivelled up half-prunes, half-alien-looking things with funny-shaped heads. But she was far from ugly.
We were wheeled off into a room to await our hospital stay. Things were going really well until that night. She had problems breastfeeding. And the night nurses had problems hearing me say no. She stopped breathing and nurses rushed in and told me she had mucus on her lungs. they informed me the only way they could get rid of the mucus was "to give her a bottle of formula." This I could not understand. I asked them if they could put my breastmilk in a bottle and they said no. I then protested, saying I didn't want them to give her a bottle of formula, and they said in the most degrading and horrible way, "If you want to kill her, it is up to you." I could not understand how giving her my breastmilk would kill her. I let them feed her formula, and the nurse sat in the corner of the room feeding her her first decent meal since her birth (of formula) without saying a word to me or letting me feed her the formula myself.
My husband arrived later that morning to find me crying. I felt like a failure because I could not feed our baby. I told him what the nurse had said and he ran off and rung our midwife. She arrived at the hospital less than half an hour later and blew up the nurses. She told them that this was supposed to be a baby-friendly hospital and that they are not meant to be so eager to feed babies formula unless the mum and dad want them to.
Later that night, the baby woke hungry. I tried for more than hour to feed her by myself, but she just would not latch on. I rang the bell finally but no one came, so I rang it again---still no answer. Finally after 2 more rings, the same nurse as the night before appeared and asked me what I wanted. I asked her to help me latch her on, and she said (and I quote), "Oh no, I can't do that. I'll have to call your midwife." I said, "No, I don't need my midwife. I just need some help latching her on." She replied, "Your midwife has stated quite clearly that I am to ring her if there are any problems at all." (My midwife had written at the top of my page, 'No formula or bottle, please call me if needed." So the nurse went off and called my midwife at 2 in the morning.
I went home the next day, after 2 nights in the hospital (4 nights early). That's very early after a c/s. The stress of having one more night in that hospital with that nurse was overpowering. Things did improve at home, but our daughter never breastfed. After trying for 9 weeks of pumps, syringes, bottles, sterilizing, breast shells, shields, and crying, we decided to give up and the postnatal depression I'd had disappeared when I saw her weight go up.
Oh yes, it turned out we were right---she was 3 weeks early at birth [Kmom note: At least!]. Because my husband is 6 ft. 4 and I am 5 ft. 11 all the ultrasounds showed her to be bigger and taller than she was. I don't regret the c/s but I do regret having her early because I now can't help thinking if we waited, she would probably have turned, and I would have had a 'normal' birth and not had such troubles breastfeeding.
It turns out now that nurse has been fired; I was not the first or the last person she degraded. She was rude to all first mums, especially those under 20 years old and unmarried (as we were---I was 18), and those overweight (thought I'd love to weigh that again!). It is sad to think just one person can make what should be such an exciting time into a stressful, demoralizing experience.
I hope this helps other people to stand up for what they believe and realize that just because someone has a piece of paper it does not make them right.
Baby #2 (Zach): I had an uneventful pregnancy, except for a lot of stress due to my husband leaving me when I was 5 months pregnant. Up to that stage I had put on very little weight, but between 5 months and 9 months, I had put on over 45 pounds (yes, it can be done!)
I was induced 12 days past my due date. I was trying for a VBAC. My mother and I turned up at 8 a.m. We sat around for what seemed like ages, and eventually the gel was inserted at 10 a.m. At 8 p.m. that night, still nothing, not even one measly little centimeter. I had had a few contractions but nothing much. They didn't show up on the monitor so I was given more gel. At 10:30 p.m. still nothing showed up on the monitor, even though I was having a lot of pain in my stomach. They said it was not proper contractions; if they were not proper contractions, I don't want to know what real ones felt like! So I gave up and had some pethidine and slept the night at the hospital. The next morning I went back down to the labour ward, was given an internal, and I had dilated 4 cms while I was asleep. But my midwife felt something on the baby's head. The OB/specialist was not sure if it was the umbilical cord or a finger, so I was sent for a scan. By the time I got there everything was okay. No sign of any cord or finger. He was estimated at 9 pounds, 11 oz. (we already knew the sex).
At 9 a.m. the waters were broken and more gel was inserted. At 1 p.m. I was still only 4 cms dilated and in a great deal of pain. But these were not considered to be 'proper' contractions, as they hardly showed on the monitor. They were felt across my c/s scar. [Kmom: This automatically raises the possibility of rupture in people's minds, especially during an induction. Usually, this pain is simply from adhesions from the old scar, but of course it's impossible to confirm that, which is an uneasy thing. In this case, there was no rupture, so it probably was adhesions.]
My midwife and I were not happy with my progress (or lack thereof). So for many reasons we decided on a c/s. Those reasons included failure to dilate, large baby, pain felt across old scar, and baby's heart rate dropping with each contraction. [Kmom note: Here's suspicion of malposition again---stalled at 4 cm, painful labor, no progress, and fetal distress. Also, they felt something was strange about the baby's head---probably the fontanel/sutures being in the wrong place because baby was posterior!]
So I was prepped for surgery. We arrived (my mum went in with me) at the operating theatre at about 2 p.m. A spinal (but only one this time) was inserted and at 2:12 p.m. my beautiful baby son was delivered weighing 10 lbs. 11 oz. He was 65 cms long with red hair and dark blue eyes, with a huge head measuring 40.5 cms (16 inches).
It turns out he was posterior and his head was too large to fit through my pelvis (apparently, even with my huge 5 ft. 11 frame and large bone structure, I have a small tilted pelvis! Typical). [Kmom note: a 16 inch head is larger than usual, as is a 10 and a half pound baby, BUT that doesn't mean the baby couldn't fit. The key here is the fact that the baby was posterior; a posterior baby presents with a much larger head diameter than one who is anterior and correctly lined up. So if this baby had been turned correctly, it might well have fit through. It certainly does NOT mean she has a small pelvis, or even a 'tilted' one.]
After 4 days in the hospital I went home and put all my baby clothes into bags and put them in the garage. My little baby was nothing like a baby---he was the size my daughter was when she was 3 months old! I didn't get a baby, I got a 3-month-old! Zach is now 2.5. He's huge---the size of an average 4 year-old. He is over 100 cms tall. His big sister is even bigger, standing at a whopping 120 cms for a 4.5 year-old. I'm getting used to the fact that these two wonderful children of mine will always be bigger for their ages.
Julie2's Story (induction, 2 c/s for macrosomia)
Birth Story
My whole pregnancy I was measuring average for each week, I ate right
and worked up till the ninth month. At my 40 week appointment my doctor thought the baby was about 7.5 lbs and since I had no
dilation or effacement she tried to soften my cervix, the next morning I went in
to be checked and I was still 0 cm, 0 % effaced and my daughter was floating. The doctor decided to induce me to get things going, we show
up at the hospital at 10 a.m. and they start the pitocin.
By 4:00 p.m. that afternoon my dr. came in to check me and I had NO CHANGE!! That night I was very discouraged I walked around the hospital, rocked and went on the birthing ball, the next morning at 6:00 a.m I was checked and still no change, I was quite upset with this news! After another long day on pitocin at 4:00 the resident dr, came in to check on me, I was the only one in labor and delivery so he stopped in to say hi, when he checked my stomach he thought the baby was a little larger then previously thought. He sent me down to ultrasound, still hooked up to pitocin mind you!, and she measured 13 lbs 4 oz on the ultrasound.
Needless to say he contacted my dr. who then ordered the pitocin to stop. They scheduled me for a c-section the following morning and at 8:20 Molly made her way into the world, weighing 10lbs, 11 oz and was 22 inches long. I just grow them large, must be all the peanut butter I eat!
3 weeks from now I will deliver my son planned c-sec, on the ultrasounds he was measuring 8 lbs at 35 weeks, so I am sure he will be a big healthy boy like his sister was. In case anyone is wondering I did not have gestational diabetes, in fact I have low blood sugar. Everyone assumes because I had a big baby that I must have had something wrong with me, but it honestly was just the protein I ate while pregnant!
Adele's Story (PROM, induction, c/s)
Kmom's Notes: It would be interesting to know if this baby was malpositioned. Having the waters break ahead of time, having little progress despite hours of active labor (even with pitocin), getting 'stuck' between 4-7 cm, and the baby staying up high and never engaging are often signs of a baby that is malpositioned. The baby was undoubtedly head-down, but may have been facing the wrong way (sunny-side-up/posterior), with its head tilted to the side (asynclitic), or with its hand/arm beside its head (compound). At this point there is no way to know for sure, but the pattern seems to be consistent with many malposition stories.
It's also not uncommon for women who have been through an induction and c/s to have their milk come in relatively late (this happened with Kmom's first baby too--she can relate!). It's unclear whether this is due to the anti-diuretic effects of pitocin (it tends to make you retain water in your tissues) or the effect of the cesarean (many c/s moms have their milk come in a bit later than normal). It may also be influenced by a tendency for cesarean babies to get more bottles and formula than babies born normally, and for nursing access to be delayed.
Breastmilk supply is very contingent on supply and demand; it works best when babies are nursed shortly after birth and very frequently thereafter. When babies are given lots of bottles and pacifiers, the 'demand' is much lower and the body tends to respond by producing less. Fortunately, however, in this case the mom was encouraged to pump a lot, which probably helped preserve their breastfeeding possibilities. Many moms in this situation are not given breastpumps or any instructions/encouragement.
Birth Story
First of all, I have to say that I had a wonderful and very caring doctor that I wouldn't trade for the world. When I went in for my first appointment I asked him about my weight and he said that it probably wouldn't be a problem and I had a few more risk factors than an average-sized person, but he'd keep a close eye on me and expected that I would do fine. I asked him about a c-section because my very skinny sister had to have all 3 of her children by c-section and he said that he expected I would do fine and delivery vaginally. After this first appointment I don't think we ever talked about my weight again!
When my blood pressure went up towards the end of my pregnancy he wasn't surprised because the same thing happened to that very skinny sister of mine and he said these things sometimes run in families. He ordered the non-stress tests 2 times a week until I delivered just to be sure the baby was okay. Besides it being a pain to go to the hospital 2x a week it was no big deal.
So, my water broke 4 days before my due date with NO labor pains whatsoever. So my doctor check me into the hospital and they induced my labor. Long story short, after 15 hours of active labor I only dilated to 4 and the baby still hadn't dropped down. So Dr. A said, "Let's do a c-section," and all I felt was complete and total relief! Dr. A was my sister's doctor also and she had the exact same problem with her deliveries which is why she always had to have c-sections, so he said it was very well something hereditary and had little to do with my weight.
So my son was delivered by c/s weighing 10 lbs, 7.5 oz. Very big baby--we all have big babies in my family so this wasn't surprising either. Because my son was so big some of the nurses at the hospital said I must have had GD and the doctor didn't catch it, but I asked Dr. A about this and he said he tested me for it 3 times and it was never a problem and I just had a really big baby. My sister's babies were all 10 lbs. too.
My milk didn't come in and because my son was such a big baby they had to test his blood sugar and that was all wacky so we fought that for a whole week. We had to give him formula until my milk came in which was 5 days later with me pumping like a crazy woman. After 2 days my son also developed pneumonia for some reason. He came out of it fine, but it was very stressful especially with the blood sugar problems and me not getting my milk in for so long. But we got to come home after 7 days and after that it was fine.
All in all, I had a positive experience. I did have a few nurses say things about my weight, but all in all they were very nice and by the time I got to that point I didn't care what they thought anyway! I think having a caring doctor is the biggest comfort because you can check everything out with him so you don't care what they think! It helped with my sister having the same doctor because he knew what problems she had as well and we knew it had NOTHING to do with her weight because she's so darn thin! :-) I think that helped a lot. I am having another baby soon and we are planning another c/s; I am glad and relieved. I just hope and pray my milk will come in at a timely fashion and we don't have any other complications. I hope the same for all of you.
Ellen's Story (induction, c/s)
Kmom's Notes: This mom was induced at 10 days past her 'due date'. This is very common practice now, but many childbirth advocates have criticized this policy of mandatory induction at or before 41-42 weeks. Research shows that first-time moms NORMALLY go about 8 days past due date on average, so this was not really 'overdue' in that sense. Doctors are concerned that once 42 weeks has passed, the rate of problems does rise, but even so, most women go 'past term' with no problems. In other words the risk, although increased, does not mean that all or even most would experience problems if 42 weeks is exceeded. And induction introduces its own risks.
It becomes a real judgment call as to what the best protocol should be when women near or go past 42 weeks, but some women just go longer and have no problems doing so. In particular, women with long menstrual cycles tend to go longer and should probably have their due dates moved back to reflect their longer cycles and later ovulation dates. Other women simply seem to "cook 'em longer." But it's not an easy decision to know what to do, and one must balance the risk of going post term with the risk of induction and all its interventions.
Induction for a first-time mom results in high cesarean rates. Induction on an unripe cervix also results in high cesarean rates. In addition, this mom's lack of response to induction may have meant that her baby was younger than they thought (note baby's trouble latching on to nurse), or that the baby was in the wrong position for birth and needed to shift to go into labor. Or perhaps her mom just tends to have longer pregnancies than the norm. Serial induction might have helped this mom (trying, then stopping and coming back several days later), as this often jumpstarts the body's own production of labor hormones. However, by forcing the issue 4 days in a row, the mom was exhausted and more than happy to agree to an elective cesarean.
Birth Story
Like most mums-to-be, I had planned for the perfect natural delivery with no pain relief if I could help it. At 34 weeks it was suspected that my baby was breech so I was referred to a consultant to check this. She was not but it made me realize that I may not have such a perfect delivery. I thought about my choices if I had a c/s and decided that I would want to stake awake so that my husband could be there.
We had always assumed our daughter would be born early but when 40 weeks had passed I began to think that I would have to have her induced. Sure enough, I was admitted to the antenatal ward once I had gone 10 days over my due date. I was induced with prostin [prostaglandin gel] that day, which was awful. The next day I had not dilated so I was induced again twice and on the 3rd day, I was induced a fourth time, having still not dilated. I had no Braxton-Hicks contractions or anything.
By this stage it was becoming obvious that this baby did not want to be born so the consultant said if I had not dilated by the next day there would be a decision to make--more prostin or a c/s. I think my facial expression must have given it away that I didn't want to be induced again, as that afternoon I was informed that I'd been booked in for a c/s and that I'd either have my waters broken if I had dilated or have a c/s the next day. I couldn't believe I was finally going to get my baby.
The next morning the midwives prepared me for a c/s. I preferred the thought of this to having my waters broken and I was happy about the way my baby was to be born. I didn't feel scared at all--just excited. When I was taken into the operating theatre the anesthetist tried to put the spinal block in--I didn't understand a word she was saying, though, and I got quite upset as it just wouldn't go in. After 45 minutes on the final attempt it went in---phew!!!
My husband was brought into the room and the operation started. I heard one of the surgeons comment on the baby's nose, and a few minutes later I heard a loud scream. "It's not even half way out yet," the surgeon said. A few minutes later our daughter was brought over to us, then rushed off to a machine for the mucus to be cleared out. [Kmom note: This is one of the risks of elective cesarean---more breathing problems and trouble getting rid of the mucus at times.] She had her vitamin K injection. She was then taken to the ward with Daddy and I was sewn up and sent to recovery. This was hard after not being able to eat as it was right next to the kitchen. And it was so hard being away from my baby but I was just happy I had the girl I wanted and that Daddy could be there for her.
As for recovery I was up the next day, although I hadn't been given any pain killers that day and so it really hurt. But once they began to kick in I felt much better. I was worried about the stitches coming out but it didn't hurt at all and in a couple of weeks I was starting to get back to normal again. There were some negative aspects like not being given pain killers in time, struggling to breastfeed, etc., although I was kept well-informed with what was going on. But I look back at her delivery as being perfect. I had no problems bonding with her at all.
She's 16 months now and one active, healthy girl. I think I was at an advantage with having an elective c/s instead of an emergency one but I think the best thing to do is just stay focused on the fact that even though things haven't gone as planned you're going to get your beautiful baby. Breastfeeding was hard because she just wouldn't latch on---the midwives were really supportive and they gave her cup feeds of formula milk instead of a bottle when things got desperate. I did decide to change to bottle feeding after a few days but I feel that I was given a lot of help and that the midwives had done all they could.
Heather2's Story (classical c/s, incision infection)
Kmom's Notes: Another case that may possibly be a malposition; the mother had little dilation but lots of prodromal labor. Labor stalled at 4-5 despite pitocin, a common problem seen with malpositions. The mom was admitted still in early or latent labor; instead of sending her home to rest and see if she progressed, they admitted her and forced the issue with pitocin and an early epidural. Apparently no attempt was made to see if baby was malpositioned or to try and help labor along in any way except with drugs.
Because of her size, the mother was given a vertical incision, although this is highly questionable. A few old-school doctors still feel that vertical incisions will infect less and are better for fat women. This does not seem borne out by experience or research, yet some large women are still being forced to have these incisions, which are more risky for the mom and for any future pregnancies she might have. Certainly, a vertical incision did not prevent infection in this mom! She experienced significant trouble with her incision, something a number of fat women with vertical incisions report.
She also experienced the surgery without full anesthesia, something Kmom has also experienced. This is a major trauma and can result in Post-Traumatic Stress Disorder or long-lasting fears for any future births or surgeries. There are organizations now to deal with "Surgical Awareness" during other types of surgery with general anesthesia, but VERY little information or acknowledgement is available when this occurs during a cesarean with an epidural. In fact, hospital staff members rarely believe it and generally gloss over it afterwards. Although regional anesthesia is indeed more difficult in larger women, this problem does not occur because of size, since many very large women have had epidurals that have worked just fine, and many skinny women have experienced epidural failure during surgery as well.
Finally, to add insult to injury, her milk never came in. This could have come from many causes. Women with inductions then cesareans, as noted before, tend to have more breastfeeding problems in general. Blood loss during surgery could have been the problem (through anemia), or the drugs given during surgery, or the lack of access to the baby (she didn't get the baby until the next day, presumably after multiple bottle feedings). The treatment for infection afterwards may also have impacted frequency of nursing, or it's possible that the treatment or drugs may have impacted nursing as well.
Birth Story
After an uneventful pregnancy (beside Group B Strep), I thought I would have an uneventful delivery too. Boy, was I wrong. I had been having contractions at about 10 minutes apart for 2 days when I finally got to L&D. I wasn't in a hurry to get there, as I had been long and closed with no dilation 2 days earlier. When I was admitted, I was 80% effaced and 2-3 cm dilated and the contractions were spreading out and becoming milder.
My doctor wasn't the one on call (it was a Saturday) and I wasn't too thrilled with the one who was. She started me on pitocin to get the contractions going and I was pretty much forced into an epidural at 2-3 cm before I wanted it. 12 hours later I was 90% effaced and 4-5 cm. The contractions only picked up a little bit and I was beginning to wonder if she was going to leave me lying there with no progress forever. She finally decided to take me back for a c-section and I was happy we were going to get this over with.
They got me back in the OR and got the epidural kicked up (it had worn off an hour earlier). No sooner did they get that going and she made the first cut. She never checked to make sure I was numb or anything. It felt like fire cutting through me and the woman did not believe me when I told her I was feeling that. She said it was just pressure. HA! My whole abdomen felt like it was on fire and my guts were being ripped out. When she pulled him out I screamed it hurt so bad. After that she finally said, "I think she has more feeling than she should." I wanted to slap her. I heard him cry and then I saw the mask. The next thing I remember is them pulling me from the OR table to the bed and the nurse pushing down on my stomach. After a double dose of Demerol, I was out until the next morning.
The pain was tolerable. I wanted to get up and move around as soon as possible, so I lost the Morphine drip and off I went. I went home the next day and things were going well-----until 5 days later. I was hurting so bad I walked like the hunchback of Notre Dame. I was oozing lots of light red watery stuff from my incision. Off to the ER I go and have to be admitted for IV antibiotics to help the massive infection in my incision.
My incision is up and down due to my weight, the DR says. For a month and a half I had to have a home health care nurse come in and pack the huge hole that was in my stomach. The infection was so bad, it wouldn't heal. Now, 3 months later, I still have a small hole that will never close because of where it is located. Now I am told that if I had the horizontal incision, the infection wouldn't have been so severe, and that my weight shouldn't have had anything to do with what direction the incision went.
It has been a long road, but I am finally healed and have the prettiest little boy in the world.
Sandra's Story (HELLP syndrome, low amniotic fluid, pre-term c/s)
Kmom's Notes: HELLP syndrome is an extremely serious problem. HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. (Hemolysis is the breakdown of red blood cells, and platelets are the blood cells involved in blood clotting.) HELLP syndrome indicates liver and blood complications.
Birth Story
This was a difficult pregnancy from day one. I suffered from 'morning sickness' the entire time (also known as hyper emesis) and we found out at 20 weeks that my amniotic fluid was low. The doctor was concerned the baby wouldn't grow properly. I had to drop to part-time work status to try to increase it. The week of Xmas I was at 30 weeks (due date was March 1st) and started swelling bad. I knew swelling was common in pregnancy so didn't think much of it. At my next few weekly ob/gyn visits my blood pressure was steadily increasing, protein was spilling in my urine, and I started gaining weight after no gain for the first 30 weeks. They started monitoring me closely because I was showing classic symptoms of pre-eclampsia (which is a pregnancy-induced disease). When a woman gets pre-eclampsia her body becomes 'allergic' to the baby inside of her and it starts shutting down the mom's major organs.
We spent the next couple of weeks seeing different doctors with different opinions on what was happening with me. We visited labor and delivery several times for monitoring because of my symptoms. Because my blood work kept coming back normal they didn't officially diagnose me with pre-eclampsia. Finally on Jan. 12th the doctor we saw informed us that we would be delivering within a week and sent us to labor and delivery. As you can imagine we were in shock. We were only 33 weeks along. I was given a Celestone steroid shot that day to help develop the baby's lungs. I had to get the second shot the next day and it didn't take effect for 36 hours from then. We prayed I could hold out that long but my symptoms were getting worse. I believed I could hold out for a couple of weeks with close monitoring but it wasn't meant to be.
On Wed. the 17th we went in for a nonstress test and an OB visit. My blood pressure was up 189/97. They sent me straight to labor and delivery. I stayed all day hooked up to the monitors and was told they were admitting me for overnight observation. That evening a doctor came in and did an ultrasound to check the fluid and it was so low (it was at 3, and 5-17 is normal but they want it over 10) and my blood pressure was so high that it was decided that I would need to give birth right away.
An IV was put in (after 4 painful attempts) and I was put on magnesium sulfate (which turned out to be a terrible poison) to prevent seizures caused by pre-eclampsia. It made me VERY sick. I had to be transferred to a high-risk hospital with a NICU 35 miles away. Once we got there and got in my room I got very sick and blacked out. It scared the HELL out of me. They wanted to give me a few hours to rest before they induced me. My mom and husband were with me and we all tried to rest for a few hours before they started pitocin.
They took more blood and started pitocin around 5:30 a.m. I contracted for about 3 hours and they checked me. I hadn't dilated at all. They kept turning up the pitocin. My dad arrived around 11:30 right as contractions were getting more painful. My blood work started coming back showing my liver was shutting down and my platelets were very low. I was diagnosed with HELLP syndrome. I was very sick!!!
About 4:00 I was checked again and still hadn't dilated at all after close to 11 hours of contractions without pain medication!!! I was so frustrated, sick and exhausted I almost cried. The anesthesiologist came in and said he wanted to place an epidural but my platelet count was so bad and if it was any worse he couldn't use an epidural. They did STAT blood work and I was okayed for an epidural. They made my parents and husband leave the room regardless of my protests. During the placement, I was feeling very faint and as soon as he finished I blacked out again. My blood pressure went very low and they had to pump me full of epinephrine to raise it. My baby had shown no signs of distress until then. His heart rate dropped too low and as I came to I was told we were heading in for a c-section. I was prepped immediately for surgery.
It was scary in the O.R. Once they made the initial incision they allowed my husband in. He sat by my head and talked to me and I was okay (but I kept throwing up). Ryan came out crying and didn't stop for at least 20 minutes. It was the most beautiful sound I ever heard. My husband stayed with the baby as we had agreed. Once he and Ryan left the O.R. (I got to kiss Ryan first) I started to panic. I tried to run but my legs wouldn't move. My memory of the surgery is all round yucky. My mom came in and sat with me during recovery.
My son was born on Jan. 18th at 4:46 p.m. I was 34 weeks pregnant that day. He weighed 3 lbs., 8 oz. and was 16.5 inches long. He had quite a bit of strawberry blonde hair. He was given oxygen right away but looked good. His apgars were 8 and 9!!!! My mom and dad and husband all got to see him and touch him but not hold him. I didn't get to see him until the next afternoon.
The first night was difficult. I was put in a shared room so no one could stay with me and my roomie had her baby in with her. I was trying to recover from surgery, magnesium sulfate, and deal with not having my baby all alone. The next day around 3 p.m. I was taken to the NICU to see him and I got to hold him for the first time. He was the most beautiful thing I'd ever seen. Sure he was a preemie and kind of funny-looking, but all I could see was how beautiful he was. I spent 6 days in the hospital and visited him often. My husband stayed with me every night after the first (they moved me to a private room). Leaving the hospital without my baby on Monday was the hardest thing I ever did.
In the weeks since his birth we have been under an amazing amount of stress but we're hanging in there. I'm pumping breastmilk every 3 hours but not producing enough for all of his feedings. They say stress will do that. We visit him every day and every time I leave it hurts. He is doing amazingly well. He was only given help breathing the first night. He had an IV for several days but it came off within the first week. He is learning to suck and has been given some of his meals by bottle. He tried to breastfeed for the first time today. He latched on and sucked a little but not hard enough. The doctors are calling him a "feeder and grower" which means he needs to learn to suck, gain weight, and learn to regulate his body temperature and then he can come home. They are guessing another 2 weeks but it could be sooner. We can't wait. I love him more than I thought imaginable. He is our little miracle boy.
He came home on February 5th after 18 days in the NICU. He weighed 4 lbs. 4 oz. He eats every 2 hours. His parents are exhausted but thrilled to have him home!!!! As terrible as my pregnancy and delivery was I don't regret a single minute of it. I got a beautiful angel out of all that suffering!!!
Nick's Mom's Story (low fluid levels, induction, difficult c/s)
Kmom's Notes: It is controversial how best to manage a pregnancy with low amniotic fluid levels near the end of pregnancy; low fluid levels may simply reflect a need for more hydration from the mom or it may be an indication of incipient problems. This induction may or may not have been necessary, but the doctors felt that they didn't want to 'take a chance' given this couple's long and difficult journey to parenthood. The long, non-progressive labor suggests a subtle malposition of the baby; the mother reports that they later discovered he had his hand by his head (compound position). She also had to endure some size-phobic treatment by some of the other doctors who consulted on her case This mom did a wonderful job of coping with a very difficult situation.
Note: There are cuss words in this birth story; if you are offended by this, you may want to skip to the next story.
Birth Story
On a Monday, we had a NST (Non-Stress Test) to check on Nicholas and how he was doing. My OB was concerned because his fluid levels had dropped from 12.3 the week before to 7.3 on Monday. So he checked my cervix; not much effacement and certainly no dilation (and after all those trips to the hospital for premature labor!!). However, he still felt strongly about inducing; he didn't want to take any chances after coming this far as we worked so hard getting pregnant, keeping this pregnancy, and staying healthy. So I assumed he meant, "Let's induce in a week." He said, "No, tomorrow at Noon." I wasn't prepared. DH and I were holding hands during this entire meeting. I was frankly scared to death. This was NOT how I envisioned having my baby. So my OB talked to me about all the risks of induction, and that it meant I might have to have a c-section etc., and the risks that go with that. Then they sent us home.
I got home and had a meltdown. I really needed to do that. Once that was done, I realized there was much to do to tie up loose ends both at work and personally, so I did all that. I needed to spend time with DH as I had an "Oh Shit" moment, realizing that we would not be just 'us' anymore. The next time we walked back into the house we'd be a family. It was scary and fun at the same time to think about that. DH was restless, as I was also that night. We went to dinner to talk about things.
Both of us were not comfortable with the ultrasound at the NST for various reasons. We didn't know the tech, she didn't know us, the machine was different, and we wanted a second opinion. As anxious as I was to have this child, I didn't want to rush things that didn't need to be rushed. I knew the ramifications of being induced, being a doula. So the next morning we got up, showered, loaded the car, and headed to the hospital. We got there early and headed to our Perinatologist's office to talk to him. He fit us in right away and listened to us. He then called up my high-risk OB and we conferenced. We just stated that we wanted a second opinion, period. So they did another ultrasound, with the same machine that we had been using for 8 months and with the same tech (who knew my body and who we trusted). The results were a bit better but the perinatologist was still concerned. We talked about the risk of just waiting it out. He said that with less fluid, the cord has the chance of compressing and that could mean a bad outcome for our baby. We didn't want that at all, so we went ahead with the induction.
So we checked into our room and discussed the induction plan. They inserted 25 mcg of misoprostol (Cytotec) in my cervix. They left us to our own devices, let me eat, and we got settled in. There was no progress in 3 hours, so I walked, rocked, danced, etc. 3 hours later, still no progress, so we got another dose of misoprostol. 6 hours later, still no progress so they wanted to start Pitocin. I said, "No, I don't think so---I know that pitocin on a cervix that isn't effaced is a disaster, I want to wait some more." So we waited another 4 hours, still no progress, so I consented to one more dose of misoprostol. We left it in overnight, and I awoke to annoying contractions. I thought, "Thank God, something's happening!" So I was checked and I had effaced to 80% but no dilation.
So my peri came in and said, "Let's insert a catheter in your cervix and insert a balloon. We will start labor on its own that way without pitocin and let labor go on its own there, you have enough misoprostol in your system. I asked about pain management then, as I knew this would be uncomfortable. My peri said, "It's not as bad as your lamanaria." Well, bullshit, it was horrible to say the least! No anesthetic, and it took a half hour to get in there, and contractions started whammo! The idea is that when the balloon and catheter fall out, you are at 3-4 cm, labor progresses, you go to complete, you push, you have your baby. Well, this didn't work like it was supposed to. I got to 2 cm dilated and my water broke, so the catheter had to come out and the clock for infection was started. Pitocin was started.
The contractions then were horrible. By now it's Wednesday, I am tired already, and it's midafternoon. They don't want to check me tons as my bag of water is broken and we don't want infection. I am now running a fever so they check me and I am between 3-4 cm dilated, cervix is still 80% effaced. They start me on antibiotics, check me for Strep B (I am negative). I ask for Fentanyl and get it. This drug sucks, it doesn't help take any edge off, it just makes me feel out of control and it doesn't let me focus or keep on track. My contractions are big and powerful; 3-4 minutes apart, and 2 minutes long with double peaks. I am now sitting on birth balls, rocking chairs, and laboring on the toilet. The entire time, DH has not left my side, has breathed with me, and the support he has given me is phenomenal. During one of the contractions, he tells me, "I do NOT see how any woman could do this without the help of a doula---I wish we had two here. This is so hard, I now know what you do, and you must be really good at this as I feel like a dork." I smiled at him, and don't think I could have loved him any more. He kept apologizing to me regarding the pain I was going through, and I said, "This is a labor of love."
My contractions Wed. night have changed. I think for sure that progress has been made, I am now shaking and have this overwhelming urge to push. I go to the toilet and have tons of loose stool, and I still need to push. So I call the nurse (this is where the parade of doctors comes in). This on-call doc checks me and says, "You are still 3-4, let's turn your pit up." I said, "No, you don't! My contractions are 3-4 minutes apart as it is, with 2 minute-long contractions---do you want to blow up my uterus?" So he goes to consult with my peri, who says, "We need to get them more powerful, why don't you have an epidural now?" So I am thinking, "Okay, epidural is one step closer to a section. Shit, what do I do, I am so tired." So finally after talking to DH, I know I need to sleep. I have been at this now over 36 hours, and so I say, "OK, let's do it," thinking this will take away my pain and I can sleep.
The epidural goes in smoothly---all this bullshit about fat women who have a hard time having them inserted is crap. Now if they take, that's another story. Mine didn't take. It numbed me from under my breasts down to my navel. From my navel to my vagina and legs, I was totally awake. I could walk, I could bend my legs, etc.---it was horrible. I kept telling them that.
[Kmom note: It is harder to put it an epidural on larger women because it's difficult to estimate the distance needed to get to the proper space. However, a good anesthesiologist should be trained to adapt for both easy and harder cases. Also, recent research shows that often the problem is taping down the catheter *before* the woman moves to lying down; this tends to dislodge the catheter a little, and especially so in large women. This tends to make the epidural patchy or less effective. Researchers were able to cut the rate of epidural problems by taping the catheter down *after* the woman lies down, and the improvement was particularly marked in large women. It's impossible to know if this was the problem here, but it's a good possibility. Another possibility is that if the baby was malpositioned, that could also have affected the epidural's effectiveness.]
They decided to give me morphine via the epidural---this took the edge off, but only a little. Then they turned up the pit and from that point on, I literally thought I was going to die. I could only whimper and breathe. I couldn't talk, focus, or anything. I was thirsty and they only allowed me ice chips, which was another indicator this was going south and I was going to be sectioned. The parade of docs kept coming, each one checking me, and shaking their heads and saying, "I am sorry but you are not progressing."
Dr. S marches in my room at 5:30 Thursday morning and tells me she is sectioning me via Midline incision. [Kmom note: Some doctors mistakenly think that an up-down incision must be done in fat women because of the risk of infection, but research shows that a bikini-cut/low transverse does just fine even in larger women. Midline or 'classical' incisions are riskier for the mother and any future children she might bear because they tend to be weaker and rupture more easily. Fortunately, this mom knew not to accept this and refused a midline incision. But the fact that this doctor would even have done it is appalling and shows how much bias there still is.]
Dr. S noticed my age and asked me if I wanted more children. Now what kind of an asinine question is that to ask a woman who is writhing in pain. [Kmom: The kind that allows them to prevent more fat women from having babies, which they often believe is 'too risky'. OBs used to regularly try to sterilize minority women as well.] I said I was not sure at this point, then that I wanted no more children. She said, "Well, let's sterilize you then while we are in there." DH was just waking up at this point (I had forced him to lay down and sleep), and I said, "Honey are you freaking hearing this??" I told her to get my peri down here ASAP. I wanted to feel no more pain--I was miserable. They gave me more morphine.
The entire time this was going on, Nicholas was a trooper, no decels at all---he was tolerating labor better than I. My peri came down at 8 a.m. and I was sobbing by then. He felt I could do this vaginally and said, "Let's give this one more day since you are not infected. Your baby is well, I hate to do a section on you---I want you to birth vaginally." So I mustered all my strength up and said okay---I knew that regardless tonight I'd have a baby. DH's family came up to be with us and took turn laboring with me so DH could get a break. This was the hardest labor I think---I was having contractions 1-2 minutes apart, lasting 2 minutes long, with double peaks. They kept dosing my epidural but it wasn't doing much but numbing the section between breasts and navel.
Thursday night rolled around, still no progress. So I said to my peri to please just section me. I couldn't take anymore, we were coming up on the 58th hour of labor and I had had it. He agreed it was time. He said, "Obviously something is not right, and your pelvis isn't cooperating." [Kmom note: Or more likely, the baby was malpositioned!] So I called my mom and told her what was going on and I just melted down. By then I was scared, angry, and out of control. Little did I know what was in store for me.
I asked at that point to have the pit turned off---they were going to section me at 9 p.m., and I wanted to rest. The other on-call doc said, "Leave it on, just in case." I then lost it. There were at this point (no joke) 15 medical personnel in my room plus my family, and NO one listened to me except my family. I screamed, "THIS FUCKING HURTS!!!!!! I AM HAVING A GOD DAMN FUCKING SECTION. TURN OFF THE FUCKING PIT NOW OR I WILL RIP MY IV OUT MYSELF." Everyone stopped and looked at me, and the pit was quietly turned off. 5 minutes later the contractions stopped. Nicholas was still doing beautifully, and wouldn't you know it, I think the epidural worked a bit more as I didn't feel so much pressure.
My peri took another look at the catheter in my bladder and said, "Here is part of the problem." So they re-cathed me, as it wasn't drawing enough urine off. My bladder was totally empty for the first time in 3 days; that was a huge relief in itself. 9 p.m. came and I had dozed, my family fretted, and I was going between being relieved and freaking out. At 10 p.m. they took me down to the O.R., DH was given scrubs, and they took my old epidural out and put in a new one to numb me, lower this time. This kind of worked---I could feel a patch about 4-6 inches long way down deep in my pelvis near my vagina. They said they would take care of things.
At 10:15 p.m. they started the surgery. While I didn't feel the cut, I felt all the tugging. [Kmom: It's normal to feel tugging and pressure, but it shouldn't hurt.] When they inserted the retractors, it was then I started screaming, hot white pain came ripping, and I felt I was going to throw up. It was too late to go backwards. They had to keep going, and they just started pumping in the drugs to me, and I kept yelling. At 10:30 p.m., Nicholas was pulled from my body. DH saw him take his first breath, and it was just overwhelming. Nicholas started to cry as soon as he was out of my body. His Apgars were 8 and 9, and he was perfect.
I stayed in the hospital 4 more days. The recovery was slow. I developed blood clots postpartum and was put on Warfarin (Coumadin). I chose to stop breastfeeding as I didn't feel that Warfarin transmitted through breast milk was safe for my son. It was my choice.
[Kmom's postscript: Although Nick's mom did end up with a c/s, she did NOT have a midline/classical incision; they successfully used a low transverse incision on her. So much for 'needing' a midline incision! Nor did she choose to have them go ahead and sterilize her. But these are classic examples of size bias.
These two tactics---midline/classical incision and strong pressure to sterilize---are sometimes used on supersized women to 'punish' them for daring to have kids. They induce early, and when the induction doesn't work and the woman is in great pain and emotionally vulnerable, they tell her she must have a c/s by classical incision, and while they're in there, they might as well sterilize her too. It is UNETHICAL to have a woman in labor make the decision about sterilization; hospitals are supposed to require signed consent ahead of time and not accept a decision made under duress. But although most do not do this, some OBs still routinely try to force their fat patients into being sterilized, or if they will not agree to sterilization, will use a classical incision to make the decision to have more children that much more risky and discourage it that way.
Fortunately, Nick's mom had a wonderful perinatologist who was very much her advocate. She knew to get him in order to get rid of the fat-phobic Dr. S, and she was able to have a low transverse incision instead. He also not only discouraged sterilization but told her that VBAC is an option for her in the future if she wishes.
Nick's mom also is pursuing a complaint against Dr. S's treatment. Undoubtedly the hospital will officially support the doctor, but the very act of the doctor having to defend her actions in a meeting will make her re-examine her routine biases and hopefully make her think twice before she uses these on another fat woman. Brava to Nick's Mom! You go, girl. If more fat women stuck up for themselves or officially complained after experiencing size-phobic treatment, doctors would have a much harder time treating fat women like crap.]
Bonnie A's Story (pre-eclampsia, difficult c/s, poor treatment, difficulties bfing)
Kmom's Notes: This mother had a difficult experience---be forewarned. Although not really plus-sized in the past, she learned from this experience what fat-phobia can be like.
This mom had severe edema, and her blood pressure raised strongly by the end of pregnancy. Her labs seem to indicate she had developed pre-eclampsia. She was induced with a bunch of Cytotec, a fairly new induction agent that can cause severe problems in some women. The usual dose is 25-50 mg, and may be repeated once or twice (even that is controversial), but this mom received 275 mg over 2 days. She was also on Magnesium Sulfate to control any possible seizures from the pre-eclampsia, and mag sulfate may counteract induction meds, so that may be why she did not seem to respond to such a large dose.
She experienced severe discomfort from all the mag sulfate she was given. She also had terrible itching. She may have had a reaction to that and all the pain meds she was given; itching is a common response in women who are sensitive to the drugs. However, she was also given a sponge bath by a mean nurse who did not wash her off; the itching may have come from that, or it may simply have exacerbated a meds sensitivity. Whatever the cause, she had a very difficult time with itching.
When they did the cesarean, they had a hard time getting the baby out. This is common with malpositions, and a malposition may also help explain why she did not progress in dilation much (esp. with the mag sulfate on board). The baby had significant bruising on her shoulders and arm, which may have simply been from the doctors wrestling her out during the c/s, or it may have been because the baby was malpositioned. There's just no way to know for sure.
This story is extremely long but nearly all the details have been included because it is such an important story documenting the poor care that some women experience after birth. Many of her post-partum attendants were callous, uncaring, and even vindictive at times. They sabotaged her breastfeeding with bottles and enforced separations; when she pumped, they dumped her colostrum down the sink rather than give it to the baby! They gave her poor advice on positioning and did not catch the problem of back-arching that the baby had. If not for some last-ditch help from one last lactation consultant, breastfeeding would not have worked out at all.
But the worst thing of all was how the mother was made to feel incompetent, hardly permitted to hold her baby, and generally disempowered in her new role as a mother. What she needed was gentle guidance, understanding, and empowerment instead, especially after such a difficult birth. Fortunately, her relatives and an occasional nurse or lactation consultant did give her some nurturing and some assistance, and eventually things worked out.
Birth Story
This story is harder to write than I thought it would be. At the time, everything just happened so fast and I became so helpless. It was exactly what I thought it would NOT be.
Let me start from the beginning. I am married to an immigrant. When we first married, the stress of filing all the immigration papers and some of the complications that arose really told on my health...including an 80-lb weight gain. I had never really been overweight, and it came on like a ton of bricks. I thought I would lose the weight once the stress of the papers was over, but I didn't. There was always something new. I weighed about 240 and was "normally" about 160. I had gone from a size 10 to a size 20. I finally decided that I may never lose the weight and so we agreed to try and become pregnant in spite of it.
My pregnancy went well. Only a little morning sickness, and I wasn't even overly miserable until the last 5 or 6 weeks. I had some pretty severe edema, but everyone said it was just the summer heat. My blood pressure stayed close to my usual 104/60 (although the nurses always remarked how low it was...like because of my weight they could not believe I was healthy.) I found out at my 20-week ultrasound that it was a girl, and everything looked fine. We decided that day to call her Natalié Yolanda.
My husband and I attended a waterbirthing class, and decided that was definitely the way we wanted to birth. I began working on a birth plan, and reading everything I could get my hands on about natural childbirth...I became very non-intervention minded, and was determined to do everything as natural as possible. My birth plan reflected this. At 32 weeks, I changed midwives because I just felt like I never really made that "connection" to the midwife I had been going to. She had made several comments about me needing to be walking at least 5 miles a day (in spite of the fact that I have a detached tendon in my ankle and my pregnancy aggravated this). I just felt that she saw my weight as a big problem. I can't tell you why. I also decided I wanted to birth in a hospital "just in case". The jury is still out as to whether that was the right decision!
I went to a childbirth class at 37 weeks...a natural childbirth class that talked more about the feelings and communication surrounding birth than the actual event. The theory being, you cannot dictate the event but you can dictate your environment and reactions, to a degree. The class was incredible and my husband and I loved it. We became anxious for her arrival. From the beginning, I met resistance with my natural birth plans...from co-workers, from family, from friends. No one was overtly negative, but people just kind of alluded to the fact that I would be "screaming for my epidural" in no time.
Well toward the end, I was completely miserable. The swelling started to get really bad...I was already wearing shoes 2 sizes bigger and now could barely wear those. I got a double chin, couldn't wear my thumb ring on my wedding band finger, and even my toes had little creases in them from the swelling. I looked like a balloon person with sausage feet. The midwives had me going in every 4 days for non-stress tests, and the first 2 were fine. By the 3rd, the baby was fine but my blood pressure was getting worrisome at 192/78. I weighed almost 300 pounds.
When I took the results to the midwives' office, they explained I would have to be induced because it looked like I was developing pre-eclampsia. They offered to try and wait but I agreed to an induction because they said there was no way my condition would get any BETTER, and this way I had a chance at my natural birth still. After many misgivings, I checked in Tuesday for a cytotec induction. I wasn't crazy about cytotec after all my reading, but it seemed like a better option than pitocin, which would keep me on an IV stuck in bed and from what I'd heard, give me nightmare contractions.
When I got to the ER, they had to call for a wheelchair...and when it arrived, I could not fit!!! It looked really narrow to me but maybe that is just because I was so large and swollen. So I waited, mortified in front of my husband, while they sent for the "large" wheelchair. That one looked normal to me! So they wheeled me up to the 14th floor, tossed a nightgown at me and had me get into bed (just like all the stories I'd read). And you know what? It was a lot harder to resist anything they told me than I thought. I obediently put on the nightgown (which could not close in back and exposed me completely), peed in a cup, and got into bed to be hooked up to all the monitors.
They [ended up giving me 3 doses of Cytotec over time; 25 mg, 50 mg, then 50 mg again.] Only a few contractions. I was only 1/2 to 1 cm. dilated...they said I was getting a "softer cervix" with each dose. I was losing a lot of blood and mucus. They sent me home anyway. So home we went, with strict orders to collect every drop of my urine for 24 hours in this plastic bin they gave me (yuck!). Well that was no fun, and 24 hours later I was at the hospital lab turning in my urine and getting blood drawn. The midwife had told me this was to see if I was going to be "high risk" for the next try at inducing me 2 days later on. So we checked back into the hospital on Thursday for a second try at the cytotec...knowing if it didn't work I was stuck with pitocin. I cried and cried Wednesday night because I knew my chances for getting the birth I "wanted" or anything close to it were not very good.
When I checked in Thursday, I remembered to ASK for the large wheelchair. There was another pregnant lady checking in for induction at the same time, and she looked about normal weight. She got to walk up! They would not ALLOW me to walk up. I was terribly embarrassed, because we even rode the same elevator. The cytotec routine went the same on Thursday, with one big exception: when I arrived on the 14th floor, they told me my urine results were great and I could walk around and even go outside if I wanted. The midwife on duty, C----, was my least favorite of all of them because of her unhappy demeanor and seeming favor of interventions (she acted like Pitocin was an inevitability) during our meeting a few weeks before. She was her usual serious self, and never smiled back at me or acted even slightly compassionately. The nurse told me to go to the café and get something to eat while I still had an appetite. So after my initial monitoring and first dose of cytotec, my husband and I went down to the café, then went out to walk the halls and heard my name paged over the hospital intercom to return to the 14th floor. My midwife said, "We read your results wrong. Your protein count is 472 and the max is 300. You must get in bed NOW and I have already ordered the Magnesium Sulfate IV." I was stunned and burst into tears. I was obviously doing just fine walking around, and now they realize they read my charts wrong. She explained I was at high risk for liver failure and seizures and I became so upset that my doula asked if we could have a minute alone. She was sterile and commanding in her explanations.
My doula took me in the bathroom and comforted me and I tried to process the information I had just learned as quickly as I could. I couldn't quit crying and I told my husband to call my mother NOW. I just wanted my mom. The midwife opened the door to the bathroom without even knocking and told me I needed to get in bed, NOW. I was pissed at that point. I had been doing fine out of bed for hours; she could at least give me a moment's privacy with my doula to process the horrible news. After all, I was weeping! My doula told her firmly we would be there in a minute. I was very grateful for her support. She then answered me that she did not know about my chances for a Cesarean anyway at this point, but that we could ask for Dr. M----- and he could advise me forthrightly.
I finished up in the bathroom and got in bed, and they immediately began strapping on monitors, prepping me for the IV, and explaining to me that I was probably going to get sick from the Mag Sulfate since I had just eaten (gee, thanks guys for telling me to go eat!!!). The midwife dutifully explained that I could only have one small glass of ice chips per hour, and no food. That sure made me mad. They wouldn't even let me drink water!! This was turning into my worst nightmare. I felt like a prisoner. And to make it worse, my baby was their prisoner too, by default. They stuck my hand with the IV line. Thank God, the nurse, named J-----, was very compassionate because at that point I felt all alone in the world. They rolled in the bag of Mag Sulfate and I started to cry all over. They promised to give me something in the IV first to help with the nausea. When they hooked up the Mag, it was exactly how everyone has described...it was hot and burned the veins in my arm. It truly hurt. I asked for ice packs and my mom and sister (who had arrived by then) helped hold the ice to my entire forearm and wrist where it was aching like someone was scraping my bone. My husband fed me ice chips and I tried not to cry. Dr. M----- came in the room and told me we would see what kind of progress I made between then (it was almost noon) and 5pm. He said he felt I had at least a 50% chance of being able to have a vaginal birth. Of course, waterbirth was out of the question at this point because of the Mag and the IV and blah blah blah.
Once the Mag hit, I felt nauseous and a little out of it. I began to feel tired and irritable. I was thirsty...the ice chips didn't seem to help. And they had given me 50 mg more of the cytotec - my 2nd dose that day - and in spite of the nausea I began to feel some sharp hunger pangs. This made me even grumpier. The slightest loud voices or people eating in my room made me furious. After a few hours, I figured out that the "hunger pains" were actually contractions. After my 3rd dose of cytotec, they got even worse. I had managed to avoid a catheter until this point, and when I went pee I was losing all sorts of goopy, bloody mucus. The nurse, J----, informed me that my cervix was much softer and she thought it was about a 2. My midwife decided she needed to check too. She made me put my fists under my hips and dug around, asking me to tilt my pelvis because there was so much "flesh" in between her and the cervix (??????). I took it as a fat reference, but I was used to it by now. I was cautiously happy because at least a 2cm estimate meant progress.
By 4pm I was having to breathe through the contractions and I reserved some hope that my body was working after all. My arm was the most painful thing....whenever the Mag released (it was on some kind of timer) it hurt like little demons running up my veins. When Dr. M---- came in at 5, he told me that my cervix was "up somewhere in Montreal" and the baby was at least 9 or 10 pounds. He said my cervix was tipped posterior and it wasn't even 1cm. Oh. He said that I would have to have a Cesarean because my blood pressure was already too high in a reclining position, and if I was allowed to labor much more normally I could have a brain hemorrhage or seizure or blah blah blah. I was stunned. He said they had to get the baby out NOW. I just could not compute the information...but it is not like I had time. Instantly, my room was invaded by teams of people to prepare me. My family was shooed out except my mom and my husband were there at some point. The wicked midwife (I might mention at this point, she was the only MW in the practice I didn't care for and now I knew why!) was brushed to the side and I felt like she was more of an uncompassionate nurse or pawn than a true midwife.
My mom hugged me over the side rail of the bed while I cried silent tears. I was so scared I could barely breathe and I couldn't believe
this was happening to me. My mom prayed for me and my sweet husband hovered with a very worried look on his face.
My husband and doula changed into scrubs. I suddenly felt like I was in some alter reality and was
watching everything from outside my body, like a dream. I wanted more than anything to be NOT pregnant and my mind searched frantically for some way
out of this. But there was none. My insides were quaking and I just tried to keep calm.
Some lady came in with a plastic case and I thought it was an epidural, but it turns out they were there to shave me!! I was too terrified and out-of-it from the Mag to ask why the hell they were shaving me for a Cesarean. When they finished, it was time to go to the operating room. No one explained anything to me, and I was shocked when they told me I had to WALK to the operating room. I had been told all day I wasn't allowed out of bed! How incredibly perverse. So I walked down the hallways to the O.R., pushing my little IV stand. I secretly wondered if it was because it was inconvenient to get the "large" wheelchair. My mom took a photo. It is really pathetic.
In the O.R., I was terrified. It looked just like everyone describes...Sterile, cold, and little trays of scary-looking tools. I looked my husband in the eye and I was afraid I was going to die. I think I said something to him about taking care of the baby if I died. While we were waiting, I remember my doula asking me if I was still having contractions. She understood how I felt; I could see it in her eyes. That made me cry from deep in my soul; my body was trying so hard and I felt like I was betraying it, and the little baby inside me. The anesthesiologist got called away on some emergency and my husband, my doula and I were left there with me sitting on the operating table to ponder my fate. I cried the whole time. It ended up being a blessing in disguise though, because by the time the anesthesiologist got back, I was a little more calm. Dr. M----- walked in and took one look at my face and said, "You are really scared, aren't you?" I just nodded. The anesthesiologist was a very nice and patient man, soft spoken with kind eyes. He talked me through the spinal and it wasn't that bad. The Mag Sulfate hurt more than the spinal, in truth. The instant the needles were in it started to take effect.
They heaved me around to the "cross" position (with much grunting - I was SO afraid they would drop me!) and inserted the catheter...I cried out more than once because I could still feel. Catheters hurt! Then they tied my legs together and tied my arms out in the "cross" position. The anesthesiologist checked me several times to make sure my nerves were deadening. My doula kept me centered in the midst of my fright and told me to feel myself breathing. That helped a lot, because you feel like you are dead or dying. The partition went up and they started cutting. The thing that surprised me the most was that I could still feel!! I could not feel pain, but I could feel things moving around inside, the knife cutting. Then, of course I felt it when they brought her head out. I heard all sorts of exclamations about how much hair she had. They had a hard time getting her body out because she was so big and broad. They pushed and pulled on the baby and I so hard that I thought I would fall off the table. Dr. M----- made a joke about having shoulder dystocia from a c-section. Well I thought it was a joke...it turns out later that her whole shoulder and arm was black from bruising. He also joked about delivering a 3-month-old. They all made bets on her weight.
Once she was out, I remember asking if it was "still a girl" and they said it was. I asked if she was OK. I couldn't see her because the "baby team" that handles the Cesarean babies was hovering around her. In maybe 4 or 5 minutes I could turn my head while they were suctioning me out (sounds just like you are at the dentist) and stitching me up. I saw a very pink baby with a head of wild black hair, screaming her lungs out. I felt relief she seemed well and then I just sort of detached from the situation. I heard them talking about how much meconium had been in her water and how even the placenta was stained green. Someone made a comment about how my fallopian tubes looked like chicken's feet. That irked me. My husband was given the bundled baby and tried to show her to me, but I could not really see her and was not coherent enough to tell him to lean her down further. He took her out of the O.R. while they finished sewing me up to show her to my family and tell them I was OK. I remember them putting a shot of pitocin in my IV and my doula telling me how remarkably fast they had finished sewing me up. Then they all heaved me onto another bed (again, it felt like they were going to drop me...and I know I was not handled very easily) and started rolling me out. I thought they took me directly to my room, but I found out weeks later that I went to Recovery. I must have blacked out because I have absolutely no recollection of this.
I remember them wheeling me to my room. The baby was in the warmer on the other side of the room and my family was crowded around her. My sister was videotaping. They were giving her shots, slicing her heel for the PKU test, and putting Erythromycin in her eyes. She was intermittently screaming and I remember feeling so drugged and helpless. I wanted to see my baby but I couldn't even raise my voice to say anything, and at this point I was completely resigned to the hospital machine. After doing her PKU 4 times (they kept saying they weren't getting enough blood), shooting her up with Vitamin K and Hepatitis B vaccine, weighing her (9 lbs 8 oz) and generally torturing her, some lady brought her to my bed. Not my husband, not my family, but some lady who talked too fast and acted like the God of my baby...all in a very nice way. She held my baby girl in front of me for what seemed like eons, while I struggled with everything in me to keep my eyes open and seem alert...the drugs were overpowering. She talked and talked and to this moment I cannot remember what about. I assume nursing.
When she finally let me have the baby, she said I was too drugged to hold her and I would have to try nursing lying down because of my swollen belly and my "large size." They messed with my bed, moved me over, propped me up on pillows, and took my gown off to my waist. Then they put little Natalié Yolanda down beside me and she told me to move my arms out of the way. She took my breast in one hand and my little baby's brand new head in the other, and tried to force us together. I was humiliated and I remember just looking away once she told me to move my arms out of the way. Natalié cried. She wouldn't be peaceful, and she certainly would not just let me hold or bond with my baby.
Unfortunately, all the activity made me vomit - I knew it was coming and warned them just in time to get the baby off my lap and a little bowl in front of me. I heaved and vomited about 20 times. It was awful. They tried again. Natalié showed no interest in eating and after she was manipulated and shoved into my breast enough times, she was inconsolable and the lady lifted her out of my bed and I don't remember what happened after that. I was told I could not hold her because of the drugs, that I could drop her. I just wanted to close my eyes and wake up in another world where this was not happening.
The rest of the night was a blur. A gruff nurse named K---- took over and stripped me and lathered me up in my bed and began to wash me down everywhere. I could feel my IV and catheter line tugging as she heaved my heavy, swollen body over this way and that, soaping me down. It was like she thought because I was big, I couldn't feel. I remember wanting to ask why she didn't rinse me when she began toweling me off, but I just couldn't get the words from my brain to my mouth. Then she began stripping and washing Natalié in this little metal bowl. I vaguely remember my husband getting the video camera and Natalié was screaming again. Poor thing. I tried to stay awake and watch the first bath but I couldn't even keep my eyes from rolling back in my head. I felt so sick. I faded in and out. They moved us to a different room, and then the nurses changed again. I found out later the gruff nurse did not want to attend me, and that is why she was so mean. Great. The new nurse was nice, and held the bowl for me while I threw up over and over and over. It hurt so badly. I felt so detached from my baby at this point I barely noticed her sleeping in the bassinet beside me. I felt sad and USED somehow.
The next day was a blur of having more than one person calling themselves "lactation specialists" come in my room, and proceed to try and instruct me in the complex art of breastfeeding. I would hesitantly take off my gown, and they would take my baby in one hand and my breast in the other, and get in a pulling match with Natalié. My little one was a back-archer from the start, and strong as a horse. She would throw her head back and resist the pushing until she shook with the effort, screaming hysterically. They would be pulling my breast, rolling my nipple painfully and manipulating us to no end. I gritted my teeth and finally told one of them it hurt when she was tugging at my nipple, and was shocked when she said that it "couldn't hurt" and that she "had to!" At no point was I allowed to simply hold my own baby and try to feed her on my own.
I began to feel like a failure. I cried whenever I moved it hurt so badly. I could feel the catheter and was not able to sit up at all because of the pain it caused in my urethra. One of the "specialists" told me if I could not sit up in the bed, there was no way Natalié could try and nurse. So I cried and brought the bed up as high as I could. Of course, then the pushing match would start again. I was told over and over to please just keep my hands out of the way. I have no idea how someone could be expected to succeed in this position. I was mad at how hard they were forcing Natalié. She became instantly hysterical whenever they tried. They would eventually sigh and give up, put her in her crib, squalling, and go off to find a bottle of formula. Then they would cup feed it to her at my insistence; I knew she should not have artificial nipple if she couldn't nurse. She would slurp it down, burp, and peacefully go back to sleep. Since she wouldn't nurse, they rolled in a pump and instructed me how to start pumping my breasts so that my milk would come in. All the focus was on my milk. I would pump and pump, and get a few cc's of colostrum from each breast. Instead of feeding it to Natalié, they would wash it down the sink and give her formula. When the shift changed and I got a really nice nurse, I asked her if I could please feed it to Natalié. She was kind and helped me feed her the little bit I got during her shift. The formula made Natalié spit up a lot. I know now that new babies do not need near as much food as they were forcing down her. No wonder she showed no interest in nursing! She was not hungry.
The Dr. had come that morning and mercifully told them to stop the Mag Sulfate. He also prescribed Lasix, which I knew from my days at the racetrack was a strong diuretic. He did say the catheter had to stay in though, which disappointed me. During this day the nurses and "specialists" started becoming concerned about Natalié's whistling while breathing. She had a real wheezy sound to her breath, especially when upset but also when resting. They brought up a specialist from Pediatrics who said she was OK once he checked her over. Later in the day, she was wheezing much worse so I asked them to take a look. The nurse was very concerned and told me they had decided to take her down to the intensive care nursery for testing. She assured me it would not be long, and she would let me know what was happening. I didn't want to part from Natalié, since I had finally gotten to hold her, but I also wanted her to be OK.
They wheeled her off and I sent my husband with her, since I was stuck in bed with a catheter. During this time, I was going crazy with itching. All over my body, I developed sores and itched until I made wounds in my skin. Eventually, I couldn't take it anymore and asked the nurse if she thought it was some sort of allergic reaction to the painkillers they were giving me in my IV. She said she didn't know but could give me Stadol for the itching. I didn't want that so I asked if there was anything else. She said Benadryl. So I told her to do it...I needed relief. The Benadryl knocked me out like light. I could not even talk; my tongue was so heavy in my mouth. I hated it...at one point, I was sure I would die of thirst but I could not lift my voice to call the nurse and I had no idea where the call button was. A lady from my work came to visit me and I couldn't even keep my eyes open to acknowledge her. I found out later she was alarmed because I was so incoherent.
When the Benadryl finally began wearing off, I had more visitors. This went on for hours. No word on Natalié. My husband had been gone for hours and the nurses had changed shifts. He came back once in a dither because they wanted to give her a bottle and a pacifier and he knew I didn't want that. I said NO! And he said it was for some kind of test. I said NO...they could tell me what kind of test but otherwise no. He left. The new nurse knew nothing of my daughter and I asked her to please find out. My husband stopped in once to tell me everything was OK and they had run tests and she was fine. The nurse asked me if I would like a sponge bath, and it hit me.... that was what was wrong with me!! That gruff nurse had used soap and not rinsed me off! I had dried-on soap all over my body. I did not even remember until that moment. I told the nurse and she agreed to just use water so we could get the itching to stop. It worked! But now I had sores on my face, chest, and arms from itching. I was so embarrassed because two of the sores were on my face, and one on my chest right between my breasts. They looked like boils. I already looked so ugly with my sweat-matted hair, swollen face and body, and now I had big red sores on my face...this made me ashamed to have photos taken. I grieved this bitterly when I was back home, that I did not have photos of me and my new baby.
It was evening by now. My sister finally took her leave and as soon as she stepped out of the room, hysteria began to set in. My family was gone, my husband was gone, and my baby had been gone for almost 10 hours! I had to pump, and when I did I began to cry as I knew my baby was missing the precious colostrum my body was making to give her immunities. I called the nurse and asked her about my baby. She didn't know. She did give me a number for the nursery. I called and was told the nurse in charge of my baby was busy and I would have to call back in half an hour. I began to cry. The harder I cried, the more I thought. The more I thought, the harder I cried. Where was my baby? Was she OK? How was she eating without me? Formula? By some miracle, my sister had decided to bring some blankets from her car up to my husband; she came back and found me a dripping, crying mess. I called the nursery again, and they told me she was already on her way up to me. I calmed down. My sister decided to wait with me. The clock ticked. Over 40 minutes passed. When I told her about how long they had had Natalié and what had happened, she went out to find out what was up. She came back to tell me that Natalié had indeed been moved up to my floor, but to the nursery there. They had her hooked up to all sorts of monitors and told me that I could not see her because she could not be brought to me, and I could not get out of bed because of my catheter. I went ballistic.
My sister left again and told them that I was going to flip out if I could not see my baby. She must have moved heaven and earth, because they unhooked Natalié from all of her monitors and brought her to my room. This horribly mean, huge woman with an inch of makeup on named J---- was her nurse and would not hand her to me. She held her in front of me and lectured me on how many babies they had to take care of more important than mine, and that she didn't have time to cater to my wants to see my baby, and that she was their responsibility until the head Nurse Practitioner signed off on her. I lost it - I told her not to be rude to me and to please just let me hold my baby. She said, "I am TRYING not to be rude to you. You have to understand that we are busy. We have babies much more important than yours, with much worse problems." Blah blah blah.
I didn't even hear her mouth talking after that. I went off. I said, "This is MY baby. You have had her for 10 hours. You did not even tell me she was OK, or what was wrong, or if I wanted to feed her. Someone took her from my room with an assurance they would be right back, and now you are telling me she is your responsibility. She is MINE. You can't just take her." I was sobbing uncontrollably. She tried to argue with me and raise her voice. My nurse, my husband, my sister, and this woman were all crowded into my tiny room, looking at me. She was still holding my baby! I said, "Just give me my baby," over and over. After much lecturing about how I only had 5 minutes, she handed me Natalié. I just buried my head in her and took deep breaths. The 5 minutes was no joke and she was back to take her quarry. I asked how long until I could have Natalié back. She said the head Nurse Practitioner came on at 10, and she would evaluate her then. She haughtily said that Natalié would probably be released, but no guarantees. I told her I would wait until 10:30 before I started calling and asking. My loss of control had made its mark though; her pride was stepped on. She was not going to be doing me any favors.
I waited with my sister, a lifesaver, and we made lists of questions to ask and what we would do. We called my doula and a friend who used to work at the hospital for advice. At 10:15, there was a knock and K--, the head Nurse Practitioner, had come to see me. She was nice but extremely patronizing. I apologized for losing it with her nurse, and tried to outline my frustration coherently. She said she had come to see me that afternoon, but that I was sleeping. This made me mad...they woke me every hour for blood pressure and temperature checks anyway! I guess she came when I was out on the Benadryl. She also defended herself that everything had been explained to my husband. I was baffled at their ignorance; my husband is obviously foreign and has heavily accented English and no knowledge of medical terms. She said they had no idea (right!). She in turn explained to me that Natalié's esophagus was weak; that the cartilage rings had not hardened fully. She said that she was getting plenty of oxygen, the tests showed, and so she would release her to me when she got back to the nursery. She said the condition was somewhat common, and not dangerous because the esophagus was not closing completely. She also said her little nasal passages were swollen from all the aspirations. Apparently, they had aspirated her a 3rd time in the nursery for fluid her lungs. She was having a hard time breathing. The "test" with the bottle was to see if she could both breathe and suck at the same time; basically, to check and see if her nursing problem was physiological.
The huge, horrid nurse brought Natalié back to me about an hour later. It was almost midnight by now. She triumphantly told me that I could have her in my room, but only on the condition of "supervised feedings". I was surprised and asked what this meant. And she said, every 2 hours she would come and "supervise" while I tried to nurse Natalié. I asked her why, and she said that they were concerned that Natalié would starve without enough food, because I didn't want her to have a bottle or formula. I was shocked. I agreed, though, because all I wanted was to hold my baby. I took her out of her bassinet and laid her on my chest and dozed while looking at her sleep. I was completely on my guard for whoever wanted to steal her away again!
That mean nurse did indeed come to "supervise" her feeding. I apologized to her for my outburst in an attempt to smooth her ruffled feathers if we had to get along in the middle of the night, and she had the power to take my baby away from me. She eventually warmed up a little and tried to "help" me feed Natalié by trying nipple shields and this odd syringe and tube contraption that fed formula into the nipple shield so the baby would supposedly get the idea to latch on. Nothing worked, of course. I was very quiet and listened while she went on to tell me she had not had enough milk for her son and had to supplement with formula, and it was no big deal, and she had no idea what the lactation people were so worked up about anyway. She told me that giving a bottle or formula was fine, and would not cause any of that "nipple confusion" nonsense they were so worried about. She was very opinionated about it.
I finally just gave up. They broke me. I was running on only a few hours of drug-induced sleep, had been medicated within an inch of my life, was in severe pain from my section (I cannot take narcotics so I requested only 800mg of Ibuprofen), and felt rejected by my own baby and totally inadequate for not being able to figure out how to breastfeed my child. So, I let the nurse bottle feed my little Natalié. And thus began my resolve to get the hell out of that hospital. I kept pumping my breasts anyway, in hopes that maybe when I got in the privacy of my own home I could do it. I had no idea just how bad letting her have a bottle was.
A different nurse came on duty in the middle of that night, and I begged her from the first moment to let me have my foley
catheter out. She said the Dr. had specifically written on my chart not to remove it, but she promised to ask him first thing. It was hurting my
urethra every time I moved, and by morning it was aching whether I moved or not. She was an angel. True to her word, she came in about 5 or 6AM and
snipped the line and mercifully yanked it out quickly as I yelped in pain and grabbed myself. All I cared about was it was out and I was free! She
also helped me to get a bigger gown that fit my body, and helped me find my own underwear since the disposable ones the hospital gives you only work if
you are a size 12 and under. She was super nice about it, and I cheered up a little.
She then went off duty at 7AM and I got a not-so-nice nurse. The Dr. came in and said I could shower and get out of bed and I almost hugged him I was so grimy at this point. She not-so-nice nurse made a big show of telling me I had only 5 minutes in the shower. I secretly thought...once I get in there, what are you going to do to get me out? The Dr. had told me to remove the pressure dressing from my incision while in the shower. When I started to stand, it was harder than I thought it would be. I was dizzy and weak and the incision hurt so bad I welled up with tears. But I was determined to get my shower so I smiled wildly (I must have appeared half-crazy) and got in the bath as quick as possible. The shower felt soooo good. I lathered my hair and body over and over and had just started working on the incision dressing when Ms. Not-so-nice came to tell me to get out but hey! I still had to take off the dressing...Dr's orders you know. The only thing was, I stupidly tried to hurry and it came off with a 2x2 section of my whole skin on one side. It hurt so bad! After I got out and showed the nurse, I asked her for some Neosporin or A+D ointment so it wouldn't get infected and maybe a couple band-aids. She said she would have to ask the Dr. for permission! I was incredulous. What bullshit. I told her forget it, I would ask my own mother to bring me some.
A nicer lactation consultant came that day, and she brought me a bottle of
sterile water to mix with the colostrum I pumped to feed Natalié. I never fed her formula again! They moved me to the 12th floor that day and I think
they sort of forgot about their "monitoring" of my feeding, so I kept feeding her only my colostrum and water. I fed it to her in the bottle when
they were looking, and in the cup when they were not. I was largely ignored once they moved me to the 12th floor, because I was no longer considered
"high risk".
One of the midwives from my clinic came to see me - M-----, the one who had been there the day of my first induction. She brought Natalié a little stuffed pink bear and sat and talked to me for a while. I so wished I could have had her for the birth. She was sympathetic to my wishes for a natural birth and was careful to tell me what was going on and why; she understood I needed to process and grieve my losses of what I had hoped birth would be. I know things probably wouldn't have gone any different with her than with the midwife I ended up with, but at least I would have felt supported instead of like the enemy was in my camp. I felt special that she remembered to come see me and decided that my initial judgment had been correct: all the midwives in my practice were great except the one I got.
That night I was awake most of the night. I held Natalié all night and plotted my way out of that place. It felt like jail. Starting at 7AM with the nurse shift change, I asked every 30 minutes when I could go home. My diligence paid off (squeaky wheel gets the oil?) and the Dr. came 'round about 9 to tell me I could go home if I wanted to that bad. I thanked him profusely. He told me to come back on Tuesday (it was Sunday) to get my staples out...By 12, I was signed out...after about 6 lectures and 20 signatures, I was free. All I wanted was OUT, where I could get to know this precious little baby I hardly knew but already loved. It took them almost an hour to find the "large" wheelchair. I just kept asking. I had this feeling of urgency...I was so afraid they would find some reason or other to keep me or Natalié there.
The next few days were tumultuous and difficult. I had a severe bladder infection from the catheter and it hurt like heck every time I peed. I had to call the Dr. for antibiotics. Fun, more meds. Natalié would not nurse any more at home than in the hospital, so I pumped constantly and was nauseated from the Ibuprofen. My mother was a godsend and helped out. I could still barely walk.
We tried breastfeeding almost every time but she would try to latch on, then rear back and cry wildly and gasp. I was afraid she couldn't breathe. I would then feed her my milk, which came in the day I escaped the hospital, from a bottle. I was over-engorged and my breasts were dripping constantly...it was painful, miserable, and sad because I didn't know why I couldn't feed my own baby. I began to get discouraged after a few days and was weeping over the thought of having to switch to formula. I considered pumping and bottle feeding, but I was so miserable and it didn't seem practical.
I followed my sister's advice and decided to make a final last-ditch effort and call her friend, who was a lactation consultant, post-partum doula, and general baby expert. After my previous experience with "experts", I didn't expect much. But I had met this woman before and liked her very much so I decided to do it. She agreed to meet with me. We had been emailing for a day or two, and her responses were so helpful, I knew that this was it: if she could not help me, it was over.
My mom taxied us out to her office about 45 minutes away on a miserable pouring rain day. But once in her office, she handed me a nipple shield. I looked at it dubiously. She told me how to put it on (something the hospital staff never did, they just shoved it at me) and she took my baby from me and checked out her mouth, tongue and nose. She declared her perfect and then showed me how to hold her. She explained that back-arching babies have to have their arms and legs spread in order to "open up" to nursing. She showed me how to hold her. With one try, Natalié latched on and nursed without stopping for 20 minutes. I think I smiled the entire time. My mom and I were exclaiming over and over, "Look at her, look at her!" She was nursing like she knew all along. Well of course she did!
I was struck with gratitude for this wonderful woman who saved my relationship with my baby and made me realize that it was not my baby or I who was defective, but the people at the hospital! Imagine, in about 4 minutes our whole world was righted. Why couldn't someone at the hospital simply shown me how to hold her instead of telling me to keep my hands away? Was a back-arching baby so rare? I doubt it. I grinned all the way home and our lives changed forever that instant. I began to heal, and Natalié was calmed.
Since then, our only sorrows have been those of the past. Why did I let all that happen? How much was really necessary? How much was fact and how much perception? Did the interventions cause the problems, or was I saved because I had interventions? I have cried and cried, and writing this story has taken me 7 weeks of soul-searching. All I know is this: never again.
Even if I have to have another cesarean, I will never again lose control and dignity. I will be informed, firm, and if that means being a "bad patient", so be it. I certainly had some bad nurses! On the flip side, I had some wonderful nurses. I can't believe the power that one person on a 12-hour shift has over your life when you are helpless. I can't even remember the names of some of my co-workers after having been off work a few weeks, but I can tell you the name of the nurse who left soap on my body to dry after my Cesarean. I am struck by the power they have to affect your life and your memories.
I am also struck by the prejudice against fat people. I had never been "fat" in my life, until recently before my pregnancy. But by the time I gave birth, at 300 lbs., I felt like I was living in an alter reality. I can tell you, as someone who used to be "normal", that you ARE treated worse...it is not in your head. When I was thinner and considered pretty, I was almost always treated with respect. Bloated, ugly, and with boils on my face, I was treated with barely even courtesy. It is like you don't count. Several times I heard muttering about the nurses having to get the larger arm cuff for BP counts. I can't imagine with over half the US population of women being a size 14 and over, that it would be THAT unusual. When you roll this treatment into the whole hospital experience, it just adds insult to injury.
I am not sure what I will do with the next one, but I can tell you that it will be different. I would like to try a homebirth and I still desperately want my waterbirth. But those fears haunt me...I have a lot of thinking and praying to do.
I love my daughter more than anything in this world and would do it all
again for her. I am just so deeply sorry her start in life was so abrupt, so tragic, and so stressful. I wish I could take it all back and be more
knowledgeable, healthier, and have been able to save her from nurses, probing, bottles, formula, separation, and everything else. I pray every day
that she feels secure and loved.
And I am eternally grateful to the woman who made it possible for me to nurse my baby. Thanks for taking the time to read my story.
[Kmom note: Bonnie A went on to have an empowering
VBAC at home. You can read a short version of this story below, or the
full version in the BBW VBAC stories section. There are also photos of
Bonnie's c/s birth side by side with her VBAC birth at www.pattiramos.com/bonnie.html.
]
Cindy's Story (failed induction at 42 weeks)
Kmom's Notes:
Birth Story
To start off, I didn't find out I was pregnant until I was 14 weeks along! Needless to say, it was unexpected. However, after the initial shock, DH and I were VERY excited. I was in a fairly new job about 800 miles from 'home' though, and it was tough.
I loved my dr. She was wonderful from the beginning. She was excited as I was. The only part about my weight that she mentioned was that I should try not to gain more than 25 lbs. since the average healthy gain is 25-35 lbs. And she monitored my sugar levels to make sure I didn't have gd (in my 3rd trimester it was apparent my child would be big).
The pregnancy was pretty uneventful---that is, until the end. At 36 weeks, baby was still breech and the doctor tried to turn him externally. Well, after about an hour of that with no success, we had decided that we would have a c/s. So of course, stubborn child that he is :-) he decided to turn on his own at 38 weeks. So then the c/s was off and it was back to vaginal birth. During this time, I had several ultrasounds to monitor baby's position and size, which was fun----I think I had 6 ultrasounds in my last trimester. We also found out he was going to be huge. At 40 weeks, the u/s tech predicted a size of nearly 10 lbs. So the doctor sent me back 2 days later for a different u/s tech to measure. The latter tech measured him to be 9 lbs, so the doctor decided to give it more time so that I could progress into labor on my own.
At 42 weeks, still no signs of labor, no dilation, nothing. So we went to be induced. First we had the cervadil overnight [prostaglandin gel]. Then we started the pitocin the next morning. I had a few cramps that I found out were contractions, but it was really nothing. The easiest way for me to tell if I was having a contraction was to look at the monitor. The doctor increased the pitocin levels for 3 days! Still nothing, nada, zip. So finally we went in for the c/s. I was so happy to finally get it over with. I wanted the c/s about 2 weeks ago, though!
Everything went great, and when baby came out, he was indeed huge, healthy, beautiful, perfect in every way. The only problems I had afterward (other than being really sore and that mean old nurse making me walk 10 feet to the chair) was the pain relief the doctors/nurses at the hospital opted to give me when I told them I was in extreme pain. First they gave me a shot of Ibuprofen, which did absolutely nothing for the pain. Then they gave me a morphine drip. This was horrible. It gave me the dry heaves. After you've just had major surgery on your stomach, dry heaves are not the most pleasant thing to experience to say the least! FINALLY they gave me Lorcet, which was wonderful. I could even walk again.
There was only one thing I wish I hadn't heard/experienced. One of the nurses commenting that I must have had GD since my child was so big. I did, however, inform her that I did NOT have gd and that my doctor was very conscious that I was at risk and monitored me throughout.
Although I possibly could have delivered naturally, who knows when it would have been? My mother's pregnancy with myself was a whole month late. And as far as having a big child, neither my husband nor I were what you would call small----me at 8 lbs. 15 oz. and DH at 8 lbs. Although I could have gone past 42 weeks to compete with the woman from India who had a 15 lbs. child, I am not one of those women who thinks of herself as a failure for having a c/s. I am relieved that I didn't have a long labor. A long induction, yes, but not painful, and I caught up on some of my reading.
I am pregnant again (this time planned). I weigh 220 lbs. At my first visit, my doctor never mentioned wt. gain, but I did ask. He stated that I could gain as little as 10 lbs. and have a healthy 8 lbs. baby. So that is my goal---to just eat normally because I know I am already getting the extra calories (that I didn't need before) that I need now. I just don't want to gain 50 lbs. again---yuck. And we have decided to have another c/s. Doctor gave me the choice but also told me I didn't have to decide for a long time. My response was, "I didn't go into labor the first time, why would I start now?" I guess I don't deal so well with the unknown and would much rather have everything planned down to the last detail.
Anna's Story (PCOS, PIH, induction, malposition, TOL c/s)
Kmom's Notes: Anna feels that her doctor wrongly attributed her blood pressure in pregnancy to "chronic hypertension" because of her size. In fact, her blood pressure was normal before pregnancy, was normal in the first several visits, and then started to rise. However, when she asked about pre-eclampsia, he told her she had chronic hypertension and she felt that this assumption was based on her size and not on the facts. After her pregnancy, her follow-up visits record very normal blood pressure readings. Obviously, she did not have chronic hypertension, and the higher BP was due to pregnancy.
This was Anna's second child. Her first had been born by cesarean, and she was hoping for a Vaginal Birth After Cesarean this time. Because of her rising BP, Anna's labor had to be induced, which strongly lowers the chance for VBAC in most cases. However, women *do* have VBACs with induction; unfortunately, her baby was slightly malpositioned, which made it difficult to be born vaginally. Because the doctor did not know how to help the baby re-position, a repeat cesarean became the wisest choice at that point.
Anna showed great strength of character by demanding that the anesthesiologist re-do her anesthesia for the cesarean! All along, they were not taking her seriously when she told them she was not getting good relief with the epidural. They also did not take her seriously because their monitors showed her contractions weren't very strong. (Many large women report that contraction monitors do not accurately measure the strength of their contractions.) When the anesthesiologist tried to tell her that her epidural was sufficiently strong for a cesarean, she fought back and PROVED that she still had feeling and needed more. Reluctantly (because doing a spinal after an epidural does have risks), he did a spinal, and she was able to have a 'good' cesarean experience. If she had not been so assertive, she probably would have been one of the unfortunate few (like Kmom) to feel their cesarean surgery. Standing up for herself like this in the face of their disbelief was amazing.
Birth Story
Having experienced secondary infertility due to PCOS and three miscarriages, we were delighted and frightened to find we were expecting again. I had pre-eclampsia in my first pregnancy, so they monitored me closely as a result.
About 4 weeks prior to the due date, having seen my blood pressure increase slowly with each visit, my
perinatologist wanted me admitted for possible delivery. My ob/gyn, who seemed
convinced (despite the fact that my first couple of BP readings with this pregnancy were
normal) that I was chronically hypertensive, disagreed. He sent me for observation to the maternity floor of the hospital, but
told the nurses that if my BP stabilized, I was to be sent home. After six
hours on my left side, I did see a bit of a decrease in BP, so they sent me home to follow up the next Tuesday with the ob/gyn.
On Tuesday, I went to my appointment, and my BP was 175/110. That was the highest it had been, and I argued with my ob that I was ready to deliver.
He begrudgingly sent me to the hospital, again for "observation". After several hours without a change in my BP, he decided to go ahead and induce
labor. Cervidil was inserted and a pitocin drip started, and just a couple of hours later, my labor began.
The nurses were wonderful. They monitored me closely, and tried very hard to encourage my plan of a natural, drug free labor and delivery. After
twelve hours of no sleep, they finally convinced me to do something for the pain. My cervix had only dilated to 3, I was progressing very slowly, and I
was already exhausted. I hadn't eaten since 6 AM the day prior, since once I was admitted to the hospital, I wasn't allowed anything but ice chips. I
agreed to some narcotic relief, the doctor decided to break my water, and I finally slept fitfully for about two hours. The pain seemed to be getting
worse, and upon inspection, I had progressed to 5 cm.
The nurse asked about an epidural, and even though I had strongly desired a natural birth, I felt
totally wiped out and needed some relief. Finally, with the epidural, the pain subsided, and I was able to get some bit of sleep. It seemed to me
that the epidural wore off quickly, and twice, the nurse called to bring someone in to give me a little more medication. The third time, with the
pain seeming to me to be very intense, a new anesthesiologist came in and told me that based on my 'strip', the contractions weren't that bad and I
should be fine with what I had. He also noted that I hadn't progressed past the 5 - 6 cm point in quite some time, and said that if the pain did
continue, I could call back. After about 45 minutes, the nurse who was taking care of me stood up for me and demanded that someone come and give me
more meds for the pain. The anesthesiologist came back, and another round of drugs was administered.
About 5 that evening, February 14th, after having been in labor about 21 hours, I felt like there was something passing - there was no pain, but I
felt for sure something was coming out of me. Seconds later, the feeling passed, and the nurse checked under my gown. She became quite frantic,
scooped up the waterproof pad that I was laying on, placed it on a table out of my view, and ran to get another nurse. I became extremely concerned, and
my husband didn't seem to know what was going on, and when the other nurse came in, they both agreed that my doctor needed to be called immediately.
Apparently, I passed an extremely large blood clot, and after the doctor came, he deemed me okay to continue with the labor.
After several more bouts of trying to convince people that my epidural wasn't working, and the pain was really bad, the nurse confirmed that my
labor seemed to have stalled. I had been at the 6 - 7 cm point for a long time, so the doctor was called in. At 2 AM on February 15th, the decision
was made by the doctor, myself and my husband to go ahead with the c-section. The baby's head wasn't in position, and I was so exhausted that
I felt if the time to push came, I'd be in a terrible predicament. The anesthesiologist tried to convince me that my epidural was just fine, but I
proved to him that my feet and legs were totally feeling, and the contractions were absolutely being felt. I refused to go into surgery until
something else could be done, so he agreed to a spinal. I am certain that had I not demanded something else, I would have felt the scalpel make the
cut.
At 2:34 AM, on Thursday, February 15th, after 31 hours of labor, our second
daughter was born via c-section. She had APGARS of 9 and 9, and after a few minutes of introductions, she was taken to the nursery. She
remained there for a few hours. I insisted on stitches instead of staples, so I didn't have to have the staples removed, which I found uncomfortable
after my first c-section. She and I went home four days after surgery, and except some minor drainage from the incision, I healed well.
I believe that the ob/gyn made a call regarding my increasing BP based on my weight. I kept close track of my BP, and I know it was normal up until
about 4 months into my pregnancy. I learned during this labor and delivery that if you don't speak up, you won't get what you want. I hope I remember
the lesson in other areas of my life!
GAMom's Story (high blood pressure, PROM, transverse malposition, c/s)
Kmom's Notes: This mom has not been evaluated for either PCOS or thrombophilia but may have some autoimmune problems affecting her fertility; test results have been contradictory. Progesterone supplements in the beginning of pregnancy seem to have helped this pregnancy continue. She also took low-dose aspirin for part of the pregnancy.
In a follow-up question, she noted that the hospital did not tell her to have her staples out at 3-4 days; she waited until her 2 week postpartum checkup to have them out! Ouch.
Birth Story
My husband and I had 3 miscarriages (all between 8-10 weeks). We really wanted a baby. My OB-GYN was great. He immediately put me on progesterone suppositories due to prior miscarriages. We had our first ultrasound at 7 weeks. You could see the sac and heart forming. Our next ultrasound was at 15 weeks and you could see the babies heart beat. I was SOOO relieved. My husband was great. I still didn't want to get all my hopes up. We got pregnant when we weren't supposed to. It had only been 2.5 months since our last miscarriage and the doc wanted to run some tests. Oops! :-) We had our first round of tests and it came back with levels increased. Our doctor informed us that it was probably just a false positive but sent us to a perinatologist anyway. We saw him once a month for quite a few months. Boy, do we have great ultrasound pictures. Our baby girl developed quite rapidly over the time. All measurements were great and on target. Two amnios were attempted but the needle wasn't long enough. And MAN, did they hurt!!!! They monitored closely and took precise measurements to ensure the baby was okay.
We were finally released from him and seeing our doc every two weeks. Everything was fine. Our baby had been head down since January at every visit. My blood pressure starting to rise a little to about 140/80 and 150/90 toward the 33 week. My doc put me on bed rest and then it soared higher. He released me back to work and it was fine. At the next visit it was a little higher ( I was seeing him every week now) and it put me on home rest, not bed rest. It did much better. I went out to dinner with my husband on Friday night and that night my water broke. It was just leaking and I really couldn't tell much difference between that and going to the bathroom a good bit. By morning around 8,, we called the doctor and he sent us to the hospital. My water had definitely broke.
Because it had been broken for a while they wanted me on bed rest there. They hooked me up to all the monitors and the baby was fine, but I was not in labor. They did an ultrasound and she had turned transverse. All things considered, we opted for the c-section. The epidural was easy and I was awake for the entire thing. My beautiful baby girl was born that night at 8:30. She was healthy w/ apgars of 8/9. She roomed in w/ us for Sunday and Monday. Monday night I put her in the nursery because we were going home on Tuesday. She choked on them (they fed her a bottle!) and turned blue. As upset as I was, it ended up being good because she needed oxygen. Her O2 levels were in the mid 80's. They put her in NICU and gave her antibiotics, oxygen, and lots of tests. She also had to go under the bili lights after that test came back. I was in there as much as they would allow. She nursed well, but I never did have milk that came in. She got a lot of colostrum though.
Within three days she went to the intermediate nursery on an apnea monitor and oxygen. they couldn't wean her off the oxygen and she had a few apnea episodes. After it was finalized that her lungs just weren't completely developed because of her prematurity and high birth weight for her prematurity, we PITCHED a big fit. To make a long story short, she came home on oxygen and has been great ever since. She is now 8.5 months old and still on the monitor, but no oxygen since 1 1/2 months. She now weights 20 pounds, 29 inches tall and is a very HEALTHY baby girl.
I wish all the supersize moms had as great a doctor and experience as we did.
Jen C's Story (induction, unknown malposition, c/s)
Kmom's Notes: Again, classic signs of malposition that the OB missed. Days of 'false labor', very intense labor pains, uneven dilation, feeling pressure despite an epidural, early need to push, fetal distress, etc. Unfortunately, the doctor blamed the problem on the 'layers of fat' keeping the baby from going through the pelvis (what nonsense!) instead of recognizing the baby's obvious malposition. She then told the mom that if she lost weight, she 'might' be able to have a baby vaginally. Although the doctor is almost certainly meaning well, it is yet another form of underlying fat-phobic attitudes. Although a doctor may not show any overt fat prejudice, there still may be underlying assumptions that reflect unconscious size bias. Assuming that layers of fat can keep a baby from coming through is indeed size-phobic. Women much larger than this mom have had vaginal births!
Birth Story
My original due date was March 6th. My OB was supposedly the best where I am from; my family doctor referred me to her. I kept having false labor and the doctor kept and eye on the baby's guessed weight (she thought the baby was between 7-8 lbs). She decided not to induce as I had no prior problems in my pregnancy. I had no PIH, no GD, no edema, nothing. But I did have horrible morning sickness, which caused me to lose about 15-20 lbs in my first trimester. I had anemia, which I was put on iron pills for, and I had low cholesterol. In the end I had acid reflux so bad it would keep me up at night (I never had it before my daughter, and to this day there are certain foods I cannot eat without taking an antacid prior to eating it). Generally I was very lucky, a very uncomplicated pregnancy. My hope was to have this baby vaginally. Not once did it cross my mind that I would have to have a cesarean----boy was I wrong!
I had 'false labor' on March 13th and went for the hospital for the 4th time, only to be told it was seriously trapped gas, which I was given some nasty liquid for. They asked me if I wanted to stay overnight or come back in the morning for a Non-Stress Test. I decided to go home and tried to sleep with it on my mind. I got to the hospital the next day, had the NST which proved the baby wasn't doing so good in her environment, so my doctor called back the nurses and told them she wanted to have an induction that day (the original induction was supposed to be the next day). Around 11:30 a.m. she came in and asked how everything was going. I told her I was miserable and just wanted to have the baby already, so she broke the bag of waters and started me on pitocin and had the antibiotics for Group B started as well. [Kmom note: Breaking the bag of waters probably set the baby's malposition for good and made it very hard to resolve.]
The major contractions didn't kick in until 1:30 p.m., although right when she broke the bag of waters I had a major contraction. She joked and told me that was what a REAL contraction felt like (my doc was kind of cold, so this little joke was a surprise to me and even made me smile). I decided on Fentanyl for the pain; I had already gone over the birthing plan with my doctor and told her NO EPIDURAL! The pain became too intense for me and I remembered what one of my friends had told me---that you cannot get the epidural after you're dilated so many cms. I was about 4 or 5 and I told them I wanted the epidural, which shocked my OB but she got the anesthesiologist in there and I had no more pain. UNTIL the baby started descending later on and I kept telling my absolutely wonderful and caring nurses that I felt like I was 'going to pee'. They checked the catheter and were puzzled. The anesthesiologist upped my dosage of epidural but it did no good. By this time I was shaking, my BP was extremely low, and I was so cold the nurse brought in 4 warmed blankets and covered me and turned the heater on ('transition!').
I kept complaining about having to go pee, the nurses were still puzzled and still checking my catheter when I finally shouted, "You don't understand, I have to PUSH!" They checked me once again and said that I was dilating strangely (had been at 6.5 cm for a couple of hours), more so on the left side than the right side. Apparently the left side was completely effaced but the right side wasn't. One nurse thought I was dilated 8 cm--I was overjoyed to hear that, thinking only 2 more cm to go! But another nurse came in and told them I was still only 6.5 cm. I was tired and frustrated when the baby's heartbeat started dropping and my OB said to me, "We're going to have to do a cesarean, the baby's in distress." I asked her why the baby wasn't progressing and she told me that the baby's head wasn't going through my pelvis, and told me that layers of fat were (possibly) stopping her from descending. Being in labor and tired, I totally misread/misinterpreted what my OB was saying and started crying, saying I didn't want a cesarean.
I was prepped for a cesarean and taken to the OR across the hall from my room. It seemed like forever that they were prepping me and I kept asking where my fiancé was because he wasn't by my side. When he got in there, the OB asked me, "Can you feel us cutting into you?" and I told her no. By 9:22 p.m. my daughter was born. She wasn't breathing at first so they had to give her oxygen. Her Apgars were 4 and 7. I got to see a glimpse of her for about 3 minutes (this really upsets me to this day) and then she was whisked away to the NICU, and I was sewn up and wheeled to recovery. In recovery, I was so drugged up I had no clue what was going on. My nurses were constantly checking on me due to the high fever I had (105 degrees). [Kmom note: A fever is very common after an epidural.] Luckily it went away pretty quickly and I recovered with a 'score' of 100%. The nurse attending told me she had never seen anyone get a perfect score on their recovery and was quite impressed. All I wanted was to see my baby! Four hours later I got my wish, but the memory is non-existent since I was on antibiotics, pitocin and morphine.
Getting up the next morning to walk wasn't too easy. I hunched over and protected my stomach, thinking my guts were going to fall out. But my doctor did a wonderful job. Both of us were allowed to leave the hospital 3 days after her birth. I tried breastfeeding her in the hospital but I was nervous as my mother (who didn't really breastfeed either myself or my younger sister) kept telling me 'how to' breastfeed my daughter, not to mention my daughter wasn't too happy that it wasn't coming out fast enough for her. So when I got home, I reluctantly gave her a bottle of formula, my fiance next to me, my father and his girlfriend watching. She was so happy that she was getting something and seemed content. It really relieved me. I pumped for 2 weeks thereafter, and eventually couldn't make a schedule and my milk dried up. She is not 1 year old and not quite walking yet, but very active and very squirmy.
I have plans to have another child. When I saw my OB I asked her what the possibility of having a VBAC was. She told me that it was fine, as long as the baby isn't over 7 lbs. [Kmom: Baloney! The critical issue is not the baby's size, but getting it positioned well!] She also told me (not naggingly, I might add) that if I lost the weight before having my next one, I may be able to go through a VBAC with a bigger baby. Although I thought she was the best possible doctor for my cesarean situation, I didn't care too much for her bedside manner and I hope to find a more suitable doctor. I don't know if she was fat-phobic; she never really commented on my weight, but that comment she made right before the cesarean still unsettles me a bit. I am just hoping that I can find someone who is very fat-friendly and willing to work with me. [Kmom: She should try a midwife first. Although there are bad apples in any barrel, midwives are much more likely to be size-friendly, and research shows that she would have a greater chance for a VBAC with a midwife.]
Polly's Story (PIH, elective c/s)
Kmom's Notes:
Birth Story
While I was pregnant, I visited this site many times and I often read the testimonials of other larger-than-average women who had delivered babies. I hope that my simple words can calm you like those stories did me.
I lost over 100 lbs. before I got pregnant by using a liquid diet. I weighed 324 and lost to 217 lbs. When my husband and I tried to get pregnant, it took only two months. We were thrilled! I went to a high-risk OB because he took my insurance and because I had a history of hypertension, although at the time of conception my pressure was normal. It was an extremely wonderful experience. He NEVER mentioned my weight or my weight gain as a problem during my pregnancy. He was always concerned about my history of high blood pressure, but when that came to pass, his attention to it was perfect. Even though I was 36 at the time, I refused all prenatal testing. I knew that God's hand was on this and whatever was going to happen was His will. My husband and I put our faith in Him and opted to pass on all of the testing.
The nurses were wonderful in his office. I often had to remind the lab techs to use a larger blood pressure cuff on me to get a more accurate reading, but they soon remembered on their own. I had to go more often than most women due to my rising blood pressure. I also had more sonograms than usual due to the uncertainty of my conception date. (As is often the case with some women with irregular periods, I had trouble dating my due date. The early sonograms turned out to be beneficial as they are more accurate than later ones!)
As my blood pressure was 190/100 or most often 150/90, I went to the doctor more often. I had to often go through testing (blood work, urine tests, ultrasound, and fetal monitoring) to make sure that it was not toxemia. Mine never was. In the 8th month, I began going to the doctor twice weekly and finally had to start doing fetal monitoring for about one hour twice weekly. It was the most uncomfortable thing that I have EVER experienced! However, it is so reassuring to hear that little heartbeat and 'hear' him moving.
Anyway, four weeks before I was due, my doctor put me on limited activity and I quit work to stay close to home. After several visits to the hospital for hours of fetal monitoring, my doctor, husband, and I decided to do a c/s one day when my pressure was 160/90. I was 38 weeks. My doctor was afraid to induce labor because nurses had a horrible time tracking my son's heart rate because he moved so much. (Turned out I had too much amniotic fluid which gave him room to swim! While this is not a good thing, my doctor said that in my case it was not alarming.) He did not want to give me medications and not be able to tell the effects on the baby. So within an hour I was cleaned up and ready for a c/s. I had absolutely NO problems. The procedure went great, the baby was (and is) fine, and I had NO pain whatsoever.
During my visits to the hospital and doctor's office I never encountered any discrimination of any kind. All of the equipment fit my body type fine except for the pressure cuff. (I have since learned that it isn't that uncommon for people to need the large size cuff.) All of the hospital gowns, lovely disposable undies, and surgical equipment were fine. I even worried about getting onto and off of the surgery table. That went fine. Those nurses are used to women flopping here and there. There is even a special 'board' to scoot you from the c/s table back onto the gurney.
I think it is so important to find a doctor who you are comfortable with and who is not judging you. I am the type to listen to doctors and think they know everything. I know that some of you are not that way. But if you are like me and hinge on every word of a doctor, I think that it is VITAL that you find one who can make you feel comfortable and who is experienced with a wide range of circumstances. During my pregnancy, I thought about studies which find that overweight women have higher risks of complications. I hope and pray that your pregnancy is not haunted by such thoughts. I found great comfort and peace in knowing that God would overcome. I hope that your pregnancy and birthing is pleasant, and one day a fond memory for your family.
Elayne's Story (PCOS, triplets!, preemies, c/s)
Kmom's Notes:
Birth Story
We knew going into trying to conceive that things would be
difficult. I knew at 17 that I didn't ovulate, and I'd been on the pill ever
since. After nine months without a period off the pill, I started infertility
treatments, namely Clomid. I was told there was a 5% increased risk of twins,
and no mention was ever made of triplets or more. We thought twins we could
handle.
On my successful cycle, we'd gotten up to 150mg of Clomid, and the doctor said
that if it didn't work this time we'd have to go up to the injectible drugs. But
I did have a good follicle, and the doctors decided to give me an HCG injection
to induce ovulation. Nobody bothered to tell me this could increase the risk of
multiples.
I tested positive, and made my first appointment with the midwife I had selected
for my homebirth. At 5 weeks, I had some cramping and bleeding on a business
trip, so when I got back I scheduled an ultrasound with my OB to check on it.
We saw four sacs and three heartbeats. Apparently, I conceived quadruplets and
then miscarried one, which accounted for the bleeding.
Things were pretty uneventful for a while (if you can call triplets uneventful).
I was forced out of my job and just took it easy, little to no physical
activity, limited errands, etc. At 20 weeks, when I went for a Level II
ultrasound, they discovered my cervix had dilated to 1.5cm. I wasn't
having contractions, just uterine irritability, so they decided to just do a
cerclage. I was on and off bedrest after that. Every time they let me off
bedrest, I started having contractions. I'd come in to the hospital, they'd give
me IV fluids and sometimes keep me overnight, then send me home on bedrest
again. Every time I went to the hospital, they put me on the toco monitors, but
no contractions ever registered, regardless of what I was feeling.
At 24 weeks, I began developing gestational diabetes. With diabetes running
rampant in my family tree, and being hypoglycemic myself, I am very familiar
with blood sugars and testing. I already had my own monitor, more of a toy
before but used seriously now. I checked my fasting sugars every day, and
occasionally checked after meals. At 24 weeks, I began getting very high
readings after meals, 160+. That week, I also had sugar in my urine. Despite all
this, my OB insisted that it was impossible to detect or even develop diabetes
before 28 weeks, and he refused to test me. Knowing better, I put myself on a
strict diabetic diet, allowing for multiple gestation, and kept track of my
sugars. This was very difficult in the hospital, though, because I couldn't
control my diet. More than that, nobody seemed to understand how much a triplet
mom needs to eat to have big healthy babies, regardless of her size.
At 26 weeks, I went into full pre-term labor. At first I thought it was gas
pains, because it was all in my back. A couple of hours later, I realized that
gas pains don't come every seven minutes on the dot, and the contractions also
started to radiate across my belly. We went into the hospital, and they
immediately put me on the toco monitor, and spent the usual hour trying to catch
all three babies on the strip at once (never happened). As usual, no
contractions registered on the monitor. They started to blow me off, and I
protested that I was really feeling strong contractions. The nurses tried to
feel them through my belly, but they said they couldn't feel anything. I asked
them to please check my cervix, like they had always done every time before.
They refused. Instead, they sent me home on a sedative, Seconal, treating me
like I was nuts. The sedative knocked me into a daze. I was still feeling
contractions, and just barely aware enough to register the times (moving through
6 minutes into 5 minutes apart during the night), but I wasn't coherent enough
to think, "Gee, maybe I should call another doctor or go back to the
hospital."
By the time the Seconal wore off the next morning, my contractions were very
strong, 5 minutes apart. I still waited a little while, out of pure
sheepishness, because after being sent home the night before I believed them, I
thought surely I was imagining it. That morning, though, I started suddenly
bleeding heavily, and we did go back to the hospital. Sure enough, my cerclage
had ripped out. Not only that, but I was dilated to 5 cm already. Even with all
of this, though, my contractions, though painful, STILL never registered on the
toco monitor. They admitted me and put me on bedrest, and gave me magnesium
sulfate, terbutaline, and antibiotics and steroids for the babies. The
tocolytics worked almost immediately, shutting my contractions down to nothing.
Unfortunately, it was too late. I dilated to 6 cm before the drugs kicked in,
and 24 hours later my water broke.
There was no hope for a vaginal birth of triplets, certainly not at 26 weeks.
They were too small and fragile to really withstand the stress of a vaginal
birth. So we went for an urgent c-section. The anesthesiologist came to talk
with me beforehand, explaining how the spinal worked, all of which I knew after
having a spinal for my cerclage. I told her about the spinal wearing off before
I even left the operating room last time, and added that painkillers in general
have little to no effect on me. She blew me off (like everybody else), telling
me not to worry.
We went into surgery at about 11:00, and my babies were born at 12:09, 12:09,
and 12:10, about 30 seconds apart. I got to touch the girls briefly as they went
by. My boy needed resuscitation more urgently, so I only got to see him in the
portable incubator before he was taken upstairs. By luck, my L&D nurse had a
student nurse working with her that day. The student had to be there for
the section, but couldn't do anything. So we gave her a camera, and she took a
ton of pictures of the births. Bloody, but they're the only pictures I have of
my babies not attached to anything for the next three months.
By the time my third baby was born, I was beginning to feel more than I should.
By the time they were stitching me up, I felt every stitch and every twitch.
They made my husband leave the room, but he saw them pump four or five drugs
into my IV before he did. None of them really worked. They finally gave me
Versed, so the end is a little hazy...yet I still remember a good deal of it.
On the upside, I did get a letter of apology and reference from that
anesthesiologist, for me to show at any future surgeries.
Breastfeeding was a complete failure. Not on my part; I was a milch cow. I was
putting out 50 ounces a day when I quit. I tried and tried and tried to have a
"No Nipples" order put on the babies' charts, because I was concerned
about that interfering with breastfeeding. The hospital staff insisted on giving
them bottles anyway. They breastfed exclusively for two weeks before getting
their first bottle, and they were doing well, getting latched on and getting
decent amounts of milk out. The hospital still insisted, and the very day they
got their first bottle, they refused the breast. I continued to pump until they
came home, but with no help I did not have enough time to pump and bottlefeed.
We now have one baby with cerebral palsy, and the other two have a tendency to
wheeze and catch bronchitis from every little cold, which we understand is a
result of their having been on ventilators for almost two weeks after birth.
Other than that, fortunately, they are doing well. We're working on getting
pregnant again, hopefully with only one baby this time. I'm taking Glucophage to
control my PCOS, and it seems to be working well.
My babies' website, www.huntfamilyhome.net,
has even more information about the pregnancy and birth.
Analisa Norris Roche's Story (fraternal twins, bedrest, breech, c/s)
Birth Story
Went in for my 35-week checkup the morning of December 24. Found out I was about 2 cm. dilated and 60% effaced. I had been on bedrest until about two weeks previous, so had a lot of errands that hadn't been run. Eric and I did a few of them on the way home while Mom was home with Meg. Ian, Tony, Mikki, and Andrew showed up shortly for Christmas shortly after Eric and I got home, and we spent the afternoon hanging out, talking, messing around, enjoying each other for the first visit in a long time. I kept wondering on and off that day if I was leaking amniotic fluid since that's how my labor with Meg had started, and I felt wetter than usual. Got up to go to the bathroom around 8:30 pm and had a big burst of fluid, so then I was sure. I sat on the toilet and slammed the wall with my fist and screamed profanities b/c I was upset that it was so early (only 35 weeks 2 days). Started crying, told Eric, told the family, called my OB who told me to get in.
We were pretty concerned about the risk of cord prolapse since Patrick was presenting foot-first, so we rushed. I was glad to hear that my own OB (in a practice of three) was the one on call that night. I was quickly checked in and then it took a very nerve-wracking 2-1/2 hours to do all the surgical prep stuff. Asked me a ton of questions, signed releases, Eric changed into scrubs, blah, blah, etc. I had plenty of time to get more and more nervous since this was my first Cesarean, my first epidural, etc. Finally wheeled into the operating room around 10:30 pm. Epidural administered, probably the most unpleasant part of the whole experience. Fortunately, I was allowed to hold onto Eric while it was done, which undoubtedly helped a lot.
Eric then sat by my head while they cut me open. Neither of us could see anything b/c of the draping. I felt only the slightest tugging sensations. They told him when to stand up to take pictures, which didn't turn out very well due to the poor angle he was at, but that's all they would allow. Patrick was born at 10:54 pm and Catherine at 10:55 pm. Eric made sure I still wanted him to go with the babies instead of staying with me, which I did. They were taken into an adjacent room since the operating room didn't have enough space for all the people and equipment for two babies. Eric came back briefly to tell me their weights (4 lb. 7 oz. and 4 lb. 8 oz.) I was so depressed at that point b/c my babies were so small and I couldn't hold them and they had to be taken to the NICU while I was sewn up. I got to look at them really briefly, but Catherine's breathing was rapid and shallow so they were in a hurry to get her moving. The stitching felt like it took forever with me there in the OR and Eric and my babies up in intensive care. Then they wheeled me to recovery just after midnight.
I chatted with the nurse there and tried to be upbeat. I asked
for Patrick since he was quickly sent to the regular nursery, but I was told I
couldn't see him until I had spent two hours in recovery! Eric came down to
update me and went quickly back to Catherine (who received Erythromycin despite
our having declined it, grrr). I was really antsy and bored in recovery, wide
awake, etc. I asked the nurse what I had to do to have a pump ready in my
postpartum room since the babies were going to be too small to nurse, and that
wonderful woman had one waiting for me, all set up to use, by the time I got up
there. I looked around and then asked for a magazine to read to try to take my
eyes off the really really slow-moving clock on the wall across from me, and she
went in search of something. Came back with some Parenting drivel, which I
willingly browsed. Next time Eric came down he went to the car to get my novel.
I was later told I was the first person they ever had ask for something to read
in recovery, which really surprised me!
Catherine was blessedly out of the NICU by the time I was sent upstairs around 2
am so I was then able to hold and try (unsuccessfully) to nurse my babies...and
my life as a twin mom began! We were in the hospital four days, my recovery was
easy and fast, and the babies came home with us on December 28! (Nice side note:
the whole visiting family brought Christmas dinner and gifts to our hospital
room the next day).
Breastfeeding got off to a rough start since the babies were too small and too sleepy to nurse well. I pumped around the clock and Eric finger-fed them for about two weeks. Every two hours I would spend two minutes pumping, take one baby and work on nursing, hand that baby over to Eric, take the other baby and work on nursing, hand that baby over to Eric, then pump for 20 minutes. It was exhausting, but well worth it. Within several weeks they were champion breastfeeders, impressing several lactation consultants, and we haven't looked back since!
Julie's Story (size-phobic treatment, 3 c/s including a TOL c/s)
Kmom's Notes: This is the story of Julie's three cesareans. The first was probably due to a malposition, the second was outrageously unnecessary (due to size-phobia) and potentially endangered her child, and the third (after a trial of labor) probably was necessary due to knots in the baby's umbilical cord.
This is also the story of Julie's journey towards taking charge of her life, of finding more respectful care and having a say in her birth choices, and of empowering herself. Even though she didn't get her desired VBAC, her birthing choices were much more empowered and meaningful, and although she still second-guesses herself and is disappointed that things took such a difficult turn, she is thrilled to have her daughter. She says, "She is an angel baby, so sweet and pleasant. I just love her to death."
Birth Story
On May 1, 2001, my third child, a daughter, was brought into this world by a cesarean birth. Her birth wasn't planned that way. In fact, I had meticulously planned a natural hospital VBAC. That did not happen, and her birth will forever be a bittersweet memory, and a constant reminder that I do not have complete control over the events in my life. This, my third birth story, actually started on Wednesday, February 26,
1992 with the birth of my first.
The Monday before, I had waddled into my city's favorite ob/gyn's office two weeks overdue, swollen, tired, and miserable. This doctor was probably the town's (a small town) favorite doctor because of his bedside manner. He told his patients exactly what they wanted to hear. He insisted that his patients call him by his first name "Jack." Later I would refer to him "Jack-the-Ripper." After my internal exam, "Jack" announced that I was 80% effaced and 2-3 centimeters dilated. I had read all the mainstream pregnancy books available so I knew exactly what he was talking about. I thought I was quite birth educated. I was elated to hear that I was a good candidate for induction.
Wednesday morning I went to the hospital happy and eager to meet my baby. I arrived at 6:00 a.m. I was shaved and given an enema. At 7:00 a.m. the nurses started the pitocin and an hour later "Jack-the Ripper" came in to break my bag of water. Shortly after, my contractions began. The pain was unbearable, and it did not completely go away between the contractions. The only positions I was allowed to labor in were lying on my left and right sides and lying flat on my back. I begged the nurses to sit up, but they were afraid that "Jack" would see me and have a fit. Under these circumstances, I labored. Every hour a nurse would come in and tell me that I had dilated another centimeter until I hit five
cms. At five my body stopped (I believe in protest).
"Jack" came in at 3:00 p.m., looked at my husband like he saw him for the first time and announced that this baby wasn't going to come out because the baby probably had shoulders like his father's. My husband is a big man-6'2', 300 pounds. He told me that he would have to give me a cesarean because I had stalled at 5
cms for several hours and all he could feel was caput coming down the birth canal. Even though I was one of two women who had admitted we would be devastated to have a cesarean in my prenatal class (strangely enough, we were the only two who ended up with cesareans), I was relieved that the pain would soon be over.
Thus at 4:38 p.m. I was cut for the first time. I had a son, nine pounds, five ounces, 21 inches long. This would begin a nine-year journey.
In my ignorance, I did not change doctors for my second child's birth. Because he told me that I could have a
VBAC, I stayed with him. However, the closer that my due date approached, the more he talked of scheduling a cesarean. Five days
past the due date he had given me (this date was 3 ˝ weeks earlier than when I thought my due date should be), he pulled out the big guns.
"Jules, sweetheart, you would be a fool to have this baby vaginally," he tells me.
I replied, "Then call me a fool. I don't want another cesarean. I don't want another spinal headache, and I want to be able to hold and feed my baby before he/she is eight hours old."
He said, "Honey, you would be putting this baby's life in danger." I scheduled the cesarean that afternoon for two days later.
I walked into the hospital as if I were walking into the gas chamber. I had to remind myself that I was going to have my baby that day. Everyone around me was ecstatic, and they couldn't understand why I was so depressed. They kept telling me that I had to do what was best for the baby. "Nothing matters except a healthy baby." I felt selfish and misunderstood. Of course I wanted what was best for my baby and surgically removing my child from my body didn't feel like the right answer either.
This time the doctor ordered me to report to the hospital the night before so that I could have a good night's rest. I couldn't sleep at all. I did have the cesarean the following morning. I was terrified. As he lifted my daughter from me, he said that she wasn't the "moose" he thought she was (He told me she would weigh about nine pounds despite the fact that the ultrasound tech said that my baby looked to be between seven and eight pounds. He told her that she wasn't getting the whole baby on the screen.). He went on to say that he was glad he "took" her anyway because she had a double nuchal cord around her neck. On the videotape my pediatrician says, "I wouldn't count on that, Jack." According to my pediatrician, my daughter was four to six weeks premature judging from the look of her genitalia. Luckily, she didn't have a difficult time breathing. She weighed six and a half pounds and was 18 inches long.
I was able to immediately hold my daughter (after the nurses checked her first). In fact, I was able to hold her as they rolled us back to my room. Unlike my son, I breastfed her minutes, not hours, after her birth.
What came next was hellish. I got a spinal headache. My doctor ordered a blood patch. This is a treatment for spinal headaches in which a nurse draws some blood and the anesthesiologist injects it into your spinal fluid to "patch" the hole left from the spinal. I had to sit on the edge of the bed, roll my back toward the doctor, and be still while she injected another needle into my back. It was the same procedure that was used for the spinal except this time I had an incision from my navel to my pubic hair. (Yes, the doctor cut me
vertically, so now I have a stomach that looks like a "bum.") I didn't know what was more excruciating: the pain from the headache or the position I had to hold for several minutes because the nurse couldn't get a vein to draw the blood from. She stuck six times to get it. Even after all this, I still had the headache.
Five days later, he took out my staples, and on the way home, my incision came open. We went to the hospital. The suture tech on duty began the process of giving me Novocain shots in my incision area and discovered that a few sutures in the underneath layers had burst as well, so he had to call the doctor. I lay in the emergency room for five hours with my stomach wide open and a screaming newborn. My doctor didn't have the nerve to even repair his handiwork. Another surgeon came in to do it. I had to have another spinal, and yes, I got another headache. I didn't feel human for two months, and I had a newborn and a three-year-old to take care of.
I had made up my mind that I could never have another child. I just couldn't face another series of events that I had just experienced; however, life had other plans. I found out I was pregnant March 1998. After a month of denial, I contacted a doctor who came recommended to me by a family member. During the next three weeks, I began researching the subject of VBAC. I bought a copy of Silent Knife, and my outlook on birth was forever changed. Armed with new knowledge, I told my new doctor that the reason I changed doctors in the first place was because my last doctor patronized me and refused to let me have any say in my care. I informed him that I was an educated person and that I wanted to be included in the decisions that were made concerning my health. I also told him that I didn't think I needed either cesarean, and that I wanted to have this last child naturally. He told me that it would be my decision how I would have this child.
During the next office visit, I began asking him more questions about how he managed his VBAC births. I didn't like the answers at all. He told me that he would induce me at 38 weeks and that I would be constantly monitored. I knew from my limited reading that this was the best way to have another surgical birth. Thank God that I had bought a copy of Sheila Kitzinger's Complete Book of Pregnancy and Childbirth. In the back was a resource section that included an address and phone number for ICAN. I called the number and an angel on earth answered. Kathy Gray-Farthing. She listened to me for over an hour. I poured out my soul to her, and she understood. She sent me a copy of the Clarion and on it wrote directions on how to join the internet list. I immediately logged on, and found a group of brave women who had been and who were in the same place I was now.
I introduced myself and got a heartwarming welcome. All the women advised me to look for another caregiver. Some mentioned midwives and others mentioned homebirth. Homebirth? I didn't even know it was legal let alone a possibility. I had a lot to learn. And learn I did. I read everything I could get my hands on. I bought every natural/waterbirth videotape I could find. I was glued to the ICAN list. With each passing day I knew that I had to switch providers. I started looking for midwives. I had contacted the select few in my area (even they were 50 miles away), and because they were
CNMs who practiced with a group of doctors, their procedures weren't any different from the doctor I was going to. There were no
DEMs closer than Philadelphia or Morgantown; each a few hundred miles away from me. Even if I could have found a midwife who would take me on as a client, my husband refused to consider a homebirth. Even with all the information I gleaned from the list and from my extensive research, he could never get over the "what if?"
Then the unthinkable happened. I miscarried. With the help and support from the wonderful women at ICAN, I was able to avoid a D and C, and I was able to catch my angel as it slipped from my body. I was 13 weeks into my pregnancy. The doctor's office personnel were less than sympathetic and viewed me as a freak because I did not want to have a D and C. I never walked back in that office.
Not long after that a new OB made his appearance in our town. He bought a half page ad and he claimed that his philosophy of care was one of partnership. I made an appointment and put all my cards on the table. I told him that I would like to have another child, but I would not be scheduling a cesarean, and I would have a say in how my care was managed. I told him if he could not live with that, he could tell me now, and I would be on my way. He spent nearly hour listening to me. I told him the stories of my previous births, and he could not imagine shaving his clients, nor giving them enemas. He told me his cesarean rate was about 10% and that his VBAC rate was 80% closer to 95% when the women he cared for wanted the VBAC. He was gentle in his speech and his manners. He seemed like an answer to my prayers.
I became pregnant in August of 2000. Because I still didn't trust him (mainly because he was an MD), I lied about my due dates by two weeks so that I would not be pressured into induction. I drew up a birth plan, and he accepted all my wishes. He spent another 45 minutes with me answering all of my questions and reassuring me that although he couldn't guarantee I'd have my VBAC, he didn't see any reason why I couldn't. He even referred me to find information at one of the ICAN chapters in Cleveland. He had worked with some of the midwives there and had even been present at a few homebirths but "not in a professional manner."
Soon after I contacted Kathy G. Farthing and asked her to become my doula. She was wonderful. I immediately felt connected to her. We were in constant contact via the internet, and at times she was my anchor when I was being tossed about on the seas of hormones and emotions of pregnancy.
I surrounded myself with positive birth stories. I read every natural birth book I could order from the internet. I bought a birth ball so that I could sit on it to keep my baby in a favorable position. I read the internet list faithfully. I rejoiced when the women who seemed like sisters to me received their empowered births and cried when they did not.
After my first trimester, I began drinking Red Raspberry Leaf Tea tea and taking
Evening Primrose Oil capsules orally at the beginning of my pregnancy and vaginally at the end.
In April, I went to the ICAN Conference. I had hoped I would go into labor there. Talk about the dream team of birth teams! Unfortunately, that would not happen. But I did meet some wonderful women. I would go into labor one week later, April 30, 2001. I had been cramping at night for the past 2-3 weeks. I would wake up and the cramps would go away. That morning they didn't seem to be stopping, but they weren't getting any stronger either. I went to work anyway. (I am a high school teacher.)
By 11:00, I noticed that the cramps were regular. They would come about every 10 minutes. I think I was in denial. I had never gone into labor on my own before, and I was a week ahead of my due date. By 1:00 p. m., I could no longer ignore my body. I told my principal that I was in labor. The look on his face was priceless. He wanted to call an ambulance, but I told him that I was driving home myself. The drive home was a bit interesting. It was a good thing that I didn't live too far from the school. I called my mom to have her pick up my older children at school, and then I called my husband to come home and we labored together, slow dancing, walking hand in hand, and rocking on the birth ball. I called Kathy to give her a heads up, and she told me she'd come when I was ready for her. I was ready about 5:00. She arrived about 6:15 with my sister. We labored at home for another hour or so. My contractions were coming about every couple of minutes, and I didn't want to spend transition in the car. We got to the hospital and I refused the wheelchair. I think having Kathy there gave me the courage to buck the system. Plus, my hospital had never had a patient with a doula so I think they were a bit taken aback.
We go to the maternity floor and as they were hooking my up to the external monitor, my water broke. It was thick green pea soup. My heart sank. In all of my birth scenarios, this was something that I never thought would happen. After this, I watched as one by one my natural birth wishes slipped out of my hand. Even though my doctor was great, the hospital was not and the nurses were less than wonderful. One of them was even sadistic.
Because of the meconium, I had to labor in bed, I had to have an amnio-infusion, and a hep-lock. I felt as though my body were hosting a three-ring circus. Despite the deplorable conditions, my birth team helped me build a safe place. Even though I was in bed, I used my birth ball, I continued to use different positions such as hands and knees, sitting in semi-squats, etc. I was 4
cms when I arrived and I had hit 8 cms by 10:00 or 11:00 p m. Every time my doctor would come in he would tell me I was going wonderfully and that he was confident that I was "going to do this." He was impressed by Kathy. He later asked me for some of her business cards so that he could give them to his patients.
Transition was hard, but I remembered something that Kathy had said in her conference seminar the week before, "Anyone can take any type of pain for two minutes at a time." What I remembered most was the dry heaves I had. The nurses wanted to give me something for the nausea, but I knew that sometimes throwing-up could help with dilation so I refused. I stayed at 8
cms all night long, but my doctor never gave me any inkling that I was running out of time. As long as the baby was doing fine, he just left me to do my thing.
Sometime during the night, the baby's heart rate didn't respond well to one of my contractions. Instead of rushing me to the operating room, he performed a blood-gas test on her and the test came back fine, and so I labored until the next morning. At around 11:00 a m, my contractions were weakening. He wanted to give me pit. He knew that I did not want to have pitocin. I asked to talk to Kathy and my husband, and we agreed that perhaps pit would help me to dilate, since my uterus was tired and pit was better than a section. He started the pit on the lowest dose and only gave me enough to allow my body to respond. These contractions were much gentler than those I experienced with my son's birth.
Not long after, my daughter began showing signs of distress. The nurses were having me lie on my left side, on my right side, on hands and knees. Her heart rate was not coming back up after my contractions. I was still at 8
cms. The doctor was called in and he asked me what I wanted to do. I was exhausted. I had spent the last 12 hours in transition, shaking, dry-heaving,
hiccupping, etc. I looked at Kathy, knowing she would not let me give up too soon, and said that I couldn't do this anymore. The doctor told me he was sorry, and I was prepped for surgery.
Kathy and my husband went into the operating room with me. [This time the spinal
worked without a headache afterwards.] Despite some argument from one of the nurses, my husband filmed the birth of my daughter and Kathy took some awesome pictures. My daughter was born with 2 true knots in her umbilical cord and apgars of 3 and 7. She had to be intubated and bagged. I wasn't able to hold her until 10:00 p m that night because she was in observation. I still feel terribly guilty about how she was treated upon her entrance into this world.
My deepest regret is not fighting hard enough for a homebirth. I believe that I would have been able to dilate if I had been permitted to walk around. Why I just didn't is beyond me. What would they have done to me, sent me home? I should have just gotten out of be and said, "Oops, I forgot." I believe that the meconium wouldn't have been such a big deal if I had been able to deliver vaginally. I still do not know what to think of the knots in her cord. Would they have tightened as I pushed? Only God knows, but I believe in my heart having her at home would have been better for the both of us.
So what I learned was that despite my careful planning, all of my reading, and finding the "perfect" doctor, going to a medically conservative hospital was what mattered the most. As Nancy Wainer says, "Don't go to a Mexican restaurant if you want sushi."
Pam K's Story (false gd diagnosis, induced for suspected macrosomia, c/s; postdates induction, c/s, then VBA2C)
Kmom's Notes: This is typical treatment for larger women in many ways. Because bigger moms do have slightly larger babies as a group (and obesity is a risk factor for really big babies), doctors often estimate that their babies are going to be huge. In the first story, the doctors kept raising the estimated birth weight; from 8 lbs., to 9 lbs., to 10 lbs., then to 11 lbs. They tried to talk her into an elective cesarean, but when she refused they induced for suspected macrosomia. As is so often the case, the induction ended in a cesarean, and the baby was not macrosomic after all.
Despite having a really wonderful OB for her second pregnancy, Pam ended up induced for post-dates with baby #2. Inductions of VBACs often end in cesarean, and hers did too. As she discusses below, she had a difficult experience with a nasty spinal headache afterwards.
With baby #3, Pam chose homebirth, with unofficial back-up from her wonderful OB. She became very proactive about nutrition, and she occasionally monitored her blood sugar to be sure it was still normal (it was). In this pregnancy she did not go "postdates" and feels that perhaps some nutritional changes were part of that, although we'll never know for sure. Pam went on to have a VBA2C at home, in the water! She chose a hands-and-knees position to push out her baby, which often is a good position for larger women.
Pam is a doula who works to help support other women in their births, and is also a member of ICAN, the International Cesarean Awareness Network. Choosing truly VBAC-supportive providers was a key part of her preparation for baby #3. Had she seen a traditional OB, she almost certainly would have been told she had no chance at a VBAC, between being supersized and her history of a "failed" trial of labor, possible GD status, borderline "big" babies, and tendency to go postdates. Yet she went on to have a wonderful VBA2C anyhow. It's important to remember that many women with one "failed" trial of labor do go on to have VBACs later on, and that women of all sizes can have VBACs.
Birth Story
Birth #1: My pregnancy as a whole was non-eventful until the end of my sixth month when I "failed" the GTT and was labeled a gestational diabetic. This of course
skyrocketed me in to the high risk category and I spent the remaining 3 months testing my blood levels four times a day and
following an eating program that controlled my supposed GD quite nicely. (Subsequent review of
my records revealed that I was indeed misdiagnosed. Also, despite the fact that
I informed anyone who walked into my room that I was GD, my levels were never once tested over the entire time I was
hospitalized.)
My OB practice was a two doctor partnership with a third back-up for emergency or
unusual situations. The primary OB, a woman, was very accepting of my desire for a natural birth and
though I know she did not agree with all my plans, did not overtly discourage or sabotage me. However, At 38 weeks
she informed me she would be leaving town in two weeks for Easter and proceeded to do an unauthorized membrane strip. I responded not at all--not even a cramp--but she assured me I would deliver before she returned from
her vacation. I made my next appointment with her partner who was not nearly as encouraging as she was and indeed seemed to be a bit hung up on my
weight. However, my 39 week Bio Physical Profile was perfect, I had dilated to 2 cm and there was no reason to hurry things along.
At 40w6 day I had another BPP,
again perfect, but this time the perinatologist called my doctor and said I was "ready" as he estimated the baby to be over 11 pounds. (This man never
ever spoke to me face to face. He would talk to my husband, to my doctor, and to the technician if no one else was there--all in my presence, but
never to me) Each week, the estimated weight of the baby had crept up--at first it was "over 8 pounds at term", then "over 9", "over 10". Over 11
made me a bit nervous, and I agreed to an induction if my cervix had shown no signs of progressing. Surprisingly (not) I was still at 2 cm, so after a
great dinner, my husband and I headed into the hospital the Thursday night before Easter for
Cervadil. My doctor (the male) showed up and offered me a cesarean because of my size and GD diagnoses and estimated weight of baby.
I was very surprised but refused graciously. I did not see him again until my daughter was delivered.
Friday morning, 41 weeks pregnant, I truly believed I would have this baby with no pain medication and be home in time for Easter dinner. The pitocin
was started several hours later than they had told me, but I did manage to have a few mild contractions and had a fairly nice day visiting with out of
town friends and hanging with my husband. My doula was in and out, finishing up errands so she would be
available when I needed her. Finally, around 9 o'clock Friday night, with no change whatsoever, the pit was
discontinued. Of course, I had not been fed all day and the nurses were not in the least bit
concerned about that, so our friends ordered me a pizza and shared some birthday cake from my favorite bakery. I was then moved to a
larger room. Sent everyone home around 11 or so , to rest up for phase two.
I was awakened about midnight by a resident who explained that my doctor had called from his car on the way home from the theater (and wasn't he so
considerate, thinking of me while he was out on the town!) and suggested a Foley
catheter to inflate my cervix. I agreed and was thrilled to be at 4 cm on Saturday morning!
Saturday we started the pit again. Cranked it up pretty high throughout the course of the day, but I tolerated contractions with ease. I did everything
I could think of to help such as walking (the miles I put on that telemetry
unit!!) nipple stimulation, even sucking my thumb. [Kmom note:
There may be an acupressure spot on the roof of the mouth; some theorize that
sucking the thumb can help stimulate labor sometimes.] Nothing seemed to help.
Of course, I was sneaking the occasional peanut butter cracker and juice as I was NPO for the duration.
[Kmom note: NPO is the abbreviation of the Latin words for nothing by mouth.]
This time, they did not turn of the pitocin. We continued through the night and into Sunday--Easter Sunday when I expected
to be holding my baby at Easter Dinner. The most memorable moment to me was receiving an Easter Lily from the Baptists women's guild. I was Catholic,
delivering at a Jewish hospital. I was quite amused by the blending of beliefs and still have pictures of that beautiful lily.
Sunday I saw the back-up doctor for the first time. He suggested rupturing
membranes and I agreed. (In retrospect, I should have walked out days ago, but I was naive.) He left, a resident did the deed and inserted
internal monitors and I stood up and had a real contraction--I actually had to stop and
breathe! I then proceeded to have what my doula described as "transition-like" contractions for the next twelve hours. It was obvious
the staff was tired of me as they pretty much left us alone. I insisted on laboring in the shower, complete with telemetry and birth ball. After 12
hours with ruptured membranes, I was still at four cm and told I could either have my cesarean now or wait another 12 hours but it was no longer an
option. I looked around the room--at my husband, so tired, so scared, yet so supportive, at my doula who had been with me for four days with only
brief breaks and who had given up her Easter with her family for naught, at my mother who was due to leave for Florida within the week--I gave up. I
won't go into the circus that ensued over the next few hours situating everything, but to illustrate the experience, my father showed up as I was
being wheeled into the OR and I truly believed I was going to die. My father has a major aversion to hospitals and I honestly did not expect to
see him until I was home.
And so , I finally saw "my" doctor, in the operating room, as he performed major abdominal surgery on a perfectly healthy mother and perfectly healthy
baby. Neither one of us had shown any signs of distress, despite my not having had real food or drink for several days, despite the massive amounts
of pitocin dripped into me, despite ruptured membranes. My daughter was
delivered, by this man who was annoyed at his shortened lunch hour, while I lay on the table unable to feel myself breathe. My memories of that morning
are interwoven with images of the Salem witch trials, where they would crush supposed witches with large cinder blocks.
Allison Kathryn weighed 8 pounds, 15 ounces and had apgars of 9 and 10. He told me he had made the
incision in a place that should not be aggravated by my "flap" and apologized for the size of the incision as he had anticipated a much larger
baby. Then he was gone. He is still my mother's GYN and still encourages me (through her) to plan elective cesareans each time I am pregnant.
The story of my physical recovery is short, but the emotional healing has been slow. Nearly five years later, as I anticipate the birth of my third
child, I am still haunted by those visions of being crushed while my child is cut from my body. And that is how I remember the so-called birth of my
first-born.
Birth #2: When my first child turned one year old, we decided it was time for our second and immediately conceived. I assumed I would have a natural birth this time, despite my prior cesarean, and found a caregiver who would support that. Dr. B was the ideal OB. He was a strong proponent of natural birth and truly supported me in every decision. My pregnancy was noneventful, except for the usual stressors of selling our house, quitting my job, buying a house, etc. Medically, things were perfect.
When it came time to test for Gestational Diabetes, Dr. Bowen examined my results from my
first pregnancy, shared concern that I was misdiagnosed, and asked if I would be willing to forgo the one hour GTT for the three hour. Sure.
Results were a bit odd, so I repeated it. All clear! One possible risk factor eliminated! He did not consider my weight an issue, other than
contributing to my personal discomfort, and was even willing to allow me to weigh myself at another place to minimize my binge triggers. He frequently
consulted with me concerning my pregnancy, making it clear he considered me a partner in this, not a patient.
As the end of pregnancy approached, I chose to allow vaginal exams as I needed some reassurance I was progressing. Imagine my thrill at 38 weeks
when I was dilated to 2 cm! Then two weeks later I was at 4!! That was as far as I had progressed with my first four day induction. I began to
believe I might really do this. Dr. B discussed some natural methods of induction with me, emphasizing it was
totally up to me. I tried castor oil numerous times, intercourse, and even the cohoshes at his suggestion. I
experienced a few mild contractions and some major diarrhea, but no real progress.
At 43 weeks, Dr. B asked me to have a Bio Physical Profile. He assured me he
would interpret the results himself, with me, and not let the "expert" at the U/S center influence him. He was very aware of my mistrust of that
particular doctor. I agreed and we scheduled the BPP for Thursday, January 28th. This was my husband's 32nd birthday, his goddaughter's (who would be
the godmother of our baby) 16th birthday, and ironically, Dr. B's anniversary. I had hoped that our baby would be born on this day, keeping
up the family tradition.
My mom met us at the hospital for the U/S and we had our 21 month old daughter with us as well. The technician was one I had met several times in
different capacities and was very comfortable with. There was no sign of Dr. S--my nemesis. The baby looked wonderful and responded well, BUT my
fluid levels were virtually immeasurable and my placenta was rated as very deteriorated. OF course, we all focused on the
distressing news instead of the positive--the baby was FINE!! So, a flurry of phone calls ensued and
that was when we realized the mistake in selecting that day for the U/S.
Dr. B was out of town and his back-up was less than satisfactory. First,
she refused to talk to me on the phone, instead sending orders through various nurses and secretaries. My mother had left by this time, and we
were trying to deal with a toddler and figure out what we needed to do. Finally, I managed to get through to the receptionist who apparently was as
annoyed as I was and had Dr. B call me on his cell--out of town, on his anniversary. After discussing the situation with him, we decided it was not
an emergency, and I agreed to let his back-up examine me and agreed to an IV to see if we could increase fluids. My largest concern was that his back-up
did not have privileges at the hospital I had chosen to birth at, due to a paperwork
mix-up. I simply prayed that I would not go into labor until he was back in town that evening. By this time, my husband had left to take
our daughter to his mother's and I called my doula to be with me. I agreed to an oxytocin challenge to see how my baby tolerated contractions, thinking
perhaps I could actually jump start labor that way and by this time, I was coherent and sure my baby was fine. Interestingly enough, I did not even
see my "doctor" until after all the tests, IVs etc and even then she was abrupt and unfriendly. All was well, so I dressed and left quickly, with
instruction to call Dr B in the morning.
Managed a few contractions that night, but in the morning called Dr B and agreed that given the info at hand, we should probably induce. Dropped my
daughter off, had a quick lunch and went to the hospital. Spoke with Dr. B who then said, "well, I'll stop by the desk and get things started and be
back in a bit." Shortly after that, another doctor walked into the room, said he was there to get things started, proceeded to examine me and lecture
me as to why I should not consider a vaginal birth. I was apparently a bit irate, especially when he reported I was at 1 cm and the nurse
said "But Dr. B found her at 4." At that point, he stalked out of the room. Several
minutes later he came in with a very distraught head nurse who apologized. They were very busy that day and she had handed him the wrong chart! I was
not his patient. This was not reassuring, but reminded me to be vigilant throughout this birth.
Shortly thereafter, we got the pitocin started and I began contracting. Within about 12 hours, I progressed to 7 cm. Twelve hours later, I was still at 7 cm. 3 hours after that, I was still at 7 cm. I had done everything I knew, with the help of my two doulas and my husband and my mother. I walked, I ate, I labored in the shower. Dr B was a great support--I found out later that he had to stay at the hospital throughout my entire labor as this particular hospital did not have residents or an OB on call at the time. He never gave any indication that he was impatient or would rather be doing anything except babysitting me for the weekend.
27 hours after my induction started, Dr B came in and asked if we could discuss
my options. He laid them out, simplest to most interventive. Continue as we were and see what happened. Increase the pitocin. Consider an epidural
to see if that would relax me and allow me to dilate. Consider a cesarean. I asked his opinion. He said, "I think you are headed down that
road." I looked around the room at my "support" team and nobody met my eyes. Nobody
told me I could do this, that I was fine and my baby was fine. They had lost faith and so did I. I said "Let's do it" and cried. Dr. B hugged me
and said "Next time!" Everyone except my husband left and I cried and cried. (He told me later that he was very surprised I gave in. He did not
expect that and had no idea I was so tired and discouraged as I had been handling labor quite well. I wish he had told me that at the time. It
would have made all the difference.)
Preparing for the cesarean was a bit of an adventure. I had a great anesthetist--2 in fact, but they had a terrible time getting the spinal
placed. (We had decided on a spinal as I reacted quite strongly to the epidural
previously.) Eventually, they got me numb, and at Dr. B's request allowed my mother and both of my doulas in addition to my husband into the
operating room. My mother and husband were at my head on one side, my doulas had a front row seat at the foot of my bed. I have to say that I was
very disappointed with their interest in the surgery as opposed to ME, but as a doula, I also understand the unique opportunity they had. (In
retrospect, I think one of the biggest problems was that everyone kept thinking of me as a doula and not as a laboring woman.)
The surgery was noneventful, Daniel was easily delivered, screaming all the way and promptly peed on everyone and everything. I was able to see him briefly and Mark went with him to the side of the room where the warmer was. My mom went back and forth, so I was left alone a bit more than I would have appreciated during the repair. Fortunately, Mary, one of the anesthetists, was super and made sure the have Mark bring the baby over as soon as possible. She had him hold Daniel up to my cheek and I was able to stroke and cuddle him while he was still a bit messy and fresh. He was perfect--weighed nine pounds even and showed no signs of postmaturity, despite a severely calcified placenta (I saw it--it was pretty bad!)
I was able to hold him on the way back to my room, but felt very woozy and out of it. In fact, once I was in the room, the nurses became very concerned and took the baby (who then pooped on everyone) and began working on me. I remember fading in and out and Mary apologizing as she inserted an IV without gloves on. Apparently my blood pressure dropped significantly and they were a mite worried. I recovered fairly quickly, and settled down to bond with my baby. Mark called immediate family members, then I sent him home for sleep. Daniel and I had a wonderful night napping and cuddling, and I swear he smiled at me. Interestingly enough, I didn't call anyone for several days. It was very difficult for me to integrate this birth.
I developed a spinal headache which was far worse than anything I had ever experienced, and challenged our
breastfeeding relationship, but I had good nurses and a great lactation
consultant so was able to work through that. I also had my first experience with Therapeutic Touch, courtesy of the hospital. I stayed
longer this time, but once the headache was under control, I was eager to get home and begin life as a mother of two. Recovery was relatively easy,
as with my first cesarean, though not something I would choose to deal with when caring for a newborn and toddler.
In retrospect, this birth was much more difficult for me, because despite being educated and prepared, I still allowed others to influence my
decisions. I cannot blame my choices on ignorance or naiveté. I simply relied on people who did not see my needs, only strengths, and this was a
fatal flaw. I learned a lot over the next three years. After about 10 months, I discovered ICAN online and have become very involved since. I
have continued to search and to learn and to grow and heal. Now, my son is three years old, I am nearing the end of my third pregnancy, and I have
realized the ultimate lesson for me: I cannot birth in a hospital. I am planning a homebirth and hope to have a third, triumphant story to share
within a few months.
Baby #3: Pam went on to have a home waterbirth VBAC after 2 cesareans. See the summary of the story below, and the full story on the BBW VBAC stories section, or in the VBA2C Stories section.
SL's Story (SROM, induction, group B strep, c/s)
Name: SL Age: 20
Pre-pregnancy Weight or Dress Size: 220lbs
Baby Info: Girl, 7lbs 2ozs
Wt. Gain in Pregnancy: None, lost 21lbs
Infertility Problems? No
Any Complications: None in pregnancy, apart from high blood pressure
occasionally
Type of Birth: Emergency c-section due to FTP, fetal tachycardia &
Group B Strep
Birthplace: Hospital Provider: OB
Breastfeeding: No
Special Notes on Pregnancy:
Kmom's Notes: Because her water broke before labor (Spontaneous
Rupture of Membranes=SROM), this mom was induced. Problems putting in an
epidural caused a cascade of problems here, ending in cesarean.
Birth Story
Sophie was born in an operating theatre at the maternity unit of the local hospital. I had been in labour for 58 hours!
My waters broke at 5am, a week before my due date. DH took me to the
hospital, where they examined me and said that I wasn't even 1cm dilated but my waters had definitely gone! The doctor said to go home, get some rest and
come back at 9am the following morning if nothing still was happening. So we returned the next day (keep in mind my waters were still leaking!), where, at
11am, the doctor gave me prostaglandin gel, which is a form of induction. I was instructed to walk around because that is supposed to help
get things going. All day DH and I walked around and around! I was getting a few
niggling pains, like period pains.
At 5pm I was examined internally again and told I was 1cm dilated. Hurray! They gave me some more prostaglandin gel at 5.30pm and once again we had to go walkies! Towards the end of the evening the pain started to get worse, but I felt reassured because I thought that at least something was happening! I had to stay in the hospital overnight due to the attempted induction. After having contractions all throughout the night, I felt optimistic that it would soon be all over and my baby would be in my arms. However, when the doctor examined me at 8.30am, I was still only 1cm dilated and was told I was going to be put on a pitocin drip, which would speed up the contractions but make them a lot more painful too.
Well, I had been quite brave I think up until this point, without any painkillers. But hearing them say more painful contractions had me demanding an epidural before they put the drip in! I was taken down to labour ward, where they put the epidural in. But it was a student anesthetist that did it, and he put too much in. He estimated my weight wrongly and thought I was heavier than I actually was. I was numb from the neck down, it was horrific. They got one of the senior doctors to come in and he confirmed that they'd made a mistake. At this point, to me, the room was spinning all of a sudden and I vomited everywhere. My DH was my lifeline, he actually caught my sick! It sounds gross but at that point I knew for sure that he really did love me!
Anyway, after I was sick, they noticed my heart rate was 140, way too fast so they did an emergency echo-cardiogram. Then, my baby's heart rate went up to 180. She was in distress. Suddenly there were doctors and midwives everywhere, shouting, "We have to do an emergency c-section now!" I have never been so scared in all my life, and DH hadn't either. He had to sign a consent form to say that they could do the c-section (I was numb remember, I couldn't sign it!) and then I was shaved and given a spinal block "Just to make sure you're completely numb," they said. (I was thinking 'u gotta be kidding me, right!') So I was rushed down to the operating theatre, DH all dressed in green scrubs at 2.45pm and at 3.06pm on Friday 21st July 2000, 58 hours after my waters had broken, Sophie was born, weighing 7lb 2oz. (I was sick again as they were pulling her out cause it didn't hurt but I could feel all this tugging, eew) . She let out a loud squawk as she came out so I knew she was just fine! Her apgar scores were 9 at 1 minute and 10 at 5 minutes.
She was wrapped in a towel and handed to DH, who looked totally shocked and overwhelmed! I couldn't believe this gorgeous little red thing with loads of dark brown hair was really ours! It was the best moment of our lives. We have a gorgeous, active, bright little girl, Sophie. She truly is a blessing.
MH's Story (pre-existing hypertension, induction, c/s)
Kmom's Notes: It can be very hard on a woman emotionally to have general anesthesia for a cesarean. For more information about the issues this can bring up, please see the FAQ on Emotional Recovery After a Cesarean on this site.
Birth Story
My pregnancy was pretty good. Because of controlled [pre-existing] hypertension (not pregnancy-induced), I was labeled high risk. That was okay with me actually, as hypertension is something that can be scary in pregnancy. I had 3 level 2 ultrasounds until the last 5 weeks. Then I had one at the doctor's office every 3-4 days, with a non-stress test. During my 39th week visit, the doctor did an u/s and said the baby was well over 8 lbs. Because of the hypertension, I was going to be induced during my 40th week if I had not gone into labor already. So, because I was very adamant that I wanted *my* doctor to be the one that was there during delivery, and he was on call the next couple of days, we decided to start the induction that night.
I was given Cervadil in hope that my cervix would soften, as I was not dilated at all, and just a bit effaced. Pitocin was started the next day at 5:00. I started having contractions about 9:00, but nothing strong at all. My doctor checked me at 12:00, still nothing. Checked again at 5:00, and still, nothing. At this point, we had to decide how to proceed. I could go home and see if anything happened over the weekend, with a scheduled c-section if I didn't go into labor myself, the pit could be turned off, and started up the next day (but my doctor didn't want to do that, and neither did I), or a c-section then. We chose the c-section.
After I was prepped, the anesthesiologist came in and attempted to give me a spinal. After 5
attempts, he said he didn't think it would work. I said try it two more times, and then I'd agree to a general. It didn't work. I was knocked out
completely. The next thing I remember was waking up, being moved from the operating table to a bed, then I turned to my left, and my husband was
standing there with our beautiful little boy! I was in a lot of pain, as the morphine did not work. I was given a
Demerol drip, and that did work.
Yes, I think I was pushed into the c-section. I am going to try very very hard next time for a VBAC. And, I will flat out refuse to be worked on by the same anesthesiologist. It is because his ineptness that I did not see my baby be born.
Kathie's Story (borderline BP, induction, c/s)
Kmom's Notes: As far as her borderline blood pressure goes, it's very suspicious that Kathie's bp was always very normal at the hospital during monitoring and high at the doctor's office. Either the doctor's office was not using the correct size cuff, or Kathie experienced "white coat hypertension" (elevated bp readings from the stress of seeing a provider, or in this case, a hostile provider).
A doctor automatically ASSUMING from the start that you are going to have high blood pressure, gd, and/or a c/s simply because you are large is a BIG RED FLAG that this doctor is fat-phobic. Almost always, these doctors create a scenario that make these women have highly interventive, difficult births. Beware of the self-fulfilling prophecy of your provider's expectations! And never hesitate to switch providers if your intuition is uneasy. It's NEVER too late to switch providers---even in labor!
Birth Story
I became pregnant in August of 2000 with my first baby. I went to my ob and was officially told I was pregnant and due April 16, 2001. My ob showed signs of being fat phobic at that very first appointment and I should have changed immediately! However, I decided to stick it out and ended up regretting it all through my pregnancy.
At the very first appointment she told me that I would have pregnancy induced hypertension and most
definitely I would have GD - all because of my weight. I believe my highest blood
pressure reading was 150/85 at which point she made me have fetal monitoring every week for the last 4 months of my pregnancy. Funny thing was I always
had a normal blood pressure at the hospital when I was being monitored (117/70). The "high" blood pressure in my opinion was brought on by my ob.
I believe now looking back on it that she wanted to find something wrong with me during my pregnancy to prove to me that an over weight pregnancy was, in
her opinion, an unhealthy pregnancy. And I never had GD...as a matter of fact my numbers were great...I think my test came back with a number of 100.
Anyhow, April 16th came and went and I wasn't even dilated or have a soft cervix or anything. My ob insisted that I needed to be induced because of my
weight...she didn't want the baby getting too big. Also I was swelling quite a bit and she said that all the water gain wasn't good either. So, on the
evening of the 17th I went to the hospital and was given cervadil. This was supposed to soften my cervix and get it ready for inducing in the
morning. This actually brought on slight contractions, but nothing that was
really painful. The next morning (the 18th) I woke up around 5 am. I had to go to the bathroom and when I stood up all this liquid came out! My first
thought was I didn't know I had to go that bad! Anyway, I made to the bathroom and I went for what seemed like a really long time. I thought did
my water just break? I thought I had better mention it to the nurse. She checked me and said that I had in fact broken my water. I was only dilated
about 1/2 cm at that point.
They immediately started me on pitocin. They increased the amount every 15 minutes or so, which I believe is very common. Boy did this bring on the
contractions hard and fast! I finally understood what my ob meant when she said I wouldn't be able to talk through them! My contractions were
coming every minute or minute and a half and I was still only dilated to 3 cm. This was around 12 noon. A few times during the morning I had to be
placed on oxygen because the baby's heart rate dropped, but they were able to get it stabilized and I didn't have to remain on the oxygen for very long.
This was very scary! I had no idea what was happening to my baby! The nurses were wonderful! They never got
panicked or anything and that in turn kept me very calm.
At around 3 pm I asked for an epidural...my contractions were coming every minute and lasting probably 45 - 60 seconds, but I was only dilated to 4 cm.
My ob came in and checked me a few times during the day. She did say that I should have had the baby by now. She didn't know what was slowing things up. What I found very irritating about her during all this is she didn't speak
to me. She didn't ask how I was or how I was feeling. She would come in and talk to the nurse and completely ignore me! Ugh! So frustrating. If my
husband or I would ask a question she would give a cursory answer and walk out! I believe this was a reflection on how she felt about me because of my
weight!
The nurse came in and told me that it would be a few minutes before I could get my epidural because the dr. was in surgery! So they gave me a shot of I
believe it was called new morphine? Any way...it was to take the edge off the contractions. It worked, but I remember thinking with each
contraction...boy I'm glad they gave me that shot...it still really hurts but can you imagine how much it would have hurt with out it??!?! Finally
around 4 pm the dr. came and gave me my epidural. Sweet relief! However, only half my
stomach was affected by the epidural...I could totally feel the contractions on one half and not on the other. So the dr. came back and gave
me some more medicine.
After that it was just a big blur. I laid there until 8 pm when the ob came to check on me...I was still only dilated to about 5 or 6. She kept saying
to the nurse she should have had this baby by now. I was confused because everything I had heard about inducing was that it gets the job done fast. To
be honest I was too exhausted to ask what was wrong...I had been up for 2 days by this time. I just wanted it to be over!
Finally at 3 AM on Thursday (the 19th) they checked me and I was still only dilated to 8 cm. The ob said she would do a c-section because it was coming
close to being 24 hours since my water broke. (Oh yeah...they did start me on antibiotics earlier - about 12 hours after my water broke). Finally my
son (8 lbs. 15 oz. 21 1/2 inches.), was born by c-section at 4 am with my hubby by my side...that is until he got woozy and almost fainted
and had to leave! Men!
I honestly believe that the ob made me lay there for almost 3 days before she decided to do the c-section because of my weight. She told me way at the
beginning of my pregnancy that I would probably have to have a c-section because I was overweight. I think, again, that she wanted to prove her
point.
Nicky was sent to the NICU 2 days later because of rapid breathing. They kept him for 4 days and did blood cultures. There wasn't any infections. He
does however have a very small ASD and VSD (Ventricle Septal Defect and I can't remember what the ASD stands for.) Anyway, the cardiologist said they
are so small that there is no need to worry. I took him to the cardiologist in Dec. of 2001 and she said that he is doing so well that she doesn't have
to see him for a year! He is growing and gaining weight like crazy!
Laurin's Story (insulin-dep. gd, pre-eclampsia, induction, c/s, wound problems)
Kmom's Notes: Laurin experienced the classic signs of pre-eclampsia---sudden severe weight gain, spilling protein in the urine, swelling, high blood pressure, etc. This is potentially very serious, and induction is the usual response.
She also experienced a baby malposition. The doctor said that the baby's head was turned to the side, making the baby either occiput transverse or asynclitic (depending on what the doctor meant exactly). Breaking the waters typically makes it very difficult for the baby to rotate to the most optimal position for birth, and they often get 'stuck' as she did here. Usually breaking the waters does not hurt, but Laurin experienced significant pain. This probably was due to the fact that she was only 1 cm dilated, or the doctor may also have tried to manually stimulate the cervix at that time as well, which can sometimes help. However, in Kmom's view, this painful procedure should only be done after asking permission, and when it is not, many people believe this borders on assault. Unfortunately, doctors rarely ask permission to do this or have the patients give informed consent.
A seroma is a pocket of fluid that can collect underneath an
incision after surgery. Although women of all sizes can experience this,
it does tend to be more prevalent in women of size. Research shows
that suturing the subcutaneous layer, and/or putting in a surgical drain can
lower the risk for wound complications like this in larger women, although they
cannot *guarantee* that there will be no problems.
Birth Story
My daughter was due on June 22, 1998. I had planned to work until June
12, but by June 1 I was so swollen and exhausted I begged my doctor to release me from work on June 5. He agreed without any prodding. I had
my 38 week doctor’s appointment on Saturday, June 6, the very day after I stopped working. When I got weighed, the nurse exclaimed that I had
gained 25 pounds IN A WEEK!!! And my usually 140/70 blood pressure was “sky high”, as they put it (but I can’t remember exactly what it was).
Then they tested my urine, and found I was putting out large amounts of protein. My doctor immediately diagnosed preeclampsia and sent me home
to pick up my husband and my “hospital bag” and ordered that I go to the hospital to have my labor induced right away.
When I got to the hospital, they hooked me up to a fetal monitor, an automatic blood pressure cuff that takes your blood pressure like every
five minutes, an IV drip of magnesium sulfate (which prevents seizures in
pre-eclamptic patients) and pitocin, and they catheterized me. The only problem with that is that mag sulfate tends to counteract the
effectiveness of pitocin, so I was not having the strong contractions I should have. And there I lay for approximately the next 36 hours,
having only minor contractions and not progressing in the slightest. About 24 hours into my non-laboring labor, one of my doctor’s
associates decided to try and speed things along by breaking my bag of waters. I found this to be the most excruciatingly painful event from
my entire birth experience, but that could be because I was only 1 cm dilated. It was horrible! After she did that, she also inserted an
internal fetal monitor, which was a wire attached to the baby’s scalp. I have to say, after the pain I went through with breaking the bag of
waters, I began to wonder whether I was cut out for this birth stuff! All of my friends said that part was a piece of cake!
Breaking the bag of waters worked to a certain extent, but I still only dilated to 3 centimeters. This baby wasn’t going anywhere! The doctor
said the baby’s head was turned slightly and was stuck in my pelvis. She didn’t even get to the –3 station. So, at about the 32nd hour,
they decided that I needed a cesarean section.
I had some difficulties when they tried to give me an epidural—I was so swollen that the anesthesiologist could not find the proper
area and said if he missed, I could be paralyzed. Not something I wanted to hear! So then they decided to
give me a spinal block instead and I was wheeled into the operating room while DH waited in scrubs outside until the spinal had been
administered. That went through without a hitch, and DH was invited into the OR to be with me during our baby’s birth. He stood at my
right shoulder and tried to keep me awake during the surgery. Baby was born about 5 minutes later, beautiful and very healthy. The nurse
brought her over for me to see, and I kissed my newborn daughter on the forehead and they took her away to get weighed, etc. while my husband
tagged along, video camera in tow.
I didn’t have much pain from the cesarean section. The nurses were amazed at how quickly I could sit up and was walking around. I tend to
think it’s because my abdominal muscles were already used to lifting a lot of weight. I still had to take it slow, but all in all I thought
the cesarean was a cake walk.
I was released from the hospital 48 hours after the c-section. Everything was fine with my recovery and my DH and I were enjoying our
first baby. Then one night, three days later, I was getting into bed (slowly) in the dark and I felt a huge gush of fluid pour out of my
incision. I was so afraid it was blood! But it wasn’t—it was more like water, but sort of had a yellowish tinge. I called my doctor and he
said to go to the emergency room immediately. It turned out that I had developed a seroma, or a pocket of fluid, behind the wound, and it had
burst, thereby partially opening the incision. The staples had to be taken out in the ER. Then I had to be
readmitted to the hospital for another two days while they watched me for infection. Since they
couldn’t re-staple the incision, it had to be allowed to heal by itself, and the wound was 17 cm long and 6 cm deep! This involved
packing the wound twice a day with lots and lots of gauze soaked in a mixture of saline solution and hydrogen peroxide and covering the whole
mess with a lot of surgical tape and abdominal pads.
This was by far the worse thing about my daughter’s birth, because for the next 12 weeks I had to have home health nurses at my house twice a
day to attend to my wound. I felt like a prisoner of my house—I couldn’t leave for more than a few hours at a time. It’s the thing I’m
most afraid of for my current pregnancy—if I end up having to have to have a c-section that the wound would become compromised again. My
doctor assures me that knowing what they know now, they would insert drains and take special care in sewing up the inner layers to avoid a
situation like that.
As for size bias, all of the doctors and nurses were great and very supportive with the exception of the first nurse I encountered on my
first day. She was a skinny little thing from Thailand and kept making remarks like “Were you always this big, or is it just because of the
baby?” “Your hands look like catcher’s mitts” and “Are you going to go
on a diet when the baby is born?” After several hours of dealing with her unkind remarks, I asked my husband to get the head nurse and I told
her the remarks my previous nurse had made. Arlene, the head nurse for that shift, reassigned my previous nurse and she herself became my
nurse, and she was the best one I encountered.
Ellen2's Story (elective c/s)
Kmom's Notes: Ellen wants to share her story so that other supersized women know that "You don't have to have something wrong when you have a pregnancy" just because you are supersized. She feels it's important to share her story so that other supersized women won't feel the way she did when she first got pregnant. It was sad and lonely, she says.
Birth Story
I missed my first period in March. Usually my cycle is very regular. I went to an OB/GYN. He did both a urine and blood test to see if I was pregnant. Both came back negative. He prescribed Birth Control pills to get my cycles regulated. The next month nothing happened again. I called my Dr. and he said to keep on taking BC's and eventually I would get back on track. I began to feel really sick, nauseous all the time. I was stopping the car so I could vomit. I would be sick if I ate, then sick if I didn't eat. I had blinding headaches. I had to be bedridden in a dark, cold room to make them go away. I thought I had some sort of terminal illness!! I was ill like I'd never been before.
In May, I called my Mom who is an RN at our local health dept. I asked her if she could run some tests on me, any kind of tests to see what was really wrong with me. She did some tests, checked the obvious stuff, then suggested a PG test. I told her I could not be PG, the dr. did a blood test and put me on BC....but she insisted----and the simple urine test came back positive! I don't really know if I was too early, or the lab confused by blood, or if I wasn't quite PG then when the OB did the blood test. Well, I decided to make my OB appt. a few towns over where the big hospital is. I felt doomed that I or my baby was going to have problems because of my weight (that is what my family and doctors had said). If either of us needed help I wanted to be at the big hospital.
My mom came with me, and when we talked to the doctor my Mom started crying, saying that he needs to categorize me as "high-risk" and asking if I was going to die. He told her that large people have babies all the time and for us not to borrow trouble. He didn't see any reason why I couldn't have a normal pregnancy. He wasn't going to classify me as high risk because I wasn't. I loved him from that point on.
All the rest of my PG was pretty uneventful. I had normal appts, tests, and readouts. Sugar test, blood pressure, everything was perfect. My sickness and headaches went away soon. I did, however, towards the end have the pelvic pain pretty bad, like in the a.m. when I woke up. I had more ultrasound (not vaginal) than other people because it was easier for them to see how I was progressing that way. (I don't think they ever did figure out how far along I was exactly!) My due date was Nov. 28th, they said.
I started to eat only lean meats and fresh veggies and fruits from our farmer's market. I drank mainly water. I swam 6 days a week at our gym in the indoor pool. I think all this helped me get through without being miserable.
Close to my due date, the doctor said I was showing no signs of labor, that my cervix looked just like it did 6 months ago. He said we'd wait another week. Meanwhile I had an ultrasound and they told me my baby was 10+ pounds and at this stage she would gain a 1/2 pound every week. By Dec. 10th I was scared, and still had no signs that I was near ready. I asked if he would induce and he said that since I had not dilated or effaced ANY, he didn't feel like this was a great idea. He said we could wait ANOTHER week and see. At this point I wanted to get the baby out by whatever means possible. I was scared I had a huge monster growing inside that refused to come out! So I opted for a c/s. Four days later I was in the hospital having my c/s (bikini cut). The epidural and surgery went fine. My girl was perfect, weighing 9 lbs. even. {Kmom note: So much for the 10-11 lb. baby!] 3 days after that, I went home.
This is when we started having problems. In the hospital, I was earnestly trying to breastfeed. My nipples are both slightly inverted and she would not latch on. I wouldn't let anyone give her a bottle, my pedi said she would be fine with the nutrients she had in her until we both got bfing under control. I tried everything to get her to latch on. I wore the shields nonstop to help draw the nipples out, nothing was working. I don't think my milk ever came in. We were both frustrated, and after a few days, especially when I noticed her getting a little jaundiced, I felt she wasn't thriving and I started with formula and the bottle.
In a way, letting go of bfing was a big relief for me. I was suffering from severe Post Partum Depression, I was exhausted, I was extremely swollen (my shoes and rings would not fit me even though they did when I was 9 months pregnant). My incision was gushing out tons of this clear pink fluid. My doctor told me what was going on [Kmom note: probably a seroma, which is a collection of fluid under the incision, which can be more common in heavy women]. He said my incision looked really good and was not infected. My sister had to express this fluid out of a tiny seep hole in my incision. There was tons of it. I asked if she was pouring warm water on me, but it was really this liquid coming from my body!
The main problems I had were after my pregnancy. Bfing, PPD, swelling, and the seepage from the incision. It took me about 4 weeks to get back to normal physically. Emotionally I still strengthen every day. She is almost two and we just started trying for another one! This time I hope to be more prepared about proper rest when you come home from the hospital; also to know more about option of bfing with inverted nipples. I will know that PPD is normal and talk more about it. I felt like a freak at the time, and that just made me feel worse! The problems I had due to my weight were minimal----having trouble telling if I was pregnant or not, having trouble deciding how far along I was, extra fluid under the incision---but all pregnancies have minor problems.
I wrote this because I want people to know that really big people have lives, they love and are loved in return, and they have babies just like everyone else. Just because you are "Supersized" does not mean you are doomed to have problems. If you keep a positive attitude and entertain a healthy lifestyle things usually are fine.
Kimberly Hill's Story (3 elective cesareans)
Kmom's Notes: One of the risks of elective cesareans is the baby having trouble breathing. This risk is especially strong if the elective c/s is done before 39 weeks. Kim's first baby experienced this problem, evidently, but fortunately her other children did not.
Another risk of cesareans is severe blood loss for the mother. This type of hemorrhaging occurred with Kim's third c/s (the risk tends to increase with each c/s you have, due to increased scarring and surgical time etc.). From the description, it sounds like she had quite a severe hemorrhage. Fortunately, in time they were able to correct the problem and bring her iron levels back up.
Birth Story
I was about 26 when I had my first child. I was about 270 lbs. or so. I was told that I couldn't get pregnant. Once taking clomid for two months and charting temps, I got pregnant. I was so excited. I had my baby in July 98.
I had a pretty good pregnancy until close to the end. I got the whole diabetes thing and gained about 72 pounds total with the pregnancy. I found out at about 26 weeks that it was a little boy. I was very excited about having a boy for my husband. I went through the pregnancy and I got to 37 weeks and they told me that the baby was going to be very big (ten pounds). I started exchanging the newborn stuff because it would not fit.
At 37 weeks I went in for my weekly checkup. While there my blood pressure was up. So they did a check on the baby with a stress test and said that the baby seemed fine but they wanted to admit me. I went to the hospital after having an amnio at the doctors office to check the lungs. He told me that if the lungs were fine he would go ahead and take him c/s.
Well, from a Monday night to Wednesday morning I lost 17 pounds in fluid. The doctor came in on Thursday and said that that amnio came back and the lungs were not ready. I was so sad; I cried and cried. I asked to go home; he said NO, cause then I would be right back where I was at with the fluid. So I stayed there.
He was going on vacation the following week. I asked him to the amnio again on Friday morning. He did, which made me start having some mild contractions. At about five that evening he came in and said how fast can you get everyone here. I said give me an hour. He said that the amnio came back and part was fine and the other part should be okay! He said that there would be about a 1% chance that something would be wrong with the baby.
So at 6:41 PM on July 24th I had a baby boy with TONS of hair. They started
placing bets on how much he was. I heard the pediatrician say, oh he is at least 11 pounds. Once
they got the baby out and all, they stitched me up. I got to recovery. My mother then came in. I asked her
how much he weighed and she said, well he is 22 inches long. I was like,
how much did he weigh? She said he was 11 pounds and 4 ounces. I was in shock. WOW. They put him on oxygen for about 16 hours!
To this day he is a happy five--almost six!--year old.....with two younger siblings and I hope another on the way soon.
I was then 28 with my second pregnancy. I took clomid for one month and got pregnant. I was thrilled----this was going to be my girl. Well, at five weeks I started bleeding. I went in and they said well, I am sorry but there is NO heartbeat so you will pass for awhile and it will be over then you can start again. Well after about four weeks I said ya know I still feel pregnant so went back to the doctor for blood work and all. Well I was still pregnant from what the blood says.....so they did an ultrasound. There on the screen was a tiny heartbeat. I was overjoyed. Thought that my troubles were over. They looked at the ultrasound screen and said that there were two sacs and one heartbeat. I had lost a twin...WOW, that hit me hard.
I went on though, thinking, ya know GOD gave me one; He didn't take both of them. I had more bleeding throughout the pregnancy. I had to go to specialists and all. I ended up getting steroid shots due to they didn't think that I was going to make it to six months with him. YES, we found out it was a HIM. So, on I went with bleeding throughout the pregnancy; like a period, only a little more often.
I got to six months......WOW I was so happy. We went on with more ultrasounds and all---another big baby I was told. Finally at 36 weeks I started bleeding and couldn't stand for all the bleeding. So bedrest.......well it got worse. I went in at 37 weeks and they ended up having to go ahead and take him. I was so scared, afraid that he wouldn't be breathing or something. Anyway, I went and got my spinal and all. I had my baby boy at 2:43 PM on February 23rd, three weeks early. He was 20 inches long and 9 pounds even. He came out wonderful, breathing and all. NO OXYGEN, nothing. I was so happy.
Once I got home with him and all about four weeks later I went into Post Partum Depression. It was not good but I got over it with the help of some medicine and family. At the time of this pregnancy I would say that I was about 340 or so.
I then went on to have a miscarriage about a year later. Then I
got pregnant again with clomid two months later. After taking only one month. I thought this is my girl. Well
everything went well with the pregnancy until about 20 weeks; I went into premature labor pains. They
couldn't do anything for me but admit me with an IV. I got stopped at
23 weeks. I was put on oral medicine to take.
I had a good pregnancy with this baby. At 25 weeks I found out that I was having a GIRL. I was so excited. I had my baby girl at 38 weeks scheduled c/s ! She was 19 inches long and 9 pounds even also, at 2 weeks early. I had her on a Monday morning and that night I started to hemorrhage. They finally gave me a shot and things got better but I was very sick with blood loss for a long time. My hemoglobin that is supposed to be like 12 was at barely a 7. Not a good thing.
Now this day two years to the day after the birth of my baby girl, I am wanting to do this all again. I hope to get pregnant very very soon.
Jamie's Story (insulin-dependent GD, footling breech, c/s)
Kmom's Notes: A good reminder that just because a provider has the title of "midwife" doesn't mean that she's guaranteed to be size-friendly. It's too bad Jamie's OB and midwives didn't know that a chiropractic technique called "The Webster In-Utero Constraint Technique" often enables breech babies (even footling breech babies) to turn on their own, with an even greater success rate than external versions. There's no guarantee that seeing a good chiropractor would have enabled this baby to turn, but it's a shame it was not tried and a cesarean became inevitable.
Birth Story
When I was 35 I gave birth to Emma. It was my second pregnancy; my first was when I was 18. My first pregnancy was emotionally very hard on me. My parents hated my boyfriend and in retrospect he was a complete loser who couldn't really give me the emotional support I needed. Although I love my son dearly, I never had a moment of happiness about that pregnancy or birth. But there were no physical complications at all.
My second pregnancy was so much better emotionally. I was married to a wonderful man, my family loved him and his family loved me. I looked so forward to having this baby, I thought this pregnancy would be emotionally healing after the trauma of my first one. I was a little nervous about being pregnant and being plus-sized and that's what led me to this website. It was very comforting to hear that all kinds and sizes of women have happy, healthy pregnancies.
I found a midwife here in town and started seeing hr. I always felt like she thought I was a disaster waiting to happen. It wasn't anything overt she said that made me feel that way. Just little things. I have white coat hypertension [Kmom note: A common phenomenon where blood pressure appears higher in the presence of a doctor or other health professional but is normal otherwise.] I told her that but every appointment she got so nervous about my BP. And it was usually right around 140/90. That's my usual BP in a doctor's office and I repeated that at every appointment. Finally she talked me into buying a home monitor (at the cost of $99) and had me take a reading every day. My BP was fine. I think the highest home reading I had was something like 128/84.
She also seemed convinced I would develop GD and almost made me a nervous wreck over it. And when I was diagnosed with GD at 26 weeks, I felt like she had jinxed me (irrational, I know). I was sent to a perinatal center to see a doctor and nutritionist and learned how to check my blood sugars. (The perinatal center wanted me to check my BP TWICE a day even though I hadn't had any high readings at home and no longer even had them in the midwife's office now that I was used to her.)
I tried controlling the GD through diet but after a week or so of my numbers not being where they should, I was put on insulin. I freaked out when I got this news. I have a lifelong fear of needles and couldn't believe I had to give myself shots. This was one of my biggest fears going into pregnancy (the other being a c-section) and it was coming true. It turns out that giving myself the shots wasn't so bad. After a couple of days I was used to it and it really didn't bother me at all. Because of the insulin, I had to start seeing the OB who my midwife practiced under and he was in a different city. So now travel was added to every appointment (in the winter, in the northeast). Then I hardly ever actually saw the OB, just one of the other midwives in the group, unless they had a question for him.
Of course, the GD diagnosis led to more interventions than I liked. I had 3 long, drawn out ultrasounds that took over an hour each to measure the size of the baby. Big babies run in my husband's family and I told this to everyone I saw but always felt like no one listened. I don't think I ever got any more response than a nod from one of the midwives in the group. The last ultrasound I had was at 35 weeks and they estimated the baby's weight to be 8 lbs. 5 oz. The OB and midwives were convinced that I was going to end up with a huge baby. We also found out she was footling breech. We had known she was frank breech and the midwife gave us some exercises to try and turn her but they didn't work. I was scheduled for an external version but when she turned footling breech the OB said it was very unlikely to work and I should have a c-section (my second big fear come true). I was scheduled for an amnio on April 4 with a section to follow on April 6 as long as her lungs were mature enough. With my fear of needles, the thought of an amnio was almost enough to make me faint. I had no idea how I was ever going to make it through that.
Early in the morning on March 31, my water broke spontaneously. I was scared but also grateful I avoided the amnio. Emma was born at 8:20 a.m. by c-section. She was 20" long and weighed in at 8 lbs. 1.7 oz. Obviously the ultrasound estimates were wrong. I was 37.5 weeks along when I had her, two and a half weeks after the 8 lbs. 5 oz. estimate.
Although this pregnancy did not turn out to be the emotionally healing experience I had hoped for, I have a beautiful, healthy baby girl whom I couldn't love more. And I really hope to have one more someday.
ShortandBubbly's Story (PCOS, low amniotic fluid, planned c/s, respiratory distress in baby, NICU at another hospital, breastfeeding problems)
Kmom's Notes: This mom did a great job under less-than-ideal circumstances. At 37 weeks they found that her amniotic fluid levels were quite low. Instead of trying to aggressively hydrate her to see if that would improve things (research shows this can significantly improve amniotic fluid levels, often enough to prevent the need for immediate delivery), they chose to do a cesarean the next day. Because the cesarean was done without the benefit of labor and because baby was 37 weeks, baby had respiratory distress (difficulty breathing, common in elective cesarean babies). His breathing problems led to him being transferred to another hospital's NICU.
The separation, plus the delay in getting a good pump, plus the nipple confusion from having bottles, plus possible oral aversion problems all led to great difficulty in breastfeeding. Supply was also an issue, which might be due to the circumstances and/or the PCOS. Hopefully, next time, she will be able to avoid this cascade of problems, get to hold her baby right away, and have an easier time with breastfeeding. She did an admirable job under very difficult conditions, though, and that's all any of us can do.
Birth Story
Even as I look at my son as his first birthday is less than two weeks away, I still cannot believe that my body was able to create something so beautiful. I had been experiencing symptoms of pregnancy such as fatigue, slight morning sickness, and not being able to eat things that I used to be able to eat. I was also late for my period, which wasn't unusual. But what alarmed me was that I did spot for a day and it stopped. My husband (who was my boyfriend at the time) and I were living together, but having a hard time with our relationship. I bought a test at the drug store and right before I went into the bathroom, I said, "It will probably be negative." Imagine my shock and surprise when that second line appeared in seconds. I remember shaking and tearing up from happiness. We went out that night with my best friend to celebrate.
It was a pretty uneventful pregnancy. No major complications. The only thing that was bothersome at all was the unbelievable swelling that I had in my legs, knees, ankles and feet. I never experienced any real morning sickness or heartburn. There was only one time where I remember waking up with heartburn. Teaches me for drinking orange juice right before going to bed.
We found out I would be having a boy when I was 28 weeks along. It got real fun when I could start to feel him move around. I will never forget the first time I saw him kick. I was laying down on my bed and all of a sudden, I saw my belly move! It was the most amazing thing I have ever felt before. Towards the end of the pregnancy, about a month before a delivered, it was impossible for me to go to bed before 4 a.m. I would lay in bed, and I would feel very energetic and restless. I spend lots of nights cleaning or playing online.
I was 37w4d along when we went to my appointment at the ob/gyn office. Little did we know, it would be my last visit. We were in the ultrasound room and the ultrasound technician asked if I had felt any fluid come out. I had told her I hadn't. She seemed concerned and called the front desk to have the midwife come in and look at it. The midwife came in and looked at the ultrasound picture, and then told me to move into the next room where they would hook me up to an external fetal monitor. The heartbeat sounded good and strong, and they were asking me questions about the baby's movement. Finally I asked, "What's the matter? Do I not have any fluid left?" I was informed that I had very little fluid in me and that baby needed to come out. They checked for dilation, and I was not dilated at all. Nor was his head in the birth canal. He was-head down, but not in the canal, and his body was slanted off to the right. We were instructed to the across-the-street to the hospital. We would have having a baby that day or the next day.
We arrived at the hospital and they brought us to our room where I was told to get undressed and get into the hospital gown. They brought in a portable ultrasound machine where they looked again. Apparently, I had more fluid than the other machine showed, but still very little. I was then told I would be having a cesarean the next day. They prepared me for it by having me take a bath and scrubbing my belly clean and hooked up an IV into my neck because we couldn't find a good enough vein in the arm. I have deep veins. I was then instructed not to eat after 10 p.m.
The big day was here and I hadn't slept a wink! My boyfriend put scrubs and a mask on and they wheeled me into the room. In there they put the epidural in my back, and it didn't take long before I wasn't feeling a thing! When I felt a little pulling, I knew that it was almost there! I know I heard a cry, although I don't remember it. He was born at 12:13 p.m. I was told that I cried a little bit as they stitched me back up. Once I was stitched back up, I was wheeled back into the room and hooked up to a pitocin drip so my uterus could contract back to normal. Thank god for the epidural is all I can say.
I hadn't gotten a chance to see my baby yet for he was having problems with breathing. Unfortunately for all of us, he had to be shipped to a different hospital's Neonatal Intensive Care Unit. It was a very hard few days on me mentally as well as physically. I had to wait four days until I could see my boy. And he was so beautiful! Full head of hair and I could hardly see his eyes for he hadn't really opened them up for me.
I had planned on breastfeeding my boy. I wanted that bonding experience, along with giving him the best I could. Unfortunately, since he was at a different hospital, I didn't have a real chance at that. About 36 hours after my operation, a nurse brought in an electric breast pump. The first night, I didn't even get an ounce. But my other half still brought it back to the hospital where our baby was staying. I would try pumping a few times every day until I was out of the hospital. Once I was out and was able to visit, we tried to get him to latch on. He tried but once he latched on, no milk came out. I tried to keep going, but he was getting real fussy because he was hungry and didn't want to wait for his food. So he got a bottle.
The next day he came home and we tried again. For a while, I used a manual pump, and I still got hardly any milk to come out. After a week of using manual pumps, we went to the hospital to rent an electric one. I was able to give him about 6-10 oz. per day using breastmilk.
I think the other problem was that my nipples are a little on the flat side, which made it hard for him to latch on all the way. Plus, about a month after I had him, I caught a real bad cold. So I didn't pump for 3 days because I didn't want him to catch it and I was so tired. As soon as I felt better again, I tried to pump and nothing came out. I pumped for an hour and only about 1/4 of an ounce came out. I was devastated. I wanted nothing more than to be able to give my baby my milk. But I just had to tell myself that I did the best I could and that is what counts.
[Looking back on the birth,] I wish that they had waited it out [to see if I could improve my amniotic fluid level via aggressive hydration], especially once they saw that I did have some fluids left. I often wonder, if they had waited, if he would have still had breathing problems.
It's almost a year later, and I can't believe how fast the time flew by. The recovery from the cesarean was very painful. But would I do it all over again? Definitely! Next pregnancy, whenever that may be, I am going to do my best to eat right and keep active and try and have a VBAC. I want to experience the feeling of holding your baby afterwards and bonding with it.
BonaDea's Story (BP issues, induction, c/s)
Kmom's Notes: Whether this induction was "necessary" because of her BP issues is debatable. BP issues are a significant concern, especially with protein in the urine, but the rest of her lab work came back fine, so many providers would have been comfortable just watching her carefully, not inducing right away. Many midwives feel that careful attention to nutrition, extra protein, and salt to taste will help resolve many of these borderline cases that occur near term. However, her doctor wanted to err on the side of caution so he induced.
Breaking the waters so early in an induction, especially when the baby's head is up so high, is very questionable. The baby's umbilical cord can prolapse (come down ahead of the body) or get compressed against the mom's pelvis, causing fetal distress or even worse. This sounds like it might have happened here, given the baby's fetal heart rate problems after the water was broken. So the mom ended up with a cesarean---but was it really necessary? The cesarean became necessary at that point, but it's possible it might have been avoided had things been managed differently. However, hindsight is always 20/20 and no one can ever know for sure.
She also had trouble getting an epidural placed. It is harder to do an epidural on a person of size because there is more fat on the back, making the bony landmarks harder to find and the epidural harder to place properly. However, obviously there was an issue here simply beyond her size, because after 18 difficult tries with the first anesthetist, a second anesthetist was called and he got the epidural in on the second try. A different angle due to the second guy's height may have been the key, or simply a difference in skill level and experience with larger people.
But the moral of the story is, if a procedure is not working repeatedly with one medical staff member, don't keep suffering! Request that another medical staff member be brought in to try. Oftentimes a change in personnel results in a faster and less painful placement. There is no need to suffer through repeated tries; simply request that someone else try instead. Don't be shy about requesting this because of your size; requesting a different staff member is the rule of thumb for people of average size too, whenever there is a difficult placement issue. It's not always the fault of the first person or the fault of the patient; sometimes it just helps to have another person's vision, skills, and input. But don't keep suffering through repeated failed attempts; if something doesn't work more than a few times, ask for someone new.
Birth Story:
During the pregnancy, I made due to exercise, eat small frequent meals and
drink at least 64 oz almost every day to avoid most common overweight pregnancy issues. I had lost
weight until about 29 weeks and then put on what I lost bringing me back to where I started.
I didn't get gestational diabetes, urine always came up clear of sugar and protein, no Group B.
It was only after we had a super busy and stressful 3 weeks that my blood
pressure started to go up a little, just out of normal range. I was able to level it out, but then after some
more stress it went back up.
They did blood work and a 24 pee culture test for pre-eclampsia. The blood work came back fine, but the urine culture showed some protein this time, so they decided to induce me after the weekend.
We went into the hospital Monday morning, they got me hooked up and started
on the pitocin. A couple minutes later the doctor came in to check me and break my water. I
was still the same 1-2 centimeters I had been with no effacement and her head was still up.
As soon as he left the room the contractions got real bad and close together, so I requested some pain meds after using the bathroom. While I
was in the bathroom, the baby's heart rate went a little funky.
They were debating weather to call a c-section at this point, but everything leveled out and I was already 4 centimeters in very little time. He had
them shut off the pitocin and called in the epidural guy. From what I've heard and seen on many episodes of baby story, the epidural
was more scary than painful, so I wasn't hesitant at all. He was a taller guy and needed the bed way up high to do his
thing. I could tell I wasn't getting the right angle for him, not being able to
hunch over correctly.
At some point I had asked him if there was anything I could do to make things go better. He said he "didn't want to say," which translates to,
"You're too fat." He stuck me around 15-18 times along with 1-3 shots of [lidocaine]
every time. Not to scare anyone, but it hurt just as bad as the contractions which I was
not expecting at all.
[He made about 18 horrific tries.] Finally he called in a second anesthetist who was a shorter man. He lowered
the bed and we tried again. I could feel the difference in my angle right away. He got it on the second try.
Over a week later, my back is still in a lot of pain, not to mention black and
blue. If I had it to do over, I would have let him know I wasn't able to get the
right position. I would have also requested someone else after 3 tries. Didn't know that was an option.
As painful as it was/is though, I don't regret getting it. Would have had
to get it anyway. I had severe shaking with every contractions from there, but no pain and I
was able to rest a little. About noon, the nurse went to catheterize me and the baby's heart rate went
down again while I was on my back, so back on my side until the doctor gets there.
I'm at 8 centimeters already, but her head is still up high so they called for a c-section.
After what seemed like forever on that operating table, we heard our daughter's first cry. It was more beautiful then I ever
imagined. The rest of her was delivered at 2:42 pm. Brown/blonde hair; 6lbs 10oz 19
1/2in and perfect. We got home on Thursday and everything has been wonderful.
From a plus sized point of view: It was never an issue with my doctor's office.
My unexplained infertility was blamed on my weight (from another doctor's office and myself). Everything else had checked out perfect. We did
finally conceive naturally, but while taking an oil supplement ( I tend to run a little dry down there).
When it came to any procedure that couldn't be done easily, it was blamed on my size over any other reason. Such as with a certain ultrasound
measurement (something in the heart). Everyone was really nice not to say anything, but the report stated it was due to my "excessive maternal
habitus." I know plenty of thin women from my web group that also couldn't
get that same measurement either.
Same with the epidural. With the first guy I believe the problem was our height difference. He had the bed all the way up. But when I asked what I
could do differently, he as politely as possible said he didn't want to say what the problem was. The second guy came in, put my bed down. I was able
to hunch over correctly and he got it on the second try. A week later and I'm still all black and blue and in
a lot of pain from that incidence.
MichelleATX's Story (BP issues?, induction, c/s)
Kmom's Notes: A good example of the importance of using the correct-sized BP cuff!! And of hiring a non-interventive provider, one who is watchful for problems but does not expect them automatically or over-react to them.
Birth Story
I prepared for pregnancy by doing hypnobirth tapes, psyching myself up for a vaginal birth without drugs. That's not anywhere near what I ended up with.
At my second OB appointment, I was told my blood pressure was high. I felt fine and didn't pay too much attention. At my third appointment, I was again told my blood pressure was high and put on a low dose of a HBP [High Blood Pressure] medication. The medication gave me an annoying cough. At subsequent visits, my BP was all over the place--usually normal, as when it was taken by the OB's head nurse, sometimes high, usually when taken by the other nurses. Or what I thought were nurses. Late in the pregnancy, I found out the two "nurses" who repeatedly got high readings of my BP were not nurses at all, but nursing students. I also learned that they weren't always using the right, extra-large blood pressure cuff because sometimes, they just couldn't find it. Late in my pregnancy I was sent up to L&D twice for monitoring because of a HBP reading in the OB's office. Both times, L&D was unable to find anything wrong with my BP and I was sent home. I was put on bedrest the last month, with a home monitor and though I ignored the bedrest and continued my activities, I never once had a HBP reading. It didn't matter that my readings were so inconsistent--I was labeled high risk and GH [Gestational Hypertension] and that was it.
When I had my first glucose test, I failed it by 4 points, after having had a large breakfast at McDonald's. No one told me to fast! When I took my 3-hr test, I passed with flying colors. Doctor advised me to follow a diabetic diet anyway because she wasn't convinced the test was right. Diabetes does run in my family but it is typically late onset. OB suggested that we repeat the GTT later in the pregnancy but she didn't bring it up again and I didn't remind her. Blood work that day did find that I was anemic, but I conveniently forgot to take my iron supplements--they made me too sick.
Throughout my pregnancy, I was told that I was measuring very big. I was given numerous ultrasounds and each time, the tech told us that the baby was right on target, though on the smaller side of normal for development. OB continued to tell me I was big. Each u/s with the tech, we were told baby was normal, placenta looked great and that I had plenty of amniotic fluid. The last couple of weeks, the OB told my husband and I that the baby was measuring very small and that it was possible my placenta wasn't nourishing him sufficiently. She said, "We may find that it is better for him outside of the womb than inside if your body isn't taking care of him, in which case we'll try inducing but your cervix isn't ripe and you may need a c/s. We don't like performing c/s on women of your size because the risk of complication is higher and there can be problems healing."
I went in for an OB appointment on Monday, March 28, for a NST. Baby continually wiggled away and their machine wasn't picking up his heart rate or the contractions I was having every 5-7 minutes (and had been having for a week). I was sent up to L&D where I was reluctantly put in their triage room. The nurses were terribly rude and disappeared for long periods of time. I'd been there nearly an hour before I was hooked up to any machines. Their machines did confirm that I was having regular, though pain-free, contractions and baby's heart rate was okay. OB decided to have me admitted so that I could be induced the next morning. At that time, I was fingertip dilated and told my cervix was not very ripe. I was at 38 weeks.
That night, I was told I couldn't eat anything after 6PM. Between 8 and 9PM, I was told that baby was having "decelerations," his heart rate would drop for anywhere from 5 seconds to a minute, then come back strong. One of the nurses came in to fiddle with the fetal monitors and said baby was probably moving away from monitor and it wasn't picking him up. I was told that they would be giving me pitocin in the morning, but not Cytotec, the cervical ripener, because of the decelerations. I was told I had till 10PM to eat anything if I was going to eat. I had my husband raid their kitchen for whatever was available--a turkey sandwich and crackers with peanut butter. I was still starving, but the only thing left in the fridge was a ham sandwich and I keep kosher so that was out.
In the morning, they started me on a high dose of pitocin at 7:35AM. I was still having regular contractions, but no pain. I was now measuring at 1cm. Because of my GH, I was told not to get out of bed except to go the restroom. I was to stay in bed, on my left side. I was miserably uncomfortable and my hip began to hurt terribly. At 12:15PM, I felt a twinge of pain and suddenly felt as if I'd wet myself--my water broke. A sickly sweet smell filled the room and the OB told me the clock was ticking. The monitors were having a hard time picking the baby up so they opted for putting me on a catheter and putting the baby on internal monitors, which was terribly painful--I was only dilated to 2 cm. I began having contractions every 2 minutes, most of them off the charts, but was doing very well with labor. No screaming, no gnashing of teeth. I thought, "I can do this!"
The OB came in several times that afternoon and told me I wasn't progressing and that a c/s may be necessary. After 5 hours of labor, I told my husband that if they were going to do a c/s anyway, I may as well get an epidural and be ready for the surgery. I continued to hope that I would progress and be able to have the baby naturally, though. Having been repeatedly told they didn't like doing c/s on large women, I commented to my husband, "That sure seems to be all they talk about." At midnight, I measured at 4 cm. I was told that if I didn't open another cm in the next hour, we'd be doing a c/s. At 1AM, I was a 4.5 cm, 5 if they painfully stretched me.
The OB on duty said she was pretty sure that the baby had lodged his head in the birth canal incorrectly. I asked if I could change positions or, better still, get up and walk around. They refused because of my HBP, even though I hadn't had a HBP through 5 hours of unmedicated labor. They started prepping me for surgery. I cried to my husband because I was terrified of being cut open. I was terrified of the risks because of my size, I was terrified for my baby who was too large, then too small.
What I was most unprepared for with the c/s was that my body would shake from the anesthetic and that I would be freezing, even with warm blankets piled around my head and shoulders. When the baby was being taken out, I remember this dull pulling sensation from deep inside me that made me grunt with each pull. It reminded me of the disemboweling scene at the end of Braveheart. I heard our son cry. It was 2:53AM and his grandmother's birthday. I heard my husband laugh as our son promptly peed on a nurse and then got to see our baby for the first time. He was whisked off pretty quickly so that they could begin to sew me up.
That's when more surprises were in store. I was unprepared for the dull ache as they OB put everything BACK, shoving my innards into their rightful place. The anesthesiologist turned up my meds but the pain had me grunting and I threw up. It seemed to take so much longer getting everything in than it had to take everything out. Our too-large-then-too small-baby who supposedly wasn't being fed by my placenta was fine. He weighed 5 lbs 6.8 oz, 18 inches long and didn't have a thing wrong with him. He wasn't too big--so much for GD--and he wasn't too small or unhealthy--so much for a failing placenta.
I was soon in recovery and trying to breastfeed our baby. I was able to sit up immediately and wasn't in too much pain, but was still freezing. I held the baby against my chest and he pushed himself up on his arms, lifting his little head to look around. He was so strong! I began to feel very weak because I hadn't eaten since Monday night and it was now Wednesday. I hadn't even been allowed water and had been limited in my ice chips. Baby's blood sugar was low and they kept coming in to prick his poor feet. They insisted on giving him formula, but he wouldn't eat. I told him that if they'd let him sleep, he'd eat when he was ready. My colostrum quickly came in and after that, I refused to let him have anything but the breast, which angered a nurse or two. His sugars improved and he was fine.
We were released a day early. He had a touch of jaundice but it was clearing up on its own with breastfeeding. I was okay the first few days, but on the 8th day, the day of his bris, the incision nearly killed me. I underestimated what a toll the surgery had taken on my body and by the end of the day, I was sore and tired. I returned to bed. I continued to heal pretty well, but my incision looked lumpy, almost as if I lump of fat had been left poking out among the regular skin. And when I would go to the bathroom for a bowel movement, the first elimination sent a stabbing pain through me, deep inside between my rectum and my vagina. It felt like a knife was being plunged into me. That continued for 3 weeks, then cleared up on its own.
It's 7 months later now and I'm pregnant again. I really want to have a vaginal birth this time. I'm not the scared new mom I was. I'm not afraid to challenge now or ask questions. And I'm actively looking for a health care provider who is more interested in treating me as a patient and a woman and not just as a number on the scale. I know my body can do it. I know my baby can do it.
Devaskyla's Story (SROM, induction, c/s with high transverse incision, seroma)
Kmom's Notes: This doctor used a high transverse incision in this cesarean. Some doctors believe that a low transverse ("bikini" or side-to-side incision just above the pubic hair) is not a good incision for women of size because of the perceived risk of infection under the belly fold. Instead, some doctors use a classical incision (an "up-down" incision from stem to stern, see stories above), some use a low vertical incision (an "up-down" incision but only in the lower part of the uterine segment), while others will use a transverse or "side-to-side" incision but up higher, midway to the belly button.
However, as this mom found, this "high transverse" incision is often a more difficult incision to recover from. It puts the incision in the biggest part of a woman's belly, the area where there is the most fat. This makes surgery harder and means there is more "dead" space for fluid to collect in, as well as more mechanical pressure on the wound to separate.
Although research on the various types of incisions is somewhat sparse, what research there is suggests that a low transverse ("bikini") incision is better in women of size, and results in lower blood loss and less wound complications. Anecdotal evidence from women of size suggests that classical, low vertical, and high transverse incisions are harder to recover from, and many women report difficulties with prolonged pain, seromas (pockets of fluid and/or infection under the incision), wound separations, and other complications. In addition, these other scars are far more disfiguring than a low transverse scar, which is hidden under the belly fold and not easily seen by the woman or her partner.
Which incision to choose is not usually based on hard evidence or what works best for fat patients but rather on what a doctor was taught to do with fat patients. Obviously, this needs to change. Generally speaking, unless there are exceptional medical circumstances, a low transverse or "bikini" incision is the incision of choice in women of size.
Birth Story
Very soon after I got pregnant, I started doing research and reading about pregnancy and birth. Very early on in my reading, I learned about doulas. I thought that this was a wonderful idea and decided that I was going to become one. I looked at DONA's website [Kmom note: Doulas of North America, www.dona.com ] and got their reading list. I decided to try to read as many of the books as possible....
I was determined to have a natural childbirth and even considered a home birth. My husband was not too impressed with the idea, and with the combination of this being my first baby, being an hour and a half from the nearest hospital, extremely limited finances and being 5 hours from the nearest midwife, I gave up on the idea. I planned for a natural birth in the hospital, with a detailed birth plan which specifically requested limited interventions for me and no eye goop, shots, formula, or circumcision for my baby.
I saw a GP (a.k.a. Family Physician) for the first 8 months of my pregnancy. He was pretty good. A bit hard to talk to, but very low intervention and willing to answer the few questions I had. I also took a childbirth class given locally by a health nurse. It was a class I didn't really need to take, since I knew as much or more than she did by this point (except for actually having gone through it, of course) and I mentioned things she was unaware of or brought in extra information to classes.
I was due on the 15th of August and around the first I had my first appointment with the doctor who would be delivering my baby. We had to drive an hour and a half or so to get to the appointment. There was a lot of testing done (weighing, measuring, urine testing) and a lot of waiting. The city only seemed to have 2 doctors who did deliveries, one was an actual OB who dealt with high risk women, and the other doctor (who I was seeing), who was trained as an OB overseas but didn't quite qualify here, though he was still allowed to operate.
The very first thing this man said to me when he saw me was, "You're probably going to have to have a c-section. Most women under 5'2 do." Well, I knew this was complete b.s., but it's still a traumatic thing to hear, especially as the very first words out of someone's mouth. I should have run right then. I could have switched to a doctor in another town nearby--I didn't, though. The appointment didn't improve much after that, with the doctor insisting I was due earlier than I knew I was (all he did was put the wheel thing somewhere in the vicinity of when I said my LMP was, not exactly on the date; I've found he does this quite often). My DH and I left the appointment extremely upset. I was in tears, actually.
My one huge fear was having to have surgery. In all the reading that I did, I deliberately avoided reading up on it. I barely mentioned it in my birth plan. I just could not face the idea. It was terrifying.
I was supposed to have another appointment with him on the 8th, but cancelled it, and another on my due date. I called him to see if this appointment was really necessary or if I could skip it. I just didn't feel like making that drive if I didn't have to. He informed me that the appointment was actually for an induction because I was "overdue" (only by his lame excuse for calculating!). I told him there was no way I was coming in to get induced. He tried to persuade me for a while but finally realized he wasn't going to get anymore and made me give official verbal notice that he had informed me of the dangers of going over (specifically meconium-related) and basically told me it was my fault if my baby died. Nice.
I told my family what had happened and had both my mother and sister screaming at me that doctors know best and I was endangering my baby, etc. I finally hung up on one of them and my DH answered the next call and effectively told my Mom to bugger off, that I wasn't talking to either of them again until they stopped stressing me out.
On Saturday the 18th of August, I lay down for a nap around 8:30 p.m....Around 9:30 or 10:00 there was a massive clap of thunder. Found out later that the lightning hit somewhere in town, so at most it was 3 miles away. I got up about 12:15 and felt water running down my leg. Since I hadn't had any problem with controlling my bladder during my pregnancy and I was past my due date, I was pretty sure it was my water. I went into the bathroom and found a huge clump of mucus in my underwear. It was definitely my water! Yelled down the stairs to DH and told him that my water had broken and I was going to have a shower.
He started freaking out a bit and asked me if we shouldn't get going to the hospital. I told him I wasn't having any contractions yet and we probably didn't need to go until they started. Got out of the shower, came downstairs, still leaking occasionally. I still hadn't had any contractions, so I told DH to try to get some sleep. He finally did about 2:30 a.m. I went on-line and read messages and posted to my message board that my water had broken. I still wasn't having contractions and I was really upset by how messy my kitchen was, so I was reading messages while I took breaks from cleaning.
About 5:30 a.m. I still hadn't had any contractions but I was beginning to think maybe I should at least call the hospital. I called them and told them I thought my water had broken, should I come in or just go to the city? She said about it having just broken, and I said no, a couple hours ago. She told me to get on the road RIGHT AWAY. So we did. I don't know why I didn't continue with my original plan to stay home. I really wish I had. I think it would have made everything a lot different.
I got to the hospital and up to maternity by about 8 a.m. Got checked, I was at 1 cm. Still no contractions, tiny bit of meconium in the water, which the dr. "reminded" me that he'd warned me about when I chose not to be induced on my due date. My belief now is that the meconium was there because of the thunder. It really was a miniscule amount and the thunder had scared me quite badly, I can only imagine how scared a little baby would have been! It was decided that they'd "let" me go for a few hours and try to get my son to drop and some dilating and contractions to get going.
About 2 p.m. I got checked again, still at 1 cm, still hadn't really had a contraction and my son was still up really high. So, I got put on pitocin and the monitors. My son kept managing to move so they couldn't hear his heartbeat, a technique he'd done regularly during the pregnancy, so a couple hours later (I have no idea what time it was, really) the doctor checked me again and put an internal monitor on. Since I was still only 1 cm and he could only just touch my son's head, this procedure was really not fun. In fact, it was agony. Something else I wish I'd never consented to. (Not that I was given any chance to refuse.)
I was on the pitocin until about 7 p.m. or so, they upped it to the max by about 6. Dr. checked me again and I was still only at 1. I'd had a few contractions, but not very many. My back had been hurting quite a bit, but I hadn't really been feeling any contractions. I don't think my son was malpositioned, but I suppose he could have been. I still haven't seen his medical records, there may be some information about position in there.
The doctor had to go do another c/s, so they were going to leave me on the pitocin until after he was done. I asked if there was really any chance that another hour or so was going to make a difference and was told no, so I said to just take me off the drugs, which they did. I knew there was no way that I was going to be allowed to continue trying after 24 hours was up. If I'd stayed home until I was contracting and lied about how long I'd been leaking for, maybe we would have had a chance to have a natural birth. At the time, I didn't know about the low risk of infection without vaginal exams or that I could just refuse them.
I cried a lot about having to wind up with a c/s. Then the nurse came in and put a catheter in, which was also quite painful, though nowhere near as bad as the internal monitor. The dr. came back and they unhooked me from the machines so they could wheel me into the O.R. One nurse told me I had to give up my glasses, even though my birth plan said I wanted to wear them whenever I was conscious. By this point I was so exhausted and upset, I just gave them to DH. Got to the O.R. and everyone was doing whatever it is they do. I was talking to the nurse near my feet, who was there to help me bend over so they could get the spinal in, and I said that I was kind of upset I wasn't going to be able to see anything because I didn't have my glasses. She was really nice and actually sent another nurse to go get them from DH. Yay!!
My DH decided not to come in with me. He felt that he couldn't deal with it. Lucky him, not to have to deal with me being cut open! I was so upset about the section that I didn't really care at that point. I was still being my usual empathetic self. My DH feels bad now that he didn't come in with me, and has almost since the next day, but that doesn't change that I was alone, that I have no pictures of my son just after he entered the world and that because my husband wasn't with me, my baby was whisked off before I'd barely seen him and I didn't see him again for a couple of hours.
The anesthesiologist was really nice, too, but didn't believe me about my extreme reaction to morphine; he decided it was just a normal reaction and put it in my IV anyway. When he thought everything had taken effect (there were apparently shots of something put in my legs too), he told me that when they almost had the baby out I'd feel some pushing up high. Not long after, I felt the pushing, but I was thinking that it couldn't possibly be them getting the baby yet, I didn't think they'd started cutting. Next thing I knew, I heard them say that the head was out, then that it was a boy!! Guess they had started after all.
He was born at 8:49 p.m. on Sunday, August 19 and weighed 8 lbs. even and was 20.5 inches long. His head was 37.5 cm. They took him over to a bed that was all the way across the room from me. Even with my glasses, all I could really tell is that there was a baby over there and that they were rubbing him off. Eventually, they bundled him up and brought him over to me. I couldn't move my arms, don't know if they were strapped down but I had a monitor on one arm and the IV stuff on the other, so all I could do was look at him and give him a kiss. Then they took him off to meet his daddy and then to be suctioned, warmed, bathed, warmed some more, bundled up and stuck in a little plastic box in the room I'd be going to after the numbness wore off. I do have pictures of all that, at least.
I was lying there for quite a while and kept feeling nauseous, so the anesthesiologist kept putting stuff in my IV to keep me from getting sick. I knew then that he hadn't listened about the morphine. Anyway, I heard them say something, I don't remember what, and I asked him if something was wrong. I got told that because of being on the pit so long, my uterus wasn't contracting at all, so the dr. was massaging it to try to get the bleeding to stop. I guess it eventually did, because they finally started wheeling me to recovery.
And without the anti-nausea drugs, I got sick. A few times and a recurring pattern for the next 12 hours, until they finally gave me a prescription anti-nausea drug in my IV. The nurses kept trying to tell me that there must be something horribly wrong with me to be throwing up water and I kept telling them it was just the bloody morphine. Good thing I'd had it once before or I might have been getting worried.
Finally got to my room at about 10:30. DH was there holding the baby. The nurses hadn't told him how to hold the baby and he didn't have any experience with babies, so they looked kind of awkward, but even drugged out of my mind, I thought it was really sweet that he'd held our son the whole time they were waiting for me, rather than abandoning our new baby to be by himself. DH stayed for a little bit to see how I was doing, then brought my son to me and went to make phone calls while I finally got to hold my baby. And, from looking at the pictures, didn't do a very good job! He seems to have fallen in one, though I think maybe I had been trying to get a look at him without all the bundling.
Nursing was very difficult. I have inverted nipples and between that, all the excess fluid in my system and all the drugs making my son sleepy, things didn't seem as though they were going to work. The nurses were very encouraging and brought me a nipple shield, which made nursing possible. Unfortunately, I didn't know about the problems they can cause with supply, or the difficulties with getting rid of them. My milk didn't come in for 5 days so I supplemented a couple of times. Around 2 months postpartum, I had to take Blessed Thistle to up my supply. We never did manage to get rid of the shield and are still using one. I eventually discovered that, in order to make up for baby not "milking" the areola, I needed to massage my breasts and the area covered by the shield while he was nursing. It helped quite a bit with supply. I only wish I'd discovered it early on.
I stayed in that hospital until Tuesday, when I got myself released to come to my local hospital. The car ride home wasn't too bad, except when we hit a bump. I really didn't like being in the local hospital. DH wasn't with me and I had a hard time doing much without help. It's a really small hospital and I was always worried about my son disturbing everyone when he cried, one of the reasons I supplemented a couple of times. I was finally allowed to go home on Thursday, though the doctor would have preferred I stay until Friday. On the Monday (8 days postpartum), I had my staples removed. Some of them stuck a bit but it wasn't too bad. It took me weeks to stop being terrified I was going to burst open, though.
At my 6 week check-up, the doctor discovered a hard lump under my incision. She made a small slice in my skin incision and a bunch of fluid came out. She took some for testing, then stuck a "wick" in the hole, covered it with gauze and tape, and told me to go to the hospital when I needed it changed. It took several days but eventually the liquid all came out and the little slice healed. The fluid wasn't infected, thankfully. [Kmom note: This was probably a seroma.]
It's been almost 2 years now. I was in agony for the first 6 months after I stopped taking pain killers all the time. I was frequently in pain for the second 6 months. And I still regularly have twinges of pain. Usually not long or extreme, but enough to remind me constantly of the unnecessary c-section I had.
The main reason for the extended recovery time and large amount of pain is that, rather than a low transverse incision, I had a high transverse incision on everything but my uterus. The incision was about halfway between my bikini line and my belly button.
I'm not pregnant again, though I hope to be soon. And I will not be going to the hospital at all, unless there's a definite emergency. I hope to have a home waterbirth.
[Update: Devaskyla went on to have an unassisted home birth. Her story can be found in the BBW VBAC Stories section.]
Amy Moiles' C/S Story (malposition, c/s, anesthesia problems; has other birth stories too)
Kmom's Notes: This was Amy's 6th baby. Her first baby was born vaginally but was stillborn. Her next 3 babies were born by cesarean. Her next baby was born vaginally, a homebirth VBA3C (this birth story can be found in the BBW VBAC Stories and the VBA2+C Stories FAQs). With the next pregnancy, however, the baby was malpositioned---probably oblique or transverse, with the baby's arm presenting first. Although Amy planned an unattended childbirth, she ended up in the hospital with a cesarean due to the baby's position.
Unfortunately, the cesarean did not go well. They used a general, and the level of anesthesia was not sufficient during the surgery. When a general is used for cesareans, the drugs used can severely depress a baby's respiratory system, so the doctors have to walk a fine line between light enough anesthesia to avoid affecting baby too strongly, and a strong enough anesthesia to keep the mother from feeling the surgery. Most of the time they find the right combo, but in this case, the mother was fully conscious of the pain, but was paralyzed from other drugs and so was not able to communicate that she was feeling the surgery.
Birth Story
I had woke up that Thursday morning with some contractions that REALLY caught my attention. I had cried wolf all week, had the usual prodromal stuff daily. I just KNEW this wasn't the fake crap, it was IT but I also somehow knew it wouldn't pick up until evening. I had only one natural labor and I guess I just assumed they would both go the same way. They did in many ways. I had lost my mucus plug several days before and had the prodromal stuff for a good week with both. Hubby and stepdaughter went to work when I assured them I was OK. I don't remember what I did during the day. I know I got my stuff ready, set the birth tub up and putzed around with the kids. At the time I had 3 at home---my then 2 year-old, my 4 year-old, and my 4 year-old granddaughter. My older two were at school. I took a nap but the contractions woke me up so it wasn't a good nap.
Around mid-day I kinda got scared as the contractions picked up and I was alone with the kids. Both my DH and my 21 year old stepdaughter were due home by 5. DH got home early, knowing I needed help. I tried to make dinner but the contractions were no requiring my full attention. They didn't HURT, just made me focus on them. I went to take a shower, hoping that would relax me. I got dressed in my labor nightgown (the one I wore when I labored with Joshua) and was in the bed on a hands and knees position, crying that this was happening too fast for me. I wasn't in PAIN (my back hurt like the dickens but not my belly!) but I wasn't ready---I wanted the house settled and my house was loud and the kids were distracting me. So here I am, butt in the air, crying to DH and I start to leak my water. I thought I peed at first but I realized I had just went potty and it was clear and I couldn't control it. Well, I knew things would get intense. I got a long break from contractions and emailed my online friends to let them know it REALLY was happening. The contractions came back but were spaced apart and VERY do-able after that. I felt better.
How the kids got to bed---I have no clue but they did! I sent DH and stepdaughter to bed---I wanted them fresh when I needed them and I was fine. So I watched TV, chatted online, and just labored alone. I found straddling the toilet backwards helped so much. I put candles in there and pillows on the back of the toilet and would head straight for the bathroom when they came. This was strange to me since the only thing that felt good during Joshua's labor was standing and rocking. I think it was close to 2 a.m. when I woke Rob up. He got the water in the pool and was trying to help me but what worked with Joshua wasn't working; I almost didn't want to be touched, VERY different from my last birth. I was TIRED at this point. I had not been sleeping well all week and it had caught up with me. I tried to lay on the couch and take a snooze before transition hit as it felt like it was VERY close. I did snooze for a few but got up, annoyed, that my contractions just seemed to kinda stay at one point. They never got closer or stronger and then transition symptoms that I didn't even have with Joshua came. I got sick, had the chills, and was hot at the same time. I got excited things were happening. To be honest I was scared of the pain at this point. I also was STILL so very tired!
Around 5 a.m. I started thinking something was wrong. I had this band of pain in the front of my belly---not where my section scars were. It was strange. I had it a few times during the pregnancy but never knew what it was. Well, it scared me. I wasn't thinking rupture--I didn't know WHAT it was. I tried walking around and squatting and hands and knees to get things going again----the contractions had not changed since about 2 a.m. no bloody show, no triple peak contractions, no thinking I can't do this---all the sings I KNEW as transition from Joshua. Just contractions that didn't change and even kinda slowed down at this point. I called my old MW from when I had Joshua and she gave me suggestions, even gave me a clue on what that band of pain might be (I can't remember what that was now though!). We continued and I called a friend from my childbirth list. Everyone said I was doing good but I just KNEW something wasn't right. I was in the tub when I decided I needed to transport. I was thinking I had stalled at 5 or 6 cm despite the fact that I could barely feel any of my cervix. My oldest woke up and got off to school knowing I was headed to the hospital.
I left for the hospital around 8:30 a.m. and knew what I was in for. When I got there they hooked me on the monitor and checked me----I was 8-9 cm!! At this point the doctor started being VERY rude to me and Rob. She talked about breaking my water as she also called the OR that I was coming in for surgery since I had 3 sections before. I thought about pain relief---funny since I think I had one contraction the whole time I was there. Again, the doctor came back---Rob and I had asked for some time alone. I told Rob maybe I should just get the section and he said nothing, just gave me a look. I knew he thought I could still do this so we left Against Medical Advice (AMA). This made them mad to say the least. They told me my baby could die (despite the fact that the monitor showed she was FINE!).
We got home and I called another friend from my list. She talked to me and I cried but I had a new strength to keep going---I was almost there after all! 8-9 cm without transition! I tried a bath, tried different positions--you name it. Nothing was changing. I was so tired I was getting weak. I tried to eat and was drinking but I was just SO TIRED. The kids were in the bedroom, keeping busy. It must have been 2 p.m. when I gave up. I was having a hard time walking, I was so weak. NOTHING had changed---no bloody show, nothing. I did get transition type contractions but they spaced out so much at this point. I called the hospital to see if the yucky doctor was still there and she was gone. The nurse begged me to come in --she remembered me and sounded so concerned but not in a mean way. I was crying but yet I was okay with leaving.
We got there and the nurse checks me and says 8-9 cm still. My bad of water was still intact and HUGE. Doctor came in, same thing, and he left to get ready for surgery. When he left the nurse came over to me and told me my baby was SO LOW and if my water broke, baby would just fly out before they cut me. She told me to pretend it broke on its own as she broke my water. After she did this she checked me again and said, "Get the doctor, this is no head, it's an ARM." He comes in and confirms my daughter's hand in there. He tries to move it, although I am not sure why since they were planning to cut me. No luck---her arm would not move. I have never cried so hard. I begged the nurses to keep my baby safe. I was so heartbroken that I had done EVERYTHING right, did it all the way I should and it failed me.
They decided to use a general and I am not sure why. I was so tired and after my last epidural (8 tries with horrible pain) and most of my labor was in my back----I was okay with this. As I laid on that cold, sterile table---so far from how I planned to greet my baby---I prayed not to wake up (as happened during a general several years ago during my ear surgery), to not feel it and for my husband to get my daughter so she could know someone loved her. I did not fear for her, never did---somehow I knew she was OK but I also somehow knew I had some problems coming.
They put the mask on me and I hear, "She's out" and they start to cut me. I AM AWAKE!!! I feel like I cannot breathe, I can hear them talking and can feel everything. I have never felt such pain in my life. I prayed not to die from the pain. I felt like I was doubling over from pain but I knew I wasn't moving. When they stopped cutting I was so glad it was over. I felt like I sighed but I don't know if I did. It was over but I didn't hear my duaghter or them talking about her. This is when I felt the pain again. Oh my God---they are cutting me AGAIN!! I try to scream, I try to kick, I try to blink my eyes hoping SOMEONE will help me.
Then I hear my daughter's cry! I was so happy to hear her cry. Then I was asleep finally. I woke up in the recovery room asking where my daughter was. She was with my husband. That made me feel better but I wanted to see her. A few minutes later I see my husband and my daughter. She was so beautiful! She was asleep. I cry that I missed it and my husband tries to comfort me and tells me how he handled her in the nursery. He told her about our family and how many brothers she had. She was awake for him. I was never so jealous in my life. I was glad she had him to comfort her but I wanted to be the one holding her!
The next few months of healing (physical and emotional) were rough, to say the least. I ended up breaking my tailbone from her bad position and that took months to heal. The doctor also told me I had SEVERE adhesions and that took longer to "clean up" than the section itself. Turns out that was that band of pain I was feeling in later pregnancy and labor. He told me I was headed toward a bowel obstruction if he hadn't fixed it. Funny how that was my 4th section and I never heard that before.
I have since viewed my records and it does seem she was VERY malpositioned. It is unclear but it reads to me like she may have been oblique or even transverse. Her arm was what was coming first---no head at all.
Jenn Lynch's Story (PIH, possible GD, failed induction, c/s)
Kmom's Notes:
Birth Story
I was put on disability at 5 months for PIH. Every time I went to the doctor something else was found. I had high BP, borderline diabetes, polyhydramnios, and protein in my urine. At 38 weeks they decided to induce me.
I went in to Kaiser at 8 p.m. on Sunday. They decided to start with pitocin because I had not had any contractions so they were not sure if the baby could tolerate labor. If she had problems they could turn the pit off easily. I was on pit through the night and I would get contractions and then they would peter out. They would turn it up and the same would happen.
About 3 p.m. Monday they turned it off and let me shower and eat, then at about 10 p.m. they put Cervidil on my cervix. They did this every 4 hours until morning. I was dilated to 2 cm. At about 4 a.m. Tuesday, they started the Pit again. I was having contractions and they were petering out again. They were about to send me home at noon on Tuesday when my darling daughter broke my water. We heard it on the monitor. It was weird. It was a thump and then a pop and then whoosh I was all wet. There was no turning back now.
I settled into a good contraction pattern but they were not strong enough so they kept upping the Pit. I could not eat. Because of my BP I could not have the broth they provided because it was too salty and they were worried about my blood sugar so the jello was out too. I was confined to tea and ice chips.
At about midnight on Tuesday I had enough. I did not intend to get any pain meds but I had not intended on being induced and in labor for this long so I asked for an epidural. It did not work. It numbed everything but my tummy. They tried again and it still did not work. I started to vomit but I was just bringing up bile and eventually dry heaves as I had had nothing to eat. By this point I couldn't even have ice or tea because I was vomiting. I was developing a fever. My water had been broken for a while. I still had not dilated past 2 cm.
They shut everything off, gave me a shot of Demerol, and mercifully let me sleep. At about 7 a.m. the anesthesiologist came to say goodbye as it was shift change and he introduced me to the replacement. He said he will help you get through the surgery. It took me about 5 minutes before I really got what he said. After all that I was just a little bit out of it. So when my night nurse came in (she was an angel), I asked her about it. I don't think she was supposed to tell me, but she did anyway. I was so tired and exhausted at this point I just wanted it over with, so I agreed to the c/s.
They gave me a spinal and it worked beautifully. I managed to stay awake for her birth. I asked if she had hair and then passed out on the table. My husband said I was snoring. [Kmom note: They often give the mother a dose of drugs to 'relax' her after the baby is born, but it often is so strong that it knocks women out for some time or makes the immediate postpartum time fuzzy.]
My daughter was born at 10:55 a.m. Wednesday. She was taken to the nursery in the company of my mother-in-law. Her blood sugar was low and my mother-in-law had to choose a bottle or an IV. She chose a bottle. By the time I saw her and was transferred to my room the baby was sleeping and not interested in nursing. When I did try she would either go to sleep or pull her head away from me and scream.
I never did manage to get her to feed properly. She became jaundiced and we had to put her under [bili]lights. If it hadn't been for the fact that her pediatrician was my husband's old pediatrician, we would not have been able to bring her home. But he arranged for a home delivered light. We breast and bottle fed for 6 weeks but my milk never came in. I would pump and pump (rented a hospital grade machine) and got nothing. That was more of a disappointment than the birth itself. The lactation consultant was no help as my daughter would nurse fine in her office.
Tracywag's Story (posterior baby, induced vaginal birth; induction, cord prolapse, c/s)
Kmom's Notes: This mom had 2 rough labors. Not surprisingly, both were induced, which makes for harder labors. Although it is difficult to prove, many homebirth midwives feel that inducing before the baby is ready to be born increases the chances of the baby being in a poor position for birth, and thus having a rough time.
This mom's first baby was malpositioned for sure, born face-up. It is difficult to know from the story whether the second baby was malpositioned, although it seems likely. Another malpositioned baby could explain why the mother was "late" with her second pregnancy, "needed induction" and why the head had not engaged before labor. However, the baby also had knots in her umbilical cord and the cord around her neck, which might also have been an issue.
Ironically, the CNM in this case decided that labor should be induced in this mother because the baby hadn't engaged yet and the midwife was worried about the chance of cord prolapse. During the course of the induced labor, the water did break and the cord did prolapse, and a cesarean became truly necessary. The question is whether this would have been a problem if the midwife had not forced the issue by inducing labor, particularly with a baby that was probably malpositioned. Perhaps with more time, the baby's position would have resolved and cord prolapse would have been less likely. On the other hand, the knotted cord etc. might have caused a cesarean no matter what.
The mother notes that she had quite a bit of joint pain, sciatica, and round ligament pain. This suggests that she had Symphysis Pubis Dystocia (SPD), a misalignment of the pelvis that often seems to predispose women to malpositioned babies. It's unfortunate that no one suggested chiropractic care for her joint pain and SPD symptoms, as this might have made her more comfortable and might have prevented the malpositions. See the FAQ on SPD on this website for more information.
Birth Story
Baby #1: Induced Vaginal, Posterior Baby - This birth story can be found under BBW: Vaginal Births, or BBW: Malpositions.
Baby #2: Induced, malpositioned, emergency cesarean
During the last month of pregnancy, napping and bathing were my only forms of relief from the rash on my body, and this was how I was forced to spend my days. My CNM and my dermatologist could not agree on a medication that was acceptable to both of them.
Joint pain, sciatic pain, and round ligament pain helped complete my discomfort. When I was a week past due, my midwife suggested inducing labor. She noted increasing fluid retention, coupled with the fact that the baby hadn't engaged yet, as troubling at that late date and felt that inducing would give me the best chance against cord prolapse. (!)
I checked into the hospital on Monday evening. As with my first child, the process began with Cervidil insertion. I was set up for a period of external fetal monitoring, and my request for rest, food, and liquids was agreed to. Unfortunately, my heart rate and the baby's were a little too fast for the nurses' comfort. Instead of allowing me to sleep, I was kept on the monitors in an uncomfortable position on my back through the night. They came in once or twice an hour to look at the monitor and take blood pressure and temperature readings. Around 3 a.m. I was given IV antibiotics and a GBS test was done. The nurses on duty were convinced I would end up with a surgical birth and denied requests for food and water. When morning finally came, my midwife came to check me. I had not progressed at all, and she was reluctant to break my bags of water because the baby was still too high. I agreed to Pitocin, and requested an epidural be placed when the contractions became stronger.
I never really felt labor. When I started feeling discomfort, it was more from being strapped in one place. I rolled slightly to my side and the nurse rushed in and admonished me. I explained why I moved and she said the pain was an indication that the medication was working. When I refuted that, she became upset with me. She suggested I get the epidural right then, as the anesthesiologist may not be available later. I knew that was untrue but I gave in anyway. I gave up at that point; I didn't have the strength to fight anymore. I was tied to a bed with tubes, monitors and wires in every part of my body. I sobbed uncontrollably when they placed the epidural; the poor anesthesiologist thought she had injured me. I was just giving up any hope of a normal birth.
As the day progressed, people wandered in and out, and I knew labor was going nowhere. I threatened to rip off the damned BP cuff that inflated and HURT every two minutes (I was told it didn't really hurt). Mid-afternoon my midwife checked me again, there was no progression and couldn't find the head. Since my daughter had been breech until very late, she ordered an ultrasound to see if her head was still down. It was down, it just wasn't where it should be. She had me labor in a belly binder for a while, but I was still strapped in bed so it didn't do much. At nearly 5:30 p.m. my midwife came in to check me again. She couldn't feel the head in the pelvis and was concerned about the lack of progression. Within minutes I felt my water break. The midwife said very calmly, "I've got a cord," as one nurse said, "We've got green" and the other indicated they lost the heartbeat. "Somebody call Tony, stat."
The cord had prolapsed, cutting off all circulation to the baby. The "green" meant that there was meconium staining, an indication of fetal distress. My midwife ordered the surgeon paged and the theater prepared. The midwife calmly explained that she was sorry, but a surgical delivery was the only option right now. The other nurse found the heartbeat and I finally breathed again. At that point I didn't care if they took her out with a fork. My midwife prepped me while the nurse took my husband to dress for surgery.
The surgical theater was buzzing with people and machines. I was strapped onto a board, crucifixion style. I had a very hard time breathing in that position and said so. The new anesthesiologist upped my epidural, and I felt the numbness creep up and up. I no longer could move my arms, then I couldn't feel myself breathe. My midwife unstrapped my right arm and draped it across my face so that I could feel my breath on my hand. The anesthesia crept even higher, I was panicking, and the anesthesiologist told them not to let my husband in. I lost consciousness for a little while, but remember them removing my baby. Her umbilical cord had a true knot in it, and it was wound tightly around her neck. They all commented on how big she was. I listened for what seemed like an eternity. Finally, after the longest minutes of my life, I heard her cry. It was 6 p.m.
They finally let my husband in, and after a few more moments brought the baby over for me to see. I immediately became ill, and they took her away. I was in recovery for several hours, a little room that doubled as a janitor's closet. I kept asking to go to my room, to see my baby. My family had all left. I was told the baby's blood sugars were low, and they had given her a bottle of formula. When I finally got to hold her, it was after ten p.m. She had no interest in nursing, no interest in anything. I felt like I was holding someone else's baby.
I tried to clear away some of the mental fog I was in. I made myself get up, walk, and shower. I wanted my baby with me (I was supposed to be rooming in), and retrieved her from the nurses on more than one occasion. She wasn't eating well, so I requested the lactation consultant. "Breastfeed Only" was all over her charts, as was "rooming in with mom." Despite this, they consistently took her at 11 p.m. to the nursery for ped. checks, and didn't return her. I was told they'd return her when she woke to eat, her chart said she woke and they fed her a bottle. I mentioned this to the lactation consultant; she smiled and said they would never give a breastfed baby a bottle. I handed her photographs.
The hospital provided me with a breast pump, but not a convenient place to plug it in. Meanwhile, I had acquired a roommate---a loud mother of three with lots of local relatives who was happily bottle-feeding her vaginally-born son. There were never less than 5 people in this 8x10 room with two hospital beds and two chairs. I was bleeding from many places simultaneously, trying to maintain some sort of dignity while sorting out my emotions over the birth, all with a perpetual audience and Jerry Springer shouting obscenities in the background. The nurse took the pump away for a lady next door to use and never returned it. I gave up trying to nurse until I got home.
Once we were released things went much more smoothly. I still had the impression that this was someone else's child. Once a day, then twice, she'd manage to nurse. Every two to three hours I pumped. I was moving around fairly well, and even went on a few walks. My toddler seemed to be adjusting okay, and the baby slept like a dream. Eight days after the birth, my incision burst open, dramatically, in public. Since I wasn't feeling ill or running a fever, the midwife said I could wait until morning to come in. They cultured the incision, pried it open and forced some more fluid out. The student nurse was in shock at the amount. The culture tested positive for Strep, e. coli, and another bacteria I had never heard of. They put me on very strong antibiotics (Cipro). Then the real fun began.
The baby started to fuss about nursing, about taking bottles and about taking her pacifier. She also started having very loose, strong-smelling stools. I began a gastrointestinal episode that lasted 11 weeks. I took the baby to the doctor, and expressed concern about her eating. I discovered that no only hadn't she gained any weight, she'd lost it. I was advised to stop all breastmilk. The antibiotic I was taking was causing her problems. I alternated taking her in for weight checks with going in myself for wound irrigation, every day for a month. Every time I went out in public, the fluid would burst again. It didn't take much to convince me to stay home.
After a week on formula, the baby still wasn't gaining. She now had thrush, again from the antibiotics, that caused her mouth to be so painful she stopped eating. The first two rounds of anti-fungal didn't help her, so we went to another, stronger medicine that worked, but gave her diarrhea again. After five weeks, she was finally back at her birth weight. I continued to have weeping from my incision, as it hadn't healed yet, and the midwife ordered me home from work for another 3 weeks. My own gastrointestinal distress progressed to the point of painful bleeding. Vaginal bleeding problems weren't relieved until I was put on hormone therapy 12 weeks after the birth. I would hide in the bathroom and cry as often as I could.
I spoke with the midwife on several occasions about postpartum depression. She gave me the name of some resources, but didn't feel I needed medication at this time. She felt my depression was a normal response to the circumstances.
Franny's Stories (PCOS, induced vaginal birth, posterior, forceps; cesarean for breech baby)
Kmom's Notes: Another case where the baby's position makes the birth difficult until it is fixed. In this mom's first birth, it was probably the combination of the hands-knees maternal position and the doctor using forceps that helped the baby to turn and be born vaginally.
Franny's second baby was breech. This may reflect a tendency among women who have had prior malpositions to have future malpositions as well. This may reflect a pelvic misalignment more than anything else, and it's possible that regular chiropractic care could help prevent position problems in the future in women with a history of position problems.
Birth Story
Baby #1: I gave birth at the hospital where I worked at the time. I am an RN; I was working OB at the time and delivered with my 2 best friends as my nurses.
My B/P was elevated at my 38 week appt. and being the beginning of July and very hot and busy on the hospital floor where I worked, my MD sent me home with bedrest. I was swelling, but not spilling any protein and my labs were ok. I got a Non-Stress Test (NST) and baby looked fine. The next week we scheduled my induction because B/P and swelling continued and my cervix was favorable (ripe).
I entered the hospital at 6 a.m., my IV was inserted and pitocin began. I was having contractions, but they weren't anything. I was 4 cm when I started out. I walked the halls and rocked in the rocking chair. My husband and his parents were there. I worked on OB at the time and a Radiant Warmer Representative was there to in-service the staff on a new Warmer. I stood in the hallway with my IV pump and listened to his in-service at 9 a.m. By 9:30, he was done and I was tired, feeling contractions, but they weren't uncomfortable. I thought, if this is going to last all day I'm going to try to get some rest.
I went back to bed, got hooked back up to the monitor and my contractions were every 2 minutes, palpating moderate, but not uncomfortable. I had been laying down for 15 minutes and just got my eyes closed when I had 3 strong contractions that I had to use my breathing techniques through (I had coached so many other labor patients that I felt like I could do it). Then my water broke. Talk about warm soup down your leg! The contractions got really strong then. I was 5 cm. Got up to the bathroom to get cleaned up and got some pain medicine, Nubain 10 mg. I got back in bed, turning side to side and in 2 hours I was 8 cm. The contractions hurt, but they ended and knowing there was an end to every pain was a relief in itself. Back rubs, ice chips, and a cool washcloth over my eyes helped tremendously.
At 1 o'clock in the afternoon I started pushing. I pushed sitting up, lying on each side, on the toilet, standing up, squatting, and regular old lithotomy. I just couldn't get him to budge and I had pretty bad back pain. He was posterior. After 2.5 hours of pushing, I got on my hands and knees and pushed every other contraction because his heart rate was dropping. Finally, my doctor came in and I got a spinal in case I would have to go for an emergency c-section. They got me all set up for delivery and the doctor used forceps. After 3-5 contractions with pushing and pulling, we got him turned face down and delivered at 4:35 p.m. He was a bit exhausted and got a little oxygen, but cried well and after an hour of stitching, mom got to feed him. He nursed for 20 minutes like a trooper.
Baby #2: I was due 4/7. We knew dates for sure because we got pregnant with the assistance of Clomid and Glucophage for PCOS. My pregnancy really went quickly and pretty smoothly. From about 28-34 weeks baby was breech except for one brief period. Around 34 weeks I started doing the routine to turn her---lying on the ironing board, used a moxibustion stick at home, homeopathic pulsatilla, prayer, relaxation, imagery, talking to the baby, flashlight, music, the whole nine yards. I was on the verge of a breakdown about 35 weeks...called my midwife crying, "What am I going to do?"
We had talked about delivering breech and they weren't really sure. I had an appointment on Friday 3/14 for a consult with the OB (he's probably in his mid-50s and still does some vaginal breech deliveries) who backs up my CNM and possible External Version. We had planned to deliver at a birth center. That was all I was planning. I was thinking positively, I was relaxing and working on the imagery I was planning to use for labor...this baby was going to have a peaceful delivery and I was going to have a healing, positive birth.
I am a RN and work as a prenatal care coordinator for a community health clinic. I do home visits, education and referral for pregnant moms on the Medicaid program. I have worked as a doula in the past, but don't have time for it at present. I teach childbirth classes and had a class on Tuesday 3/11 from 5-7. Talked with a couple for about 30 minutes after class, then drove home, picked up my son at church (my husband is a pastor). We came home, I [ate] and read my email. I had just got Ina May's new book via Fed Ex that day and while my son was winding down...I started reading in the recliner. I had been sitting there about 15 minutes when I felt warm and wet---I jumped up so I wouldn't get the recliner wet and freaked out, "OH NO, that can't be my water!" When I pulled down my pants in the bathroom there was a lot of blood. Now of course, I'd just worked about a 12 hour day, moving constantly, and not really noticing much movement from the baby. In class that night we talked about Cesareans and abruption was going through my mind. I'm absolutely losing it, my heart was pounding, I was shaking all over, I'm shaking now just remembering how I felt. I read Prenatal Parenting early in my pregnancy and I had worked really hard on remaining calm and talking to the baby, taking fetal love breaks, especially when I'd had a rough day---now when she decides to come, I'm a mess.
I called DH on his cell phone. "Come home now, I'm bleeding." It was about 10 p.m. My son could tell I was worried because he was right there. "Mommy, are you ok?" (Side note: The next evening at Bible Study he asked for prayer for Mommy because she "Pooped blood in the toilet and it looked like Koolaid." He's still talking about that night!) DH got home, helped me find my midwife's phone number and we called her. She was a voice of complete calm, "I'll meet you on OB. It's probably just your water." DH has never driven so fast in his life! Now I was nearly a month early, I had just gotten finished saying that night at class that I would probably go close to my due date, I was too busy to have the baby early, I had home visits scheduled through the end of March, blah blah blah. I had no bag packed, had no comfort items gathered, had only 2 outfits for baby clean...I didn't have the crib pained, had no mattress, didn't have a pediatrician picked out, had not pre-registered at the hospital, I was going to deliver at the birthing center for heaven's sake!!----I WAS NOT READY!!!!
We got to the hospital and up to OB. They wanted me to change my clothes, I wanted heart tones. 130s, but very little variability...My midwife cam in and did a quick ultrasound, the baby's head was under my right rib cage, her bottom was inside my right pelvis, and her feet were over my cervix. My midwife sat on the bed with me, held my hand, and said, "We are not comfortable with delivering her vaginally this way, you need to make some decisions." DH went down to sign me in. When he came back I bawled in his arms for a few minutes then collected myself. My midwife and I talked about VBAC and she said that the doctor still did VBACs and was very pro-VBAC and had a good rate....I think she said ~80% success rate for VBACs. I made it clear that if the baby was OK, she was to be with me at all times. If she was not with me, DH would be with her. My midwife said that the pedi on call was a stickler about the baby going to the nursery, but she would do what she could.
DH's parents arrived to stay with my son during the birth. IV started (after 3 tries), into a gown, consent signed, we went to O.R. After the anesthesiologist got my fluids in (she about froze my arm off pushing about 700 cc in 10 minutes), she sat me up for my spinal (again, third time was the charm). The doctor was at my feet, my midwife at my side, and nurse on the other side. They were all awesome!---kept trying to recruit me, though. I laid back down and felt everything go to sleep, boy that is a funny sensation. With [my first child], the spinal took the pain away, so it didn't feel so weird. With no pain, it just feels like they put lead in and made it all go to sleep, kinda pins and needles sensation. They put my catheter in (gave me the option not to have it at all, but I figured I'd probably not want to get out of bed for a little bit once the spinal wore off and I knee it was also in place to make sure my bladder wasn't nicked during the surgery, so I got it).
I informed everyone that if my baby was ok, I wanted to keep her with me. I got this weird sense of humor and was defensive by joking about things, I was kinda strange. My BP bottomed out at 60/40 and my heartrate was going nuts in the 120s. She gave me something for my BP and I felt a little better. DH at my side, they started my baby's birth; tears rolling down my face, I asked him to pray with me. DH prayed from the moment he placed his hand on my face until we heard them say, "Here's baby." My heartrate came down to the 90s while he was praying and the anesthesiologist said, "Wish we could bottle that."
During prenatal ultrasounds, we had a brief peek to see girl parts, but never saw them again (breech), so I was not getting my hopes up. I knew that they would see sex before she was even out, but they weren't saying anything! After her birth, the doctor made the comment that he went in and felt limbs, he grabbed two and started to pull them out, but had an arm and a leg, had to go back and find a matching set. She cried quickly and after a peek at her, to the warmer. The pedi checked her over and I kept talking to her, "Keep crying," "Hello Amy," etc. I had tears streaming down my face and into my ears. They wrapped her up and handed her to DH; I got to touch her. The anesthesiologist held her face right next to mine so I could talk to and kiss her.
The doctor held a section of cord up for me to see. "See why she would [not] turn around?" She had a true knot in the cord that was really pretty snug. He felt that she was lucky to be here and that she would have probably not tolerated the version we had planned for 2 days down the road. Now, I have seen true knots before, even after vaginal deliveries, and everything was okay, but I also assisted a twin delivery where one twin had a knot and was stillborn, the other was ok.
The anesthesiologist offered Demerol to help with cramping and I refused because I didn't really want to see my supper again. I asked to have my placenta and the anesthesiologist said, "Well, what on earth for?" I said, "Because it's mine!" I got my placenta in the freezer, going to plant it with a Magnolia tree outside Amy's bedroom window. (I had a Magnolia tree outside my window growing up.)
The pedi took her to the nursery. DH followed and picked up our son and my in-laws so they could see her and 10 minutes later when my surgery was over, the nurses and doctors took me to recovery, and my midwife went to get Amy. I got her to the breast within about 45 minutes after delivery. She was cuddled up with her head on my breast...My son came in and asked me, "Did you get your miracle, Mommy?" More tears. He got to see her, my in-laws were in the hallway looking in, and DH was walking around with my placenta in a bucket under his arm. Back up to the OB floor at 2 a.m., got my morphine [Patient-Controlled Analgesia] pump and slept off and on through the rest of the morning with Amy on my chest. [We] ended up skin to skin for quite a bit of that time. They checked me often, but basically left me alone, never asking to take her to the nursery for her admission bath, etc. I got out of bed for the first time around 10:30 a.m. the next day, got to oral pain meds and my IV out around noon. Kept Amy with me around the clock and nursing went well. Went home Thursday afternoon around 3:30 p.m. I refused her Newborn Screen on discharge and brought her back that Saturday.
OK, the last thing I wanted was a cesarean. But what I was praying for was an empowering, positive, healing birth and even though I didn't have the natural birthing center birth, that wasn't what I was praying for. Next time I will be more specific, but I did get control in my birth experience, I was hyperaware of what I was feeling emotionally, physically, and mentally, and I feel I was so prepared for coping with pain that it has made my recovery super rapid. As far as healing, in that I feel like I can delivery vaginally without the medical need for management. I have not had that yet, but our daughter is named for 3 very special women, 2 very dear to me. Amy's birth was healing to me in that way, a healing I didn't even know I needed, but God took care of nevertheless. Positive, a resounding yes, I have a beautiful baby girl with a perfect round head, she has dimples just like mommy and lots of dark hair.
Did I get what I wanted---no, but I did have control over what I did get. Did I get what I needed---definitely. I will no longer feel sorry inside for women who had to have a cesarean, but instead I will ask how they felt about their birth. That is so much more important. A cesarean is not fun, it's not natural, it can be unnecessary, but it does sometimes save lives, and it is a birth of a precious little one, and an event that is no less memorable or special...Sometimes we just need to be reminded of it.
Amy was 6 lbs., 14 oz., 20.5 inches. She is a good baby, nursing well. At three weeks of age she is 8 lbs. 5 oz., solely breastfed, and I have an additional feeding built in for pumping. I love the Lansinoh Ziplock bags for breastmilk storage, and the Avent pump is great. It's like "I can't believe it's not electric!"
[Update: Franny went on to have a home VBAC. See below.]
Dee B's Story (induction, malposition, c/s)
Birth Story
My beautiful daughter was a total and utter surprise to me. It was 1996, I was working at an early ISP, and I was surrounded by 19-year-old male co-workers. My cycles had been irregular since college: skipping six months had happened before and resulted in no more than a heavy bleed. We were using two forms of birth control.
Sometime during April (I think) an egg cell drifted down the tube and met up with its destined partner. Still don't know quite how that happened, but hey. :) And the tiny ball of cells drifted to its new home and settled in, with me totally unaware.
Life went on for me in Silicon Valley. I had what I thought was a short period in May. My breasts hurt like never before, but I paid no attention. July, and I really hated the nausea that came with the office flu. Even though no one else in my department seemed to be affected... besides, we were busy moving, and I'd moved from grave shift to day shift. I was soooo tired from the whole thing. Who wouldn't be?
August, and I went home to NC to be with my family in anticipation of my 25th birthday. Everyone told me California agreed with me: my hair, my skin, I just... well... glowed! Then Hurricane Fran hit right before I went back to CA, and I thought the increased swelling around my middle was due to the humidity. I'd always been a big woman, so if the seat belt fit more tightly than a few weeks ago it was just more evidence for me to get off the train a couple of blocks earlier...
I was answering an email two weeks later when I felt... movement. Given the perspective of my current pregnancy, I am absolutely convinced that my placenta was anterior where this one is confirmed posterior, because the first movement I felt was rather dramatic. The placenta must have been blocking sensation. I instantly cast my mind back across the weeks to when I'd last bled and went pale. Yipe.
Two days later, I spotted. In a panic I went to a doc-in-the-box and was sternly informed that "This is no first-trimester baby." (Spotting turned out to be nothing.) I went to the first OB whose office didn't say "What do you mean, you think you're at least four months pregnant?" The ultrasound was scheduled for 10/1. If I was more than four months, I'd see the OB that day; otherwise we'd set an appointment. So far so good.
Even then I knew that US dates could be off by a lot... by the time I found out my "due date" was Christmas, I knew that meant sometime between the 11th of December and the 14th of January, really. We couldn't judge by LMP, because we weren't sure when that really *was,* so we went by the US date.
My doctor was polite, funny, and supportive. We loved her. I passed the GD test with flying (if sickened) colors. My blood pressure was fantastic, I rarely swelled, I continued to glow. I had a very short time to adjust to motherhood, but even though my father had been an adopted baby, I told people, "Anything I grow in my body for nine months is mine!"
I tried to find Bradley classes, but was told by all the local instructors there was simply no time. It wasn't twelve weeks until my due date, after all, so they could not take me. I ended up taking the hospital courses.
Christmas came and went. I was huge. I wasn't really uncomfortable, but I was concerned. How far along was I, really? What if the date was the 11th of December, not the 25th? What if the baby had an aging placenta? I was starting to thin and open, but nothing was really happening. She was moving a lot, reactive to outside noise, but fear started to creep in.
When the OB did an ultrasound on January 3 and told me my daughter was a minimum of 9.5 pounds, that did it. I didn't know of the variation from estimated weight to actual. I agreed to the induction. Even though I did know about pitocin and its effects, the thought that my daughter was so big meant she was surely overdue, to my mind. Furthermore, my wonderful doctor was on-call at the hospital that weekend. I'd have her there. It would be just fine.
No one told me that that ultrasound being able to see a tiny face, the minute-long back pain I was having with each 20-second BH surge, the being able to see hands and feet meant a posterior baby. No one told me what that meant.
January 4 we checked into the hospital at the time requested, only to be told there was no room for me. That was 7am. We waited until 11am to get a room. I went to the bathroom, only to find pieces of my mucous plug coming out. I knew I was one cm open. I took the plug dropping and light surges I was having as a good sign. Today, I'd have cancelled the induction and said "Ne'mind, we're wandering home. We'll call you when things kick in."
It took them two full hours to get a continuous 20-minute strip on that little minx. Much like her younger sibling today hates ultrasounds and doptones, my daughter *despised* the external monitor. She would not settle down at all. After six hours in the hospital, we finally had a 20-minute strip (and an exhausted kid). They put in the Cervidil and we watched the football game.
At least, we tried to. I've always reacted strongly to medications. The Cervidil put me into 90-second surges with about 45 seconds in between. Furthermore, there was a little hard head pressing against my back. I was in agony. I wanted to get on hands and knees, but the staff wanted me monitored. (My wonderful OB? Birthing other women's' babies and trying to grab sleep.) They told me they needed the Cervidil to get me to four cm. At 6pm, they gave me a second dose because my cervix wasn't opening. Thinning, yes, but not opening.
The only place I could relax at all was the bathtub. It was my refuge. I got a new nurse who was fine with me being in there for forty minutes out of each hour if I would wear the monitor for the rest. At 10pm, I was totally exhausted already from nine hours of transition-type labor and Not. One. Centimeter. to show for it. I was still at one.
The nurse came in and looked at me in the tub. She took a deep breath and said "Look... you're worn out. Let me do this for you. Let me give you a half-dose of fentanyl, and I want you to stay in that tub. I want you to have someone sit with you. And I want you to sleep. Can you do that?"
I had so very much not wanted drugs. I also knew I was fried. I agreed. I slept for an hour, barely aware of anyone else near. At 11pm they checked me... four cm. Time to get out of the tub and on the monitor for real. The IV was set with the anti-GBS meds and the pit... it's time to have this baby!
My compassionate nurse went off shift. I got a businesslike no-nonsense type. Fwoosh went my daughter's waters. In went the internal monitor, screwed into my baby's scalp. In went the internal contraction monitor. In went the tube to keep fluid around my baby girl. In went the pit. Out went my brain.
I am not a visual person. I'm very much a kinesthetic and auditory person. The pain in my back was excruciating, but I could handle it as long as I moaned. If I could just keep that moan on one note, I could cope. Three of those would get me through. Just close my eyes, squeeze the nearest hand, and moan. Three times. Yes. As long as I had breath. And keep it steady... because if it's steady, I'm coping.
I'm told the nurse came in and cranked up the pit four times between 11:30 and 4:00am. I have no idea. My eyes were closed, I laid on my left side, and sang birthsong to my daughter. I vaguely remember switching sides twice. I remember hearing her heartbeat.
At four, the nurse came in and said "Oh, honey. You sound terrible. Let us give you an epidural. You're just not coping. It's going to be at least six more hours." Now, in point of fact and 20-20 hindsight I was. I was starting to shake, though, and I completely forgot about what that might mean. I'd been awake the best part of 24 hours, and the length of the surges was still 90 seconds with almost no time between. I agreed.
They sat me up (without checking me) to give me the epidural at 4:30 or so. I immediately threw up twice. (Clear) fluid gushed from within. It took the anesthesiologist three tries to get the epidural in. I could still feel everything on my left side. The nurse refused to call him back: "Just keep laying on the left, honey." In other words, I still had to cope with every surge just as before.
Except... I had been feeling a change in the way my daughter was resting. She'd been moving from my right side down. I felt her stop moving. Then, half an hour after the anesthesiologist left, I felt her go DOWN and PRESSURE and SOMETHING IS WRONG, call the nurse!
She checked me. "You're good to go, honey!"
The OB finally came in and she was great with me wanting to squat. So I did... and my beautiful girl's heartrate dropped. And dropped. After 45 minutes, we tried the standard hospital delivery posture. Two and a half hours into pushing, the last hour with vacuum, I finally said "I can feel she's not happy. Get her out. She's not moving down."
The operating room was taken. The doctor sat with me for the twenty minutes it took to come free. The baby's heart rate recovered. I moaned through my urges to push. I could still feel everything.
In the operating theatre, the anesthesiologist was *mad* at the nurse. She had never alerted him that my epidural was spotty. He gave me a spinal and sensation finally went away. I am grateful for that, because it spared me some of the horrors some of you have experienced. I came very close, I think, to understanding all too well.
At 8:14am, my *7 pound 12 ounce* baby was born. [So much for the 9 lb. behemoth!! -kmom] From the vacuum extractor mark, she had come down into my pelvis at an angle which still makes my neck ache in sympathy... thanks to the epidural arresting her turn. (I knew something was wrong, darnit.) She showed no signs at all of post-maturity. As a matter of fact, she showed signs of possibly being as young as 38 weeks. We will never know. Blessedly, she breathed, was alert, and nursed like a champion (other than being drug-sleepy... for that, I literally sat her upright on my thigh to nurse until that phase ended). My own recovery was uneventful, except for the recurrent yeast infection at the incision site.
Now, almost eight years later, I know where the wheels fell off that bus. I can point to every decision I made that I would not make now.
At the same time... my body was ready to go into labor, which is different from many women. Cervidil was a horror, and I think my cervix was soft in the first place or I would not have opened to the pitocin the way I did----ahead of Friedman's curve. I was having light surges. I wanted to get into beneficial positions, but second-guessed myself. But the instincts were there.
I know, absolutely and without question, that had www.spinningbabies.com been around then, I would have had a totally different experience. My daughter had been posterior for at least a month. It took reading Sheila Kitzinger to understand that those 20-second surges followed by a minute of pain were, in fact, "posterior" surges. Her more dramatic post-epidural malposition was confirmed by the vacuum extractor mark on the back right of her head. Poor kid. She tried to do her part and turn.
I also know, without question, that my body can make and birth a baby. After all, it made her for almost six months without my awareness, much less help. It came close to birthing her despite the interference. I am a birthing woman. I just haven't actually done it yet.
Now her sibling is wiggling in my belly. I can feel little hands against my pelvis. I knew within a week of conception this time... my dates are absolutely solid. I have a HB planned with a great team. My husband is 100% behind me. Even my parents are on my side. (My 22-weeks pregnant sister, on the other hand, is not... and she will not talk to me about my experience.)
Sometime soon, the lessons we (both DH and I) learned from my daughter will be put into play. And my family cannot wait to meet the new baby... but we will, because we know the possible price of not waiting.
[Kmom note: Dee went on to have a VBAC. Her story is below.]
Kirsten Taylor's CS Stories (c/s for fetal distress; coerced c/s for post-dates and macrosomia)
Birth Story
Baby #1: [I had off and on prodromal labor for several days. Finally we went to the hospital, way too early.] While I was waiting to be admitted, I went to use the restroom. As I stood up, I felt a gush and new my water had broken. I went out and told Scott. Finally, they came to take us up to our room. Once in, I was strapped to the EFM, all my vitals were taken. I was only dilated to a 1-2 when I was checked; that really surprised me, but looking back, I went to the hospital WAY too early. In the video I am there smiling and laughing at times. Once we got in the room, my labor sort of slowed down significantly, but then things did pick up within an hour. I had NOT been a woman in active labor when I went to the hospital, oh well, hindsight.
The nurse said she felt hair, possibly dark but couldn't tell the color. We kept arguing how long did I have to keep this EFM on, they wanted it on for 15min. every 45 minutes. It was terrible. B/c of either my weight or baby's position, they could only pick up heart tones when I was on my back. I was having TERRIBLE back labor, and this was just the worst. I was also very frustrated, b/c I was trying to move with the contx, and every time I moved, more fluid was trickling down my leg. The nurse thought I was worried that I was losing so much, but NO! I was disgusted with the feeling like I was peeing myself every time I moved. It was embarrassing feeling and I was self conscious about pouring fluid everywhere. Silly, of course. So, I started getting into a more serious labor pattern, and the last time they checked me was around 8:10pm. I was at 4 cm. I was so frustrated that I was only that far along. I was sitting in a chair rocking back and forth, desperately needing counter-pressure on my back. I remember at one point Scott and my mom were talking and I interrupted them yelling, "Help, contx." Afterwards I apologized for yelling.
I guess it was around 9pm that Kelsey's heart rate started acting up. Things are all fuzzy after that point. They yelled at me to roll over, and I yelled back, "DEAR GOD! I'M HAVING A CONTX!!!" They were having a hard time getting Kelsey's heart to register. They told me they were having trouble with my baby. I got very nervous. They called the ob. At some point there was meconium staining, they said very thick green like pea soup. I know there was an argument about using the internal fetal monitor, we didn't want that at all cost, b/c it screws into the baby's head and sounded terrible. Scott was arguing with the OB, finally I said, Scott, it's okay, just let them. My baby's heart rate kept dropping down to around 40-50 bpm during contx, but it went back up in between contx. The last time I was checked was around 8:10pm I think. Soon after, the OB made the decision to go ahead with a cesarean.
I just remember everything around me fading until I could only see black, as if I was in a dark long tunnel. I was sort of blacking out; more emotionally than anything. I just felt it was all over. I was absolutely devastated. Part of me was so relieved that this pain was going to end soon; the contx and back labor. I then just absolutely HATED myself for thinking that; my nightmare was coming true! I just laid there memorizing the trip to the OR, so angry that my body was failing me. I didn't have the cesarean until 12:26pm. Looking back, I truly believe I was hitting transition when I was in the OR, not at all to the point of pushing, but maybe an 8 or 9. I will never know, of course, but I know I was nauseated and just feeling TERRIBLE. They tried for 30 minutes to give me an epidural. It was truly excruciating. I was in so much pain I thought I would vomit, and everyone was just busying themselves in the OR getting stuff ready. I kept asking if someone would just rub my back b/c of the terrible back labor. On top of everything else, I was freezing, so I was tense all over shivering. That made it worse. I remember the OB acknowledging me once, his warm hand on my arm, it was the best feeling. I thought I would DIE while I had to sit hunched forward for the epidural. The nurse kept getting short with me b/c she didn't think I was holding still; I was in labor. Something about the epidural was messing up, and making my thighs go crazy with pain, they were hitting some nerve. Finally, the anesth. said, we have been trying for almost 30 min, doc, do you want to use general?
I didn't even understand. I had been having oxygen, I thought I was just getting
more oxygen, but it was general. I just remember laying back with a mask on. Next thing I knew I woke up in a very dark place with a nurse busy
around me. I didn't get to see Kelsey for over an hour after she was born. She was born at 12:26pm on July 15. I didn't get to see her until
after 2am, so I didn't ever get to see her on her birthday. Scott went with her to the nursery, I was in recovery. It seemed as though there was
blood everywhere, I woke up to a very nice nurse who was wiping me down, cleaning me up. I was soo out-of-it feeling, I asked if I had had the
baby. Pathetically, I didn't even know. I was just in a dim room being cleaned up. Looking back, it probably wasn't even dim, that doesn't make
sense, it was probably my dazed state. She smiled and said yes, I had the
baby. I asked if it was a girl, she said yes. I asked if she was ok, she said yes, she was just down in the nursery with Scott getting cleaned up.
My own mother got to see my baby before I did. Scott didn't let her hold her though. He thought I should get to hold her first. I was so drugged when I finally did see her, it was just surreal. I just could only say how beautiful she was. Scott told me she had been hungry, she gave up and went to sleep before I got there. My first breastfeeding experience, I laid there passively while the nurse held up my breast and held her to it, trying to get her to suck. I couldn't even keep both eyes open as this went on. How dignified I felt.
Soon after I got home, I wrote an email to a friend of mine. I was still so uneducated about cesareans and what had gone on in my situation. Looking back, I am certain with the proper birth support, I could have birthed my daughter. I reread the email I sent to a friend occasionally. It is from a person who is filled with sadness and disappointment, and who wants desperately to believe what she has been told by the doctors. That is not the person I am now. I do not trust doctors now; I do not like them. Here is the email I sent describing my birth to my friend:
It is pretty hard to get around right now. I am not sure what Scott told you, but as for being in the hospital still, the main reason was because of the pain. Kelsey was already engaged when they performed the c section according to the doctor, so the he really had to tug to get her out of my pelvis. I had to be under general anesthetic. That, on top of just being in labor for about 24 hours and getting a c section was enough to cause me to be very sore. They have already removed the staples, now I just have stitches that will dissolve on their own.
Supposedly I will be feeling my old self (minus the new bowling ball weight boobs - haha) in about 2 weeks. I am very anxious to be able to walk around, hold my baby comfortably, stand up without a huge ordeal, lay down in bed in any comfortable position, be able to GET up from bed without my husband to help pull me up. I think they may have broken me!! This is just terrible!
As for Kelsey's complications, they were all immediate dangers that corrected themselves right after delivery. I think my being in labor for so long and her being positioned posterior (face up rather than face down) made for the distress and subsequent drop in heart rate. I was only vaguely aware of how serious the situation was while it was going on - due to the labor itself, my comprehension level was not at it's highest... But I am kinda glad of that. I panicked anyway when they said there was a problem, I don't know what I would have done had I known her heart rate had dropped to 49 bps, but I am certain it wouldn't have been beneficial to either of us. Her heart stabilized just fine after she was born. She also had swallowed very thick meconium - a lot of it according to the pediatrician, so they had to really suction her out well. It was so bad they were even flushing my uterus with water while she was still inside me to help prevent her ingesting even more, but after she was delivered and cleaned up, she was and is fine.
She is a beautiful, healthy girl. I couldn't be more in love with her. I am so glad she is here. I just can't wait until I can stand up straight and walk around holding her. I think it is just a matter of days away. I am still too weak to hold her while standing right now, but I definitely can while sitting. I can't even hold myself up all the way, and by nighttime each day, I am totally bent over and struggling to walk. Unfortunately, I have to take pain medication to help alleviate some of that - because I have to be able to move around in order to heal better... So I have to take the medication and it is slightly passed on to her when I breastfeed. I was devastated at that thought, but the doctor assured me that it will not have any negative effects on her, and that I must take it in order to heal and be able to provide for her. He says it is still better than formula feeding.
Anyway, I just thought i would write and let ya know that I am home and all is well. Now I just have to get over the initial panic of "Oh my god, I have a baby" and start living!!!
Baby #2: Unfortunately, my second daughter was also born via cesarean. I had a fairly pro-VBAC OB, perhaps the most open-minded in the area (the same as for my first daughter). When it got to the end, there were some due date issues, but the biggest issue was that my daughter measured over 10 lbs in a u/s. Even the technician who did the u/s said this was a VERY rough estimate, b/c she was hunched over inside me, making her abdomen seem larger, and they couldn't get another accurate measure; they needed to get a better estimate. But, the results were, she was measuring past 43 weeks and over 10 lbs.
I still planned on having a VBAC, but my OB called me following the results and told me of the dangers to myself and the baby. He said every day that went by was just putting her more and more at risk. Even though I knew he was wrong, I still succumbed to his scare tactics. I scheduled the cesarean for the next day. My husband had just taken my 16 month old daughter on a walk down the street when I got the call. I still remember the walk to catch up with them and tell them. I was sobbing and crying, I felt as though the world was ending. I had a good friend as my doula, and I knew it would disappoint her. I was scared even to tell her, b/c I was so disappointed in myself, I couldn't bear to have her disappointed in me, as well.
My doula came over and tried to pressured me to try herbal induction. I was so afraid that is what caused Kelsey to go into fetal distress that I had caused it myself messing with herbs. I refused, and she totally understood. She just knew how much I wanted a VBAC, but she also wanted me to know that I could cancel that c/s appt, or not show up. It was so difficult, b/c with all my being I didn't want a c/s. I had totally convinced myself that I was not going into labor b/c I was so afraid. Like the Birthing From Within talks about a mother threatened in the wild will stall labor to get to a safe place. I thought my fear of another cesarean caused me to NOT go into labor. I totally and completely blamed myself, and didn't know the way out. I thought there was just no other choice. I was so devastated. I regretted in the moment ever hiring my friend as a doula, only b/c I had to face her with the decision I made. At that time, I just wanted it to be about me and my husband.
I made the appt, and we went in the following morning. When they were prepping me for the surgery, there was a terrible nurse who was so callous and rough. She did not understand the big deal of a cesarean. She reassured me that it would be fine, but no, I didn't feel at all like it would. I just laid there going back and forth between visiting with my doula and husband, and crying and sobbing, I couldn't stop. The nurse thought I was hurting or scared. When she catheterized me, before anesthetic or anything (standard procedure that I later found out I could have changed) I still remember the pain. I felt as though she had ripped my urethra. I cried and cried, she said it shouldn't hurt. It did. What did she know? Finally my doula nicely told her off; that I was just crying b/c I was hoping for a VBAC and didn't want this.
At least I was able to walk into the OR. I felt like I recognized the doorway to it, I definitely recognized the freezing temperature of the room. I was SOOO scared of the anesthetic. That had been so traumatizing with Kelsey, they tried for 30 minutes to put the epidural catheter in my back, never succeeding. I was alone without support this time when I got my spinal. I was crying and nervous, no one seemed too concerned about it. They did try to reassure me some. When it did finally hit, I think I realized how tense I had been. I had not ever felt so relaxed. My husband came in, and I told him I wanted one of these to go. He thought I had been drugged, but no, I was just relaxed, and completely resigned to the surgery.
The OB and the anesthesiologist argued back and forth about what time this cesarean was supposed to start. I felt invisible. I was just an appt to them, but for me, this was terrible, tragic, and life-altering. I didn't really feel like it mattered whether they wanted to rip out my heart at 12noon or 12:30pm. The OB tried to get the anesthesiologist to allow my Doula to be there with me, but she said it was against hospital policy. At least the OB tried, he really argued with her over this. They all cracked a few jokes about my baby's size; the anesthesiologist, upon seeing my baby, said, "Dr. X, I sure hope you had your Wheaties today! You are sure going to need those Wheaties to help lift that huge baby out of there." I politely chuckled, and it was sort of funny, but inside, I was sooo sad. My OB said, "Please let this be a big baby. Please don't let me pull out a seven pound baby or mom is going to kill me." The anesthesiologist said he got his wish.
Olivia was screaming before they got her all the way out. She was pretty big, 9lbs 15oz, but NOT OVER 10 LBS like the U/S said; not even 10 lbs!! Ugh. Even if she had been, I could have had her naturally. The OB lifted her up for me to see, but all I saw was a foot. I tried to move the curtain so I could see, and they made a stink about me contaminating the field. Ugh. I had no idea; I just wanted to see my baby!!!
Olivia went directly with me into recovery. We were more knowledgeable and comfortable refusing the bath and everything so that I could have her immediately. The OB gave me a shot of morphine. I think as a result of it, I broke out into a terrible itching fit that was unlike anything I had experienced. It was just terrible. I itched over every ounce of my being! They offered a shot for that, but I was sooo paranoid about Olivia getting all these drugs, that I refused.
Olivia nursed like a pro from the start, and she showed no signs at all of breathing problems as a result of the cesarean. Nor did she show any post-maturity. She also had the worst acne I had seen. I was shocked when I saw her the first time, b/c she was all wrapped up in a blanket, only her little head showing, and it was SOO round and so covered in pimples. I just thought she really is Olivia with that big round o-shaped face. I thought she was just ADORABLE!! She was soo cute.
I did handle this cesarean much better physically. Even mentally at first. I was just so happy to have my baby, and she was such a peaceful, sweet baby. It took a while before the sadness and disappointment over the birth really set in. But it did come. I truly blamed my failed VBAC on my fear. I know from the Birthing From Within book that an animal who feels threatened will not go into labor until they find safety. I totally thought this was why my body failed go into labor. That which I feared the most ultimately caused me to NOT give birth vaginally. I don't know that I really feel that way now. I think there was something holding me back, but I also think if I had just given myself a few more days, it would have happened naturally.
[Kmom note: Kirsten went on to have a wonderful VBA2C at home. Her story is below.]
Alexia's CS Story (induction, fat-phobic treatment, c/s)
Kmom's Notes: Another example of fat-phobic treatment and assumptions. Alexia's first story is a lesson about not assuming your care providers are size-friendly simply because they don't spend all pregnancy yelling at you about your weight. Her midwives seemed perfectly fine---until the end of pregnancy, when they assumed her baby was huge, induced labor, did not know what to do about a posterior baby, and treated her badly. Afterwards, they made lots of assumptions about how she ate because of her size, and lectured her husband about her size and making her diet etc. Finally, they told her she couldn't birth her baby because she had a "fat vagina"----a unique lay term they used for what is called "soft tissue dystocia" in medical parlance. In other words, she supposedly had so much fat, she was fat inside her pelvis and around her vagina, thus supposedly " blocking" the baby from coming out.
Of course, Alexia went on to prove them all wrong. She had a VBAC with a baby that was BIGGER than her first. So much for the "fat vagina" theory. Once again, her birth shows that it's the baby's position that matters most, not baby's size, not mom's size, not "soft tissue dystocia," not the size or shape of mom's pelvis, etc. Fetal malposition is the key in MOST cesareans, and fixing the baby's position and laboring spontaneously and naturally is key in most VBACs.
Birth Story
Baby #1: CS
Before I got pg, I expected I'd have a healthy pregnancy and a quick natural trouble-free delivery. I had lost 50 lbs. and asked my family doc and OB/GYN at the time if I should lose more weight or get pregnant. They both said, go for it! You are healthy and not getting any younger. (I was 34.) I asked the OB point-blank if my weight was an issue and she said no, medical problems are the issue, not weight, and you don't have any. (I was 275 lbs. when I conceived.) I started seeing the midwives because my OB was pretty much like, "You are low risk so you don't need me, you need the midwives." I was happy with that.
My pregnancy with my daughter was indeed healthy and happy. I did some prenatal tests, but not all, and they didn't really pressure me about anything. I had 2 GTTs, but at the time I felt that was reasonable given that I thought I had risk factors (weight, age, family history).
My plan was to give birth at the hospital naturally with the midwives. (I liked the idea of homebirth, but I didn't think "real" people did that -- I thought this was the closest option available to me and was the "responsible" thing to do.) DH and I took a Bradley class and I did a ton of reading. I hired a doula. I wrote a birth plan that my midwives loved. In spite of my reading, I was pretty naive -- I never imagined ending up with a medicalized birth, let alone a c-section.
The only thing that concerned me was the one time I asked what they use to induce with if induction is "necessary." (OK, I wouldn't ask that that way today.) Cytotec. Why? Because it's cheaper. OK, that was honest. I had a bad gut feeling about that.
Lesson One. Don't ignore gut feelings.
When I did the hospital tour at the start of my 3rd trimester, I had a bad gut feeling that this just wasn't the way to do things, but I thought it was nerves and I ignored it.
Lesson Two. Don't ignore gut feelings.
When I hit 38 weeks, things changed. Suddenly, I was going to have this monstrous baby. 10-11 lbs. at least. (I had been measuring about 4 weeks ahead for most of my 3rd trimester.) Everyone started telling my husband he should have controlled my sugar intake and that this was my fault. (I ate well, did not eat a bunch of sugar, could have done better with exercise). I found the fact that they didn't talk to ME highly offensive. I'm not a child. I had a bad gut feeling but thought it was too late to switch. And I think deep down I felt like my weight was my fault and it was going to be a problem after all. I think all along I felt "lucky" every time I "passed" a test.
Lesson Three. Don't ignore gut feelings. It's never too late to change.
Lesson Four. I should have been more assertive.
I had been [assertive] the whole pregnancy. However, I had a lot of shame surrounding my weight, so that's one issue where my assertiveness just escapes me and I feel like a deflated balloon.
I was scheduled for a BPP [Kmom note: BioPhysical Profile] and c/s consultation the following week. I agreed to be induced with acupuncture that day because it was "natural" and I would stay home until labor got going (and I was skeptical that it would work at all -- thought I was getting them off my back by agreeing). I was enjoying my pregnancy and not in a hurry, but I was afraid of problems with a big baby. It still didn't occur to me that I could actually end up with a c/s. I ended up with prodromal labor until my c/s consultation. The acupuncturist scared the bejesus out of me about how this huge baby was my fault, blah blah blah. Again, he talked to my husband more than me.
Lesson Five. Don't underestimate "natural" stuff.
Lesson Six. Don't make fear-based decisions.
At the consultation, they did an ultrasound and estimated baby to be 9-10 lbs. At the time, that sounded huge to me and I didn't know if it was really possible! (Now, I know better.) They insisted it was probably off and that baby was probably even bigger. The perinatologist I saw was great. She wasn't worried. She said that they no longer do c/s for big babies because the research doesn't show any improvement in outcomes. (Why don't any of the regular OBs and midwives seem to know this!) She did a vaginal exam (VE) and I was 3cm dilated. She offered to strip my membranes and I agreed because I figured it would only work if I was ready. She said if I wasn't in labor by the end of the weekend, I could stop by and she could strip them again, but it was up to me.
Apparently I was ready. I was in labor by the time I got home a few hours later. I was told to stay home until contractions were 5 minutes apart. I waited about 6 hours until they were 3 minutes apart and DH was good and nervous ;-) (We had a 45 minute drive.) They didn't hurt and I was really excited. Unfortunately, I didn't realize the length of the contractions was important, too -- they were only lasting about 45 seconds. We got to the hospital and checked in. The nurses all were saying there was no way I was in labor, I was too happy, they were going to send me home, etc., until they did the 20 minute External Fetal Monitoring (EFM) strip and did a VE. 4cm, really contracting, but still short ones. Our doula met us there (our doula was actually at another birth, so we got the backup, which turned out to be good -- she and my husband really clicked).
After the 45 minute car ride and the 20 minutes on my back for the EFM, my labor turned into back labor. I used hypnosis, relaxation, and counterpressure/ heat to deal with them. They were intense but manageable. (The pain from my bulging bag of waters was much more painful! In retrospect, I'm glad my mw refused to break it -- that would have been risky and pointless.) I was throwing up and shaking and everyone kept telling me it'll be any time now, not much longer! I tried the shower, I tried the toilet, I tried standing. After about 5 hours, I laid down on my left side. After 7 more hours, I made it to 5cm.
I still hadn't thought of using pain meds -- just taking the contractions one at a time. However, after that vaginal exam, I got really discouraged. Everyone was quiet and just kind of avoiding eye contact. I felt like a failure at that point already. My midwife came in with an epidural sign off sheet and a shot of Stadol and told me I had to have one or the other or else I was going to be too tired and I was going to end up with a c/s. I agreed to the epidural because I thought it would be better/safer. The nurse won $5 on that -- apparently there was a pool on when I'd get the epidural. That really offended me. I made a complaint to the hospital.
Lesson Seven. I can really handle labor!
That's one of my best memories of that day. I'm grateful I had that opportunity. I am very confident about my upcoming labor and being able to handle things -- I figure I already handled the worst case (intense back labor).
Lesson Eight. Vaginal Exams can be very depressing.
I haven't had any yet this pregnancy and don't plan on it. I may change my mind and ask for one during labor or not. I think I'd prefer not to. When baby comes out I'll know I dilated. ;-)
Lesson Nine. I didn't talk to anyone about how I felt.
I isolated within myself and didn't talk about how I felt like a failure. I wish I would have to my doula. I think by withdrawing, I didn't really allow anyone to help/support me. They couldn't read my mind, after all.
Lesson Ten. Know what to do with back labor and an OP baby, other than hope for the best.
I slept a few hours, when they woke me up to give me oxygen. I was having trouble breathing. The epidural had traveled up so my arms were dead. They told me later they thought I was exaggerating and that it was because the BP cuff was too tight because I was fat. Then they told me my labor had stopped so they had to give me pit. Soon, DD's heart rate started dropping, so they told me I had to have a c/s.
Lesson Eleven. Why didn't I tell them to turn off the @#$% epidural to see if things started up again?
Didn't even occur to me. Now I know.
I was in shock. I cried for a few minutes, then got myself together to get through it. My c/s didn't happen for another 3 or 4 hours -- the OR was busy that day. I had to wait my turn. Right before, they offered to take me in the OR, break my water, and see what happened. By that time I was mentally prepped for a c/s and there's no way that would have been productive given her position, etc., so I just told them to get it over with. The nurse got mad because I was "so fat I couldn't get on the OR table" -- well, I defy anyone at 9 months pregnant with an epidural that deadened both arms and legs to be able to crab walk over there. Somehow I made it while everyone in the OR watched me. Ugh. My bag of waters exploded on her on the way. Oops. (Sorry, that was childish and petty, but oh so satisfying. I even laughed out loud.)
The c/s was uneventful. I was glad how things turned out afterwards with DD -- I was the first to hold her. She was only a little over 8 lbs.-- they weighed her twice, they were so shocked that they were so wrong. She was put right in bed with me and we were never separated. She roomed in. They helped me breastfeed right away. My midwife and the anesthesiologist were very nice. My mw took lots of pictures and, while I don't like the c/s part of it, I like having the pics of our first moments with DD.
Lesson Twelve. I will include this stuff again in my transfer plan.
It kills me when I hear some [women are] separated from [their] babies for so long unnecessarily. I think this was primarily my midwife's doing and while I disagree about some other things she did (which is easy to do in hindsight, I admit) I feel very grateful for this.
They didn't give me a normal bed -- they had me in something with a lift, etc. I didn't need it. I was able to do for myself and get up and about faster than their skinny patients. They were openly shocked how quickly I was up.
Afterwards, they told me I had the c/s because I was fat. When I was being prepped in the OR, they had taken my husband aside and given him a big lecture about letting me live like this, letting me have a baby, letting me get out of control during my pg, etc. I was furious. (I weighed less 6 weeks pp than I did when I started my pg, so obviously I wasn't out of control, etc. Much of what they said was based on bad assumptions and they never bothered ask me anything -- they just assumed and TOLD me.) DH had been very supportive while I lost 50 lbs. slowly (by STOPPING dieting). Afterwards, he was stressed out and pushing me to diet and, while I know it was out of concern for my health, it caused a real problem for us. Finally we had it out.
Lesson Thirteen. Don't put up with fat-phobic Care Providers and treatment.
I thought I had done everything right to prevent it, but...
A few weeks after the birth, I went back to try to process what happened and talked to the main midwife. That was the first I heard about the "fat vagina" theory. She said it was possible that I had so much fat in my vagina that it blocked the baby from being born. (My BS meter went off immediately -- baby never even got down into my vagina, so that had nothing to do with it.) Boy, I'm mad again about this whole thing!
I had breastfeeding problems and didn't get help from someone who could really help me until DD already developed a bottle preference. I pumped a years worth of milk and felt like a failure every day. Not being able to nurse devastated me more than the c/s. I was told my breasts were too big and my nipples were too big. My midwife looked at my nipples and told me DD would have to be at least 4 years old before she would be big enough to nurse. I worked with a great La Leche League [leader], but it was too late I think and I couldn't get DD to do much more than comfort-nurse occasionally.
Lesson Fourteen. Line up a Lactation Consultant early.
Mine's already on call [for next time.]
I felt like a real failure for months. I also felt incompetent about just about everything where my DD was concerned and her papa did many things for her and really bonded with her. I resented that and was really down about it. Going back to work made it worse. DH couldn't understand why I couldn't just get over it. Finally we had it out in a middle of the night fight and I let it spill about what a failure as a woman I felt like, etc. He finally got it, as much as he could. It hasn't been until recently that I feel she really has a close relationship with me now. I think co-sleeping helped us a bunch. I had been so confident about being a mom beforehand.
I got my records and they were pretty appalling. Lots of talk about my weight, sterilization (never discussed with us), race, etc. I ran them by a professional who wouldn't pull any punches with me and even she said that is not just hospital speak, that was appalling.
More lessons --
[Kmom note: Alexia went on to have a home VBAC. Her story is below.]
C/S Stories That Became Vaginal Birth Stories
Note: These are some of the stories of big moms who had c-sections (some necessary and some not) but who all went on to have vaginal births in subsequent pregnancies. Mostly the stories are excerpted here for space limitations; the complete stories are in the web section, BBW Birth Stories: Vaginal Birth After Cesarean Stories.
akp's VBAC Story (fat-phobic doctor, home VBAC)
Kmom's Notes: akp's c/s story (see above) is a good lesson in all the things that can go wrong during a c/s and afterwards, and why inducing for a "big baby" is usually a bad idea. Things were bad; fortunately they didn't turn out even worse.
Her VBAC story is a good lesson in the importance of finding a provider who really believes that your body can give birth normally whatever your size, and the importance of perseverance in the face of opposition and obstacles. As the old saying goes, when a door closes, somewhere another one opens.
Birth Story
Baby #1 Summary: After being told she'd never get pregnant and
then pressured to have an abortion, akp was pressured into having an induction
at term because the baby was thought to be big. She ended up with a
cesarean. The surgeon left sponges and other surgical materials inside
her, then dismissed her protests that something was wrong, attributing it to her
being overweight and out of shape instead. Later, she was told the mass
inside her was a tumor and that she was probably going to die. Eventually
they discovered the problem, re-operated, and removed the materials. She was
determined to have a different experience the next time. This is her VBAC
story.
Baby #2: I called around 10 OBs and interviewed 3 in person before deciding on a
VBAC-friendly OB. Things were going well and he provided forms reflecting VBAC
as safer than a repeat cesarean. At 30 weeks, things started to change. I had
decided to have a home birth by that point, so after finding the right midwife,
my OB became shadow care (he never knew that was the case) and thank goodness
for that wise decision! I started hearing "unproven pelvis" and
"dead baby" from the "VBAC-friendly" OB.
By 34 weeks he was telling me that I was high risk because overweight women
rarely have the stamina and endurance needed to have a vaginal birth. I started
bringing witnesses to every appointment because being in his office was a
nightmare. He was painfully aware of my trauma surrounding my last cesarean and
STILL never relented on the dead baby theories. The only reason I continued to
see him was because he was in my medical plan and could authorize any lab work
my midwife asked me to get (i.e. thyroid checks). By my 39 week appointment, the
doctor would get red-faced angry and tell me that I was killing my over 11lb
baby and that I required an immediate cesarean.
At 40 weeks, we compromised and I agreed to a NST. The OB refused to do it in
office, saying they didn't have the equipment. That I had to go to the hospital.
I found out later that it was a blatant lie and an attempt to force a cesarean.
The OB had called in advance, "explaining" to the hospital what he
needed done. I told him and I told them that I refuse ultrasound. They told me
that they HAD to measure the babies heart and would not do anything else via
ultrasound. AFTER they had already measured the fluid levels, they informed me
that I had a dangerously low AFI (later found out it was 6.9, which is within
the published ACOG guidelines at 40 weeks pg) and that I needed to stay and have
a cesarean. They wanted to escort me straight to L&D after the NST. I
refused. The NST was perfect, not a blip, textbook perfect. I stood up, told
them I would not sign any consent forms and that I was going home. There was
more, but lets say everyone was giving me "dead baby" and "the OB
will not tolerate this" language even while I was walking out of the
building.
At 41 weeks pregnant and after no less than 6 harassing dead
baby phone calls per day since the NST (including weekends), my OB dropped me
from his care for "non-compliance." Whew, I could finally gestate in
peace.
Around 9:00 a.m., July 14th, I felt the first small pangs of labor, only I
didn't know it was labor. At 41+4 days gestation, I was beginning to think that
E had made his home in utero and wasn't coming out. I'd had several episodes of
B-H contractions that made me wonder if I was in labor, only to be disappointed,
so I wasn't going to get excited again. Plus, I had an appointment that morning
with my wonderful midwife, V, at 10:00 and she'd be able to tell if anything was
going on. Unfortunately, I let the OB's badgering get to me mentally and spent
half the visit with the midwife that morning crying about how the baby was never
going to get here and that maybe we should consider labor-inducing herbs. After
a long discussion of the pluses/minuses, we decided to have V try to scrape my
membranes. Unfortunately, I was only 80% effaced and 0 dilated. It wasn't worth
the possible tissue damage and we left things alone. Happy to be further along
than I was when labeled FTP and c-sectioned 2 years ago, I left thinking another
week or so to go. I stopped by the grocery store and bought some homeopathics
that V has had some reasonable success starting labor with and was contemplating
starting them in the next couple days. At that point, I started feeling some
stronger abdominal pains, but they were far apart and again, I chalked it up to
Braxton-Hicks.
At noon, I was feeling contractions around 10 minutes apart, but still believed
they were B-H and would go away. They weren't regular or overly painful, so I
pulled out the breast pump I bought when #1 was born and pumped for a half hour
(V had mentioned this might also start labor). Not only did it get labor going
strongly, I think it over stimulated and caused the contractions to become close
together too early. By the time I had pumped for a half hour, about 12:45 at
that point, the contractions were 4 minutes apart and getting stronger. I put
the pump away and finished watching a movie I had rented. About 2:30, I called V
to let her know that the contractions were getting stronger and were finally
regular. I didn't need her to come over, but wanted to let her know she'd
probably get "the call" that night. I started cleaning up the house
because I finally realized labor was happening and that E was going to be here
in the next day or two.
I called hubby at work and let him know he'd have to leave work early to go and
get #1 from preschool as the contractions were strong enough that driving was
out of the question. I told him I didn't want anyone around me at this point, so
don't leave work yet, just let them know you're leaving early. Lots of luck with
that, he was so excited, he left right away and drove around a bit. I called him
about 3:30 and said he could come home because it was getting hard to get
housework done and there was a lot to do before the midwives showed up. He felt
he needed to call the midwife once the contractions were 3 minutes apart, so he
called V and I got in the bathtub. I told the midwife it would still be hours
and she agreed, but thought it would be best to send out the assistant midwife
(J) who was already in the area. J got to our house around 7:00 p.m. and checked
to see how the baby and I were doing. She couldn't tell how dilated I was, but
she could tell the head was coming down far with every contraction so she asked
V to head over to the house.
Our Doula got to the house around 8:30 and V arrived around 9:30. I moved from
the bath tub to the birth tub (kiddy pool we had bought for the birth) and
stayed in the tub until about 10:00. I kept feeling the head move down during
contractions, but then it would just move right back up, so I told V nothing was
happening with the pushing. Having been at hundreds of births, V's intuition
kicked in and she thought checking me for dilation was a wise idea--that way I
didn't expend energy pushing when it wasn't time. I was only 3 to 4 cm when she
checked shortly after her arrival and I was severely disappointed. E was also
posterior at the time, so I was having some tough back labor. Fortunately, he
didn't stay posterior for long (changing my positions also changed his).
Around 10:00 I moved from the tub to the bed-definitely not a favorite. It was
horrible changing positions, but I knew the ladies (V, J and my doula) were
right and changing positions was the best thing to do. After some contractions
on the bed, I had to go to the bathroom and went to sit on the toilet. That is
when things really got moving. I sat on the toilet from around 10:30 until
almost midnight, trying to urinate and not wanting to change positions again
(the first 2 to 3 contractions when I moved were hard to get through).
When I started grunting and pushing hard to urinate, V realized it sounded like
I was actually pushing the head down and got the group to remind me of changing
positions again. I really didn't want to at that point as contractions were one
on top of the other and it was all I could do to catch my breath in between. Our
Doula got me up and half carried me over to the bed as I could hardly walk with
the strength of the contractions. As we left the bathroom, my doula brought up
that finally had some bloody show. I was almost crushed as I assumed that meant
I was probably only about 6 at that point. I figured most women have bloody show
well before 3-4 cm, but I knew I had to be further than that since it had been 3
hours since I was checked. Ugh, prayer time-at that point; I thought about
transporting to the hospital to get an epidural, but I had had one previously
and back then, it stopped my labor all together. I was not going to have another
cesarean!
So, I lay on the bed, it was midnight, the contractions were difficult and my
doula kept reminding me to breath and stay on top of the contractions. I
couldn't breathe through the contractions anymore and just held my breath
grunting through them. I felt like my body was pulling into one huge 6 foot
contraction and I shouted that my body was cramping up. V and my doula both
tried to help with the cramping immediately, I grabbed my leg (I was on my side)
and just lifted it up. Obviously, it was just the natural urge to push and not
cramping, but I didn't know it at the time.
V had thought I was in pushing stage, but didn't want to say anything as nothing
in labor is for sure. V let the others know and my doula got the camera ready,
got DH and so on. I was still clueless and kept having these contractions that
forced me to grab my leg and contract my whole body. I told everyone that it
felt like he was moving down then going right back up and V reassured me that it
what was supposed to happen. Finally around 12:15 I understood what was
happening and could feel the head moving down-actually he was almost out. V saw
there was meconium and knew I had low amniotic fluid, so she instructed my doula
to make sure I didn't push after the head was out. I heard everyone talking
about it, but could only concentrate on getting E out. I knew I would tear if I
pushed too hard, but honestly, I didn't care any more. I pushed with all I had
and then kept pushing some more. A few contractions later, E's head was out and
V/my doula were telling me to take short breaths and not to push any more. V
quickly suctioned E's mouth and nose and he was born at 12:35 a.m. on Friday,
July 15th.
The extreme hormones and euphoria of what we had accomplished removed any
remembrance of the pain a few minutes earlier. It was incredible. Nothing
ever felt like that before. E was so beautiful and things were awesome. I bled a
bit more than I should have, so after a while, V started pushing for the
placenta to come out. V tugged a little on the cord, to encourage the placenta
to release and I pushed with all I had at every contraction. Finally around 1:15
the placenta came out and more bleeding occurred. V continued with the herbs and
started telling me that I was going to have to get a shot of pitocin if I didn't
stop bleeding soon. I really didn't want pitocin as I'd had it with Elizabeth
and I knew what it felt like. No thanks! We all prayed and really concentrated
on stopping the bleeding, which happened fairly soon after that. After reviewing
the placenta, it looked as though I had a partial separation of the placenta
from the uterine wall-causing the extra bleeding. Fortunately, all ended well
and it was just clean up from there.
I did have a short 1st-degree tear right at the very end from pushing too hard
and fast, but I knew that would happen at the time. Within a few hours, I was
eating and showering, thanks to my wonderful birth team. It was an amazing
experience and I wish that all women could know the joy of birthing in a
comfortable environment with an experienced team of women. There was such a
sense of calm and peace through the entire experience that I would never birth
unnecessarily outside of my home again.
Kmom's Notes:
Birth Story
Susan's first child was born by c/s after 26 hours of 'very dysfunctional labor'. Her second child was born by VBAC, and this story can be found under the section, BBW: VBAC Stories. Her third child was born by elective c/s, however, because he was transverse and had a true knot in his umbilical cord. She feels all her births went very well, whether vaginal or c/s.
Dee's Story (c/s due to size-phobia, insulin-dep. gd, vbac)
Kmom's Notes: Dee's story reflects the importance of choosing your provider wisely! Her first doctor was a fat-phobic man who expected her to fail based on her weight, and created a self-fulfilling prophecy. However, be sure to read her VBAC story so you can read how she empowered herself and found a NEW and supportive doctor!
Birth Story
In retrospect, I realize there were many clues thrown out by my ob/gyn over the months of my first pregnancy that forewarned of an unnecessary c-section. The biggest clue was his repeating the mantra, "Of course, at your weight, it's likely to end up a c-section." I weighed 247 at the beginning of the pregnancy. In spite of a very healthy and uneventful pregnancy, my labor was long and ineffective. My waters broke at 10 in the evening, 13 days post dates. I went into the hospital immediately because....well, I wanted to have that baby! While I had light contractions all night long, they were ineffective.
In the morning, I was given prostaglandin gel. That got things rolling and within a half hour I was having strong and consistent contractions. I was through transition, fully dilated and effaced and felt the urge to push around 3 pm. Four hours later I was still pushing. All throughout the day, the doctor repeated his mantra omen. Neither he nor the nurse encouraged me to move about, change positions or try any alternative birthing techniques. So, it was no wonder, again in retrospect, that E was born via c-section, with dislocated hips and a huge hematoma on his scalp from the different types of vacuums the doctor tried to use.
Note: Dee went on to have a VBAC with her next child, despite severe insulin-dependent gd and much stress. Her story is told in BBW VBAC section.
Margie's Story (5 children; #4: c/s, insulin-dep. gd; #5: VBAC, insulin-dep. gd)
Kmom's Notes: Margie has 5 children; the first 3 were born vaginally after quite interventive births. Her fourth child was born by c/s after she developed gd and a difficult pregnancy. The baby was born at 11+ lbs., much bigger than her previous children. His story can be found at the website URL listed below (Cameron).
She then went on to have a fifth child, a gd vbac (a long summary of this birth can be found in the VBAC stories, in the malposition stories, and in the gd stories). The fact that she'd had 3 vaginal births before her c/s increased her chances for a VBAC, as did her supportive staff and taking good care of herself. Her birth stories (all of them) can be found at:
http://pregnancy.miningco.com/health/pregnancy/library/stories/b13797.htm (1st 3 births)
http://pregnancy.miningco.com/health/pregnancy/library/stories/blcameron.htm (4th birth)
http://pregnancy.miningco.com/health/pregnancy/library/stories/bl9907196.htm?pid=2839&cob=hom
Birth Stories
Pippa's Story (GD diagnosis, induction, c/s; then long homebirth transport VBAC)
Kmom's Notes: Pippa's VBAC story is an amazing story of perseverance! After being forced out of her homebirth option at 40 weeks, she had decided in panic to simply schedule a repeat cesarean in order to avoid a repeat of her first traumatic induction and c/s.
However, a wonderful midwife (married to a doctor) generously offered to have her come to her house, receive some hypnotherapy treatments, and then Pippa could opt for returning home and continuing her birth there, or staying with the midwife and birthing with her. Pippa and her family chose to drive NINE HOURS to take up this supportive care provider's offer of help!!!
Labor was long and not easy, and eventually they decided the best course was to transfer to the local hospital near the midwife, under the care of an OB there who the midwife trusted. Eventually, though, Pippa dilated fully and was able to push out her daughter just fine. Having supportive caregivers who believed in her made all the difference in the world, and being given the chance to labor at her own pace without rigid limits was also important. It's virtually certain that had she stayed with her prior OB, she would have been forced to have a repeat cesarean under these circumstances. Instead, by having more flexible and caring providers, she was able to VBAC despite challenges along the way.
Many VBAC moms face seemingly impossible dilemmas near the end of their VBAC pregnancies. Often they feel like they have no choices because of insurance or medical circumstances, or their formerly supportive caregiver suddenly changes their tune and pressures them/sets them up for a repeat cesarean. But in reality, most moms have more choices than they think they do, if they are just open to the possibilities and look around enough. Pippa was 40 weeks when she switched providers, and drove 9 hours to find a provider supportive of VBAC! Other women have found providers up till the last minute, sometimes even in the middle of labor, sometimes against daunting odds.
It's usually not too late to make other plans or find another choice, if you open your mind to the possibilities. Many women have VBAC'd despite incredible obstacles. Never say never.
Birth Story
Baby #1 (born by c/s): I was 32 when we decided to try for our first child, so I was quite surprised to find myself pregnant immediately. The first half of the pregnancy was uneventful and I was very laid back until I failed a 3 hour glucose test and was diagnosed with gestational diabetes. I started seeing an endocrinologist and monitoring my blood sugar, and although I found I was able to control the GD with diet, I was given to understand that I now had a high-risk pregnancy and was in danger of having a macrosomic baby that might need to be delivered by c/s.
I took Lamaze classes and opted for a wait and see approach to labor and delivery, hoping it would be bearable, but open to pain relief if I felt I needed it. I ate very healthily and gained 40 lbs. during the pregnancy, with a lot of water retention at the end. My due date passed with no signs of labor and after I passed one week overdue, I started having regular non-stress tests. However, the doctor advised that it was not a good idea to go beyond 42 weeks of pregnancy, so on his advice we agreed to induction at 42 weeks.
The induction was to take place on Monday, May 6th, at 2 weeks past my due date, so we went to the hospital birthing center as planned. The first thing they did was to put gel on my cervix because I was not dilated or effaced. Three doses had to be administered at 6 hour intervals; I was surprised at how much it hurt, but the on-call OB was a large man, with large hands, so maybe that was partly why it was painful...Somewhere around 1 a.m. they decided nothing was happening and gave me the choice of going home...or staying in the hospital for the night. I chose to go home... I felt sure I would go into proper labor overnight.
The next morning contractions had ceased and we returned to the hospital...They wanted to administer oxytocin through an IV, after having established that there was no effacement or dilation. They started the drip very slowly, explaining that they wanted to give me as much time as possible to efface and dilate. After increasing the dosage at hourly intervals up to the maximum, but early evening I finally started to have mild contractions about 4-5 minutes apart...Over the next couple of hours, the contractions increased in intensity and I was made to lie down in bed as the nurse said the baby didn't seem to be doing well when I sat in a chair---I suspect it was more that the monitor wouldn't stay in place. My abdomen was getting quite sore from having two tight elastic straps around me for so many hours...They measured my blood sugar and my endocrinologist decided that I could have a glass of juice. [We used Lamaze breathing techniques for several hours to cope.]
My waters suddenly and violently ruptured and they were mildly stained with meconium. I didn't believe this was anything to worry much about, but the next couple of hours passed in a haze of being ill and the contractions getting much stronger. Some time after midnight the nurse called the obstetrician in; they were having difficulty getting fetal readings off my abdomen because the baby was moving around.
I asked for some pain relief as I felt I needed some help to deal with the contractions; all my energy was being sapped by the nausea and vomiting. I was told my labor had not progressed sufficiently for medication. At this point my heart sank and I was totally discouraged....When the OB came in, I was sick and in pain and I knew I couldn't handle much more. I started throwing up again as they rolled me into a better position and inserted an internal fetal monitor. Having spent almost two days hooked up to monitors, I was used to hearing my baby's heart beat at approximately 140 beats per minute, so I was alarmed when I saw the monitor reading only 67. I looked up at the OB and said, "That's not very good, is it?" He looked down at me, "I think we'd better get this baby out quick." "C-section?" I asked, and he just nodded. I felt a big sense of relief to know my labor would soon be over and I was terrified they'd change their minds and make me go through with it. My total focus was on how awful I was feeling and it took a few minutes before I started worrying about the baby.
They rushed me into surgery and prepped me, and I signed all consent forms. My arms were strapped down and I had a catheter inserted. I was still having bad contractions, which seemed worse lying flat on my back on the operating table, and I kept my eyes shut the whole time. But all the while I was praying that my baby would be okay. In the background I suddenly heard the fetal monitor bounce back up and the doctor's voice was saying to me, "I think this baby is making a fool of us!" I remember thinking, "Thank God---and please don't change your mind about the c-section now," which of course they weren't about to do.
I was given a general anesthetic, and we estimate that it was no longer than 10 minutes from the time they wheeled me past my husband in the hallway to the time when my son was born and handed to his daddy. For the first hour of his life, he was held, cuddled, and loved by his very proud and overwhelmed father. I woke up in the recovery room an hour later, but my memory of that time is very hazy. I know I was given my baby, and asked if I wanted to breastfeed him, which the nurse helped me to do, but I remember nothing of that first breastfeeding session. Then a little later I was transferred to my room. So my son was born at 48 minutes past midnight on Wednesday, May 8th, weighing 7 lbs, 9 oz and was 20 inches long.
Recovering physically from the cesarean surgery was not easy, but I found it much easier than the emotional recovery. After experiencing bonding and breastfeeding difficulties with my son, I joined the ICAN online mailing list, where I received wonderful support and understanding as I struggled with feelings of inadequacy over my 'broken' body and feelings of incompleteness surrounding the actual birth process, and feelings of fear and doubt over the future pregnancies that I had anticipated. A few months later I also became aware that I was suffering from post-traumatic stress symptoms related to the surgery, including operating room flashbacks and hyper-vigilance. I was now suspicious and distrustful of all medical care providers and institutions, and because I was terribly afraid that I might end up with another cesarean, I was determined that my next birth experience would be safe and non-interventive, at home with a midwife.
Birth #2 (homebirth transport, hospital VBAC): Pippa's full VBAC story can be found in the BBW VBAC Birth Stories FAQ. She was planning a homebirth in Canada with a midwife, but was risked out to OB/midwife "shared" care because of an unstable lie. The OB berated the midwife for even considering a homebirth and decided to induce Pippa at 41 weeks to avoid a "big baby." (Her previous baby was only 7 and a half pounds.) He dismissed Pippa's concerns about induction and increased risk for rupture, and urged her to rush to the hospital if she went into labor spontaneously, saying she was at risk for a prolapsed cord because of her "poor uterine muscle tone" and unengaged baby.
Because of her prior traumatic induction and c/s experience, Pippa decided to have an elective repeat cesarean rather than enduring a similar scenario a second time. A midwife from Vermont on the ICAN list read of her decision, and offered Pippa the opportunity to travel to her house to have some birth-related hypnotherapy (she and her husband, a prominent doctor and author, are experts in this), and if desired, to have her baby there. Pippa investigated them a bit more and decided to take this opportunity.
At 40.5 weeks pregnant, Pippa and her family drove many miles to this midwife's house, had the hypnotherapy, went into labor on her own, had a long difficult labor that involved a transfer to the local hospital, received mostly respectful care there (in combination with her midwife's care eventually), and ended up with a VBAC. It was not an easy birth but Pippa says, "This VBAC was an incredibly healing experience for our whole family."
Maggie's Story (3 babies: size-phobic dr.+ c/s, 2 VBACs)
Kmom's Notes: Maggie's first 2 babies were both about the same size despite a much bigger weight gain the second pregnancy. She also had a VBAC with a baby that was 9 lbs., something some doctors tell you that you probably can't do. Her third baby was smaller, for whatever reason, and again she had a very fast VBAC. In both of her VBACs, she had pitocin augmentation without any drugs, a very impressive accomplishment!
Birth Story
My first pregnancy I had a fat-phobic doctor who complained about every pound I gained and kept telling me about a patient who lost 50 lbs while pregnant. Because of insurance, he was the only doctor I could choose. Even though I knew it was unhealthy I would diet before my appointments to try to get a lower weight and then semi-binge after the appointment. My blood pressure also measured high during office visits because I was so anxious about my appointments. My normal blood pressure is 110/70, even when pregnant.
I ended up gaining 24 lbs and had a 9 lb daughter by c-section because the doctor thought she wouldn't fit. I never went into labor -- had a biophysical profile that measured the baby at 10 1/2 lbs +/- 1 lbs -- this is what the doctor based the c-section decision on. Despite all this I had a very easy c-section and recovery -- was able to have an epidural and be awake during the surgery. I considered the c-section a breeze and had no fear about another -- in fact was so comfortable with the known, was more nervous about going into labor.
Note: Maggie went on to have a VBAC with a baby that was slightly bigger than her first baby. So much for being 'too big to fit!' Just another example of the typical attitudes about large women and their babies. She recently had another very fast VBAC as well. Maggie's VBAC stories are also in the BBW VBAC story section.
Another point for BBW's -- I got pg first month with babies #1 and #3. So what was different with baby #2? Not sure and no confirmation from doctor but I had been on phen/fen for a year prior to trying to conceive and it is my belief that my hormone levels were out of whack from the dieting etc. Also about weight gain in pregnancy, I've had a wide range between baby #1 and baby #2 but found that all the baby weight was gone by 6 weeks postpartum. I did breastfeed and that helps for a while and then my weight would stabilize.
Franny's Story (posterior, forceps vaginal birth; c/s for breech; home waterbirth VBAC)
Kmom's Notes:
Birth Story
10 days past my due date I was miserable and called my midwife for help (this pregnancy lasted more than 2 weeks longer than my first and 6 weeks longer than my second...I felt like I was pregnant forever, add to this that I took off work for maternity leave at 38 weeks and I felt a little like an elephant, in more ways that one). My midwife recommended that I see the Chiropractor and get a massage. I chose the latter and by evening (Wednesday) my contractions had started.
I went about my normal activities, fixed supper, went to church, bathed the kids, put kids to bed, went for a walk. Contractions were regular, but not very strong, more like annoying. Thursday AM we were to drive an hour away to see the midwife...I didn't think I could handle being in the car that long, so I told her to head our way. (She has 7 kids of her own, the youngest just turned 1 in November). I napped and felt like they were fading away and she said she'd just drop in to see how I was. I had gone into work for a bridal shower on Tuesday and one of my co-workers, an OBGYN Nurse Practitioner said I should just go to the hospital and have another cesarean since I was so far over my due date...had a lot of mental work to do to get over that.
Midwife arrived at 3 and I told her what I was thinking/feeling and she helped me get rid of it and by 3:30 my water broke. By 5, my doula and our friends that were going to watch our kids were present and I was starting to get uncomfortable. Around 7pm, I was 4cm (the first time my midwife ever had her hand in me). I got in the tub (borrowed a spa in a box from a friend) and got hot, then had to get out to cool off. I had just attended a Michel Odent conference and had his words in my head. If a woman gets in the tub at 4 and makes no rapid progress after 2 hours, he recommended a cesarean. I kept thinking that I didn't have the urge to push, so had I made progress? After dark (9ish?) I got back in the tub and was very cold, my husband found a space heater and was holding it on me next to the tub and jokingly went "oops" faking dropping it into the tub and it took me over an hour to get back into a regular pattern. Had to get into the shower to get warmed back up and they encouraged me to drink some really salty hot broth.
By 11 I was loud and hurting, they also tried to cram a peanut butter and jelly sandwich and juice down my throat...PB is NOT easy to get down with 'labor mouth'. I was all over the place position-wise, remember enjoying a forward leaning position. I starting pushing around midnight, although my midwife said I wasn't *really pushing* until about 1 or so. Was in the tub when I started to push, but kept a rim of cervix and got out to the birth stool so the midwife could help hold it while I pushed. While on the birth stool I remember saying, "I give up. Take me to the hospital, Help me" and they gave me some homeopathy. When she was crowning I got back in the tub.
The midwife said I have 'a large perineum' and so it felt like crowning took FOREVER. I remembered what It was like with Daniel and I realized that I ever got to the point where I could push past the pain and make progress...I finally figured out the pushing thing this time...but the pushing into the pain to make progress, then the contraction ending and feeling the baby slide back up and knowing I'd have to push back through that pain again with the next contraction was nearly overwhelming. I was on my knees in the tub, resting my head on the side of the tub, Aryn put his arm along the back of the tub so I could rest my head and I accidentally bit him...didn't even realize I was doing it until he flinched.
I got to the point where I felt like my urethra was going to explode and I reached down to support my labia and felt her head...It didn't take long from that point...it was so empowering to realize how close I really was. Once her head was out, her body followed quickly, the midwife just allowed the water to catch her. Once she was out, I flipped over and reached for her. Within seconds, I was pulling her up so I could see her, unlooped 2 nuchal cords and brought her out of the water to my chest. She opened her eyes and looked at me and started to whimper. No lusty painful scream, but more like..."Wait a second, what just happened?"
I felt between her legs and discovered she was a girl, but waited until our son came into the room to lift her out of the water for him to see and announce. I was convinced I was having a boy because my pregnancy was so much like it was with Daniel...Instead I have a little girl that looks just like her big brother. I was out of the tub about 30 minutes after her birth and we left the cord attached for about 2 hours, at that point we were able to cut without clamping and it fell off when she was 4 days old. I had a small 'scuff', but nothing worth messing with suture-wise. My midwife had a herbal bath to soak in with Abby and it felt wonderful...had to learn the hard way to strain out the herbs though :-0 clogged the tub.
Abby nursed very well and my milk was in by 24 hours. She never lost weight. Was 8-5 at birth, 2:04am Friday, October 14th and was 8-9 on Monday evening. Abigail has been a joy, a wonderful baby. Sleeps through the night (started at about 1 month) and was smiling by 6 weeks. She does have some gassy spells, but they are brief. Will definitely do it again!!! But will wait until Abby is in preschool or Kindergarten...a newborn and a strong willed 2 1/2 year old is just way too much for me!
This was an editorial I sent to our local newspaper after my daughter's birth explaining my decision and outcome in relation to the release of 2004 C/S rates. Several of the OBs in our area were really ticked and found out that I was the Childbirth Educator at the local Medicaid clinic and were not happy. Our Medical director wanted me to assure him that I was not teaching or encouraging homebirth in my class. I replied that I simply told my story and that I did not believe that homebirth was an option for our clients for 2 reasons...they can't afford the out of pocket expense of homebirth and local docs refuse to provide back up.
The results are in and 2004 saw another increase in surgical birth rates -- 29.1 percent of women delivered their babies by cesarean last year, according to a National Center for Health Statistics report released last week.I chose not to become a statistic
Some doctors cited the reason for the increase was that more women are having elective cesareans, but keep in mind that "elective" does not mean that it was the woman's choice.
Earlier this year when we discovered we were expecting our third baby, I visited my OB/GYN to begin prenatal care. I was informed that we would be forced to have a cesarean if our baby was born at their hospital simply because I had a cesarean with my second child.
The cesarean rate has increased astronomically in the past 30 years: 5.5 percent in 1970, 16.5 percent in 1980, and 22.7 percent in 2000. The World Health Organization states that the cesarean rate should be 10 percent to 15 percent. Our bodies have not changed in 30 years, but medical management has. Although some babies have been saved by surgical delivery, a look at maternal and infant mortality rates show that nearly 30 countries lose fewer moms and babies than the United States and most of those countries have lower cesarean rates.
Having a vaginal birth after cesarean (VBAC) carries nearly half the potential complications than repeat surgery. Due to a 0.5 percent to 1 percent risk of uterine rupture, The American College of Obstetricians and Gynecologists has put very strict guidelines on VBAC, stating that the doctor and operating team need to be immediately available.
American Academy of Family Physicians guidelines noted that there are other problems that occur more often, and they found no evidence suggesting better VBAC outcomes based on the availability of resources. American Academy of Family Physicians went on to state that policies for VBAC "appear to be based on malpractice concerns rather than on available statistical and scientific evidence."
So, how'd I do it? I hired a midwife and kept my OB/GYN as backup. I found a doula -- someone trained to provide emotional and physical support during labor...and obtained a portable hot tub for pain relief. I ate well and read to educate myself. When labor started, my midwife came to me, and my daughter was safely born at home in water.
I'll do it again with my next baby. As long as doctors and hospitals do not allow alternatives, such as midwives, birthing centers and natural options for pain relief, more informed women who want to be able to make their own decisions will join me.
Maddy's Story (2 c/s, 1 posterior VBAC, due soon with #4)
Kmom's Notes: Another posterior baby story.
Birth Story
Baby #1 was a 42-week planned c-section for breech. The doctor wasn't comfortable trying to deliver her, and couldn't turn her (the cord looked like it might be around her neck). No labor or cervical changes at all.
Baby #2 was also a 42-week baby, an attempted VBAC with "midwives." (Hah! I trusted in the "midwife" label, but they really knew next to nothing that could have helped me. Spontaneous labor began the day before I was to be induced, but I was "only" progressing 1 cm every few hours, which wasn't fast enough. By the time 30 hours had passed, I was "stuck" at 6.5 cm, and had a beta-strep infection, so I consented to a c-section.
The hospital was horrid, and I vowed never to go back there, no matter how far I had to travel. Later, I learned that not eating, and being tied to the bed to "get a good reading on the monitor" had probably significantly contributed to my "failed" VBAC effort.
Note: Maddy went on to have a VBAC after *2* c/s, something not every doctor is willing to try (in fact she encountered one doctor who flatly told her no to trying, calling her 'overweight and out of shape' and that it would be a 'waste of your time and mine'). But by finding caregivers truly size-friendly and supportive of VBAC and knowledgeable about turning posterior babies, she was able to have a VBAC anyhow!
Update: Maddy went on to have another VBAC, this time a much easier birth at home with baby #4. Both VBAC stories can be found in the BBW VBAC Stories section.
Jenanne's Story (c/s, then VBAC)
Kmom's Notes:
Birth Story
First, I must offer a plug for my midwives -- they were *gold*! I love 'em and wish to God they were doing VBAC when I had my second child; as it was I ended up with an obstetrician then... but I digress.
My labour began lightly about two weeks after my due date. The midwives had, in fact, told me that if I didn't start before Monday (this was on Friday), I'd be sent to the hospital for the birth instead of being allowed to give birth at the center. This seemed a fate worse than death, so my labour began. :)
Contractions stayed erratic but no more than 10 minutes apart for two days. Finally, things began to speed up -- consistent 5 minute apart contractions -- but at the same time, my daughter's heart rate began to flux from 40 bpm to 200 bpm during contractions. I was taken at that point to the hospital where a mere thirty extremely invasive minutes later, the doctors decided to perform a c-section on me. I had an epidural for this; my midwife and my godmother were both allowed in the OR with me. Some small tugging and tense minutes later, E was born! She was utterly healthy, cried like a baby, and was beautiful beyond what my 19 years could imagine....
Latch on was a nightmare; blisters, bleeding, pain. The lactation consultants, La Leche League, and more were unable to make this better and six months later I stopped breastfeeding as a birthday gift to myself (my nipples took six more weeks to heal after that!).
Jenanne went on to have a VBAC after a short labor of about 4 hours. In fact, her daughter was born 30 minutes after her OB went home because she was only dilated 2 cm. She says, "I was convinced that I wouldn't be able to give birth vaginally; that I was 'defective' -- so no one was more surprised than me when her head crowned and *whoosh* she was born!" She had a small tear, but declares that the "healing was a breeze compared to the c-section!"
Dee Bitner's VBAC Story (c/s; hospital transfer VBAC)
Kmom's Notes: Dee had a prior baby by c/s because of a malposition.
Birth Story
At 41 weeks, 5 days I'd been taking cohosh off and on for a couple of days. I was planning a home birth with midwives. Nothing was happening. I agreed to an ultrasound to check baby size. I was delighted to hear that Pounce (gender still unknown, since she was LOA - remember that position!) was between eight and eight and a half pounds. My husband and I both knew I could birth a baby of that size. This US was at 8am on Friday morning, by the way. I had slept for about four hours that night... Turner Classic Movies was showing Hiyao Miyazaki films and I really wanted to watch them. (Yes, I'm a geek. Thanks!)
While on the table, I had three surges (contractions, for those not familiar with HypnoBirthing [HB] language). My husband is currently working grave shift, so we ate breakfast and went home. He went to bed. I should have, but being stupid I stayed up and got on the computer. Surges were light and far apart. I'd had stronger and more regular for weeks, so I didn't think anything about it. I took a brief nap at around one, but people kept calling the house and waking me up.
At around five, I realized surges were closer and they were getting stronger. My husband had to go pick up our older daughter, but I had a distinct feeling that things were different. By the time he got back, I knew they were. A good friend (a guy friend, actually) who was more or less serving as my doula came over and the three of them worked together to fill the Aquadoula. Once it was filled, I got in. It felt fantastic. By this time it was approaching midnight.
Saturday morning, 42 weeks, I posted my last to the ICAN list and got off the computer. I should have slept. Instead, I used my HB techniques and listened to music. Things became a bit more intense. Around 4am I called the midwife. She came over...
And I was two centimeters and minus one. Just as I'd been two days earlier. The baby was not pressing down on the cervix. The midwife left at 5am with surges erratic if strong. My Mom came over to get my daughter.
At 6am, all hell broke loose. I'd tried to rest in the tub, but something felt wrong. My husband had to sleep, so the family friend took over. We went downstairs so I could vocalize without waking him. I went into strong, long, close, intense surges. If I'd had a hint of back labor, I would have known what to do, but the surges were all up front.
I labored like that till about 3pm. The tub ceased to relax me. The only place I could relax and focus was the shower, but of course we didn't have that much hot water so I couldn't stay there. I began to feel panicky. I knew I needed to stay upright to bring the baby down, and lying on my side felt awful anyway, so I sat on the birth ball or stood and danced. At 3pm we called the midwife over. She checked me, and I was at 3, same station, only fifty percent effaced. She called in the senior midwife.
At that point, I realized a couple of things. One was that something was odd with the baby's position in some way. The other was that I was exhausted. I'd gotten about six hours total of sleep since Thursday, and it was Saturday afternoon. I was not going to open any more until I got rest. I wasn't going to get rest without help.
The senior midwife got there and confirmed what was going on. She watched me through a surge and we discussed options. I kept saying that I needed to sleep; that once I slept I would open up quickly and easily. The midwife also thought the baby was posterior. At some time during the night, she had flipped around. For the first time in more than six weeks, she was in a bad position. My instinct also told me that something was keeping her up in my womb, and that the uterus needed some time to work her down.
We made the decision to transfer so that I could get sleep. I hate epidurals. With my older daughter, it had only taken on one side. Still, it was the best way I was going to progress at that point.
The ride to the hospital (all of fifteen minutes long) was... I'd really like to forget it. Since I'm in a CPM-illegal state, my midwife came along as my doula. When they asked me a question, rather than say something that might have gotten her in trouble I asked her to talk for me. It worked well. In triage, they insisted I lay down while they got their triple-cursed twenty-minute strip. Now... intense as things were, the only time I felt *pain* was when I was lying down. If I was standing up, the surges felt productive and (if not a pleasant pressure) mostly like pressure.
They verified the baby was tolerating surges well, so they took me up to L&D. Then I had to wait for the results of my blood test. Meanwhile, I labored as best I could. I did have lots of blood showing, so I knew I might be progressing, but it was very difficult lying down. Then I started to feel the back labor. On the one side, yay, the baby was moving down. On the other... well.
They went ahead and put in an internal monitor. Once the stupid belts were off I tolerated things better. There was meconium, but at 42 weeks who would be surprised? They pumped fluid back in to cushion her.
Finally, at 9 or so, I got the epidural. Sure enough, my blood pressure (normally low) dropped. They gave me epinephrine to raise it, but I responded well to that. Pounce continued to be OK. And I finally got the sleep I needed to open. The midwives left to get rest. If I'd had any brains, I would have called them back later, but I didn't. :/
When they examined me before the epidural, I was open to six. After sleeping, I was still open that much, but (predictably) the surges had spaced out and weakened. We agreed to a very low dose of pitocin to get them going, since we were now on the clock. What I'd hoped would be an intervention-free birth was going down the cascade, but after three hours of sleep I could think again. I told anyone who would speak to me that I really wanted to labor down. They agreed. It was about 3 am.
At about 4 am I started to feel rectal pressure. I didn't say a word. I was back to using my HB techniques, since I could still feel surges through the epidural and I could definitely feel pressure. I focused on imagining white light around my baby and the baby's head moving down and into the birth path. At about 5:30, the pressure went from being only during surges to constant. I still didn't say anything. Everyone thought I was sleeping, but I wasn't. I was deep within myself with the baby. The baby's heart rate continued to do well.
Finally, I told them I was feeling pressure. Sure enough, I was complete and the baby was at +1. I continued to labor down for a while while they set up for the birth. We tried a practice push to see how Pounce tolerated those. Everything bounced back perfectly, so we moved ahead toward birth.
The doctors confirmed that the baby had moved back around to LOA. That gave me the permission I needed to let go and work with the pushes. It took me about 45 minutes to get the hang of pushing efficiently, but I finally figured out I had to curl the upper part of my body and push straight down along my spine. That moved the baby.
It felt like it was taking forever. Every instinct in my body told me to be up on my feet with one leg up on something, not lying on my side with my feet on a squat bar. I began to feel a little panicky again from fighting those instincts, but my husband was strong and supportive and kept me focused. The doctor who came in was the same one who'd been there in triage. She'd been supposed to go offshift at 6, and it was well after 7.
Suddenly, during a push, I thought the doctor had inserted her fingers to stretch me. I gasped "You're hurting me!" and stopped pushing. Everyone immediately yelled at me to keep going, the baby's head was RIGHT THERE. I realized with a shock that Pounce's head was the stretching and man, did I throw myself into that next push! And then there it was: the head on my perineum. I couldn't reach her head, but it didn't matter. I could feel it.
The next push, her shoulders slipped free. I felt a rush of fluid follow her out of me. The peds team was there because of the meconium, but her apgar scores were 5 and 9... just like her big sister's. And my husband was the one to tell me that we had birthed Inari Joy Aurora instead of Gawain, which I'd desperately wanted him to do.
I had a third-degree tear and she had a mildly fractured collarbone. I think she'd had a nuchal hand, since I tore from the inside out instead of back to front. She didn't have any dystocia, so I believe her collarbone fractured as her hand was being pushed down. Also, as I'd suspected, her cord was wrapped once. She'd been prevented by that from dropping down.
Do I wish I'd had her at home? Yes. Always. But I feel very good about my decisions.
Lynn's Stories (c/s, then home VBAC)
Name: "Lynn" Age: 36
Pre-pregnancy weight: 275 lbs.
Baby Info: boy, 20" long, 9 lbs. 5 oz.
Wt. Gain in Pregnancy: estimated 50 lbs.
Fertility Problems: none
Any Complications: umbilical hernia
Type of Birth: midwife-assisted homebirth VBAC
Birthplace: home Provider: midwife
Breastfeeding? tandem nursing
Special Notes on Pregnancy:
Kmom's Notes: SPD refers to Symphysis Pubis Dystocia, or pain in the front of the pubic bone area. No one knows for sure what causes it, but it is probably caused by a misalignment of the pelvis, both in the back (around the sacrum) and in the front, in the pubic symphysis (where the front pubic bones come together). You can read more about SPD in the Pubic Pain FAQ on this website.
Birth Story
A brief rundown of my c/s story:
After an uneventful pregnancy, where I learned a lot and even changed providers to CNMs at 35 weeks, my water broke at 37 weeks, ON MY WAY TO A PRENATAL! I went to the hospital as instructed, about 10 hours later, with not a single contraction. I was induced with Cytotec followed by pitocin. Thirty hours later I was still at 4-5 cm., where I had been stalled for many hours. By then I'd had every intervention known to man, and had been "allowed" to labor with ruptured membranes far longer than most hospitalized moms. They turned off the pit and everything stopped, and it was time for a c/s. My beautiful baby boy was 7 lbs. 11 oz. They kept him from me the entire first day. I was so unprepared for a c-section, I didn't even know to fight. For several weeks I thought "in another time, the baby and I would have died..." Once I found ICAN and read Silent Knife, I learned how my choices could have been different. I knew I would have a homebirth the next time.
My VBAC Story:
My HBAC story begins in March 2004, when we found out I was expecting, only 6 months after my first post-partum cycle..........
[Lynn goes on to have a home birth after cesarean, after a pregnancy full of pubic pain from SPD and many other concerns. She had a long hard labor, with lots of prodromal labor beforehand. It was a real test of patience and dedication! But she did go on to have a VBAC. You can read the full story on the BBW VBAC FAQ on this site.]
Devaskyla's VBAC story (c/s, then home VBAC)
Birth Story
[See Devaskyla's first birth story, a c/s story, above.]
VBAC Story: Things started the exact same way this time as they did with my first son, only difference being it was a couple weeks earlier in pregnancy. My water broke on Tuesday morning. I woke up around 3am and felt a bit damp, but figured it was just sweat since our place is hideously hot. Around 4:30am, my husband came to bed. We talked for a few minutes and I thought I felt something. I thought maybe I was losing my plug, so I went to the washroom and realized that I was getting gushes of fluid. I really hadn't expected things to start this way and had been taking vitamin c for most of the pregnancy to try to avoid it, but was hopeful that labour would start in a few hours.
During the day on Tuesday, I would get an occasional contraction, but never more than about 1 an hour, sometimes I wouldn't get one for several hours. Wednesday was more of the same, although I was getting one almost every hour. There were even a few that were closer together than that. I kind of lost it on Wednesday night. Between the leaking and the fear that I was looking at a repeat and labour would never start (which I know was completely irrational, but I was tired and desperate for labour to start). I lost it so bad I seriously considered going to the hospital. My husband very bluntly asked me would I rather leak or be cut open again? That quickly brought me back down........
[You can read the rest of Devaskyla's VBAC story in the BBW VBAC Stories section. She has a long hard labor with a fetal malposition; she perseveres anyhow, and baby is eventually born, coming out occiput transverse.]
Lori C's Story (diet-only GD, induction, vaginal birth; fetal distress, c/s; HBAC)
Kmom's Notes: A good lesson in the risks of breaking the waters. It offers very little benefit in most circumstances, but does carry risks. In this situation, baby #2 went into fetal distress after the doctor broke her waters, and she ended up with a cesarean---under general anesthesia, no less.
Lori had a tough VBAC labor because she had a long, premature urge to push, which is very hard to resist. Fortunately, with good labor support, she got through it and went on to have a VBAC with her baby.
Birth Story
What an experience - laboring and birthing . . . something that I hadn't completely had the opportunity to experience until this day. Not the picture perfect HBAC that I had dreamed about, but I wouldn't have done it any other way! The third time's a charm, they say!
Baby #1: Induced vaginal birth
My first birth was a medically managed vaginal delivery after I was induced at 38+ weeks for fear of big baby (I had diet controlled gestational diabetes) - she was 7 pounds, 13 ounces.
Baby #2: Cesarean
The second birth I wanted to do things very differently, but kept the same hospital OBs because, after all, they would just catch my baby . . . Well they didn't even do that. After laboring for just 8 hours, the doctor broke my water and I progressed from 3-8 centimeters in 30 minutes, had a premature urge to push and my cervix was swelling. The doctor saw fetal distress, and took me back immediately for a c-section - I was out under general anesthesia, and within 7 minutes, the baby was cut out of me, and my life would be forever changed.
I answered a calling that I felt and became a doula to try to help women avoid the traumatic event I experienced on my son's birthday. I also found the International Cesarean Awareness Network at about 6 months post partum, whose unconditional support and understanding brought much healing to my heart. Both of those changes in my life forever changed me, and although we weren't planning any more children, I was glad to be helping other women. Well, God had other plans for us, and we found out in October 2004 that we were pregnant for the third time.
Baby #3: VBAC
The Birth Story of Kayla Anne, June 30, 2005, 6:20pm
This time, I felt as though I really did everything I could to plan the safest and healthiest birth for myself and my baby. I hired a midwife, 2 doulas, and decided that birthing at home was the safest place for me to be. And this is the story of my third child.
Around 12:30am on June 30th, I awoke to a contraction. Several minutes later, another contraction. Could this be it? Could this be the day that I've been waiting for for over nine months? The contractions were mild, coming about every 6-8 minutes probably, though I was hesitant to time them knowing it didn't mean much. The feelings: excitement, worry, peace, calm, joy . . . all mixed together in my being. Excitement that I would actually have a fair opportunity to birth my baby the way God intended, which I had never previously had. Worry as to what the road ahead of me would bring. Peace that I would trust my instincts, my body, my supporters, and birth my baby! Calm that I was remaining at home for this sacred day. Joy that I would soon birth my baby and meet this joy that I had nurtured and loved for over nine months.
I lay in bed, not wanting to awaken my husband, Mike, wondering if I should call C, my midwife. I gave myself some time to go back to sleep, and after about an hour, I called C, as she had requested prenatally, to give her a heads-up that I thought I was in labor. She asked that I call her again when anything changes. I also called my sister, T, to let her know, as she had gone to Pittsburgh the day before, but we wanted her to be with me for the birth, and to take care of my other two children, Hallie and Bennett. I couldn't sleep, as contractions were still coming, though still tolerable, so I decided to distract myself a bit, check e-mail, and get some final things prepared for the labor and birth.
At about 3am, I called C to let her know that this was definitely labor, and the contractions were getting a bit closer together, but I was managing well. She decided that she'd be on her way, and I was wondering if I'd called her too early. I don't think I was ready for support at that point. I hadn't even awoken Mike. I liked the time that I had alone, laboring with my baby, smiling as I thought of what was to come. I knew that was soon to change, so I woke Mike up and told him that today was the day. I labored a bit longer in bed, on my hands and knees, and then I decided to call my doulas and let them know that C was on her way. I decided to stagger when people were coming, so I called W first, and called M a bit after.
I labored for a while on the birth ball after Mike blew it up, which felt really good. Sometime between 4 and 5am, W came and immediately started rubbing my back, which felt very calming and relaxing. I mentioned to her that I had just called M, and so she should be here in a while. By about 6am, my entire birth team was there including my midwife, birth assistant and two doulas. Oh, and my sister was on her way, and I decided to wait to call my mom until I was further along in labor. When M came, she took over with the back rub, which felt so nice and relaxing during contractions. I also held Mike's hands during each contraction, as I needed to feel him close, and be with me throughout this journey.
I coped in various ways throughout the morning including on the toilet, on my hands and knees in bed, on the birth ball, standing up and leaning, and at one point (around 9am) I got into the Jacuzzi tub, and then later in the morning, I got back in again. The kids were in and out, and gave me kisses, and it was nice for them to see mommy working hard, getting ready to birth their baby brother or sister. My sister, T, had come at some point earlier, and she was also in and out (more in than out, from what I was told, but I felt so surrounded in support with my eyes closed, that I don't know exactly who was with me throughout labor). All of my support people gave me just what I needed even before I asked. I had plenty of water to drink, cool clothes with lavender on my forehead, hands to hold, voices to calm, and all was well.
I remember around 11am, I started to feel the urge to push, and I wanted to get out of the tub to use the bathroom, as I didn't feel as though it was time to birth, but just to go to the bathroom. Someone commented about not letting me push the baby out in the toilet, but I knew it wasn't time. I was feeling the urge, but the time wasn't right. I asked C to check me, and I was at 4 centimeters dilation. This was crushing news for me, and my first emotional setback. I felt as though I was working so hard, yet my body was progressing so slowly, and I didn't think I could do this all day. I remember someone saying that my body was going to labor just how it needed to, and with that, I tried to find my patience within. With everyone's help, I regained my strength to continue on, and so I did.
Throughout the day, I tried so hard to resist this increasingly overwhelming urge to push, which just got harder and harder to control. I needed to look in M's eyes, and count over and over again. I kept being told to "try not to push", and I was trying, but I couldn't help it, my body was doing it. That was a bit frustrating for me to hear this from everyone repeatedly, and I probably voice my frustration more than a few times. I'm not sure what I did for coping other than counting wherever I was (and I was definitely mobile - standing in the bathroom, being on the toilet, on the bed, next to the bed, in the tub . . . though I do have some moments that I remember.
I remember sitting on the birth ball, leaning on my bed, with the birth assistant on my left side rubbing my arm just breathing. She had such a calming presence, and I felt less of a need to vocalize with her next to me. I remember at one point being in the bathroom with just Mike and C and having a Popsicle while laboring on the toilet. That was around noon, when my mom got to the house. The one and only time I saw her was when she came into the bathroom gave me a kiss, and told me she was so proud of me. I remember being in the bathroom with M and W next to me, leaning on the countertops, looking into M's eyes desperately while trying to count to distract myself from this incredible urge that was overtaking my body. At that point, I thought to myself that I have got to get to the hospital to have an epidural to stop myself from pushing - at that point, and once more later, were the only times the thoughts of transfer entered my mind. We were counting over and over from one to four, and during one contraction I said FU@*!! M said, "Let's go with that", but repeating that word when I thought I'd never want to do that again wasn't appealing, so we went back to counting.
Resisting this urge was the hardest thing physically and emotionally for me. I knew probably too much about the birth process, and kept thinking that I was going to get nowhere by how I was having to deal. I felt like in order to not push, I had to squeeze my bottom, but I also knew that by squeezing my bottom, I wasn't going to dilate the way my body needed to. I felt very much stuck between a rock and a hard place, but luckily I never thought to myself that I wasn't going to birth my baby - I just thought that maybe it would be at the hospital instead of home.
I was checked again sometime between 3 and 4pm, and was found to be 6 centimeters dilated. Another breakdown moment . . . 14 hours into labor, resisting the urge to push for over 4 hours, and I was only 6 centimeters?? I couldn't believe it. Emotionally, I was done. Physically, I was done. That was a moment of another good cry, which my midwife encouraged as I lay in bed feeling so defeated. I don't know what I said, or if I said anything, but I really had a hard time moving forward from there. What choice did I have though? The labor wasn't stopping until this baby was out, so I continued on.
C suggested that she give me something to help me relax for an hour, and then they try to power the baby out. I agreed, but did feel a bit uncomfortable about the "powering the baby out" part, but we'd cross that bridge when we got to it. I got into the tub at about 4 or 4:30pm while they gave me some nasty tasting drink to help me relax (homeopathy, not alcohol, though I could have used a drink by that point!). Boy, that was good stuff. I could feel the contractions, I could feel the urge, but my body couldn't push with the feeling. C said a couple of very empowering affirmations that I just grasped and repeated for the next hour. Through each contraction, I said, either "I am strong" or "Release the baby" to help me relax, and this was probably the most bearable time that I had had since about 11am.
After about an hour, they started dosing me with some more homeopathics to try to get my contractions going stronger and closer together. That, along with some nipple stimulation immediately got my contractions harder and closer together. I was worried at this point about uterine rupture because I knew the chances were greater when my labor was messed with, but at this point, I was exhausted and knew I needed to get the baby out. The urge to push came back fiercely at about that time, and C checked me and found me to be about 8 centimeters dilated. She manually tried to dilate me to complete while I pushed with my contractions, and WOW - it hurt! She also suggested breaking my water, which at that point was fine with me. After a bit more time, she had her birth assistant (senior midwife too) check me just to confirm what C thought was a lip, and the birth assistant said I could push past it.
I'm not sure why or how I ended up getting out of the tub to birth my baby. M later told me I was restless and said I wanted to get back in bed. Anyway, I pushed a couple of times on my side, and then Mike got behind me and I pushed semi-reclining until my baby was born. The feelings were so much more intense than I thought they'd be, and I was much louder than I thought I'd be. At one point, I remember saying (multiple times), "Guys, I'm done." And they would say, "Yes, you are almost done." But that's not what I meant. I meant I was done trying, and I thought to myself, how can I get myself out of bed, down the stairs, into the car, and to the hospital to have my baby, but that wasn't necessary.
Really, I was almost done, and after about an hour of pushing, I did it! I pushed my baby out! I couldn't believe it. I was ecstatic, and so relieved that it was over. I just kept saying, "WE DID IT!!!" with great pride and joy! I am so grateful for the support that I received, and for the belief that everyone had in me. The belief and confidence that others had in me and my body carried me through the times in labor when I didn't have confidence in myself, and that's just what I needed to birth this baby. And this is the biggest accomplishment of my life - I birthed my baby the way that God intended safely and comfortably in my own home! I wouldn't have it any other way!
Jen S's VBAC (difficult c/s, then VBAC)
Kmom's Notes:
Birth Story
Jen's c/s story is above; she felt it was a horror story akin to a rape for her. Jen's full VBAC story can be found in the section on BBW Birth Stories: VBAC stories.
Alexia's VBAC Story (induction, fat-phobic treatment, c/s; home VBAC)
Kmom's Notes: Another example of fat-phobic treatment and assumptions. Alexia's first story is a lesson about not assuming your care providers are size-friendly simply because they don't spend all pregnancy yelling at you about your weight. Her midwives seemed perfectly fine---until the end of pregnancy, when they assumed her baby was huge, induced labor, did not know what to do about a posterior baby, and treated her badly. Afterwards, they made lots of assumptions about how she ate because of her size, and lectured her husband about her size and making her diet etc. Finally, they told her she couldn't birth her baby because she had a "fat vagina"----a unique lay term they used for what is called "soft tissue dystocia" in medical parlance. In other words, she supposedly had so much fat, she was fat inside her pelvis and around her vagina, thus supposedly " blocking" the baby from coming out.
Of course, Alexia went on to prove them all wrong. She had a VBAC with a baby that was BIGGER than her first. So much for the "fat vagina" theory. Once again, her birth shows that it's the baby's position that matters most, not baby's size, not mom's size, not "soft tissue dystocia," not the size or shape of mom's pelvis, etc. Fetal malposition is the key in MOST cesareans, and fixing the baby's position and laboring spontaneously and naturally is key in most VBACs.
Birth Story
Baby #1: CS
Before I got pg, I expected I'd have a healthy pregnancy and a quick natural trouble-free delivery. I had lost 50 lbs. and asked my family doc and OB/GYN at the time if I should lose more weight or get pregnant. They both said, go for it! You are healthy and not getting any younger. (I was 34.) I asked the OB point-blank if my weight was an issue and she said no, medical problems are the issue, not weight, and you don't have any. (I was 275 lbs. when I conceived.) I started seeing the midwives because my OB was pretty much like, "You are low risk so you don't need me, you need the midwives." I was happy with that.
My pregnancy with my daughter was indeed healthy and happy. I did some prenatal tests, but not all, and they didn't really pressure me about anything. I had 2 GTTs, but at the time I felt that was reasonable given that I thought I had risk factors (weight, age, family history).
My plan was to give birth at the hospital naturally with the midwives. (I liked the idea of homebirth, but I didn't think "real" people did that -- I thought this was the closest option available to me and was the "responsible" thing to do.) DH and I took a Bradley class and I did a ton of reading. I hired a doula. I wrote a birth plan that my midwives loved. In spite of my reading, I was pretty naive -- I never imagined ending up with a medicalized birth, let alone a c-section.
The only thing that concerned me was the one time I asked what they use to induce with if induction is "necessary." (OK, I wouldn't ask that that way today.) Cytotec. Why? Because it's cheaper. OK, that was honest. I had a bad gut feeling about that.
Lesson One. Don't ignore gut feelings.
When I did the hospital tour at the start of my 3rd trimester, I had a bad gut feeling that this just wasn't the way to do things, but I thought it was nerves and I ignored it.
Lesson Two. Don't ignore gut feelings.
When I hit 38 weeks, things changed. Suddenly, I was going to have this monstrous baby. 10-11 lbs. at least. (I had been measuring about 4 weeks ahead for most of my 3rd trimester.) Everyone started telling my husband he should have controlled my sugar intake and that this was my fault. (I ate well, did not eat a bunch of sugar, could have done better with exercise). I found the fact that they didn't talk to ME highly offensive. I'm not a child. I had a bad gut feeling but thought it was too late to switch. And I think deep down I felt like my weight was my fault and it was going to be a problem after all. I think all along I felt "lucky" every time I "passed" a test.
Lesson Three. Don't ignore gut feelings. It's never too late to change.
Lesson Four. I should have been more assertive.
I had been [assertive] the whole pregnancy. However, I had a lot of shame surrounding my weight, so that's one issue where my assertiveness just escapes me and I feel like a deflated balloon.
I was scheduled for a BPP [Kmom note: BioPhysical Profile] and c/s consultation the following week. I agreed to be induced with acupuncture that day because it was "natural" and I would stay home until labor got going (and I was skeptical that it would work at all -- thought I was getting them off my back by agreeing). I was enjoying my pregnancy and not in a hurry, but I was afraid of problems with a big baby. It still didn't occur to me that I could actually end up with a c/s. I ended up with prodromal labor until my c/s consultation. The acupuncturist scared the bejesus out of me about how this huge baby was my fault, blah blah blah. Again, he talked to my husband more than me.
Lesson Five. Don't underestimate "natural" stuff.
Lesson Six. Don't make fear-based decisions.
At the consultation, they did an ultrasound and estimated baby to be 9-10 lbs. At the time, that sounded huge to me and I didn't know if it was really possible! (Now, I know better.) They insisted it was probably off and that baby was probably even bigger. The perinatologist I saw was great. She wasn't worried. She said that they no longer do c/s for big babies because the research doesn't show any improvement in outcomes. (Why don't any of the regular OBs and midwives seem to know this!) She did a vaginal exam (VE) and I was 3cm dilated. She offered to strip my membranes and I agreed because I figured it would only work if I was ready. She said if I wasn't in labor by the end of the weekend, I could stop by and she could strip them again, but it was up to me.
Apparently I was ready. I was in labor by the time I got home a few hours later. I was told to stay home until contractions were 5 minutes apart. I waited about 6 hours until they were 3 minutes apart and DH was good and nervous ;-) (We had a 45 minute drive.) They didn't hurt and I was really excited. Unfortunately, I didn't realize the length of the contractions was important, too -- they were only lasting about 45 seconds. We got to the hospital and checked in. The nurses all were saying there was no way I was in labor, I was too happy, they were going to send me home, etc., until they did the 20 minute External Fetal Monitoring (EFM) strip and did a VE. 4cm, really contracting, but still short ones. Our doula met us there (our doula was actually at another birth, so we got the backup, which turned out to be good -- she and my husband really clicked).
After the 45 minute car ride and the 20 minutes on my back for the EFM, my labor turned into back labor. I used hypnosis, relaxation, and counterpressure/ heat to deal with them. They were intense but manageable. (The pain from my bulging bag of waters was much more painful! In retrospect, I'm glad my mw refused to break it -- that would have been risky and pointless.) I was throwing up and shaking and everyone kept telling me it'll be any time now, not much longer! I tried the shower, I tried the toilet, I tried standing. After about 5 hours, I laid down on my left side. After 7 more hours, I made it to 5cm.
I still hadn't thought of using pain meds -- just taking the contractions one at a time. However, after that vaginal exam, I got really discouraged. Everyone was quiet and just kind of avoiding eye contact. I felt like a failure at that point already. My midwife came in with an epidural sign off sheet and a shot of Stadol and told me I had to have one or the other or else I was going to be too tired and I was going to end up with a c/s. I agreed to the epidural because I thought it would be better/safer. The nurse won $5 on that -- apparently there was a pool on when I'd get the epidural. That really offended me. I made a complaint to the hospital.
Lesson Seven. I can really handle labor!
That's one of my best memories of that day. I'm grateful I had that opportunity. I am very confident about my upcoming labor and being able to handle things -- I figure I already handled the worst case (intense back labor).
Lesson Eight. Vaginal Exams can be very depressing.
I haven't had any yet this pregnancy and don't plan on it. I may change my mind and ask for one during labor or not. I think I'd prefer not to. When baby comes out I'll know I dilated. ;-)
Lesson Nine. I didn't talk to anyone about how I felt.
I isolated within myself and didn't talk about how I felt like a failure. I wish I would have to my doula. I think by withdrawing, I didn't really allow anyone to help/support me. They couldn't read my mind, after all.
Lesson Ten. Know what to do with back labor and an OP baby, other than hope for the best.
I slept a few hours, when they woke me up to give me oxygen. I was having trouble breathing. The epidural had traveled up so my arms were dead. They told me later they thought I was exaggerating and that it was because the BP cuff was too tight because I was fat. Then they told me my labor had stopped so they had to give me pit. Soon, DD's heart rate started dropping, so they told me I had to have a c/s.
Lesson Eleven. Why didn't I tell them to turn off the @#$% epidural to see if things started up again?
Didn't even occur to me. Now I know.
I was in shock. I cried for a few minutes, then got myself together to get through it. My c/s didn't happen for another 3 or 4 hours -- the OR was busy that day. I had to wait my turn. Right before, they offered to take me in the OR, break my water, and see what happened. By that time I was mentally prepped for a c/s and there's no way that would have been productive given her position, etc., so I just told them to get it over with. The nurse got mad because I was "so fat I couldn't get on the OR table" -- well, I defy anyone at 9 months pregnant with an epidural that deadened both arms and legs to be able to crab walk over there. Somehow I made it while everyone in the OR watched me. Ugh. My bag of waters exploded on her on the way. Oops. (Sorry, that was childish and petty, but oh so satisfying. I even laughed out loud.)
The c/s was uneventful. I was glad how things turned out afterwards with DD -- I was the first to hold her. She was only a little over 8 lbs.-- they weighed her twice, they were so shocked that they were so wrong. She was put right in bed with me and we were never separated. She roomed in. They helped me breastfeed right away. My midwife and the anesthesiologist were very nice. My mw took lots of pictures and, while I don't like the c/s part of it, I like having the pics of our first moments with DD.
Lesson Twelve. I will include this stuff again in my transfer plan.
It kills me when I hear some [women are] separated from [their] babies for so long unnecessarily. I think this was primarily my midwife's doing and while I disagree about some other things she did (which is easy to do in hindsight, I admit) I feel very grateful for this.
They didn't give me a normal bed -- they had me in something with a lift, etc. I didn't need it. I was able to do for myself and get up and about faster than their skinny patients. They were openly shocked how quickly I was up.
Afterwards, they told me I had the c/s because I was fat. When I was being prepped in the OR, they had taken my husband aside and given him a big lecture about letting me live like this, letting me have a baby, letting me get out of control during my pg, etc. I was furious. (I weighed less 6 weeks pp than I did when I started my pg, so obviously I wasn't out of control, etc. Much of what they said was based on bad assumptions and they never bothered ask me anything -- they just assumed and TOLD me.) DH had been very supportive while I lost 50 lbs. slowly (by STOPPING dieting). Afterwards, he was stressed out and pushing me to diet and, while I know it was out of concern for my health, it caused a real problem for us. Finally we had it out.
Lesson Thirteen. Don't put up with fat-phobic Care Providers and treatment.
I thought I had done everything right to prevent it, but...
A few weeks after the birth, I went back to try to process what happened and talked to the main midwife. That was the first I heard about the "fat vagina" theory. She said it was possible that I had so much fat in my vagina that it blocked the baby from being born. (My BS meter went off immediately -- baby never even got down into my vagina, so that had nothing to do with it.) Boy, I'm mad again about this whole thing!
I had breastfeeding problems and didn't get help from someone who could really help me until DD already developed a bottle preference. I pumped a years worth of milk and felt like a failure every day. Not being able to nurse devastated me more than the c/s. I was told my breasts were too big and my nipples were too big. My midwife looked at my nipples and told me DD would have to be at least 4 years old before she would be big enough to nurse. I worked with a great La Leche League [leader], but it was too late I think and I couldn't get DD to do much more than comfort-nurse occasionally.
Lesson Fourteen. Line up a Lactation Consultant early.
Mine's already on call [for next time.]
I felt like a real failure for months. I also felt incompetent about just about everything where my DD was concerned and her papa did many things for her and really bonded with her. I resented that and was really down about it. Going back to work made it worse. DH couldn't understand why I couldn't just get over it. Finally we had it out in a middle of the night fight and I let it spill about what a failure as a woman I felt like, etc. He finally got it, as much as he could. It hasn't been until recently that I feel she really has a close relationship with me now. I think co-sleeping helped us a bunch. I had been so confident about being a mom beforehand.
I got my records and they were pretty appalling. Lots of talk about my weight, sterilization (never discussed with us), race, etc. I ran them by a professional who wouldn't pull any punches with me and even she said that is not just hospital speak, that was appalling.
More lessons --
POSITIVE STUFF I'M BRINGING TO THIS NEXT PG
BAGGAGE I'M BRINGING TO THIS NEXT PG
WHAT I'M DOING DIFFERENTLY THIS TIME
Baby #2: Home VBAC (HBAC)
I started experiencing prodromal labor on 29 July and had regular contractions for about 8 hours a day every other day for a week. Every time I had them, they got stronger than the time before, but it wasn't until Thursday 4 Aug that I thought, "This is it!" I had been swimming and my contractions started soon after I got back from the pool. When contractions were strong and 2.5 minutes apart (around 1am), I called my doula and midwife and they came over. We hung out for a bit and then I wanted to get in the tub.
My MW asked if she could check me first and I agreed. We were all surprised to see that nothing noticeable was going on – in fact, where two weeks ago, my cervix had been forward and baby was low and we could feel her head, now my cervix was high and posterior and we had trouble even reaching it. She noted that baby's head was asynclitic. She didn't say any of this with any judgment or anything – just matter of fact so we could figure out what, if anything, to do. I started getting nervous. I tried to relax. They got some sleep. In the morning, things had spaced out again, so they told me to not think about being in labor or try to be in labor or anything – just to relax and do things to take my mind off it. I posted for suggestions to deal with things and went about my day, doing laundry and stuff around the house. Periodically, I did some lunges, pelvic rocks, etc. The contractions picked up again a bit and I got frustrated, so I had a glass of wine in the afternoon, which spaced things out again and allowed me to relax enough to take a nap. [Kmom's note: a glass of wine is a traditional midwife's remedy for a tired pregnant woman who needs a break from contractions for a while. It's no more dangerous---and probably less dangerous!---than taking a sleeping pill or other drug at the hospital, which is likely what they would have done.]
After I put my daughter to bed, the contractions started increasing. I was sitting on my exercise ball, rubbing my belly (kinda up and back because it felt good). I assumed I was in for another cranky prodromal night. My husband tried rubbing my back. Around 11:30pm, they were back to 2.5 minutes apart and as strong as the night before. Pattern was the same and I was getting frustrated. I decided to do a trial run in the birth pool. Being belly down felt like crap, so I decided to heck with OFP, I'm leaning back. They kept getting stronger as I kept rubbing my belly up and back, up and back. I thought, these might be prodromal, but I need some help! I called my doula to come over around 1:00pm. She was on the way and I started to realize, say, I think this might really be it this time. I hesitated calling my midwife in the middle of the night again, but by 1:30, thought, "To heck with it, I'm calling!"
My doula arrived to get me through the most intense part of transition – she really helped me by slowing down my breathing and bringing me down to earth. I floated on my back in the pool (used pool noodles under my arms to "recline") and focused on relaxing my bottom and letting my hips rock back and forth. She also helped my husband help me by putting ice cold cloths on my forehead and stuff. He was really feeling it with me and I could tell he wasn't sure how best to help me get through it. He hates seeing me in pain. I remember saying over and over that I was terrified my midwife was going to come and tell me I hadn't progressed at all (c/s was for FTP ultimately). The contractions were right on top of each other.
Then, I had one contraction that morphed into a kind of a push – it was like throwing up in reverse. I said something like, "I get a break before pushing, right? Right???" And then I got this push urge so strong my belly arched up out of the pool. Wow! Intense. I yelled, "I have to push" and my doula yelled back, "Don't push!" There was no option – it was not under my control! I was starting to get tense.
Luckily, my midwife ran in right then, threw her stuff down and looked me in the eye and told me to start saying "Yes" with each contraction. It really made me work with them better. I felt something shoot through my cervix – turns out it was my bag of water. They got me out of the pool with the bag hanging halfway to my knees and onto the bed to check me real quick before getting me on the birth stool. I asked my midwife, please tell me this isn't going to take hours of pushing! She said it would be about 10 minutes.
Sure enough, 10 minutes and 4 pushes later, there was an almost 9 lb. baby! It was an amazing sensation – I thought baby would feel like one big lump, but I could feel the head, shoulders, body pass into and through my vagina and then out. Baby crowned for a while (relatively) because I was scared I was going to tear as she came out, but then I just went for it and she flew out. MW supported my perineum and I didn't tear! I did have some abrasions, but nothing requiring any stitches. I felt GREAT. All the intensity, etc., stopped the second the baby was out. Phew!
Started nursing baby right away. Delivered placenta about 30 minutes later. Was up to pee within an hour. She was 8 lbs., 14oz., 20 inches long, 14 inch head (perfectly round -- no time to mold!). [Kmom note: She was bigger than the c/s baby. So much for CPD and a "fat vagina!"]
Nursing is GREAT this time. The first 3 weeks were hell, but then within a space of days, it was the best thing ever and has been ever since. I lined up and met with my LC before the birth. I had more realistic expectations the 2nd time. I had lots of support. When I started experiencing cracked nipples and other problems the 2nd time, I was ready with soothies, etc., and I didn't try to tough it out. I didn't hesitate to ask for lots of help with positioning, latching, etc. I set small goals for myself. I treated myself to nice nursing clothes. I paid attention to my baby and my body and figured out what things worked best for us. I disregarded the "rules" and experimented. I remembered how tough pumping was and how I mourned the loss of the nursing with my 1st, so I was really motivated to make it work. I don't think I could have pumped exclusively for another year. I was seriously considering going to formula if that happened.
I had never seen a chiropractor before my c/s, but after hearing so much about it on the ICAN list, I decided to try, even before I tried to conceive again. I wanted to do everything possible to avoid another positioning problem. Plus, I had been having back pain -- lower since the c/s, upper from years hunched over a computer at work. The chiro care loosened me up and made me feel younger and more flexible. I think it also made me aware of my body physically and was a good step towards taking better care of myself. I haven't been very nurturing toward myself. I also had virtually no ligament pain, pelvic pain, sciatic pain, etc., with the 2nd pregnancy and I had had all of those with the 1st. I do think the chiro care helped with my HBAC ultimately.
HBAC was the best decision we ever made. My DH was amazed at the difference in the experience for us and is a total convert. I felt so overwhelmed with love for my c/s baby afterwards, too – like she had made this experience possible for us.
Bonnie Alvarez's Story (induction then cesarean; home waterbirth VBAC)
Name you wish used in FAQ: Bonnie Alvarez Age at baby's birth: 29
Prepregnancy weight or dress size: 250, size 22
Wt gain in pregnancy: 39 lbs
Any trouble getting pregnant/infertility issues? none
Baby size and gender: 1st/girl/9 lbs 8 oz, 21", 2nd/girl/9 lbs 1 oz, 21"
Any complications: no
Place of birth: hospital with #1, home with #2 Type of care provider: Licensed Midwife
Breastfeeding? Yes
Any special notes you want to add about the birth: VBAC, waterbirth
Birth Story
My first birth
[see above] was a cesarean - ostensibly because of malposition/macrosomia (big baby), failure to progress (I was induced 2 times over a 3-day period because I was at 41 weeks), pregnancy induced hypertension (they were taking my BP with a cuff that was too-small and was giving a false-high reading), and pre-eclampsia. The pre-eclampsia was based upon edema (the only thing that was actually true: I did have edema), and protein in my 24-hour urine collection. However, during that 24-hour period I was losing my mucus plug, and mucus is chock-full of protein...you make the deduction.
The cesarean, in my opinion, was completely preventable with better prenatal care, such as nutritional information. Also, all but one of their "reasons" was bogus...only the edema was true, and edema never killed anyone. The baby was never under any stress either...her heart tones etc were always strong. Having wanted a natural waterbirth, the whole thing was a real shock and had real after-effects...nursing problems,
PPD, and a general sense of failure and anger. I know that I was definitely categorized as high risk for at least 2 reasons: being overweight (irrelevant if healthy) and because the midwife who I got stuck with was probationary and was covering her butt.
Hence, the big victory with this birth. I researched and interviewed for this birth...and I found what I needed.
Naomi's Blessing ~ A home waterbirth VBAC journey
Today Naomi is ten days old, and I think I am ready to begin writing her birth story. Well, our birth journey is probably a better expression. The last two weeks have been a revelation for me - physically, mentally, and spiritually. I think that there has been a lot of old wounds healed, and also some new hurts discovered. The birth took place in my mind and soul just as sure as it took place in my body. Here is where our story begins...
[You can read Bonnie's full VBAC story on the BBW VBAC FAQ]
But, none of it was a bad feeling in my mind - I was so grateful for everyone who helped me get through and so enamored with my new baby...surrounded by family and love. I never could have done it without each person there: My older sister Lisa helping to calm Natalie when I was screaming, my husband, my mom, Patti my friend and doula, and of course Amanda and her assistant, Marie. It was truly wonderful, in spite of all the pain.
Not everything in life feels good, and one thing I can tell you: this pain was productive; it had a beginning and an end and a purpose. My c-sec was terrible; I was powerless, had no choices, had my baby taken from me and was filled with drugs. I was in unfamiliar surroundings, with an uncomfortable bed and was not allowed to eat, even after the surgery. Loving family could come and go; my husband was there; but they would not give him a bed or even a decent chair and so he was beyond exhausted. There was simply nothing in the world that could compete with my own bed and a grilled cheese sandwich after the birth.
I have lots of thoughts and theories and reflections, and will write them
separately. But one thing I can say to those reading it: It is worth every second. My baby's heartbeat never went below the 120's - even in the pushing stage after 38 hours of labor with ruptured membranes. My BP was 120/68 when I was 8 centimeters
dilated and in horrible contractions. I am telling you, my cesarean for PIH and
Pre-Eclampsia was a complete farce. It's true, I was healthier this pregnancy...but had I had good home care instead of getting my BP taken by MEDwives and doctors who were
trying to scare the crap out of me, I never would have had "high" BP in the first place...which by the way was still way lower than most c/sec's for the same reason. They looked at me, saw an overweight woman with a 9+ lb baby, and said, "cesarean." Of course, they did not tell me this directly and I did not know how to read the signs.
My greatest triumph in this is not even me; it's my baby. I knew her, smelled her, saw her, and coherently held her right away. She was alert, no drugs. She was not terrorized by needles and heel pricks...she was not deprived of 1/3 of her blood by having her cord cut too soon...she was not washed and scrubbed within seconds of being born and robbed of her soft vernix. She was not placed in a warmer all by herself under bright lights for over an hour because I was in recovery. The list goes on, as she was aspirated so many times they bruised her nostril passages and when she couldn't breathe, of course they had to take her for tests - and bottles of sugar water and formula...
I am telling you, if that is all I got out of this VBAC, it would have been worth it. But I personally got soo much more. The "fast-food" society we live in has come to birthing: if it is not ready by a certain time or within certain "averages", well then, it is a medicated/extraction/c-sec birth for you! Hop to it! And I am wondering where these "averages" come from...well hospitals of course. Where they induce and monitor and interfere like crazy. I mean, I cannot imagine letting someone tell me what position to be in or clothing to wear - what I can or cannot eat or drink - if I can or cannot shower or go to the bathroom. What is wrong with us to allow and even welcome this kind of treatment? It is very disturbing.
Anyway, my beautiful baby is now 3 weeks old and perfectly healthy. We went to the doctor the other day...and the staff there was so amazed I had her at home, they actually sent people out to look at us and/or meet us, "This is the lady who had her baby at home," like I was some kind of
anomaly of nature. They always asked, "Weren't you scared?" and "Was it an accident?" and I answered, "No, what scares me is the hospital; those are the brave people. We only go there when we're sick," and "No, after 42 hours of labor, it was definitely NOT an accident!" And of course then they were even more shocked.
I feel so bad for people who don't know about the wonderful option I had. Until I was almost complete (10 cm), I never even considered a hospital or drugs...and even then, it was for the pain (too late anyway for painkillers) and not because of any danger to me or the baby. And I realized, if I went, I would be an *automatic* c-section, probably with a general. Great, knock me out and cut me open and take my baby, after I had already *almost* made it. No thank you! That is what helped me those last few hours: I had already come so far; was I going to throw it all away? I decided I would try until I passed out. And of course, God helped me make it.
That is the story of Naomi's Blessing. [To see pictures of Bonnie's
cesarean compared to her VBAC birth, see www.pattiramos.com/bonnie.html.
]
Sallette's Story (c/s, VBAC after long hard labor)
Kmom's Notes:
Birth Story
I was due May 15th and on May 27th, the doctor wanted to induce. I was willing even though I wasn't dilated or anything (or dilated just a fingertip) because it was in the desert and it was 100 degrees. Also I hadn't even had a Braxton Hicks contraction or anything no matter how much I walked, etc. I was clueless about how often inductions lead to c-sections.
I went into the hospital around 7 p.m. on the 27th and they did a prostaglandin gel application. Started having contractions right away (all back labor). Around midnight they did another p-gel application and my contractions got stronger. By 5 a.m. I hadn't dilated anymore so pitocin was started. Talk about hell. Again it was all back labor, not a single contraction in my stomach even though baby was not posterior. I had been walking periodically until the pitocin was started. An interesting thing to note was that my water never broke but I had minimal amniotic fluid, like none at all. Nothing came out when they put on an internal fetal monitor. By 10 a.m. I was begging for some pain relief and I still hadn't dilated AT ALL, so I got an epidural.
By 1 p.m. I still had not dilated and the baby was showing some minimal signs of distress. The doctor told me that if I had dilated at all he would wait because the baby wasn't experiencing major signs of distress but since I had not dilated he recommended the c/s. I think that it was the right thing; my son wasn't breathing right when he was born and had to spend a week in the NICU. The doctor noted when he did the c/s that I had no amniotic fluid at all. I never had leaking or anything. C had a lung infection and I really think that I probably had not had amniotic fluid for a while and that is why he had the infection. So basically I had a c/s for "Failure To Progress" (FTP).
Update: Sallette had 2 VBACs after this birth! Although she had a long and difficult labor both times, she was thrilled to get a VBAC and persevered despite difficult odds and tough choices. Her stories can also be found in the BBW VBAC Story section on this website.
Balek's Story (postdates induction, posterior baby, c/s; hospital VBAC with no interventions)
Kmom's Notes: Another classic story of a malpositioned baby, forced into labor before it could align itself properly, and so resulting in cesarean. Note that "Balek" was able to use Optimal Foetal Positioning (OFP) to help the next baby be more well-positioned. For more information about OFP, see the FAQ on this site on Malpositions, and also the book available from www.birthworks.org or www.midwiferytoday.com.
Balek also had a history of a DVT (Deep Vein Thrombosis), while on birth control pills as a younger woman. She was tested and has no known clotting risk factors. There didn't seem to be any reason for the DVT, so the birth control pills were blamed. (Birth control pills are known to increase the risk for blood clots.)
A past history of DVT does raise the risk somewhat for a blood clot during pregnancy and birth, especially one by cesarean. Her family doctor in pregnancy #1 chose to treat for DVT risk only when they had an induction (which limited movement, another risk factor for clots) and a c/s (which increases the risks for clots). Treatment was heparin shots (a blood thinner compatible with pregnancy); one following the failed induction, then 2x/day after the induction and c/s, then Coumadin (warfarin) for 6 weeks. Heparin is preferred for pregnancy; it is a very large molecule and does not cross the placenta. Coumadin is used post-partum because it can be taken orally (instead of getting shots). Both are compatible with breastfeeding, according to Balek.
In pregnancy #2, the CNMs lost track of the fact that she'd had a prior DVT, although it was in the medical record and they'd been informed at the first visit. She got a call from one of her CNMs around the 8th month saying, essentially, that she should have been on heparin all along. They met with the perinatologist who is the CNM's primary OB backup and discussed DVT risk, plus they found information elsewhere as well.
After talking with a close family friend who is a physician, they agreed to take 5000 units 2x/day of subcutaneous heparin, self-injected. Her providers told her to just stop taking it when she went into labor. She asked if there was ANYTHING they would do differently if she was on heparin [Kmom note: mothers on heparin are often induced], and they said no. According to them, heparin is cleared from the system pretty quickly (hence the 2 or even 3 doses per day people take) and according to the perinatologist, a study has shown it to be cleared more quickly from pregnant women than from the general populace. According to them, a woman on heparin with a normal delivery and no episiotomy loses more blood than a woman not taking heparin, but not enough to be anything like a problem. In the worst-case scenario of a uterine rupture, the difference is not significant, because so much blood is lost in either case.
Post-partum, she is still taking the heparin but will switch to Coumadin/warfarin until 4 weeks postpartum. She says that she is honestly not sure it's all worthwhile, but "nobody knows any reason why it would be hindering either, so I'm doing it, although...I'm of two minds about it!" She points out that if she had any risk factors (like clotting disorders), it would NOT be a gray area; it would clearly be necessary to use heparin during pregnancy and warfarin postnatally.
Birth Story
Baby #1 (Failed Induction, Induction with Labor, C/S)
We liked everything about our family doctor except that she wasn't comfortable going past 42 weeks of pregnancy. She told us up-front that she wasn't, and that if we wanted to go past 43 weeks we needed to find another care provider. But she was so great otherwise that we stuck with her.
So I was induced with some suppository (don't know what) at 41 weeks, 6 days, and Pitocin the next morning. There were lots of contractions but labor didn't start. Go figure----the baby was posterior and not engaged! Our doctor sent us home and scheduled another induction for 42 weeks, 2 days.
At that point, still posterior and not engaged. A different suppository was used that evening. My waters broke around 5 a.m. but the contractions stopped. Pitocin was started very early the next morning. This time I went into labor. I labored all day with the damn External Fetal Monitor [EFM] strapped on, and I stayed in bed the whole time (although the doc and nurse encouraged me to try sitting in the rocker).
The baby had scary decels at one point so I had an internal fetal monitor attached and then an amnio-infusion. The decels stopped, so the doc was right that it was from cord compression. I was given an okay to try pushing when I felt an urge to do so, around 9 cm dilated. My cervix didn't swell so I continued. I got to 9.5 cm with an anterior lip, but even with the doc helping to lift the cervix over the baby's head, nothing doing!
Basically, I got tired. Nothing was changing, I wasn't making progress, and I lost hope and just wanted to be done. Around 9 p.m. our wonderful doc offered me options: keep going, have an epidural to rest and try again in the morning, or a c/s, with the baby out within 15 minutes of the spinal. DH and I were left alone to choose. We chose the c/s because the baby would get the least medication that way, plus I was so tired.
The doc who did the c/s had just had a c/s herself 6 months before. She tried to keep the cuts small. As she was sewing me up, she assured me that I would have no trouble with a VBAC next time. Our baby girl came out of me crying and pink, at 42 weeks, 3 days. My DH never left her side, and he brought her to me in the recovery room. She was nursing 70 minutes after her birth, as soon as I was back in the LDR room. I went home with my family 3 days later, as soon as they would let me go.
Baby #2 (VBAC, zero interventions)
At 38 weeks, our fetus turned transverse. After all my work on optimal fetal positioning, this was hard to take! We kept it up and by 39 weeks the baby was anterior and LOA, thank goodness! The baby began to engage around this time---at least, I felt all kinds of interesting stretching sensations deep and low inside me.
By 40 weeks, the baby was engaged enough that the CNM could only feel its chin. I was so happy because this was already farther than I had gotten with my previous birth. We knew exactly what we wanted and what we would and would not agree to, and we stood firm that we would not do any NSTs or other tests until 42 weeks (and not the standard 41 weeks). We also continued to refuse induction or even to discuss it. I strongly feel that induction is dangerous in general, and especially for a VBAC. I did agree to do kick counts to keep the CNMs happy.
At 40 weeks, 6 days, I had contractions that built up gradually all day. I thought it might be early labor, but then they stopped in the evening, so I figured it was Braxton Hicks contractions. Nothing happened the next 2 days. At 41 weeks on the nose, I had a nice few BH contractions in the evening, and some bloody show. But no "real" contractions and no labor.
At 41 weeks, 1 day, with more bloody show in the a.m. but no contractions, we decided to try castor oil. We knew the baby was LOA [Kmom: Left Occiput Anterior, or perfectly positioned for birth], vertex (head-down), and engaged, or we never would have done this! But while the castor oil made me visit the bathroom 3 times that morning, it didn't seem to do anything else. Oh well, I thought. My DH went off to school.
That same day, I was online around 2 p.m. while nursing my daughter down for her nap. We both slept until around 3:20 p.m. Then she was fussing so I woke up and brought her to bed with me to nurse so I could rest, since I was having some BH contractions---which got more intense pretty quickly. By 3:30 I couldn't stand having my daughter nurse because she kept moving during the contractions. I went back to the computer to see if changing my position did anything, and I starting timing the contractions. At about 3:45 the contractions were 45-60 seconds long and 2-4 minutes apart.
At 4:15 my DH was home, at 4:30 the doula arrived. Still no breaks longer than 4 minutes. At 5:00 our babysitter for our daughter arrived. With the help of the doula and my DH, I stayed on top of the contractions, feeling them as tremendous pressure but not directly as pain. I just lay on my couch, listening to Enya, relaxing through the contractions, and letting my uterus do its work.
About 7 p.m. we left for the 2-block trip to the hospital, hoping to get there before transition. When I was standing outside, I felt the beginning of a desire to push. I allowed myself to push gently, as the contractions seemed to want (but it wasn't breath-holding or bearing down). I was really pushing during the contractions as we walked down hospital corridors, starting to grunt and bear down. (I also peed all over myself!) Our doula saw a resident she knew and so we didn't go into triage; we went straight to a labor/delivery room. I was examined, I was complete, and the CNM gave the go-ahead for pushing (that I was already doing!). NO I.V., NO saline lock, NO fetal monitor, NO NOTHING!
I did hard pushing from about 7:30 until 8:49 p.m. Our son came into the world the way nature intended, with no drugs, no cutting, and no interventions at all. (Also without much head molding.) He had meconium in his amniotic fluid so he was deep-suctioned, but that was IT for interventions. We held and cuddled him for an hour, until the law required his Vit. K and eye stuff. Then we held and cuddled him some more. He wasn't even bathed until 4:30 a.m.
We left the hospital 24.5 hours after his arrival. We were (and remain!) very tired, but overjoyed with our boy and with his birth, too. I had a lot of tearing and bruising (I didn't ask what degree, but it took a long time to sew up) but he's worth every stitch and sore spot.
So much for the "CPD" [Kmom: Cephalo Pelvic Disproportion, baby 'too big' or mom's pelvis 'too small' for birth] written as the reason for the c/s with my daughter!!
Anita's Story (Spontaneous rupture of membranes, c/s 12 hours later; induced hospital VBAC, home waterbirth VBAC)
Kmom's Notes: Anita got trapped by the hospital "rule" that some hospitals follow---that if your water is broken for 12 hours (or 24 hours in other hospitals), you must have a cesarean due to "risk of infection." Of course, this risk of infection is largely created by the hospital doing vaginal exams and other invasive procedures. When all vaginal exams and other invasive procedures are avoided and the mother's temperature is carefully monitored, many midwives find they can safely go longer after the waters break spontaneously.
Anita had an induced hospital VBAC, complete with episiotomy, with baby #2. She was scared into inducing early to prevent the baby from becoming "too big" even though research shows that inducing actually significantly lowers the chances for a VBAC.
With baby #3, Anita planned a homebirth with a direct-entry midwife. However, labor progressed really quickly after days of Braxton Hicks contractions, and the baby was born at home, in the water, shortly before her midwife arrived.
Birth Story
Baby #1 (cesarean): I went into labor 5 days early with spontaneous rupture of membranes (her water broke before labor). [There was meconium.] Like an obedient patient, I went to the hospital, got hooked up to an electronic fetal monitor, and was told, "Doc will be here in 20 minutes for your emergency c-section."
I freaked. My sister had one of those! I screamed that they had better get an anesthesiologist up here pronto for the epidural because I refused to be gassed. In the time it took the anesthesiologist to stick me, the doc to get there, the nurse to shave me, I had a BM on a bedpan in a room full of bustling, loud, rude nurses, and my son's heartrate stabilized. I was "allowed" to continue to labor. After 12 hours (the hospital's "magic hour" for c/sec after membrane rupture), I was sliced and trimmed, muscle and tissue yanked back with a metal spatula, and the doc in my belly near up to his elbow, tugging and pulling my babe out by his neck.
I remember catching a glimpse of his face as they paraded past me out the door with my son. While I was closed up, my mom taped his first bath, shampoo, weigh-in, and he was left alone on a warming table for 11 minutes screaming his poor lungs out to be held. This is NOT the way birth is supposed to be and I am MAD that this happened to me and my son, and angry at my ignorance at allowing it to happen.
Baby #2 (hospital VBAC): After an uneventful pregnancy, I apparently had learned nothing from my previous experience except to change doctors. I was attended by a VBAC specialist who induced me with artificial rupture of membranes 5 days early. After nine hours of pitocin, I was told I could push. I was velcroed into stirrups in lithotomy position, nurses announced when it was time to push while instructing me to hold my breath. I was given oxygen (no wonder baby needed it000I had to hold my breath to push---where does that idea come from anyway?).
As his little hairy head crowned, I was given an episiotomy without my consent. His cord was wrapped around his neck, but instead of somersaulting him through it she chose to cut in on the perineum. One more push, ripping the remainder of the way---end to end---and my son was born gray and floppy. They took him to a warming table and after about 90 second he let out a faint weak cry. They wrapped him and whisked him away for the next four hours for observation. (Why they couldn't observe him as he laid on my bare 98.6 degree chest to be warmed, I don't know. He developed colic which persisted for some 18 months, and he continues to be high need, at 3 years old.) The doc stitched for the next 50 minutes. But I had VBAC'ed!! Looking back on it, I was thrilled then, but appalled now. It was horrible, but still better than my c/sec.
Baby #3 (unassisted home waterbirth VBAC): This time, I learned TONS. I chose a direct-entry midwife and planned a home birth. I was having mild contractions I identified as merely patterned Braxton Hicks contractions, 8 minutes apart, and I was able to sleep through them. They continued through the day until right after dinner, they went to 5 minutes, and then 4 minutes. Still painless, I figured it was just getting close to due date, and I would probably do this for another couple of weeks. After all, my midwife predicted that I would be late.
I had called her early Thursday afternoon, just to let her know the contractions were still there. She and I both agreed I could do this for quite a while! That night, I went for a walk outside, but that didn't seem to do anything. I decided I was tired of these Braxton Hicks, and decided to ask my husband for a "jumpstart" to see if we could change things. (My midwife says, "What gets 'em in there gets 'em out!") Shortly after that "jumpstart" I started having much more intense contractions, now 3 minutes apart. DH had already fallen asleep, so I handled it by myself for about 30 minutes before I knew I needed some help. I woke my husband around midnight, and had him time them. Yes, 3 minutes apart, lasting about 45-60 seconds. I called my midwife at that point to put her on alert, thinking to myself, "It's just the lovemaking, this will go away." While speaking to her, I thought I would start crying. Contractions were getting intense, and I didn't want my husband to touch me. I called my mom as planned, and she decided to come out just in case, even though I was sure we'd just send her back home when the contractions quit.
DH and I decided to go downstairs where the birthing area was set up, and he started readying the futon while I sat on the toilet, emptying my insides. I began to have an inkling that this might be it. Contractions continued in intensity and speed, and I trusted my body and just let it happen. At one point, my moaning through contractions turned into a grunt. "Am I pushing? Nah. It's just the lovemaking." I was really moaning through contractions while he rushed to set up the hoses for the birth tub and finish the bed, racing back to me every 2 minutes to help me through a contraction. I decided to have him begin filling the tub, and I sat on a chair. When I noticed contractions were one on top of another, I told him to call the midwife and have her come. Contractions were non-stop!
The tub wasn't full yet, my mom wasn't here yet, and contractions were really intense! I was moaning really loudly, grunting at times ("Am I pushing?") on that chair, and begged to get in the water. It wasn't quite full yet but I didn't care. DH helped me get off the chair (pulled me off) and I practically fell into the water. It instantly helped, but almost as instantly, I was definitely pushing! DH said, "Are you pushing? Don't push!" I told him to page our midwife, and she called back from her car phone. "She's wanting to push!" he said. She said, "Don't waste your time telling her not to."
My body had taken over. DH was saying, "Don't push!" and I was saying, "I don't have a choice!" I could feel the baby moving down! At one point, I felt down and the head was right there. ("I'm really having this baby!") I was on my knees, holding on to the side of the tub. DH didn't panic, just kept talking to the midwife on her car phone. My moaning and screaming, at that point, had woken up our other 2 boys, and they were crying upstairs. I screamed, "Where's my mom??!!?" She showed up finally at about 1:20 a.m. and calmed the boys down.
I began screaming for her to get the camcorder, the baby was coming! All of a sudden the head was out! Contractions had spaced out, and I could feel hair! I sat calmly in the water, amazed at this little hairy head between my legs. I called to the boys to come see the baby be born! They stood beside the tub, my mom standing there with a camera and the phone, DH beside the tub.
After about 1-2 minutes of calm, I felt another contraction---a short little push, and WOW! Out squirts this BABY!! ("I just had a baby!") DH scooped him up from the water, and handed him to me, and IT'S A BOY!! He was very quiet---he didn't even seem to know he'd been born! He was sound asleep! He was breathing, we could see his chest moving, but he made no sounds, just laid against me. We rubbed his back, and he moved and whimpered a little, then went back to sleep! He was beautiful and perfect.
The midwife arrived about 15 minutes later, and the placenta came out soon after that. I had no perineal tears. He weighed 8 lbs. 12 ounces, with auburn hair and dark blue eyes. One of my boys cut the cord, and the other wanted to cut some of it too! The older boys went back to bed, and we sat around and got to know our new precious one. From the first active labor contractions to his birth was about 2 hours, 15 minutes.
I was told the complications of my first birth, which ended in a cesarean section, were "failure to progress" due to "cephalopelvic disproportion." My second birth was induced to keep him from getting "too big." My beautiful unassisted home birth is now listed technically as having the complication of "precipitous labor." I am thumbing my nose at the system and crying inside for what my other two boys and I missed before.
Emily's Story (shoulder dystocia, vaginal birth; breech baby, c/s; homebirth VBAC)
Kmom's Notes: Emily's first baby had shoulder dystocia, where the head comes out but the shoulders get stuck. This can put the baby at risk for birth trauma. Fortunately, there was no lasting damage from this. The baby was 8 lbs. 13 oz., just on the border of 'macrosomia'.
As is common in hospitals, she was on her back to push (which reduces the amount of space for the baby to get out), and she had an epidural (which reduces the mother's mobility to adjust herself so baby can get out easier, and also may reduce the muscle tone needed to help baby get in the most optimal position for birth). Also, many OBs tend to rush the delivery of the shoulders, which may also increase the risk for shoulder dystocia. Although it is difficult to say for sure, these factors probably played a big role in this baby's shoulder dystocia. However, to the doctors, no other factors were important; it was all about the mother's pelvic size to them.
Emily's second baby was breech and she had a cesarean. With her third baby, her doctor did NOT want to 'let' her birth vaginally and tried to scare her away with horror stories due to her VBAC status and past history of shoulder dystocia. Emily would have been forced into a repeat cesarean against her wishes had she not had the guts to switch providers shortly before her due date. [It's never too late to switch providers!]
She ended up having a beautiful homebirth that went so fast her midwife did not even make it in time! And the baby she birthed this time (on hands and knees, without any shoulder dystocia) was 2 ounces bigger than the one that was supposedly "too big" for her pelvis.
Birth Story
My first baby had shoulder dystocia, weighing 8 lbs. 13 oz. I was on my back with an epidural and I believed this is what largely caused this. My doctors didn't want to hear this and it was all a pelvis problem to them. My pelvis 'just wasn't big enough to birth large babies.' Then when I added in my c-section [with my second child] due to my son being breech, I had double trouble.
The doctors wanted me to sign up for a repeat c-section [with #3]. But they didn't inform me of this until I was 34 weeks pregnant. They tried all kinds of scare tactics to get me to sign up for a repeat c-section. Thankfully I had a friend who told me about ICAN [the International Cesarean Awareness Network, www.ican-online.org] and I was able to get a lot of information and support.
I started researching the idea of a homebirth. I decided this was the best thing and I really wanted it. But my husband didn't quite agree. We didn't finally decide on a homebirth until 2 days before my due date.
I am so glad because I know if I would've gone into the hospital I wouldn't been convinced to have another c-section. I had two days of contractions 10 minutes apart. Then when I went into active labor it only lasted a few hours. I really believe if we hadn't have planned a homebirth, we probably would have had one anyways. Or in the car on the way to the hospital birth. Because by the time I really thought I was in labor I was going into transition. My midwife didn't get there in time, but helped my husband on the phone.
My son was born right before Xmas, weighing in at 8 lbs. 15 oz. I delivered on my hands and knees, which I believe is one of the best positions, especially if you've ever had trouble delivering a large baby before. My son slipped right out with no trouble. He was 2 ounces bigger than my daughter and the same length.
This was the best birth experience I could've ever imagined!
Kirsten Taylor's VBA2C Story (home VBA2C)
Birth Story
Baby #3: Finally, here is my third daughter's birth story; my HBA2C.
My husband and I hadn't planned on having any more children, at least not for several years. It was a surprise the following October when I found out I was pregnant again. It was then that I became absolutely OBSESSED with everything VBAC. I was so saddened b/c all the doctors said there was ABSOLUTELY no way I was going to have a VBA2C. The hospital near where we now live wasn't set up in case of emergency, so I felt uncomfortable with homebirth. It was the women of ICAN who mentioned a home-away-from-homebirth, and my doula volunteered her home without me even asking. She said, "The doctors won't let you? Fine, come to my house. Have your baby there!"
After finding a midwife (I interviewed and hired the first one I met), I did plan and have a beautiful, empowering HBA2C at my doula's house. I am forever changed by the experience. It is so empowering, so amazing. I relive my daughter's birth in my head all the time. What a beautiful memory it is.
I was due on June 17, and my midwife was fairly nervous about continuing
on past 41 weeks. I thought we had some wiggle room, but in the end, she got pretty uptight. She had told me that come Friday, June 27, she would
want me to contact my former OB and she would discontinue my care. I was absolutely SHOCKED. I thought we would discuss things at that point, not
just be let go. Well, she called me to apologize; she said she didn't mean there was nothing we could do between now and then. She urged me to
let her try to strip my membranes. I did so, and ended up down a crazy path of trying to get my body to go into labor. I did want to trust my
body to go into labor naturally, when it was ready, but I felt cornered and desperate. She did end up giving me until Monday, which was all
the time I would need. With her support, as well as my doula's, I tried all the subtle and not-so-subtle induction alternatives we could think
of: miles and miles of walking every day, acupuncture, chiropractic, herbal, homeopathic, so much sex that even my husband wanted a break (and
wa-a-a-ay more than any pregnant-and-due-any-minute woman would EVER want!!! haha) and finally two days of castor oil. I had had steady BH
contractions on and off for days. The induction stuff did seem to pick things up, but it would always taper off.
Then, Friday, my body just STOPPED!! I had 3 contx all day. Well, Friday night, as I was lying down with my older two daughters putting them to
bed around 10pm, things started again. I was having strong but totally manageable contx that were really felt in my back. I FINALLY got my girls
to sleep, then went and told my husband. I asked, just in case, what was the alternative plan to take my MIL to the airport the following day if
we were busy having our baby... They were shrugging it off, saying it wasn't an issue, but I persisted. I somehow just felt different this time-- though I honestly had thought this earlier in the week, too, so they
didn't take me too seriously. Anyway, they finally said my MIL would just have to change her flight if
that happened.
Well, the contx. quickly picked up, and by 11:20pm, they were about 2-4 minutes apart, lasting for 30-45 seconds, and I was needing my husband to apply counter-pressure to my back. During one contx felt a pop inside, and thought maybe the baby had her head caught in my pelvis oddly and that it rotated - nope, I took one step and had a small gush of water. I had been nagging at my husband that this was definitely it, and we needed to go to the grocery store as we were supposed to provide snacks for everyone at the birth (midwives, doula, ourselves, etc.) He thought I was insane to even want to go to the store, b/c the contx were strong enough that I was totally needing counter pressure, and not really in a condition to go shopping. I was just worried that the midwife and everyone would just starve to death if this labor took too long. Once my water broke, I swore it was green with meconium, and I got slightly hysterical for a few minutes - I knew that was a risk with some of the induction stuff, and was why my first daughter was c-sectioned to begin with, so I just KNEW it was meconium and that we were doomed. My husband called our doula, and I demanded that we were on our way b/c I wanted the baby's heart rate checked ASAP... The idea of shopping at the grocery store went out the window with my water breaking. At least I had sense enough then! Well, I had a few more gushes of amniotic fluid that were clear as can be, so I calmed down. But, we were NOT going to the grocery store as my contx were picking up and I didn't want to be any further in labor as we drove for 30 minutes to my doula's house. The drive was surprisingly manageable, but not at all pleasant. They were doing road construction, and it was SO bumpy down the usually smooth highway. I remember thinking how thoughtful of them to tear up the highway right before I went into labor. haha. My contx started coming at 2-3 minutes apart and lasting for about 50 seconds. Once I got to our doula's, they quickly settled into 2 minutes apart and lasting for 1 minute. The doula called the midwife as soon as we arrived, and she came soon after.
I was so frustrated b/c I had had a recent u/s that said the baby was in the perfect position, yet I was still having terrible back labor. I just couldn't get strong enough counter-pressure. I began to get very frustrated with how quickly the contx were coming. I complained once that I thought I was supposed to get a break to rest in between. I had been standing and bending over the bed and rocking and swaying to handle the contx. I was sooo tired, I was worried that this was going to be a 36 hour labor like this. I also laid in bed some, on my side, and enjoyed the ability to rest in between, but was not as successful at managing the contx in bed. My husband suggested that I try standing with one leg on a step stool, b/c he remembered from Bradley classes that it could help turn a malpositioned baby. I told him no, then my midwife told me I should do it, so I did (which he later chuckled that it irked him a bit that I listened to her and not him).
I desperately wanted to get into the birth tub we had rented and had set up, but the midwife wanted to make sure I was in very active labor (around a 7 dilation; I didn't know this was her policy before we decided to rent the tub.. grrr) before letting me. I started wanting to find out how far along I was soon after that, b/c the water sounded GREAT!! Finally, around 4am I demanded that the midwife check me, and she did, warning me that she really didn't want to with my water broken. I insisted, thinking I would hear that I was at a 7 or 8 and it would help me continue. She checked and I was at a 4. She was thrilled, she said my cervix was completely melting away and had thinned out. I was devastated, and started to get really upset again, that a 4 just wasn't enough. I had reached a 5 when I was last checked with my first daughter, so I felt I was so far from that, I really wanted to hear that I had made it past that critical mark this time. I knew this was going to take at least 6 more hours according to the traditional 1 cm an hour estimate. She tried to reassure me that this was AWESOME progress.
About 20 minutes later, I suddenly felt the baby had turned (still using the stool for one leg to help the baby be able to turn). The contx suddenly left my back and were full strength in my abdomen and cervix. I was happy, until I realized that there was NO counter-pressure that could take this away - they just were STRONG. I was noticing that I was more able to stay on top of them and moan and breath through them. Then I needed to go pee, and had a bad contx while sitting down, then two more suddenly when I stood up. I suddenly heard and felt my body shift and just start the most primal, guttural sound as I grunted and began pushing. I literally get chills thinking again at how amazing that felt.
I have heard that pushing is SUCH a relief, and oh my GOSH was it!! I yelled, "I'm pushing, the baby is COMING!" as I felt her just descend straight through my pelvis. The bulge and pressure on my whole bottom end was SURREAL!! (This is the first time I EVER got this far in labor!!!) My midwife jumped up (she had been resting in a walk-in closet while my husband and doula helped me and with a VERY panicked voice said, "Kirsten, STOP PUSHING!!! Do you hear me!! STOP!!" I told her through the grunts that I couldn't - they were all blowing "sho-sho-sho" noises in my face and grabbing me by the shoulders telling me NOT to push. I was trying, and copying their breathing but simply COULDN'T stop!!! My midwife called her back-up and said to get here NOW, I wanted to push. Then I lay down and yelled at her to check me.
The walk over to the bed was HELL b/c I was literally pushing this baby out and they were all yelling at me to stop!! She was trying to explain that if I pushed through a not fully dilated cervix it would cause it to swell. I knew this, but KNEW there was no cervix in the way, not with this feeling. She quickly checked, then calmly with a surprised look said, "You're complete. We're going to have this baby now." She stayed right with me, but called the back-up again and said, "She is having the baby, get here now."
I'm not sure how many pushes it took, but I laid there on my side with my husband spooning behind me and holding one leg, and my midwife ready to catch and trying to apply counter-pressure to my perineum. At one point, I know now it was when the baby was crowning, I thought she was doing something, and I started screaming at her, "Your hurting me, your hurting me!!" My doula said, no, it's the baby, she's not touching you. I pushed again and the head was out. The midwife started urging me to quickly push more, to get the shoulders out. It was NO problem. I pushed again and out she came!!!!
They immediately moved her onto my belly and I started BAWLING, "Oh my g*d I did it!! We really did it!!! Oh, HELLO beautiful baby!!!" Then I tried to calm myself down, b/c I remembered I really wanted to welcome her into a quiet peaceful place - oh well... haha She didn't cry immediately, she just laid there looking around, and I kept asking if she was okay. I told her, "I don't WANT you to have to cry, but it is sort of my indication that you are okay." She started squeaking a bit, so I calmed down.. Everyone was assuring me that she was WONDERFUL!!! She was sooo tiny to me. I was thrilled with that b/c the midwives kept telling me she was really getting big - probably over 9 lbs. I lifted my bra and she immediately opened her eyes and her mouth and started rooting around; that was also amazing!! SOOO ALERT!! She started nursing immediately!!! IT was soo great!!
While I was trying to breastfeed Maya, I was having bad contractions trying to deliver the placenta. It was so painful; I had to have my husband hold Maya while I tried to deliver the placenta. I tried several times to push it out, but it wasn't working. Finally, I rolled over onto all fours and pushed and out it came. I laid back down as they weighed Maya and did the standard apgar tests, etc. I began shaking like crazy; I could not get warm and was just shivering like I never did before. The midwife said this was normal following labor. They covered me with blankets and watched me for a while. They were a little concerned that I was losing too much blood. The midwife massaged my stomach to help my uterus clamp down. It was so painful. I was feeling very light-headed. The back-up midwife was talking to me face to face telling me to stay with her. Finally, I started calming down and feeling more under control. Once I started feeling stronger again, I took Maya back and sat up and breastfed her. It was amazing to just give birth and sit up so soon afterwards feeling so wonderful and energetic and feed her. I loved being an active participant in the whole experience!
The worst part of the whole VBAC experience was being sewn up following the 2nd degree tear. It was stressful and excruciatingly painful. My back-up midwife sewed me up and kept apologizing for hurting me. They did use local anesthetic, but in places it didn't seem to work well at all. It was MISERABLE. Finally, they gave me another anesthetic injection that seemed to help. My midwife was SOOO slow at sewing me up. She apologized but said she hadn't done this a whole lot and was slow and meticulous about it. I just wanted it to be done so I could have my baby back! My husband held Maya and began calling our family while they began the stitching. It was such a bizarre experience; I screamed and tried to hold still while they carefully stitched me up. I was also an emotional mess; it was a wonderful feeling. I had such a flood of thoughts in my brain. I was laughing, crying, then laughing again. I was laughing about how quickly everything went, and how they all scrambled when I began pushing. How amazing the experience was. Then I thanked them all so much for everything they did to help us achieve this HBA2C. Then I became SOOO sad when I thought of a woman I had read about in ICAN who was so strong, so persistent, and amazing in her strength and determination to have a VBAC, but ultimately ended up with a repeat cesarean. After just experiencing the VBA2C myself, my heart just hurt for her. I wanted her to have this experience so much. Then I became sad when I thought about how hard I fought for this experience, and what it meant to me. I was sad because if I tell someone that I had a HBA2C, most people will NEVER know or understand what that means to me personally, how hard I struggled, or what an AMAZING experience it was. They will just take it for granted and probably wonder why I would even do something like that. I was not sad about them not understanding me so much as I was sad that they would never have such an emotionally charged and amazing birth experience that I had.
Anyway, it felt like forever while they stitched me up, then they finally finished and my doula helped me shower and clean up. I had such a heavy, hollow empty feeling in my stomach. It was so weird feeling. It felt so soft again, after feeling so hard and full with my baby inside. I started feeling a little weak and clumsy in the shower, so I finished quickly and went to sit back down.
Everyone left and gave me and my husband some time alone with our new daughter. My husband was absolutely exhausted, so he fell asleep very quickly, snoring very loudly. I finished the oatmeal my doula had prepared for me, stared in amazement at my new little daughter, and called my family to tell them all the wonderful news. I was so proud of my daughter's beautiful round head. My mother had actually told me that if I had to have a cesarean, one good thing would be that my baby would have a beautiful round head, rather than a cone head; as if that even mattered to me. I was quietly proud that my daughter had this so-called perfect head even in SPITE of the VBAC, though I would have been thrilled if it was as pointy and long as anything!!!
After it was all over, I started thinking; oh my gosh, everyone cried when Maya was born but me! I specifically remembered my husband, midwife, doula all crying. I was horrified (as if it would have mattered anyway) that I DIDN'T cry!! The first thing I wanted to do when my husband, baby and I were alone was watch the video of the birth. My husband got out the camera and we watched it through the little screen; I thought it was hilarious--- I was sobbing like CRAZY, saying, "Oh my god, you're so beautiful!! We did it!! We really did it!! Oh my god, you're here!" I most certainly DID cry; again, not that it mattered, it was just funny. When I told my midwife, she was SHOCKED that I had already watched the birth video. She said some of her clients could NOT watch the video for weeks, and here I was watching it a few hours later (and again when I got home that day). I didn't realize that might have been an issue for others, for me, it was such a beautiful thing to see; all the months and even years of stress building to that one beautiful scene!
We stayed at my doula's house and rested for a few hours. Her 3 year old daughter and roommate came by to see our baby. I apologized to the roommate, smiling, for all the noise I had made while giving birth. The woman said she didn't hear a thing, just woke up this morning to the amazing news that a new life had been born in her home last night. She was so happy for us. The midwives came in to tell us goodbye. They would come the following day for a check-up at our house. My awesome doula and her husband threw all our messy clothes into the laundry. They busied themselves cleaning up the birth mess around us; sheets, plastic tarps on the floor, draining the unused birth tub.
Anyway, Maya Abigayle Taylor was born Saturday, June 28, 2003 at 4:48am. She weighed 8lbs 2oz, was 20 inches long, with a 14 inch head. She is SOO beautiful and wonderful!! She is nursing like a pro. I had a 2nd degree tear, but was sewn up with little problem compared to any cesarean pain I experienced with my other daughters.
I was in labor from 10:30pm-4:48am. I went from a 4 to pushing in 20 or so minutes then pushed for 12 Minutes (well, tried to NOT push for about 6 minutes, then freely pushed for 6. My back-up midwife and friend who was to film the birth didn't make it in time (luckily my awesome doula grabbed the camera and got the pushing, so that was good). My midwife was SOOO shocked at how quickly it went. She was planning on calling the back-up around 6am, then figured I would have the baby around 10am - Maya had other plans.
My husband and I came home around 12:30pm. I was SOO high on adrenaline; I could NOT sleep all day, as hard as I tried. So I was up for over 24 hours.. Pretty delirious but THRILLED by that night. It was amazing to introduce our new daughter to her older sisters. They were so excited to meet her. My older daughter kept asking what the stuff on Maya's head was. We explained that it was some dried blood b/c we had not yet given Maya a bath from when she was born. Kelsey said she wanted to hold Maya, but only after we gave her a bath to wash off the blood. It was soo cute. Olivia pointed out all Maya's features and proceeded to kiss her. They both brought her all the toys they could find; too cute. Wonderful Maya slept beside me and slept great so I was able to rest. It is so amazing to be able to get around as well as I am (as opposed to with c/s), though I am still sore, naturally. My MIL took a flight out first thing the next morning. I think she was irked at our homebirth (we told her afterwards) but I don't really care. I did what was right. My family was THRILLED for me - though they all think I am insane. A title I wear proudly.. hahaha.
Leslie's Story (3 prior cesareans, VBA3C with 13 pound baby)
Kmom's Notes: Some doctors will tell women they'll never VBAC if the baby is too big. This woman had a VBA3C with a 13 lb. baby! She had a "CPD" c/s after a trial of labor with a 12 lb. baby (baby #3) but went on to VBAC with an even larger baby--and no shoulder dystocia. So much for "CPD"! And she had a VBAC after not one but TWO 'failed' trials of labor! And in the face of many complications like pre-eclampsia too.
When asked why she chose VBAC, she said, "I chose VBAC because I've always believed in doing everything as naturally as possible, and I wanted to experience vaginal birth."
Birth Story
Leslie's VBAC Story can be found in the BBW VBAC Stories section. Be sure to read it--it's quite a story!
Teresa's Story(2 prior cesareans due to malpositions, VBA2C)
Kmom's Notes: A story of malpositions! Her first probably had a malposition (postdates, distressed baby, water broke, terrible back labor, no descent of baby), and her second was stubbornly breech.
Her third probably also initially had a malposition (went overdue, water broke, back labor, labor too painful lying down, transition-like labor but stuck in early to mid-labor, baby not engaged, sudden change in labor probably indicating that baby had resolved its position, quick dilation and birth after that, baby had bruised forehead from where it was probably stuck for a while). Since this malposition was able to resolve on its own, she went on to have a lovely VBAC.
Birth Story
Baby #1 (cesarean): Water broke at 42 weeks with meconium, went to the hospital, shaved practically from the neck down, pitocin to start labor, HORRIBLE back labor, got the epidural that I swore I wouldn't get, could feel absolutely nothing, got to 10 cm and tried pushing for a couple of hours but couldn't feel anything so I'm sure it wasn't very effective. After 2 hours of pushing had a c/s for 'failure to progress,' 'CPD,' and distressed baby. (I was 20 and very naive--the doctor and hospital staff scared me into thinking the baby was in grave danger.) Baby was perfect, 7 & 9 apgars, no complications with the surgery. Had mild to moderate post partum depression for about a month. I'm now convinced that she was probably malpositioned. [Kmom note: She notes that she was not heavy for this pregnancy.]
Baby #2 (cesarean): I had divorced and remarried. Baby was breech from 32 weeks. Tried everything including version and standing on my head to get her to turn, had c/s at 39 weeks. Baby was perfect, 8 & 9 apgars. Still stubborn as a mule!
Baby #3 (VBAC): Even though my daughters' births were joyous occasions and resulted in two healthy and beautiful babies, I felt like I had missed something. I had always wanted natural childbirth and for my third (and most likely last) birth, I wanted it desperately. As crazy as it may sound, I longed to feel the pains of labor, to feel my baby emerge from my body, and to hold my baby while he was still warm and slippery with amniotic fluid, instead of hours later after a dozen or so people had laid hands on him. So I did everything I could to attain that goal. I read every book ever written on VBAC, scoured the internet for information and statistics on the safety of VBAC, went to Yoga class, made my husband read about natural childbirth, hired a doula, and generally drove everyone close to me a little crazy, including my wonderful and VERY patient husband.
The last and probably most important step I took to ensure that I got the birth that I wanted was to change doctors at 34 weeks. I didn't feel I was getting the support I needed from the doctor/midwife team I was seeing. My office visits were with the midwives, but since I had had 2 cesareans I was considered 'high risk' and so the doctor (whom I never actually met) became involved in my care. The 'rules and requirements' of my labor changed from visit to visit and became more and more conservative the farther I got along. There seemed to be too many conflicting opinions on VBAC. I felt that whoever ended up on call when I went into labor would determine the fate of my child's birth. The emotional burden of that was too much for me to handle. I needed to know that everyone around me wanted the same thing that I did and BELIEVED that I could get it.
I found a wonderful and much smaller doctor/midwife team. During our consultation visit the doctor explained all the risks of VBAC that I had heard many times before. He asked me how I wanted to proceed and, after that initial visit, cesarean section was never mentioned to me again. I was treated just like any other pregnant woman---not one who might expire at any moment. I think the changing of doctors changed the odds of success in my favor----both emotionally and physically.
For the rest of Teresa's VBAC story, see the FAQ on BBW VBAC Stories.
Misha's Stories (PIH, induction, c/s, then 3 VBACs despite malpositions)
Kmom's Notes: The OB blamed this mom's stalled first labor on the size of the baby (which he thought was over 9 lbs.), but the baby was just over 6 and a half pounds. Because big moms measure larger than smaller moms and can have bigger babies, many docs assume that all babes of big moms will be big and are quick to assume that any problems are due to this.
The joke was on the OB. After having a cesarean because her first baby 'was too big,' Misha went on to have 3 VBACs, one with a 9 lbs plus baby! Her 3rd VBAC was a home waterbirth VBAC.
Birth Story
Baby #1 (Alexandria Paige): At 22yo, I went into my first pregnancy very excited, but also very naive. I signed up with an OB, ' cuz isn't that what you're supposed to do when you're pregnant? I'd scarcely even heard of a midwife, and certainly not in any modern context. I looked forward every month to prenatal visits, and took every word from the doc's mouth as law. His office gave out copies of What To Expect When You're Expecting to every newly pregnant mama (how generous), so everything I knew about pregnancy and birth was learned from that. I skipped the c/s parts ' cuz of course that wasn't going to happen to me so why waste my time.
After a couple rocky incidents (suddenly getting asthma/being hospitalized for it in the 5th month., and a breast cyst in the 7th) things seemed to be fine and we were getting very excited to meet our baby. Just over a month before my "Estimated Due Date" I came down with symptoms of Pregnancy-Induced Hypertension. I was put on left-side bedrest, and became bored out of my mind watching the OJ trial. I went to twice-weekly BP checks at the doc and played the victim to a tee, loving all the extra fussing over and attention.
Eventually, after a few wks. of this, it was wearing thin. I thought I would "never" go into labor, and was begging the doc to do something. He agreed to try to induce w/ prostaglandin gel. I knew nothing about the risks of forcing a baby out too early, and certainly didn't have any good objective info on drug risks, etc. I figured everything would just happen, the doc would be there just in case something happened to me or the baby, and my body would simply give birth. Oh I would try to do it naturally, but wouldn't feel guilty if I didn't.
So
at 38 wks. I went in for an application of gel. It took 4 tries a few days
apart, and at 39 wks. it finally threw me into hard labor. 4 hours after the
application, I started contracting and it took only a few minutes for them to
become only a couple minutes apart and brutally painful. My doctor came in and
said, "I'm sending up the anesthesiologist to give you an epidural.
Otherwise you'll be too tired when it comes time to push." I was so happy!
The epidural was great (or so I thought at the time). I could lay there pain
free, sleeping, talking to hubby and family, and just wait for my baby to come.
The rest of the story is pretty simple. As soon as I had the epi, they started
pumping me w/ pitocin (again I had no knowledge of any risk - all along the
line, we had been encouraged to just sign whatever they gave us - "you
don't need to read all that fine print"). About 12 hrs. after labor had
started, and being stuck at 5cm for 5 hrs., my doctor came in and informed me I
was having a c/s. I started crying, and the anesthesiologist., who was trying to
get me to sign papers, said "What are you crying for? You need to stop that
so I can get you to sign these." I was scared, and esp. frightened of being
awake for the surgery.
Finally
I was wheeled into the OR, my husband was not allowed in till after he'd started
cutting (during which time I was freaking out - I NEEDED my husband w/ me), and
I laid there w/ my arms strapped out as on a crucifix, barfing through the birth
of my first child. I heard "It's a girl," and started crying
again. I caught a quick glimpse of a pale little face buried in a receiving
blanket as she was taken to the nursery. Back in my room after being stitched
and stapled, I shook violently despite all the warmed blankets piled on me, and
thought I was dying because the epidural had gone too high and numbed my chest,
causing me to feel like I couldn't breathe. I was finally able to hold and nurse
her 3 hrs. later. The recovery was miserable and painful. As a result of
the pain meds I was taking ( and no one telling us [ that it would make
our daughter so sleepy that she would sleep too long between nursings]) in
addition to my failure to seek breastfeeding help, she was supplemented by one
month and weaned by 3 months.
One side note - during the time when my dilation was "stuck", my OB
told me the baby was over 9 lbs. and that was why she wasn't coming down. After
they weighed her (all 6 lbs. 11 oz.) I heard him say "Boy, was I ever
off!"
I have found one thing (besides my daughter) to be thankful for in having gone through this experience. If I hadn't, I may never have learned all I have about birth and the way it can and SHOULD be, and in turn never would have been able to help reach out to other women who start their pregnancies as I did.
[Misha went on to become a much more informed and empowered health consumer, and she went on to have several more VBACs. Her stories can be found on the BBW VBAC Stories FAQ as well.]
Jer's Story (footling breech, c/s; induction for macrosomia, fetal distress, "failed" TOL c/s; Unassisted VBA2C)
Birth Story
Like all VBACs, this journey began long before this pregnancy. My first child, my daughter, Rhiannon, was a c/s due to her position: double footling breech with triple nuchal cord. My second child, my son Gareth, was a CBAC-- a c/s after a long, hard struggle to VBAC. I was abandoned at 41 weeks by my "midwife" (I hate to dignify her with that title); I was induced with pitocin, labored hard and hellishly for 17 hours (12 unmedicated), and finally ended up with a c/s under general anesthesia for iatrogenic fetal distress.
Both my babies were "macrosomic"-- Rhiannon weighed 9 lbs 5 oz, and Gareth was exactly one pound larger. The midwife who betrayed me panicked because of my son's predicted size-- she convinced herself, and me, that I couldn't possible birth such a "monster." I'm proud to report that I can indeed-- and did!
The birth was unbelievable. It was AMAZING! We planned a homebirth to avoid all the crap we'd been put through in hospital with Gareth. I wouldn't trust an OB as far as I could throw one, and these days I feel pretty much the same about midwives. So we decided to do it ourselves. Unassisted pregnancy and birth isn't for everyone, but I wouldn't choose anything different now.
It was great. I did my own prenatal care-- monitored my blood pressure, measured my growth, really watched my diet (since nutrition is the MOST IMPORTANT aspect of growing a healthy baby). No one to bug me about useless tests that I would refuse anyway. No cups to pee in and carry around (how degrading!). No one demanding I schedule another c-section!
I was a healthy as a horse-- something I couldn't help but be smug about when the 18-year-old I worked with who was also pg, but having traditional OB care, ended up on bed rest and then had to go to the hospital for possible pre-eclampsia (she's fine now, delivered a healthy boy in hospital-- medicated vaginal birth). I worked (at a library) right up until the day I went into labor-- Wed Sept 7, 2005.
I left work at 2 pm, went to my mom's apartment for some quiet time, then headed home at 5. I stopped to get some gas-- reached down to "pop" my fuel lid-- and felt something else pop instead! I stood up and immediately confirmed it: yup, my water had broken!
I got back into the car and drove straight home. I had a couple contractions-- nothing bad-- but I was good and soaked when I finally parked in my driveway. I went into the kitchen and found my husband, John, washing dishes. "I need you to go get some gas," I told him. "My water broke."
John jumped immediately into freak-out mode. I got him calmed down and convinced him that he wasn't going to have to catch the baby right there in the kitchen. Rupture of membranes doesn't automatically mean labor, after all-- most women go into labor within 24-48 hours after their waters release, but it could still be days.
Nothing much happened after that for several hours. The leaking was annoying-- Rowan wasn't engaged, so his head didn't stop the flood. He did move down a little, so it was a bare trickle rather than Niagara Falls. I had a few contractions, but still nothing to indicate I was going to give birth anytime soon. I went about my life-- ate some supper, watched TV, got the kids fed and bathed and tucked in. John and I went to bed at 10-- but I didn't stay there long.
My contractions suddenly picked up noticeably. Lying down-- even sitting-- was uncomfortable. I wanted to be up doing pelvic tilts-- that felt better. Hmm. This might really be labor, then....
At 10:30, I woke John up. "I need you to fill the pool," I said. "I'm getting in the shower." We had a kid's "fishy pool" (inflatable wading pool, about 2 1/4 feet deep and 5' across) set up in the living room. It already had some water in it, but I needed hot water-- as it happened, HOT water!
Water is *wonderful* to labor in. It's not called "the midwives' epidural" for nothing! Once it was half full or so, I climbed in-- bliss! Floating through contractions was so much easier than standing through them-- although I ended up standing up through most of my labor, I think because Rowan's position and descent demanded it. I got into a pattern-- stand for two or three surges, then float through a couple, then stand again. Get out occasionally to go to the bathroom or get into the shower-- the high-pressure hot water on my back felt good. Mostly I stayed in my pool, though-- and John added some more boiling (!) water every once in awhile.
I had no concept of time. I'd made John turn the clock so I couldn't see it-- I didn't want to stare at it all night. I'd jokingly said, early on, "Wouldn't it be great if the kids could wake up in the morning and meet their new baby? And I could call Mama and tell her to just stop by on the way to work?" (I hadn't told my mom and sister I was in labor-- I know them; they'd be up worrying all night.) I was expecting to be there for the long haul-- my labor with Gareth lasted 17 hours. I figured I had a long way to go.
John set up a camp bed in the living room and slept as much as he could, so I spent most of the night laboring alone in the dark, like a cat. It was marvelous. Not easy-- it's hard work; that's why it's called LABOR. ;) It was intense. Not painful-- I can't call it painful. But it's... inevitable. Inescapable. Uncontrollable. You can't get away. I kept thinking of that kids' game, "Going on a bear hunt"-----"Can't go over it, can't go around it, have to go through it!"
At some point-- John says it was around 1 or 1:30 am-- I realized I was starting to push with each contraction. "Can't be," I told myself. "It's too soon! I'll swell my cervix shut!" But I couldn't help it-- I was pushing. Rather, my body was pushing, with me along for the ride!
I got up and went to the bathroom. Believe it or not, the toilet is one of the best places to labor, because we're already so used to "opening up and letting go" there. ;) I spent a few contractions sitting there, then went back to the pool. By now I was roaring through each contraction-- howling like a mama wolf! It's wonder I didn't wake the kids up!
Surge. Roar. PUSH! Breathe. Again. And again. And again... and again... again...
On and on and on. How much can a person take? This is silly-- I didn't have to do this! But then I remembered what a former yoga teacher once told me: "The mind gives up before the body." And on I went.
I didn't feel I was making any progress (although it looked much different from John's point of view, he tells me!). I started crying. "I can't," I wailed. "No more. I can't do it anymore."
"Yes, you can," he said firmly. "You can. You ARE. You're almost there."
With the next contraction, I felt some burning-- ring of fire? That's a sign that baby is crowning, that the head is almost out. Oh, surely not...
I reached down-- and stared at John. "There's a head there! Right there!!" And there was-- a hard, smooshy, wrinkly, wet head. Rowan was crowning-- I was about to give birth!! John felt it too, and his expression was awestruck. "You're almost done!"
With the next surge, I pushed-- and the head was out to the ears. Then I waited. And waited. The next contraction seemed a month away! That was the only truly painful moment of my entire labor-- having a head halfway out of your body STINGS!!
Finally-- contraction. PUSH!! And-- I had a baby in my arms!!!!! Rowan was born, and I caught him, with John assisting!! WE DID IT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
John checked his watch: 4:33 am. I couldn't believe it. 5 1/2 hours from the time hard labor hit, I was holding my baby. INCREDIBLE!!!!!
At 6:30 we woke the kids up. "Come meet your new baby brother!" They were amazed-- talk about the Stork arriving in the night and leaving a little stranger! Then John called my mom: "You might want to stop by on your way to work and meet someone..." My mother and sister came at 7:15 or so, with a box of Krispy Kremes. Just as I had dreamed!
We took Rowan to the pediatrician when he was 6 hours old, where he was pronounced "perfect"-- all 10 pounds, 5 ounces of him!! Exactly the same size as my "impossible-to-deliver monster." We even went to Walmart that afternoon. That was fun: "Aww, look, a baby! How old?" "Um... 8 hours." "WHAT??!?!?!??!?" It was hilarious... and empowering!
I did have one complication-- when I delivered the placenta, it came out in pieces-- and it didn't all come out. I wound up with an infection and had to have a D&C on Sat, then spent a couple days in hospital getting IV antibiotics. That wouldn't have happened if I'd transported right away, but I just kept hoping it would resolve on its own. But all's well that ends well-- it's a terribly rare complication, and it was probably caused by my previous c-sections. It certainly won't stop me from freebirthing again, if I should be blessed with another pregnancy! And Rowan wasn't admitted, so I kept him with me and nursed him, so we avoided formula too. Yay! :D
It was amazing, truly. I'm so glad we stayed home. I got up and took a shower 20 minutes after the birth. I could pick up not only my infant but my toddler afterward without worrying that my guts might fall out. Sure, I was a little sore-- but it was NOTHING next to recovering from major abdominal surgery.
Don't EVER let anyone tell you that c-sections are "the easy way." I wouldn't trade my unmedicated birth for all the anesthesia on the planet. It was phenomenal!!
All in all, it was a fabulous experience-- it took lots of reading, soul-searching, researching, learning, thinking, and praying, but it was the right choice for me. I'm so glad I did it. Till now I felt like I'd had two kids without ever giving birth-- sometimes I wondered if I was a babysitter, and Rhiannon and Gareth's "real mom" would show up someday to claim them. Now I know for certain that Rowan is mine-- I'm that real mom now. And I can wear my button with pride: I'm a VBAMC Mama!
Anonymous S's Story (elective c/s for macrosomia, VBAC with 12 pound baby)
Kmom's Notes: Doctors tend to be very scared by the thought of a big baby. They are afraid of the baby getting stuck (resulting in birth injuries or even death); they are also afraid of getting sued because these situations are often the source of litigation. While real, these problems are more common with the way doctors usually make women give birth---on their backs or sitting on their tailbones (thus reducing the size of their pelvic outlet), often with epidurals (which makes moms less able to move to help if a baby's shoulders do get stuck). This is a recipe for problems with a big baby, but doctors know no other way for women to give birth, or refuse to consider other alternatives.
Thus, when a baby is predicted to be big, most doctors pressure the mother into having an elective c-section in order to protect themselves from potential lawsuits. They also feel they are protecting the baby from possible injury, although most big babies are born without problems anyhow. Unfortunately, choosing an elective cesarean is trading one set of potential risks for another set of real risks, and forever increases the mother's risk for problems in future pregnancies.
This mother grows big babies. Her doctor pressured her into an elective c-section with her first, an 11 pound baby. With her second, she chose to go for a VBAC, even when expecting another big baby. She did have a VBAC, and one with a baby that almost a whole pound bigger than the baby she had the c/s for! In order to avoid the typical hospital management that increases the risk for shoulder dystocia, she stayed home, stayed mobile in labor, and labored without extraneous medications.
The mom did have a post-partum hemorrhage, probably due to a partial separation of the placenta. She chose to transfer to the hospital and get a transfusion in order to recover faster, but it was not a life-threatening situation. This combination of the flexibility of home care with the back-up of medical care when it is needed is why many advocates feel homebirth can be a safe and reasonable option for many women, including those with "macrosomic" babies.
She notes, "Two hours after the birth, I transferred to the hospital. Received 2 blood transfusions and was home within 24 hours. I would have been fine at home, but it would have taken a lot longer to recover. I felt fine but faint. I am the rare type of person that did not respond to IV fluids and IV pitocin given by my midwife at home and [by] the doctors at the hospital (a total of 11 hours of this at both locations with little change in my condition)." In this situation, hospital transfer and transfusion made sense and was accomplished with a minimum of fuss.
Birth Story
Monday morning...I woke up with very mild but regular contractions. They didn't hurt me, but made everything feel tight, including my back. I thought that I must be in early labor and was very excited. Two hours later, after I had called my midwife, the contractions stopped.
That night, again in the wee hours, I began again to have contractions. They were a bit stronger than the night before, and very mildly painful. I had also had a bit of bloody show the night before, so I knew that I would have the baby soon. I again called my midwife in the morning. She said to let her know when I had been having contractions 4-5 minutes apart for at least an hour. The contractions were only every 10 minutes apart. Then, during mid-morning, the contractions stopped again. I was again disappointed and began thinking that I was never going to have this baby. I had never been in labor before, and I started wondering if those were really contractions, although I knew they were. I knew from reading other birth stories that this was prodromal labor. I threw out my fantasies about having the quick birth that nobody arrives in time for.
[On Tuesday, the same pattern repeated.] I felt like I was in the movie, "Groundhog Day"...I spoke again with my midwife who was reassuring that everything was just fine, and to rest and eat well and keep hydrated. That night my doula came over to see me. She knew from talking to me that I was a bit distraught. I had a good cry and told her that I knew I was doing this, but I didn't want to keep doing this every night. I was so tired of being in labor and not having a baby. I wanted her opinion on how long this would go on, as she was also a midwife. She reassured me that my body was working, just slowly.
The next night (Wednesday) the contractions were a lot more intense and closer together. I spent another night on the rocking chair and getting little or no sleep. I was feeling very lonely being the only person awake in our dark house, with everyone asleep all over the neighborhood, and what seemed like the entire world. I felt very alone and I wasn't optimistic at all. I knew that my contractions would go away again, and they did.
That morning I had a scheduled prenatal appointment with my midwife. I had written in my birth plan that I didn't want any vaginal exams. The reason was that I didn't want to get discouraged if I was not as far dilated as I thought I was. However, once there, when she asked me if I wanted one, I agreed, since I wasn't actually "in labor" at the time. She told me I was already 4 cm dilated and that I was completely effaced. She told me that the baby would come soon and she also told me that when labors are slow like this, the baby will tell you why when they are born. She sent me home with blue and black cohosh for me to take after I had had a nap, if I wanted things to progress further.
We all went home and after a good nap I took the blue and black cohosh (yuck!!). It didn't do a thing but I did notice that my contractions slowed down even further. That night I didn't even go to bed because my contractions were about every 7-10 minutes and I didn't like to be touched during them, or be lying down (which seemed to make them even more painful). I spent the night in our spare bedroom laying in the bed and then jumping up during a contraction. I was able to fall asleep during the intervals though. Sometime around 6 in the morning, they finally got to 4-5 minutes apart and were such that I couldn't talk through them. I called my midwife and doula, who both said they were on their way.
My doula got there first and began setting up the birth tub. By the time my midwife got there, my contractions had again spaced out, but only to about every 6 minutes apart. She told me that she expected them to slow down even further, and for me to take advantage of the time by resting up and getting lots of protein and drinking lots of water. By this time, I was putting my daughter's cloth diapers in my underwear. During the contractions, my first reaction was to want to tighten up during them. But I knew that I should stay relaxed. Staying relaxed in my pelvic area caused me to pee during the contractions. I figured it was better to pee than to fight the contraction. She assured me that this was not that unusual, even though I had never heard of this.
She checked me and I was at 5 cm and the baby's head was still floaty. She said that as soon as my water broke things would get going. She does not ever break the waters artificially and I wasn't sure at that point whether I was happy about that or not. I remember just wanting the waters to break and telling the baby to break the water so he or she could be born. My midwife said she was going to go home and for me to call her again if things got moving. My doula stayed for a few hours, until my contractions did again slow down even further. She left with the birth tub full in the living room.
I spent the day sitting on towels, standing up and breathing through my contractions, which were quite intense. I had given up on the diapers and now just stood over a towel. I was drinking a lot and there was no shortage of pee when I had a contraction. My daughter (who has only been potty trained for about 6 months) was very interested in the fact that I was peeing on the floor instead of the potty. She knew that when I stood up I was going to have a contraction and pee on the floor. At about 3 that afternoon, my water finally broke and seemed to keep gushing and leaking for at least an hour. However, it didn't make my contractions any stronger. So much for that, I thought. By that time, though, I was in better spirits most of the day. I knew that things were progressing. I still had a few times when I cried to my husband that I couldn't do this another night. He said that he was going to stay up with me all night if he had to, so I wouldn't be alone----even if it meant he had to drink coffee all day long to keep up with our daughter.
Not five minutes after my daughter went to bed, at about 10:30 p.m., my contractions really hit me hard. They went from every 10-15 minutes apart to every 2-3 minutes apart, and much more intense. There was also not much time in between them. I told my husband to call my midwife and doula. While waiting for them to arrive, I felt like I had to have a bowel movement. The area in our bathroom where our toilet is situated is very small and I didn't feel I had enough room to sit comfortably. I was also afraid that I might push out the baby. I ended up standing in the bathtub with my husband reassuring me that if I went in the bathtub, it would be okay.
All of a sudden my lower back hurt terribly during the contractions. I had to have my husband press on my back really hard, while I rocked and moaned and breathed. In between he was racing around trying to get me a cold drink and a cloth for my head. We barely had time in between them, and I was thinking it was incredible that they were picking up so fast. My husband kept reassuring me that I was doing so well and he was so proud of me. I got to a point where I didn't know what to do to feel better during a contraction and I felt a bit panicky. He suggested the labor pool. I had been in it for a while during the afternoon but I thought it was too hot (it was July and the hottest days so far that year), but I agreed to try it. I stripped off my clothes and got in and it felt great. I closed my eyes and would squeeze my husband's hand and really moan during contractions.
I barely registered anyone else arriving but soon my doula and midwife were there. They immediately began holding my hands if my husband needed to step away. And when he was there she would put cold cloths on my head. They both kept me drinking cold Recharge and ice water. Most of the time I was holding onto both of them during contractions. I was holding on very hard. I was moving into positions that I would never be able to do on a normal day and on dry land. I remember hearing my midwife comment on these incredible positions I was going into. At the time, though, I remember feeling almost a sense of panic at some points, trying to do what I could to get out of the pain that the contractions were causing until they stopped. Whatever I was doing, the relaxing my pelvis, and the moaning, helped.
At some point I told everyone that I thought I was pushing. My midwife said that was fine if I felt like it. I asked her how long she thought it would be. She said that for first time moms (which I was considered since I had never been in labor before) that the average was two hours. I felt as if she had said two years, but I think I would have felt that way even if she said two minutes. The contractions were so close together that I felt like I was barely getting a rest in between. I had time to take a sip of a drink, look at my husband, before another one came. My midwife came over and knelt next to me and explained to me how best to push, from behind, not from the front, and at what point during the contraction. What she said made sense to me, and it did seem to help me push better. It felt better too.
After a while, my midwife asked if she could check me. I agreed, but was afraid she wouldn't have time to finish before another contraction hit me, and I was scared it would hurt too much if she was still there when a contraction came. She checked me and said I was at about an 8 with a little lip. She said that she could hold back the lip during a contraction and I could push through it if I wanted to. I said okay. This was extremely painful but I'm glad I did it. During that one contraction...I pushed as hard as I could and went from 8 to complete and the baby crowning.
At that point, my midwife leaned into the pool to help me. I was sort of squatting but then leaning back and holding onto my doula's hands very hard. My husband was also leaning in because he was going to catch the baby and hand the baby to me. The midwife told me to push only tiny pushes and grunts instead of big pushes. I don't think I did very well. I was able to make small grunts, but I feel like I wasn't able to slow down my pushes. I had one tear and I think this is from when it came. I felt like I was going to tear really bad. Luckily, I didn't.
When the baby's head came out, there was a rush of commotion. My husband kept telling me that our baby's head was out and to take a look. I didn't try too hard to look and I felt like I just wanted to get the baby the rest of the way out. When it came time to get the baby's body out, there was a cord around his shoulder and he also had what my midwife calls "sticky shoulders," so she leaned in and helped him out. She handed him to my husband, who handed him to me. I felt like for a little bit I was just trying to catch my breath. I was so happy that this baby was finally here. It felt a bit unreal. My husband came around beside me and we both held onto him and looked at his face for a while and kissed him. When he came out, he came out crying, he was not quiet at all. After a few minutes, we realized that we didn't know what sex he was, so we checked and were very surprised he was a boy. He was finally here, born at 2:25 a.m. on Saturday!
After the cord stopped pulsing, my midwife helped my husband to cut it. Then she told me I should get out of the tub. My husband took my son and my midwife and doula helped me out of the tub. Evidently I said something like, "I don't feel so good..." and then I fainted. The 3 midwives there pulled me up and out of the tub and onto the couch. I came to with the assistant calling my name and looking at me. I was not familiar with her face so I was very confused as to what was going on. I did begin to feel better but would go in and out of feeling good and feeling faint. I pushed out the placenta in a push and it didn't hurt like I was worried it would. I wasn't bleeding very much at all, but I continued to not feel very good. When my blood pressure didn't come back up, my midwife started an IV. During this time, I held my son and nursed him for at least an hour. He feel asleep and was very content. He also latched on right away, which was nice.
At least one more time I fainted while laying on the couch. Finally after I was on my third IV, my midwife told me that she thought it would be a good idea for me to go to transfer to the hospital since my blood pressure was so low and the IV wasn't making it come back up. I agreed and she called an ambulance. After she called, I felt better again and she told me that I didn't have to go if I didn't want to, but that the paramedics were still coming. She and her assistant got me into a shirt and found a blanket to cover me up. When the paramedics got there I was able to answer all of their questions and was very coherent and was feeling somewhat okay. Still, I opted to go to the hospital. My husband and doula were busy getting the baby ready to go. They also woke up our friends upstairs to come and stay with our daughter, who had slept through everything.
At the hospital, someone mentioned weighing my son. We knew he was big, because my midwife had told us she thought he was at least 10 pounds. She used the hospital's scale to weigh him and when she exclaimed, "TWELVE POUNDS!!" I practically burst into tears. My husband came over and was pretty overwhelmed too. I cried first out of happiness that I had such a big, healthy baby. But then I cried because he was bigger than my daughter, and I didn't have a cesarean, and that meant my cesarean with her was absolutely unnecessary. I had known this for a long time, but having proof was a bit overwhelming to me. It made me very sad for all that she and I missed out on for her birth, and angry at my OB for talking me into it. I never went into labor with her but had a cesarean on the advice of my OB, who felt she was too big to be born vaginally without shoulder dystocia. I was told even if her head fit, her shoulders would get stuck and she would have permanent arm damage. She weighed 11 pounds 5 ounces, much smaller than my 12 pound boy. It was at this point my midwife came over to me and hugged me and told me something that still makes me teary when I think about it. She said, "Don't let anyone ever tell you what you can't do."
Basically at the hospital for about 9 hours, they did the same thing that my midwife was doing, which was give me IVs and pitocin. I was not bleeding and they just couldn't figure out why I wasn't "bouncing back" from the blood loss at birth. Finally, I had to get two blood transfusions. I felt better almost immediately. I left early the next morning. Basically, what happened to me was that I most likely had a partial separation of the placenta right before my son was born, and I lost a lot of blood during the delivery. Not too much blood, but I seem to be someone that can't take any amount of blood loss. Anyone else, from what everyone has told me, would have been fine after an IV.
My son was able to stay with me at the hospital, as a guest, not as a patient. He was not admitted, so no one bothered me about taking his blood sugar and all of the things they did to my daughter when she was born. All o the nurses were surprised to learn that he was born vaginally and not by cesarean.
Even though I had to go to the hospital after my son's birth, I know homebirth was the best choice. I don't even care that I had to go, since his birth took place at home. It seems almost a different thing to me, and not at all connected with his birth. I also know that if I had delivered in the hospital, I still would have had the same thing happen. But in the hospital, I am certain that I would have had a repeat cesarean. First my labor kept starting and stopping and I would have been labeled "Failure To Progress" and given pitocin, and then I would have needed an epidural, and I don't for a second think I could have pushed out a 12 pound baby with an epidural. So, a cesarean. Second, there is no OB who would have "allowed" me to birth my son if they suspected he was as big as he was. So again, a cesarean.
I loved everything about this birth and I am so proud of it.
Maria's Stories (SROM, induction, c/s; dumped by midwife at 35 weeks, hospital VBAC)
Kmom's Notes on Pregnancy: This mom has PCOS, which sometimes can create an excess level of fear and vigilance in the providers about blood sugar problems and big babies. Women with PCOS do have more of a tendency towards blood sugar issues, but to worry about this at 35 weeks when all previous tests have been negative and there is no history of a big baby is ludicrous.
Because this mom questioned the validity of a test like this so late in pregnancy, the midwife released her from her care, leaving the mom virtually without options. However, Maria took lemons and made them into lemonade; against all odds she found an OB who was supportive of VBAC and supported her in labor despite never having met her before labor.
And that big baby the midwife feared? He didn't even weigh 7 lbs at birth. So much for the heavy mom with PCOS must equal heavy baby theory!
Birth Story
Baby #1:
October 17th, 2004; 7:30 am- My water broke. I got up to pee and suddenly thought I was peeing on myself. I peed and then it just kept coming down and I knew this was it. I called my grandmother to let her know that my water had broken. I then tried to call my Obstetrician, Dr. D, but no one ever got back to me after I paged the On-call doctor twice. I didn't know what was going on. I called my mom. She came and picked up me and Chris. We walked out of my mother in laws apartment with a suitcase, a birthing ball that was fully blown and some other things. By now it was 9:30am.
We got to the hospital and we were there by 10:00am. I was triaged pretty much right away since I was leaking everywhere. I was put on a monitor for 30 minutes and was told that I was having sporadic contractions by the resident. Well duh, I knew that. I can feel them! The resident then checked me and I was 3 centimeters dilated, 80% effaced and she said my water had definitely broken. I was going to be admitted and I thought YAY! We're going to have a baby today!
I was given a room in Labor and Delivery and Dr. P came in and introduced herself. She came in and checked me once I was settled in and confirmed that I was at 3 centimeters, but she was not happy that my contractions were not regular and said to me "We have to put you on Pitocin now". I began to argue with her, "There's nothing else that can be done? Cervadil? Nipple Stimulation? Nothing?" I thought she was insane. I asked her to call Dr. D. I didn't want this. She came back saying that she was not answering her phone. I was sure something else can be done before Pitocin. I refused the pitocin at first and she said to me that either I went on Pitocin or I am risking the lives of both me and my baby, since there is a risk of infection with ruptured membranes. So after talking with my mom and grandmother, I opted for the Pitocin.
Here I was, 6 hours into having been put on Pitocin and Dr. P comes back. She decided to check me again and I was at 6 centimeters and completely effaced. She then said to me, "I don't like your progress on the pitocin and I think we might have to do a cesarean if this continues." Then Dr. Psaid " I believe you should get an epidural. You will feel more comfortable and if a cesarean becomes necessary, you will be able to see the birth of your baby. I also feel that the epidural will help you tolerate these contractions better so that you can be able to dilate quicker." So I asked Dr. P, "What are my other choices?" And she said, well, if you don't dilate, then we will have to do a cesarean under general anesthesia." I tried to argue with her even more and she said to me, "I'm the doctor, you're the patient, so we are going to do what I want to do". So at the time, I thought, Wow, I don't want that! So I got the epidural.
I made sure that the Attending Anesthesiologist was the one who did my epidural. I have back problems as it is, and didn't want any residents screwing with my spine. After the epidural, Dr. P comes back in, and says to me, "Look how happy you look now!" and then says to the nurse and my family, "Isn't she so happy?". I just rolled my eyes at her and made a fake smile. I could still feel the pressure of the contractions, but not the pain at this point. She also insisted that since we were not getting a good reading on the fetal monitor and now I'm in bed anyway, we should put it in Internal Fetal Monitor on my baby's head.
A couple of hours went by, and it was now like 8 pm. Dr. P came in and checked me again and I was 7 centimeters. She said "We might have to do a cesarean if this continues, we will increase the pitocin now." I was starting to get mad. I didn't want this. Dr. P instructed the nurse to increase the pitocin every 30 minutes and that she will be back to check me in an hour. She came back an hour later and said I was at 7-8 centimeters. Dr. P then said to me, "It looks like we are going to have to do a cesarean because you're not progressing fast enough and it's been too many hours since your water broke." I said to her "NO, I am NOT having a c-section! It hasn't even been 24 hours since my water broke! I want more time!" So after arguing with her for about 10 minutes, she finally said, "Ok, as long as the baby looks ok, we will let you continue to labor." She then told the nurse to increase the pitocin again.
About 10 pm, my daughter's heart rate began to fluctuate during a contraction, so then they lowered the pitocin. A bunch of doctors and nurses came running in and Dr. P told the nurse to decrease the pitocin and see if that works, of course this was after having another argument with me. This happened two more times after the pitocin was decreased once. Dr. P then said to me that my baby was under distress, and since I'm "Failing to Progress" and due to "Fetal Distress" we were now going to do a cesarean. I said to her, I do not want a cesarean, I am scared. I started crying. She kept insisting that this would be the best thing for and my baby. I didn't trust her at this point.
I did not believe her. I went into the Operating Room in tears. Here I was shaking, cold in this unfamiliar place. Krystina was born at 11:06pm on October 17th, 2004. She weighed 5lbs 12 oz and was 18.5 inches long! It was less than 24 hours since my water broke, and to this day I feel that I was butchered. I am pregnant with my second child and I'm now seeing midwife and strongly considering to have a homebirth after a c-section. I cannot see myself giving birth in a hospital and having everything go downhill. I strongly feel that Dr. P has taken something away from me. I can't seem to completely explain it. To me, Dr. P, is Dr. Knife.
Since this has happened to me, I now tell women to make sure they are fully informed before going into labor and to look at their choices in childbirth. Ask around about your Obstetrician and the doctors that go on call for your obstetrician. That was a mistake I made. I didn't know that Dr. P went on call for Dr. D. I know that Dr. D would have let me have my natural birth and let labor go on its own without forcing the knife on me. No one should have to be forced into a cesarean unless it's absolutely necessary, not cause you have been in labor for X amount of hours and now the doctor wants to go home. Birth is a natural process.
Baby #2:
My story really goes back to October of 2004. My daughter was born by c-section and it was one of the worst experiences in my life. The hospital staff was very mean to me. They did not consider any of my wishes after I was told my birth plan would be followed I was given pitocin and practically forced into an epidural. I had a very horrible experience overall and dealt with Post Partum Depression. I was c-sectioned for failure to progress and fetal distress. My daughter was born with an apgar of 9/9 after I was told that her heart rate was going too low for it to be "safe". I later found out that a lot of what I was told during labor was false information. After giving birth, my ultimate goal was to have a VBAC and prove the OB who cut me wrong.
Two weeks before I gave birth, my midwife told me that she won't be able to be my care provider anymore due to some of my health issues [PCOS and hypothyroidism]. I was disappointed, upset and had no idea where to turn. I failed the One Hour Glucose test the 2nd time I took it, and was refusing the 3 hour glucose test so she told me that I needed to see an OB.
On November 7th, I began to have contractions that were lasting on and off. At this point, I was still sorta seeing the midwife till I could get to the OB's office the next day when she would be in. As the night progressed, the contractions began to get closer together and were somewhat stronger. Around midnight, I took a warm shower and they came to a halt. I woke up at 4am to some strong contractions on November 8th, but didn't think too much of them. I tried to get some more sleep, but I just couldn't, so I stayed up for a couple of hours. Around 8am, contractions started to pick up a little, and soon after, the midwife called me to check up on me. She instructed me to go the OB's office to get checked out. I called the OB's office and they told me to come in around 12:30. I called my grandmother and she picked me and and DH up and we headed into the city. I also called M (one of my Doulas) to have her meet us at the OB's office. We got to the OB's office and the office manager told us to go straight to Labor and Delivery.
We got to the hospital but didn't go upstairs right away. I stayed downstairs and dealt with the contractions in the lobby until M got there. In the meantime, I called my other Doula, E. We headed upstairs and I was admitted to triage upon arrival. I wasn't checked till we had been there a couple of hours and they picked up contractions for a couple of hours. Upon arrival, the nurse wanted me to change into a gown, but I refused the gown and said, "No, I want to stay in my ICAN t-shirt." So then the whole "What if there's an emergency" argument started and I said, "So cut it off." M said "There won't be an emergency". I had to laugh at that.
The one resident was so pessimistic and must have told us the risks of a VBAC so many times, I wanted to kick him. When I was checked, it was about 2pm. I was 3 centimeters dilated. I was admitted. We got a room in Labor and Delivery and Dr. D2 (the OB) came in to check on me about an hour later. I was 3-4 centimeters and so she decided to break my water. I was slightly hesitant about having my water broken however, she did say that my bag was bulging and it would break at any moment so I agreed.
After my water was broken, contractions began to pick up and got a lot stronger. I think I was handling them very well. At 10pm, I was checked again and was only 4-5 centimeters, so Dr. D2 said that as much as she knows I wanted to avoid pitocin, she just wants to give me the minimum and see if that will help me progress, cause I am taking a long time to progress. M and E were a great support in all of my labor. I remember the most helpful thing that they did was the Rice Tube Sock. I was dealing with a lot of back labor and it helped a lot. I found that swaying, the rocking chair, and standing helped through a lot of my labor as well.
Around 3 am, it had felt like I had been in labor for days, and I felt like I needed some sleep, so I requested an epidural, not so much for the pain, but to make the pain disapear so I can get some rest. The Anesthesiologist came in and I signed all the paperwork, and he did the epidural. It lasted an hour. I was right back to feeling the pain again, the epidural did not go in right. I was begging at this point for another epidural or something cause I needed some more sleep. Around 8am, I got another epidural and Dr. D2 came in and checked me again, I was 5-6 centimeters.
There were a few times I had doubt in my mind that I would get my VBAC, and I know I said at one point "My grandmother did this 8 times, I CAN do this!" At this point, I didn't know what would happen since I had so little progress. She said I would be checked again around noon. I don't know how the time flew between 8 am and noon. I did take a nice long nap though. I also had to fight with the nurses about not getting a catheter. I allowed them to put one in the first time, and it hurt so I begged to have it taken out. The nurse said she will only take it out if I can pee on the bedpan every so often, or it has to go back in. They increased the pitocin slightly after the epidural began to work. I must have really shocked the nurse, cause she said to me at one point that not many people can go on a bedpan with an epidural in place. I told her that I wasn't many people. I just don't like the feeling of the catheter.
At noonish I started to feel a lot of pressure so they got the resident in and he checked me. I was 8 centimeters with a lip! WOO HOO!!! That's where I "got stuck" last time. So instead of laying on my left side, I switched to my right for a little while to even out that "lip", and the baby's heart rate dropped a couple of times, so they asked me to move back on my left. It was like 12:30 or so when he checked me.
At about 1:15 or so, I began to feel a ton of pressure, like I had to poop, so I told them to get a doctor in there now cause this kid is coming out. I don't think anyone believed me, but I felt my baby trying to push his way out. The resident checked me and said I was complete so they would call Dr. D2. I had everyone yelling at me telling me not to push, but I couldn't hold back, I was giving little pushes because it hurt if I didn't push. Dr. D2 came and was very encouraging. YAY! Now I can push! I don't know exactly how long I pushed for, but I got see my baby's head crown!
Matthew Alexander arrived into the world on November 9th, 2005 weighing 6lbs 10.4 ounces and was 19.5 inches! His Daddy got to cut the cord and his birth was witnessed by my mom, my doulas and my husband. Ended up with a healthy baby boy; my sugars were checked during labor, and only elevated once which was cause I had a popsicle.
I was very glad that I ended up with Dr. D2. She pulled a lot of strings to help me get my VBAC, whereas another OB would have given up on me. She had the belief that my body could do it and it did and I am very thankful to her. I did not get to meet Dr. D2 until I was in actual Labor, but she turned out to be the best thing for me.
Pam K's VBAC Story (Home waterbirth, VBA2C)
Kmom's Notes: This is typical treatment for larger women in many ways. Because bigger moms do have slightly larger babies as a group (and obesity is a risk factor for really big babies), doctors often estimate that their babies are going to be huge. In the first story, the doctors kept raising the estimated birth weight; from 8 lbs., to 9 lbs., to 10 lbs., then to 11 lbs. They tried to talk her into an elective cesarean, but when she refused they induced for suspected macrosomia. As is so often the case, the induction ended in a cesarean, and the baby was not macrosomic after all.
Despite having a really wonderful OB for her second pregnancy, Pam ended up induced for post-dates with baby #2. Inductions of VBACs often end in cesarean, and hers did too. As she discusses below, she had a difficult experience with a nasty spinal headache afterwards.
With baby #3, Pam chose homebirth, with unofficial back-up from her wonderful OB. She and her midwife "tweaked" her nutrition somewhat, and she occasionally monitored her blood sugar to be sure it was still normal. It was. Pam went on to have a VBA2C at home, in the water! She chose a hands-and-knees position to push out her baby, which often is a good position for larger women.
Pam is a doula who works to help support other women in their births, and is also a member of ICAN, the International Cesarean Awareness Network. Had she seen a traditional OB, she almost certainly would have been told she had no chance at a VBAC, between being supersized and her history of a "failed" trial of labor, possible GD status, borderline "big" babies, and tendency to go postdates. Yet she went on to have a wonderful VBA2C anyhow. It's important to remember that many women with one "failed" trial of labor do go on to have VBACs in subsequent pregnancies, and that women of all sizes can have VBACs.
Birth Story
Birth #1: Pressured for elective cesarean due to estimated size of the baby; induced for macrosomia (big baby). Cesarean.
Birth #2: Post-dates pregnancy, induction, cesarean.
Birth #3: I was "officially" due on April 16. I began experiencing the dreaded nighttime prodromaling syndrome. I was fortunate that it was mild----starting around midnight and ending with sunrise. Each night was a bit more intense, and I was surprised at how much the contractions hurt. I had expected to sail through "natural labor" after my experience with Pit, so I was a bit humbled, but fortunately was able to readjust and soon began celebrating the fact that my body was working on its own!!
Monday night, April 22, the contractions were strong and frequent---I was in the birth tub humming through them. If I had been a first time mom, I would have been at the hospital!! In fact, the continued into the morning and we decided to take the kids up to my SIL as I was unable to focus with my 3 yo around (he really wanted into the tub with me). I called my friend Karen to come over as I did not feel comfortable being alone and sent DH off with the kids. Of course, things slowed down significantly once we did all that! My MW suggested I keep my OB appt. and agree to a vaginal exam so we could get an idea of progress. Karen and I went to lunch, the to the appt. while DH tried to get a half day of work. Contractions were about 10 minutes apart and manageable.
At the OB's I discovered I was leaking something. We still were uncertain as to whether it was amniotic fluid or simply very watery mucous. It smelled like birth and I was concerned that the OB would notice. Fortunately he did not. He was very excited about the condition of my cervix and offered to strip my membranes. I agreed and he immediately said I had progressed another cm. (to 3 cm). He told me to go home and keep contracting and that he would probably see me before my next appt.! Karen and I went to the pool and swam and walked a bit, then she headed home to be with her family and I went to bed.
Of course, laying down made it very difficult to deal with the contractions, so I popped in my imagery birthing tapes and was able to sleep a bit. Finally, around 10 p.m. I found myself bolting from the bed with a contraction, so I headed to the tub, then the shower. Soon I was needing someone with me, so called to my DH who was snoring away. He did not hear me and I was mighty PO'd. I managed to get myself out of the shower, to the toilet, and discovered a HUGE amount of mucous. I have NEVER seen such copious mucous and was a bit disconcerted. (Dh eventually was fishing it out of the birthing tub.) Finally got his attention and decided to call Karen back over. Moved back to the tub and continued to hum through the contractions. Shortly after Karen arrived, I decided it was time to call the MW as she was 2 hours away. Things got a bit hairy at this point because the MW did not think I could be very far along. It was a bit of a circus with my trying to tell her I really was progressing and then throwing the phone to DH during contractions. She finally suggested that we time the contractions for an hour---she wanted them 4 minutes apart and lasting a minute apiece.
I was royally pissed off as I thought one of the benefits of home birth was not having to deal with the numbers game, but did not know how to get my message across. Part of the problem was that we had anticipated DH being able to assess dilation a bit, but he was not experienced enough and I could not tolerate him hunting for my cervix at this point. Anyhow, I moved from the toilet to the tub again and we began timing. Within about 15 minutes I decided we had better prepare for transport as I was not going to have the baby without an attendant, so sent DH to wash the car seat cover (yes I was really prepared, LOL) and Karen continued to squeeze my hands as I moaned through the contractions----closer and closer together. Shortly after that, I threw up and announced I was in transition. Karen commented that I wasn't acting like it between contractions but I was certain and soon felt very pushy. The odd thing was that I was totally calm and collected between them and was reassuring both DH and Karen that I was fine. I remember Karen asking if I was pushing and telling her that I was not, but my body was a little bit.
I announced that we were to call the MW and if she was not coming, we were leaving. The good news was that she had left already. I was most definitely pushing involuntarily at this point and probably could have delivered if I was willing to work with the contractions, but I could not STAND the sensation that accompanied any attempt to push. It was the most intense tingle I have ever felt----very orgasmic and simply too much for me to cope with. I spent the next two hours panting through my contractions while laying on the bed.
The MW arrived, examined me, and told me I was 9 with a lip. (I believe I was complete earlier but lying down and panting had raised the lip.) She told me to start pushing and I refused. I did eventually try to push side lying but I hated it, especially when she tried to hold the lip back. I moved to the tub on a forward leaning kneeling position and this helped somewhat. I had a bulging bag that the MW said seemed to be interfering with my progress so I agreed she could rupture it. It was very difficult for me to allow her inside and it was very difficult to push through that tingling sensation. My one "complaint" is that she was not more verbally supportive. Instead she said things like, "Well, I just can't help you then," when I would tell her that I did not like having her fingers in me, etc. I understood she was trying to help, but it was so hard-----positive encouragement would have gone a long way! I eventually was able to give a few puny pushes and she noticed some meconium, so I upped the effort a bit. She also ruptured the bag, which I did not notice at all. (Later she said she had to really tear it---and the baby still brought it all out with her, even stripping the amnion from the cord----the kid was determined to be born in the caul!)
Finally I was able to push past the tingle and as soon as I felt pain--the ring of fire---there was no stopping me. THIS I was prepared for! I remember saying, "Oh, the ring of fire, I can do THIS!" and two pushes and she was out. It was so amazing to feel her crown and emerge, followed almost immediately by her body. Good thing she was small--I could not have stopped for anything.
MW brought her right up onto my back and checked her over to make sure she had not swallowed any meconium. She was so alert and peaceful---just looking around. I remember asking what we had, and DH saying nobody knew yet. I told him to LOOK! It was his baby! And he tearfully announced it was a girl. She was born 5:58 a.m. Wednesday, April 24th weighing 7 lbs. 14 oz.
She responded well (Apgars 9 and 10) and soon I was climbing out of the tub, with my baby still attached to the cord and the placenta still inside---too weird!! DH and I cuddled her on the bed for a bit, then I delivered the placenta. I really did not have any contractions, so that was a bit of an effort and I did actually lose a fair amount of blood (4 cups), so my midwife did give me a Pit injection as we had discussed in advance. I also did a lot of nipple stim. to help contract. After the Pit, I had some wonderful afterpains and fortunately, the bleeding stopped without having to transfer.
Approximately 2 hours later, DH cut the cord, I nursed, peed, and the MW finished the paperwork, the cleanup, fixed us breakfast. She and Karen let themselves out while we slept in our own bed with our new baby. I cannot imagine this birth happening any other way---I could never have done this at the hospital, even with my oh so supportive OB. I can honestly say I feel complete now. I have completed a chapter in my life. I am eager to see what is next for me, but am also very content to simply be for a while---a feeling I never had after my first two babies. I would do a few things differently next time, but would not change this birth for anything!
Jamie S's Story (vaginal birth, c/s for kneeling breech, unassisted home waterbirth VBAC)
Kmom's Notes: Jamie is a midwife. Her first baby was born vaginally at home many years ago. Her second baby was a planned homebirth, but the baby was discovered to be a kneeling breech baby. Although this did not automatically mean c/s in her mind, circumstances helped her decide in favor of transporting to the hospital, which she knew would mean an automatic c/s. The doctors did a vertical incision on her skin (the doctors justified this due to her size, but it really wasn't necessary), and she was separated from her baby for a good portion of the time, unfortunately. Her doctor was very unsupportive.
With her third baby, Jamie decided to choose unassisted birth. Being a midwife herself, she knew very well the pros and possible cons of this decision and made it from a place of empowerment. Because she had gained weight between the pregnancies, she was concerned deep down that perhaps this would cause problems for the pregnancy and birth, but actually found this was her easiest and most trouble-free pregnancy and birth.
Birth Story
Baby #2, or Elaya Quinn: I thought I had prepared for the birth of my second baby. I had been studying midwifery for several years, attended close to 100 births, and she would be my second child. My son had been born at home almost 8 years before and although I could pick his birth apart and find fault with the experience, everything went quite well.
This baby's birth started out normally. About 3 a.m. I got up to pee and realized I was having contractions. Knowing it could still be a while I didn't tell anyone and went back to bed. I wanted to relish in the experience by myself for a while. Around 10:30 a.m. I told Dan I thought things were progressing but that it still could be many hours. My water broke at 5 p.m.. There was some meconium and I had a fleeting twinge of panic. Heart tones were good and she was moving so I decided that we were safe to continue as planned. Because the baby had not been engaged the last time that the midwife checked me, I asked my partner to phone and ask her to come over. This was my partner's first birth. In his enthusiasm he misunderstood me and phoned everyone. Within a fairly short time my midwife, the second, a close friend who was taking pictures and doing video, and my sister arrived. It was time to party!
Things weren't happening as fast as I expected them to. I wasn't noticing the shifts that I had with my son's birth. I kept waiting for that sensation of needing to push. Secretly I wished everyone would go away and leave me alone. I was in and out of the pool, in and out of the shower, and in and out of bed. Everyone was alternately trying to give me space and renew my enthusiasm for the birth of this baby.
It was determined that the baby was a kneeling breech. This explained why this labor didn't feel at all the same as my first. It also gave us information as to how much longer this birth might be and how patient we were going to have to be during the dilation phase.
After many hours of attempting to encourage contractions to
become more regular and effective with every means known to us, I hit an
emotional breaking point. For the first time in my pregnancy I told
someone about my deep fears for the baby. I was afraid that there was
something really wrong. It was pointed out that if there had indeed been
something the matter, it would have shown up on the ultrasound I had early in
pregnancy. Immediately my focus shifted, something needed to be done to
get the baby out soon. I was exhausted. We were about 45 hours into
labor. Although most of it had been quite easy, during the last few
hours of pushing as hard as I could in many different positions without the baby
moving down I had reached the end of my physical and emotional
stamina.
With many tears and a deep-seated guilt I made the decision to transport. We all knew that moving to the hospital at that time would guarantee a Cesarean Section, but it seemed the best decision. I arrived at the hospital shortly before 1 a.m. and was treated with open hostility by the doctor. I was informed that due to the pediatrician shortages and strikes, he couldn't guarantee my baby would survive. I knew that the heart rate had been good throughout labor, so I ignored him as best I could. The sensation of being put out under general anaesthetic was pure bliss. I was no longer the one in control and responsible for the life of my child. The pain had ended and I had been absolved.
I awoke afterward shaking uncontrollably. I was informed that this was a "natural reaction to the drugs," and was offered pain medication to help quell the trembling. After a time I was told that I had a daughter, the pediatrician was with her and they thought she would be fine. A girl? As much as I dared hope for a daughter, I had prepared myself for another boy because I had thought my first one was a girl----and he most definitely was not! A girl...I was wheeled up to the nursery room window to see my baby. A tiny little face in a bundle. A girl? Not that I could tell. Mine? Not as far as I knew.
Later I phoned friends and family. It was a difficult task compounded by my feelings of inadequacy and shame. I started with those closest to me---the ones I knew wouldn't judge me because they loved me. One of my friends said to me, "You may be feeling fine about your decision to transport--to have the CS now-- but eventually you probably won't feel as positive about it and that's okay." I dismissed this, thinking, "Maybe if the CS had been thrust upon me I would feel this way---but I had made the decision, I was in control. She's wrong."
There were unforeseen complications. My daughter was diagnosed with an infection that they never cultured anything from. She became very jaundiced due to a blood incompatibility. She was required to stay in an isolette for several days. We could put our hands in through the tiny little portals and touch her---but until she was three days old, no one could pick her up and hold her. I will never forget the first time we held her. We were told we had about 10 minutes. My son and my partner were both there and I battled with the knowledge that they both needed to hold her also and the desire to keep her for myself and never let her go.
On day four I was given permission to nurse my baby for the first time. I had been pumping and she received nothing but breast milk, but not directly from me. She was amazing. She latched on immediately and never looked back. It was like she knew that as long as she was nursing they wouldn't take her back to the nursery. I had her lying in bed with me at night, and we would both be sound asleep until a nurse approached our room and she would begin to nurse again with vigor.
One day when she was about 6 months I was sitting on the bed writing in my journal as my wee one slept beside me. I recall looking down at her and realizing that part of me wasn't yet prepared to mother her. In fact there was some part of me still waiting to give birth to her. How could I possibly be the mother she deserved when I had failed her in her first stages of life? Was this what my friend has tried to warn me about? Obviously.
A couple of weeks later 3 people asked me if I would be willing to help them work through their birth experiences. They were hoping to deal with the trauma they were battling with before bringing more babies into their lives. I agreed quite readily. As I began reading and formulating a plan of action, I realized that I would have to deal with my own ordeal first.
Almost 2 years later....In stages I grieved the loss of the birth I had planned and accepted the birth that I had. I identified the many lessons buried within my experience and tried to find ways to implement changes into my life. My daughter's birth was:
As it was intended to be
A hard learned lesson
Powerful
The entrance into the world of a wonderfully vibrant spirit whom I am Blessed to know
A beginning
The time I felt closest to my partner as we danced in the candlelight
A time to laugh and laugh and laugh
Filled with those who love us
From her birth I learned:
The value of sharing honestly
That my body is very equipped to nourish my children
The essence of space and privacy and my desire for both
That I am worthy of trust
That my hands will always supply me with the correct information
To be tolerant and patient with others
To let go of judgment of women whose birth experiences weren't "normal"
I have witnessed my daughter's strength, courage, beauty, and sweet acceptance from the beginning. From her earliest days I knew I was privileged to know her. I would go through much more than a cesarean section to be her mother. Next time I shall birth her body as easily as I birthed her soul. Tomorrow I shall release her again. And again. And again. With love.
Baby #3, or Jeremy Rowan: I had a baby. Now anyone who knows me realizes that this isn't the secret. We have proudly told everyone we know about our son. He is amazing! We all adore him. As well, pretty much everyone knows by now that he was born at home, his birth attended by his daddy.
The secret is his birth story. I have been asked many times about his birth and various people know tidbits of our shared experience, but I have yet to tell anyone the whole thing. I have sat down several times to write about his birth but haven't been able to bring myself to committing it to paper. I finally understood this morning that this is because his birth experience was so personal and intimate that to share it feels invasive. Then I realized that I don't have to share it with anyone simply because it has been written. I can hold the secret for as long as I need to and when the time feels right---then I can tell the whole world.
On Friday, June 21, I began to suspect that perhaps I wouldn't be pregnant forever. I had been having BH contractions for months, so the sensation wasn't completely new to me. It did feel a big "different" though. I mentioned to my mom that day that I thought my body was beginning ever so slowly to prepare itself for birth.
Saturday morning about 6:30 I got up to pee. I noticed that I was still having the usual tightenings in my uterus. They were more frequent although they were still quite spaced apart. I stood and walked back to the bedroom and when I got there I began to leak. I momentarily wondered if I was peeing again, although I didn't see how that could be the case---of course it was my waters leaking. I got dried off and climbed back into bed. Something was definitely happening! I drifted off to sleep again, happy but determined not to get too excited too early with this birth. I was going to sleep because it was early and I would need my strength later. We got up around 10:30 and began a fairly normal day. I told DH that something was happening and that I was in early labor. I spent the day napping and reading, eating when I felt like it, and relaxing. Dh was great for making sure my glass of fluids followed me around the house---and I drank quite a bit of Red Raspberry Leaf tea with chlorophyll. I spoke to Jolene on the phone a few times and managed even through contractions not to let on that anything was different than usual. For some reason I did not want anyone to know. I didn't want anyone clock watching for me or worrying if it took a long time. I just wanted this birth to happen.
We ate supper that night and eventually my daughter went to bed. My son Andree was away camping for the weekend--he would be home on Sunday evening. It was the perfect time to have a baby if we wanted it to be just Dan and me. I found myself struggling with what "should" I be doing. Was it appropriate to be watching TV when perhaps I should be going out for a walk? Maybe I should go to bed and get some sleep if I could. If I actually ate supper that evening could I really be in labor? Questions flooded my mind. I had an insatiable need to know how far along I was and when would this baby be born. Was I in early labor or was something actually happening? Could I get into the pool any time soon? Was this going to be another 3-day birth?
Dan gave me a dose of Sulfur, the homeopathic remedy that seems to be able to make my life better, at about 11 p.m. He doesn't ask anymore, he just prepares it and I take it. It was nice to have someone else thinking at a time when that would have just been one more question for me to obsess about. Should I take Sulfur--or do I need another remedy this time?
Dan and I spent some deliciously intimate moments together during the evening. It was so nice to be close to him and to feel his support. It was great to spend time with him and not have anyone observing us. We snuggled and talked. he was so positive that things were happening--that the labor was progressing as it should. Some time after midnight we went upstairs. I didn't have a recollection of time by this point. It was all just floating by us at a "Twilight Zone" pace. I labored in our darkened room for a while in various positions depend on what felt right at the time, the midwife in my mind warring with the mother giving birth in my body. Sometimes I was on my hands and knees, sometimes standing. I spent time on the toilet. We set up the birthing pool (a plastic children's pool) and filled it. Eventually I allowed myself to get into it. The water felt great. It was so much easier to get comfortable. I had finally found a position that eased the ever present ache in my back. I spent quite a bit of time in the water. After a while I started to feel "pushy." Part of my mind was saying, "This is way too early to be pushing!" The other part realized that if it was time to push and I did, the baby would be born soon.
After a few pushes in the water Dan suggested a change of position. Perhaps getting up and out of the water would move things along. I think he realized instinctively that something needed to change. When I was upright the contractions intensified. I went through several on the bed on hands and knees, rushing to the toilet regularly to pee (thanks to the Red Raspberry Leaf tea and watermelon I had no problem keeping my bladder empty!). Before long the contractions were getting the better of me. I was beginning to hear the blathering in my mind, "I attend birth very well--but I don't give birth very well at all!" being the most prevalent sound track. I realized that I was comparing myself in birth with others who I knew, women I had attended and the unassisted birth stories I had heard. The midwife within was holding up a measuring stick and I was seeing myself falling short. It took some work to come to the conclusion that no one else's birth had anything to do with me. No other birth I had ever attended had anything to do with this birth. My previous two births were irrelevant right here right now.
That was one hurdle cleared. I naively thought I was now on my way to birthing this baby. I got up to go to the bathroom once more and was hit with a succession of nasty contractions. I was pushing, had been for some time now but the baby wasn't moving down. I began to panic. I remember sitting on the toilet wondering what on earth I was going to do. I needed someone to save me. I really needed someone there who could make it all better and help me through it. Could I transport to the hospital for another Cesarean birth? Was that an option for me? Not really, although I can completely understand the epidural rage in hospitals today. If I had been somewhere where someone could have offered me that kind of release, a way out of the pain, I would have taken it in a heartbeat. I did think about it----quite seriously, very quickly perhaps, but seriously. I decided that I couldn't transport again. I knew that the only way through this for me was through it, but how was I realistically going to get there? I was intermittently crying and calling for help. I didn't know where to go...
At about 4:30 a.m. I asked Dan to phone Darlene. She is one of the most amazing women I know. she has attended many births and has been the inspiration for numerous Unassisted Childbirth births. She is a traditional midwife. Dan talked to Darlene for a bit and then handed the phone to me. I was still in the "Someone Needs To Save Me" mindset. What I wanted to hear her say was that she was on her way over to make it all better. She lives over 2 hours from me! She very quietly asked where I was feeling the pressure/contraction. I told her it was largely in my back. She listened to me as another wave rocked my body and then suggested that it sounded like the baby was very low, applying a lot of pressure to the cervix, but that I was not fully dilated. Therefore, I was having the urge to push without a lot of progress. This resonated with what I "knew." The midwife within stood back, arms crossed, nodding her head. The mother in labor groaned and whined in disbelief at the suggestion that could try blowing off the contractions for a time.
As the next swell hit I met it head on with a breath. While I was blowing out it was barely manageable. When I had to break to inhale, I felt myself drowning. Right there beside me I heard Darlene praising me, supporting me, validating what I was doing. She listened to me blow through two contractions and said that I should probably aim for an hour at least. As I heard her I wondered how on earth I could do that? How could anyone ever ask a woman in labor to blow away that kind of intensity? I told her I would try and hung up feeling still somewhat lost because she wasn't coming to my aid. Dan lit the candles on my birth altar, which represented the most amazing group of women I know. He knew that I needed support and saw that this was a way to help me.
For a time---20 minutes, 3 hours, who knows?---I laid on my side in bed beside Dan as he tried to get some much-needed sleep, blowing off contractions. I would look at the candlelit wall and the flickering lights. It was helpful to have the women represented by the candles present with me and to connect with other women birthing in the world. I was thankful for my experience with toning because I would moan/tone through each contraction and rock back and forth frantically until it was over. At the end of each one, I would blow it away and remind myself that I needn't go there ever again. I got up to pee one more time and was bowled over by the intensity. I sat on the toilet crying, wondering how Dan could possibly ignore my plea for help.
When I came back into the bedroom I told him that I wanted to get back into the pool. Something in me made a connection with the water and I understood that I needed whatever it was the water had to offer. I got in and Dan turned on the hot water to warm up the pool. It felt wonderful. The warm water rushing toward my belly as I leaned back helped immensely. The pain in my back was beginning to subside.
For the next hour and a half I found my zone. It was an amazing place to be. For the first time I fully understood what Pam England meant by the term, "Birthing From Within." It was the strangest place to be. Today I get only a soft-edged glimpse of that place and it continues to fade with time. It was quiet and warm and ever so calm. During contractions I would tone or blow (breath awareness being another HUGE blessing to me during this birth). Between contractions, I floated away. It was almost like during those times in between, I didn't exist. Time was completely irrelevant and one sensation was in no way related to the next. Occasionally I would look up and see Dan sitting at the edge of the pool. I think he was napping on and off---although not soundly, I'm sure. At one point, I looked up and he looked a bit concerned---but he simply smiled and said nothing. His trust and belief in me were overwhelming. When I failed to see the strength in myself he never lost that sight.
Some part of me was vaguely aware that after a time my uterus was pushing without my conscious effort. I continued to blow through contractions for a time and observed my body doing its own work. It was an interesting place to be.
Suddenly something within me shifted. Laying and blowing off contractions was no longer the right thing to do. There was a slight catch in my breath/tone during the contraction and that ever-present midwife smiled within me. I thought perhaps I would get up to pee again. I got as far as an upright on my knees position when another one came over me. After that contraction, I checked within and the baby's head was right there. I could feel it less than one inch inside me. I told Dan and he was hit with a burst of energy. It was fun to watch because the tension he was feeling lifted as we were once again in a moving forward kind of place.
I was on my knees leaning forward against the back of the birth pool which was had support with two bean bag chairs. I could feel the baby move down during contractions and slide back up between. After a couple contractions, I began to plead with him. "Come on baby! Come on baby!" That wise women within understood what the baby was doing---gently preparing his path into the world, but the mother bear within had had enough. She wanted a baby to hold and to nurse and she had been waiting long enough!
When I began to realize that the fullness in my bowels was causing the delay I experienced a moment of embarrassment. I made some mention to Dan about needing to have a poop. He thought I'd said the baby pooped. I said, "No, I am going to!" In his most complete moment of assistance, he said to me, "You do what you need to do." It was in that instant I understood the perfection of unassisted birth. There was no one present who would judge me. There was no one wondering what I was doing or why. No one was concerned about the well-being of the baby because I knew he was fine. No one suggested that perhaps I do this or that. The only other person present loved me and believed in me and trusted me. He knew that I knew what I needed to do!
I pushed and pushed and pushed! I wasn't waiting much longer to see this wee one. I could feel him wiggling within me---squirming his way out. After a momentary, "Is this a head? What is this? This feels weird!" I determined that yes, he was coming head first. The head moved down steadily, ever feeling larger and larger. My hands were over his head, supporting myself from the outside. I could feel his hair, waving in the water, tickling my palm. It began to burn and for an instant I thought, I will NEVER give birth unassisted again! I will NEVER recommend unassisted birth again! I don't think I will EVER do this again!!" And then as I breathed, his head slipped through into my hands. I saw and felt him turning, taking that last curve in the path to this world. With the next push his body was coming. His cord was looped around his neck and under one arm. I lifted it off and he swam out and grabbed hold of my leg. Dan and I both reached down for him and as he was brought to my body, Dan said quietly, "Watcha got, Mama?" I looked, although we both already knew, and confirmed that yes indeed we had a boy!
Crying, I marveled at how adorable he was and how incredibly much he looked like his sister. I was overwhelmed with pure joy. He was here and I was cuddling him and all was right with the world. He cried quietly for a few seconds and then snuggled into my body.
Dan phoned his mom almost instantly. He was excited and needed to share the news. Gramma got to hear the first wee cries of her grandson. This served another purpose as it turned out; it gave us the birth time for our wee babe on our phone bill. He was born at 6:49 a.m.
Dan woke my daughter up. She came in looking a bit bleary but happy and excited. She marveled at the wee babe in my arms and asked questions about the baby and the blood in the water. We discussed again how women bleed after giving birth. How fortunate to begin to have an understanding of Normal at 3!!
While still in the birthing pool he latched onto the breast and nursed like a pro. Dan gave me some Arnica and I relaxed for a time with my baby in arms. The placenta detached and delivered about 20 minutes after the birth, although there were still membranes holding it in close to my body. After Jeremy nursed for a while, I was starting to feel restless and wanted to get out of the water. I handed him to Dan and got more upright---pushing slightly while gently pulling the membranes. They released and I realized that they had only been held in place by a large blood clot inside a pocket of membrane.
I got to pee and climbed into bed. Within an hour after the birth, Dan, Elaya and I were nestled into bed together with the baby in awe of this new being in our lives. Andree [my older son] came home later in the evening. When he came in he seemed to know that the baby had been born. He asked Dan not to tell him if it was a boy or a girl and came up to our bedroom. When he came in, he said to me, "Don't tell me, I want to see if I can tell." He looked at the baby and his face lit up as he exclaimed, "It's a boy!!! Right??" He was thrilled; having already decided that little sisters are brats he desperately wanted a brother. He climbed into bed beside him and lay looking at his brother for some time.
That's my secret. I finished writing about it this morning. I held it secure for almost 6 weeks and now feel ready to share it. There was a real advantage to waiting. Jeremy Rowan's birth was so intensely private and intimate that to share it sooner would have disrupted something for me. It has also taken this time to simply find the words to describe the birth. I acknowledge now that I could write about his birth daily for the rest of my life and the mere words would still fall desperately short of really sharing the experience. That knowledge is something for my heart and my soul and cannot be shared in any real way, but I hope this tale may spark that passion in others who have their own stories.
Tabitha's Stories (borderline high BP, induction, c/s; borderline GD and BP, hospital VBAC)
Birth Story
Baby #1
My blood pressure had been a little high, off and on, throughout my last trimester. When I reached 39 weeks the doctor suggested an induction at 41 weeks and I agreed. I was given pitocin at 7:30 AM, doctor broke my water sometime in the late morning. I spent the entire time in bed---sometimes rolling from one side to the other, most of the time reclined. About 3:00PM I was at 7 cm. At 5:00 I was still at 7 cm and the doctor mentioned that we might need to do a c-section. At 6:30 the doctor said that the baby was fine and not in any distress and I was fine as well (had the epidural a few hours earlier) but since I hadn't made any more progress he doubted I would, and if I continued to labor into the night the baby might go into distress, so it would be best to go ahead and do the c-section while nobody was in distress. He told the nurses we were doing the c-section for CPD, and mentioned to one of them (as we were waiting in the hallway for the OR to be prepared) that I was his last patient for the day and he was ready to go home. The baby was "born" at 7:31 PM.
Baby #2
After I failed the 1-hr glucose challenge in my second pregnancy, my doctor immediately diagnosed me with GD and refused to do the 3-hr test to confirm it. I already had been sensing that he was looking for reasons to pressure me into another c-section, and this seemed to be the perfect reason for him, so at that point I decided to find a new provider who would do the 3-hr test to confirm the diagnosis (and would guarantee me a trial of labor), and I passed the test, although my blood sugar levels were still a bit high on one of the readings, so I still had a borderline diagnosis.
On Sunday, I woke up to contractions about 10-15 minutes apart. They were painless, just as they had been for the past 2-3 weeks. I had been checked on Friday and told I was at almost 4 cm, 40% effaced, but the baby's head was still high. So I sent my family to church but I stayed home. And everything stopped. I tried a few things to keep contractions going, but nothing worked.
By the afternoon I was feeling anxious, and ready for things to get going again, but I was not having any contractions at all. I consulted with my doula, and told her I was staring at a bottle of castor oil. She laughed, and said if I really felt ready, to go ahead. I took a couple of tablespoons of CO mixed with orange juice and a few hours later I took a few more tablespoons of CO. Around 7:30 I started having a few more contractions--still painless, for the most part, although I had a couple of really strong ones. My doula and the midwife who agreed to help out came over to check me out and see if I had made any progress. Lo and behold, I was at 5 cm, almost completely effaced, and the baby's head was engaged! The midwife tried to sweep my membranes, and she said there was nothing to sweep--we were definitely making real progress. I was thrilled to be so far along, when most of the contractions I had felt to that point were painless--it was going beautifully so far! We all went to bed.
At 3:00 Monday morning I woke up with some mild contractions. They were about 3-4 minutes apart, but still painless. After an hour, I talked to my doula, and told her I'd call her back when the contractions felt stronger or were getting closer together. At that point the contractions were stopping whenever I moved around, but would start again when I stayed still. I decided to take a shower, and while I was in the shower the contractions didn't stop, even though I was standing up. The water felt good though.
About 5:30 things started to get a little more intense for me, so I called my doula and told her I was ready for more support. I woke my husband up so he could take a shower, and called my mom upstairs so she could the doula and midwife in when they came. My call also woke up my sister, who was upstairs with her children, and she came down to help get the apartment ready. Mom came down and fixed me some oatmeal. The whole time I was just sitting on the couch having contractions, but doing ok. I wasn't able to talk through the contractions, but I could still eat in between them. By 7:00 I put my unfinished bowl of oatmeal down and didn't eat anything else--it was time for business. My sister and the midwife started working on getting the pool full of warm water (heating canning pots of water on the stove) while my husband and doula focused on me. I was having intense back labor, which confused me because the baby was definitely anterior and in a perfect position.
At some point I started feeling nauseated, and threw up, but it didn't bother me too much--not nearly the way the nausea took me out when I was in labor with baby #1 (it turns out I threw up twice when moving from early labor to active labor, and twice more when entering transition). My water broke at 7:45, while I was standing in the bathroom. We checked the baby's heartrate and it was beautiful. By then the pool was ready, so I climbed in--the water felt so good! I threw up a couple more times in the pool, and they sent Dad out to get me some Coke to sip on. I have no idea how long I was in the water, but eventually they had me get out so we could check the baby's heartrate again (still beautiful). I asked Dad to come down and help my husband give me a blessing. The midwife checked me and said the baby's head was in front of my pubic bone and not putting enough pressure on my cervix, so I needed to be in a more upright position--no more leaning forward. It hurt a lot more to stand up straight, and I relied completely on my husband and doula to hold me up. I was getting tired, and thinking I just needed to get some sleep.
Someone suggested that I lie on my side for a couple of contractions. It was so nice to lie down, but the contractions were getting a lot more intense. In between each contraction I actually fell asleep, but during each contraction I was almost in tears. I kept thinking maybe this wasn't such a good idea after all--and I wanted to either take a break (maybe finish things up the next day) or run to the hospital and get an epidural. I did realize at some point that just when the contraction felt unbearable and I couldn't take it anymore, it would subside--that helped me keep going, although I kept thinking that if it got any worse I just wouldn't be able to do it. They checked me again and asked if I felt like pushing--I didn't. But they said that the sounds I was making sounded like pushing sounds, and all of a sudden it was time to go to the hospital!
The midwife called the hospital to let them know we were coming, and asked them to call the doctor (they didn't). As we drove, I was able to completely relax between contractions, and then they had me blowing through the contractions. By the time we got there, 5 minutes later, I was feeling the need to push.
We arrived at the hospital at 10:53 AM. At the hospital we rushed into triage and I was put in a wheelchair. Although I had been blowing through contractions in the car, once we entered the hospital I started moaning again--mostly to let the hospital staff know things were getting urgent. We got into a room--the floor was still wet from just being cleaned. They got me into the bed and I started blowing again. The nurse checked me and said I was at 6 or 7 cm--but I had been almost complete at home. We think it was just some cervical swelling, caused by the drive to the hospital, or that she was trying to convince me that I wasn't ready to push yet. The doctor came in, irritated that he hadn't been called earlier. The nurse was a little irritated that she hadn't been able to do all her pre-birth stuff too. There was a brief discussion about the IV, EFM, and episiotomoy--I was refusing all of them, and we just kept telling the doctor that I knew the risks and was refusing them. I was supposed to sign something, but we never got around to it!
Finally the nurse said she could tell I was complete without even having to check, and then they had to get the bed ready so I could push. There was a brief discussion about stirrups and my pushing position-I refused the stirrups but finally agreed to push in a reclined position although that worried me. I decided if that position didn't work I would insist on trying other positions, but the doctor was very emphatic that I needed to be reclined so he could do his job. It was even harder not to push at that point, but my doula and midwife kept saying that the baby would take care of the pushing, and I didn't have to do much work, if I could just let him do it. Once it was officially time to push, the contractions slowed down, and someone said something about how maybe they had jumped the gun a bit and I wasn't really ready. But I did feel the need to push, and I could feel the baby moving. I was getting some mixed messages, with the doula trying to tell me to slow down and the doctor telling me to push more-the midwife could see the baby crowning and wanted me to slow down so I wouldn't tear, but she couldn't say much there at the hospital because of her status as a midwife. The doula couldn't see what was happening, but she did tell me to slow down--but that was really hard to do at that point! The head started to come out and they suggested that I feel it--I reached down and felt, but couldn't tell what I was feeling--it felt more like brains than a head. My husband was on one side of me and Mom was on the other--they were helping hold my legs because I just couldn't do it myself. My husband did some counting to help me focus my pushing, which helped (I'm a math person, and numbers really can help me focus). As soon as the head was out, his right hand popped out too! I was then able to relax and the rest was more controlled. We figure all my back labor was caused by the hand being up by his face (and the hand did cause 2nd degree tearing). The cord was around his neck too, but it was very loose and not a problem at all. The doctor started sucking out his mouth, and then I pushed him out the rest of the way easily. He was born at 11:40 AM.
The whole experience was so amazing! When I was lying on the bed, thinking I wouldn't be able to do it if things got any worse--that was as bad as it got. It never got worse than that. I know I wouldn't have been able to do it without all the help I had, but with that help, I was able to stay in control and handle it. The baby is nursing well, although he slept too much for the nurses' comfort, and actually gained weight instead of losing weight in the hospital. I was able to walk right away, and although I was a little sore from the stitches, I feel a million times better than I did after the C-section. This baby weighed half a pound more than his c-sectioned brother, the one with the "CPD" diagnosis. I'm so thrilled with how things went. The only thing that would have made it better would have been not going to the hospital at all! I definitely feel empowered, stronger, because of this.
Kmom's VBAC Stories (2 prior c/s; induced VBA2C, home waterbirth VBA2C)
Kmom's Notes: It's difficult to be objective about one's own birth experiences, as noted before. According to most OB 'experts', a VBAC would have been against the odds for me. Because I was "morbidly obese," and because I had labored twice before and had cesareans after full dilation and pushing both times, most doctors would not have given me much chance for a VBAC this time. They would have told me my pelvis was "too small" or my babies "too big" or that I had too much "soft tissue dystocia." Between my size, my age, the "CPD" diagnosis, and my 9 lb. babies, most doctors would not have even let me try for a VBAC.
However, I felt strongly that my previous c/s were caused by baby malpositions that failed to be diagnosed/acted on. I searched out providers that were very knowledgeable about diagnosing and fixing baby malpositions (and in particular, posterior positions). I got chiropractic care to help correct some major back and pelvic pain I'd been having, which also helped the baby be in a better position for birth. I pursued emotional processing of my previous births, and feel that the combo of both physical AND emotional preparation was vital in getting a VBAC this time. More details on this preparation process can be found in the BBW VBAC Stories section on my website, and the VBA2C section in particular.
One of the lessons I learned was the importance of assumptions and the opportunity for healing. My first providers assumed I would have complications; they expected them and then I had them. I assumed a high-tech hospital birth was safer, but it ended up being more dangerous and difficult. I assumed it was better to go with highly-trained OBs and nurse-midwives, and I ended up with a better outcome with well-trained but hands-off direct-entry midwives.
Most providers assumed that a VBAC was probably impossible for me, but despite their odds I had not one but two VBACs. What made the difference? Providers who had true faith in women's bodies (including fat bodies) and who assumed I could do it; chiropractic care for a better-positioned baby; and friends and colleagues who helped me towards emotional healing. But even had I ended with a c/s, the healing work alone was worth the journey. It was a wonderful journey!
Birth Story
Baby #3:
The details of my first two births by c/s are contained above. Although choosing to go for a VBAC again in the third pregnancy (after a previous "failed" VBAC) was difficult emotionally, I felt deep inside that it was the right choice. The hardest part for me was the uncertainty of the outcome; I wanted guarantees and there were none! Accepting that was part of the healing process for me (a hard part but an important one).
I also did a great deal of research into VBA2C and felt the physical risks, while real, were manageable, and that the risks of elective repeat c/s were under-valued by most OBs. So I chose to go for a VBA2C. However, I had plans in place that if I didn't have good progress within a reasonable time frame or that if I just felt that that it was prudent to stop, I would go to a repeat cesarean. I didn't want to do that too easily, but neither did I want to push for a vaginal birth at any cost. So I tried to be prepared for both possibilities and take things as they came.
The pregnancy itself was unremarkable and normal, a welcome change from my first pregnancy! I had had gd with my first pregnancy, so I am always cautious about blood sugar levels now. We monitored my levels with a home glucometer daily, and also took the gd screening test (I chose to do it only once, however, in order to minimize the stress on my system from all that sugar). I was very careful about timing and choices of food, but tried not to be overly rigid either. I also was conscientious about exercise by utilizing walking, water aerobics, and yoga during the pregnancy.
To prepare emotionally, I took several workshops and classes and worked on processing and healing old wounds from the first two births and my childhood as well. [There is a lot of detail on this in the VBA2C web section.] I feel these were absolutely VITAL in my preparation, and strongly urge women who have had traumatic previous births or difficult family histories to use pregnancy as an opportunity to work towards healing whenever possible. I can't say enough about how helpful this was to me, whether I had ended up with a VBAC or not.
Physically an important thing I did was to find a chiropractor versed in the "Webster In-Utero Constraint Technique", which can help resolve baby malpositions. It took a long time to find someone, but I did finally find a wonderful chiropractor who did know this technique. I was almost at term before I found her so I did not have as many treatments as might have been helpful, but the 3 treatments I did have were WONDERFUL and really helped resolve some lower-back and pubic pain I'd had for years (since my first pregnancy). I also think these treatments helped encourage the baby to be anterior (face towards my back, the easiest way to be born). The baby turned anterior only right AFTER my first chiropractic adjustment (Webster's Technique), and that was the first time he was ever anterior. He moved anterior within an hour of seeing the chiropractor (at 36 weeks), whereas he'd been posterior consistently before that time. So I strongly feel that chiropractic care was the reason for his turning.
We also made the very difficult decision to encourage labor to come a little early. Research clearly shows that inducing labor lowers your chances for a VBAC, and inducing early for big babies ALSO lowers your chances for vaginal birth. However, my midwives felt that encouraging labor a little early can help a few specific women and they felt I might be one of those. Although I have very strong feelings against this generally and did not originally want it for me, by the middle of the pregnancy it somehow felt like something I should do. [I now STRONGLY regret having done it, but it did seem like the right thing at the time.]
So we 'encouraged' labor to start at around 38 weeks. I began labor 3 cm dilated and partially effaced. Since I'd never had any real trouble dilating in the past two pregnancies and was starting at 3 cm already, I did not expect to have trouble dilating this time. However, despite very strong and seemingly effective contractions, I did not dilate quickly at all! We got hung up at 5-6 cm and stayed there for hours.
Much of my labor was strong but fine, and between contractions we even sang songs at times! I have good memories of that. However, little by little I became more concerned. Labor became more and more painful, my midwife became less and less supportive, and she pressured me for more and more interventions. She eventually broke my waters to try to encourage dilation through increased pressure from the baby's head, but that made the contractions EXTREMELY painful and was probably a mistake.
At this point, labor became very difficult and traumatic. Probably what happened is that the baby's arm was up near his face/head (compound presentation), which can make for very difficult and painful labors. I had previously labored all naturally in the second pregnancy, so I didn't feel that going without pain meds would be a problem, but suddenly it was. At this point, a conflict developed with the head midwife (the other was great still), and she became very unpleasant to deal with as she pressured me for more interventions (manual dilation). I also was quite uneasy at having no dilation progress over several hours despite tremendous pain, knowing that this was a risk factor for rupture. So against the wishes of my midwives and husband, I decided to transfer to the hospital. Something inside me just felt strongly that it was the 'right' thing to do. I'm so glad I did.
The second midwife accompanied us to the hospital, which notified the on-call OB. While she was getting there, we set up for an epidural. I was experiencing tremendous back labor (I got bruised from all the counterpressure!) and was very determined to get some relief. However, while we were putting in the epidural, I had to shift position, moving my hips 'just so' across the uneven hospital bed, and apparently that caused the baby to move his hand/elbow away from his face. Suddenly he dropped and I was pushing! They had to stop the epidural (I never got it, which was a bummer at the time but in retrospect was probably a good thing). The nurse checked, and I was almost complete. She helped move a stubborn cervical 'lip' over the baby's head, and we really began pushing hard.
They had me pushing in the "C" position---curled up forward, chin to chest, legs back, and this was not conducive to getting the baby out. It really makes your pelvic outlet smaller. At one point the baby stopped descending because he hit my pubic bone; my body kept telling me to arch my back to help him out, but the nurses kept telling me not to do that. Finally my midwife lowered the bed backwards so I could arch my back, and that seemed to help the baby move under the pubic bone and out. All of a sudden we were making progress again, and FAST. My total pushing time (including in the bad position) with this baby was 12 minutes!! (A lot better than the 5 hours with #2!) Once I arched my back, he came out very quickly.
I got to feel his head as he crowned----that was a GREAT feeling! Finishing pushing the baby out was not easy and hurt quite a bit, but it was such a relief and a great feeling when he actually did come out! It was very primal, and I was certainly loud in response!! But what a joy to finally have the experience of a baby coming out vaginally.
I'll never forget when our eyes met for the first time. I got to hold him almost immediately and while he was still attached to me, which was the first time that happened in 3 births. It was very special to me, and so much better than the way you meet your baby after a cesarean. I got to cut the cord myself and nursed him almost immediately, and snuggled him right away. It was very meaningful to me to get to hold him in a way I never got to have my other 2 babies before.
It wasn't an ideal or perfect birth. I really wish I hadn't agreed to induce labor or break the bag of waters. I tore a minor bit (and suturing disturbed my bonding time with baby), I bruised my bladder because the baby descended SO quickly, and I certainly did NOT like the level of pain I had in this labor. The conflict with one of the midwives was upsetting, and the hospital was not exactly my ideal choice for a birth setting. So certainly not a perfect birth.
However, even though it was difficult, it was WONDERFUL! Recovery was SO much easier than after a c/s---it was delightful to notice how many things were better! Sleeping on my tummy, the ease of getting in and out of bed, being able to laugh and cough without reserve, general energy level, being able to lift and snuggle my two older children right away----it was thrilling to tick off all the many ways that my VBAC recovery was easier! But best of all was being able to hold my baby right away, to feel him all goopy with baby juices, to be the first to really snuggle him, to know that my body worked the way it was supposed to, to have virtually unlimited time with my baby immediately after birth, and to be able to enjoy mothering without post-surgical pain!
Baby #4:
I waffled for a long time about whether to have another baby. I was older---over 40---and there was a lot of unavoidable stress in my life that made me reluctant to add the variable of a new baby. But finally, we decided that we would regret too much NOT having another baby. Stress or no, we couldn't put it off any longer and we needed to just go for it. Happily, we got pregnant quickly, despite my age.
This pregnancy I chose my homebirth midwives very very carefully, given the negative experience I'd had with one midwife last time. I wanted midwives who were pleasant people to deal with, who were very hands-off and not "OBs in disguise," who would NOT induce labor early, who knew how to handle any complications that might arise but who also could be trusted to tell us if a situation warranted transferring to the hospital for some reason. I wanted midwives who believed that "no interventions" was the best policy almost all of the time, but who were skilled at judicious use of interventions if they were truly warranted. And I wanted midwives who wouldn't judge me if I decided to transfer to the hospital for some reason, who trusted my own intuition to be wise about that decision. Fortunately, I found a practice that I really liked. Several friends of mine had used them at their own births so I was able to see that they practiced what they preached.
Again, I monitored my blood sugar at home to be sure all was normal. These midwives were more liberal about gd and would have accepted higher numbers than many doctors, but I still strove to keep my numbers as low as possible. I tried to keep my eating habits reasonable but flexible, and my numbers stayed fine despite my age. However, I was not able to exercise as much this pregnancy because I had so many outside commitments. I regret this, because pregnancy is definitely easier and more comfortable with more exercise than less, especially at 42!!!
We chose to use "shadow care" with a friendly local CNM until the end of the second trimester in order to get our prenatal tests and labwork covered by insurance to keep costs down. We paid for the homebirth midwives up front in installments; after the birth, they hired a company to help submit our paperwork to our insurance company, and eventually we were paid back for the whole birth. Our insurance company says it doesn't pay for homebirths, but with the right advocate and good paperwork from the midwives, they eventually did pay the birth in full, both the shadow care at the hospital and the homebirth care. That was a relief!
I assumed that because my previous births had all occurred near or before 40 weeks, I would have no worries about going "overdue." Hah! I'd forgotten that none of my other labors had been truly "spontaneous." My first baby was induced at 40 weeks because of gd. My second baby was not chemically induced, but the CNM aggressively swept my cervical membranes at almost 40 weeks, resulting in my water breaking soon after with a big OP baby and another c/s. So that baby was rushed out too, even though we did not use chemicals. My third baby, as described above, was induced early at 38 weeks; he too was rushed out before his time and he really showed it. So although I'd had 3 babies, I had never had a labor that started on my OWN body's timeline.
This fourth baby was different! She had her own timeline and she stuck to it. By the hospital's LMP dating, she was born at nearly 43 weeks. I would have been forced into a repeat cesarean had I continued my hospital care, just from due date protocols alone. The ultrasound did show my due date was later than the LMP due date, but only by 9 days (it has to be off by 10 days before they move the due date). However, my home midwives used the "Woods" due date method, and this was the most accurate at predicting my baby's spontaneous birth date. It takes into account cycles that are longer than average, like mine; by its dating I was only at 41+ weeks when I gave birth (instead of 43). So for women with longer cycles, it is incredibly important to get the pregnancy dated accurately.
It was hard to wait for labor to start on its own. I had convinced myself that I would go into labor a little early, considering my other pregnancies. I got everything all prepared and cleared my schedule. And then I went several weeks "late!" I had prodromal labor off and on for the last 3-4 weeks, which really tested my patience at times. I'd think, hmmmm, I wonder if this is it? But then, after a few hours, the contractions would peter out. Most women would have gone in for the induction after all that prodromal labor, but I knew too well the risks (and pain levels!) associated with inductions, so I tried to be patient and just keep going. When I got impatient and uncomfortable, I tried to schedule fun and self-indulgent things, like going out to dinner with my husband, seeing a movie, long baths by candlelight, taking pictures with my other children, birth art and birth journaling, and letting my other children paint my pregnant belly and decorate it. That helped keep my sanity and kept the waiting from being too tedious.
Finally, I awoke one morning with contractions again. I sat with them for a while, thinking they might be more prodromal labor, but after a while I knew this was "it." I gathered up my children and sent them off to their grandparents' house, and called over my doula for more support. My doula was an acupuncturist so she was going to do acupuncture for labor. Labor slowed down while we got the kids off, so we decided to take advantage of that and cleaned the house. It was a good distraction during early labor, and I felt more ready to labor in a cleaner room. Then I ate lunch and took a nap. My doula did some acupuncture points to help me rest. I took a nap of about an hour and a half.
When I woke up, labor intensified strongly, as often happens after a nap. I then had about 2.5 hours of really intense labor. We used the TENS machine to do electrostimulation of acupuncture pain relief points in the ear. This helped some, but not as much as I had hoped. Still, it was a distraction and that helped me through some rough parts. Then we took off the electrostim machine, and I climbed into my waterbirth tub, which was filled with nice hot water. Ahhhhhh!!
I'm not sure how long I was in the tub; probably an hour to an hour and a half. Transition was hard. I'm a pain wuss; I hate pain. So for me, this part of labor just sucks. Not enough to go to the hospital with all the wires and needles and risks that come with that, but I can't say this part of labor is a breeze. At one point, I wanted to bite down on something really hard and I had to concentrate really hard not to bite my doula! I settled for the side of the tub instead. Funny, it did help to bite down.
Luckily, this part of labor was reasonably short. In no time at all I was pushing. Sometimes pushing feels good to women, gives them something to do with the pain, but in this birth pushing hurt too. What I didn't know was that baby's arm was behind her back, so that made it that much more work to push her out. It did hurt; it felt like my hips were being pushed apart. But I also realized that the harder I pushed, the faster I'd be done----so I concentrated really hard on getting to the "done" part!! I touched her head and was in awe of how it felt, but I also wanted to get done NOW so I didn't linger over it. Baby's head started to crown, and I thought, YES, we're nearly there.
But there was still that arm behind her back. That made her shoulders much wider than they would be normally, so the shoulders did not want to come out immediately. The baby drew her head back up inside and started restituting (turning) her shoulders even before her head fully crowned. She was trying to get more room. I started feeling bizarre little "knocking" thumps from inside. It was baby, trying to free her arms from behind her back. She was having a hard time getting them freed. So the midwife (with full permission) put her hands inside to try and figure out what the baby was doing. She figured out WHY there was a problem, and then she fixed it. She swept the arm to the front and then down and out, and once that was done I was able to push the baby out easily. Baby was born into the water; we lifted her to the surface and I finally got to meet her and realize that she was a GIRL!!!
Baby's heartrate remained fine throughout this whole thing, and she was totally fine afterwards. My perineum remained intact despite the stretching from the midwife's hands inside me, helping the baby's arm out. So all turned out completely fine in the end. I was glad to be at home with a really competent midwife; in the hospital they would have done a giant episiotomy and might well have hurt the baby trying to force her out. The midwife knew just what to do and did it without harm to any of us.
Baby did turn out to be a big girl; 10 and a half pounds! I was sooooo shocked. But it was her arm that was the problem, not her size. My midwife noted that her head was not molded at all and that there was a ton of room inside for both the 10 lb baby AND the midwife's hands at the end, so neither pelvic size nor baby size was really an issue. She just liked to have her arms behind her back, and that caused the slow-down of her shoulders. To this day, she likes to sleep and walk around with her hands behind her back. Many babies with arms behind their backs in utero have problems coming out; we were able to resolve this easily because my midwife stayed so calm and focused on fixing the cause of the problem instead of randomly trying just any maneuver.
This birth was harder to recover from, probably because I pulled some ligaments and muscles while pushing so hard, and maybe a little because I was no spring chicken this time! Once again I hurt my bladder a bit during pushing, couldn't pee for a while, and I was sore as heck for a few days. That sucked, but at least I didn't have surgery to recover from too. That would have taken a lot longer than a few days to resolve. I did develop some mysterious postpartum edema (swelling) that was very bothersome, but in time it too went away. So all in all, not an easy recovery, but certainly easier than a cesarean.
Of the four births, this was by far the best one, despite the recovery not being as smooth as I would have liked. I had a relatively peaceful pregnancy, a relatively peaceful labor, and while the birth itself was not quite as easy as I would have liked, it was definitely easier than major surgery! It was incredibly lovely to labor and birth in water, listening to inspiring music, surrounded by birth art and loving people. It sounds a little "hippie-dippy" but it really was a beautiful and sacred experience.
It was also amazing to realize afterwards that I'd given birth vaginally to a baby a pound bigger than my "CPD" c-section babies, and 3 pounds bigger than my first VBAC baby! So much for "CPD." Breastfeeding went easily and well, and baby almost never left my arms. It felt so GOOD to have her all the time. I soaked up the ability to just hold and hold her and to not have to fight to keep her with me, something so sorely lacking after my cesareans. That separation after birth is jarring and wrong for both mother and baby. Having her at home was so healing in so many ways for us.
Final Thoughts:
I do not plan to have any more children but if I did I would choose another VBAC for sure, barring unforeseen medical circumstances.
I don't make that statement lightly. It's not always an easy path to VBAC, and it may not be for everyone. Sometimes it seems more emotionally risky to go for a VBAC, and certainly there was a healthy fear I might "fail." I'd had one CBAC (Cesarean Birth After Cesarean) with #2, so I knew it could happen. And it was a bit enticing to think of just doing more c/s for the next babies. No uncertainty, no labor pain, no fighting, no struggle to find a supportive care provider, etc. I certainly empathize when women choose elective cesareans for that reason.
And yet, I did not want to have to deal with the postpartum surgical pain, the weeks of being unable to sleep lying down in my own bed, not being able to adequately care for my older children----nor did I want to risk the problems associated with multiple repeat cesareans. And it just felt wrong for me to meekly lie down for the surgical knife like a sheep to the slaughter. If I'd needed a cesarean again, I could have done that, but to do it for no good reason----it just felt wrong.
Having had a CBAC, I knew it was a possibility again, and that concern never left me, even after having had one VBAC. And yet, I never regretted having gone for the VBAC with child #2, even when it turned into another cesarean. Certainly, just trying led to a tremendous amount of growth and empowerment that I otherwise might not have found. For that reason alone, it was worth it, even if the ending was different than I had wanted.
My emotional and parenting journey would have been much different, I think, had I chosen the emotionally easier way of a repeat cesarean. Although I am sure I would have been able to handle a repeat elective c/s and would have bonded with a c/s baby just fine, I think the emotional growth I experienced on the VBAC path was worth all the work and pain and effort, even when it did not always result in a VBAC itself.
And of course, I did eventually get to have two VBACs and the joy of those moments will never leave me. I'll especially always treasure the time immediately after birth that I got with those babies, hugging them and cuddling them in a way you just don't get to do with cesarean babies. It doesn't give me back the time that I missed out on with my other babies, but it doesn't compound and magnify the wound. Instead, it helps heal us all.
Although neither VBAC was an 'easy' or 'fantasy' birth and I really wish I could change a few decisions along the way, I am still very glad I chose to pursue VBAC. But if I had not, I would not love my babies any less. Babies are a joy no matter how they come. I would just not have the same feelings of joy around the births themselves.
What a wonderful idea that birth is about both the process (birth) and the product (baby), and that the process can be more than something to be endured, but a vital part of the JOY of a new baby too.
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