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:
Vaginal Birth After Cesarean 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 big moms who have had VBACs; that is, gone on to vaginal birth despite previous cesarean births.
The cesarean rate in "obese" women is very high, in most cases unnecessarily so. (Click here for a brief discussion of the factors that lead to a high cesarean rate in large women.) But having given birth previously by cesarean does not mean you must always do so.
Research does show that women of size are given fewer opportunities for a VBAC 'trial of labor', and therefore have a much higher rate of repeat elective cesareans, despite the greater risks that cesareans pose for large women. Many big moms who have sought a VBAC have reported strong resistance and discouragement from health personnel they have consulted, or have faced strongly restrictive VBAC 'protocols' that have essentially prevented them from having a fair chance at VBAC. There is a lot of room for improvement in the health community's attitude towards VBACs, and particularly in their attitudes towards big moms and VBACs!
Yet for those large moms who carefully prepare both physically and emotionally, who research birthing issues thoroughly, and who choose their care providers and birth support judiciously, the journey towards a better birth can be extraordinarily rewarding and therapeutic. Many VBAC moms (particularly those who have struggled with weight and body image issues) report that they have found their VBAC journeys very empowering and ultimately, very healing. The VBAC journey can be a very special one.
This special section of Vaginal Birth After Cesarean (VBAC) stories is particularly dear to Kmom's heart. After having 2 cesareans herself and then 2 VBACs, she is personally familiar with the journey towards normal birth, and the struggles that can happen in that journey along the way.
In addition, in her work with plus-sized women and in her reading of research on obesity and pregnancy, she has seen over and over again how often large women are pushed into interventions that lead to unnecessary cesareans. This FAQ is healing in that it shows that many of these interventions are NOT necessary, and that normal birth is possible for the vast majority of us, no matter our history or size.
Kmom has an area on her website devoted to Cesareans and VBACs. You will find a great deal of information and research about VBACs there. If you are contemplating a VBAC, you may especially wish to visit the FAQ on Great VBAC Resources, or any of the other VBAC FAQs in that section. Keep checking back, as many new FAQs will be added over time.
You may also want to check out the following articles for tips on lowering your chances of a cesarean and on raising your chances of a VBAC as a woman of size:
The purpose of this special BBW VBAC Stories web section is to show that fat women CAN and HAVE had VBACs, that many VBACs occur despite all kinds of negative attitudes and interference from family and medical personnel, and to show that the VBAC journey can be a powerful passage to healing and empowerment for fat women.
There are many other BBW VBAC stories out there that are not represented here yet; Kmom strongly encourages big moms everywhere to share their VBAC stories here.
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!
Note: Women with a history of cesareans may find the ICAN (International Cesarean Awareness Network) organization helpful. This group provides support and information for women who have had cesareans in the past, those who may be facing cesareans in the future (first-time or repeat), those who have had any kind of difficult birth, and those seeking a VBAC. Although the group is definitely pro-VBAC, women who simply need support after a cesarean or require information about ways to make a necessary cesarean more birth-friendly are also welcome. Information on joining ICAN's email support group can be found at www.ican-online.org.
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.
Kmom's Notes:
Birth Story
My experience with delivering my second child as a VBAC was as follows: I was 13 days past my due date and getting desperate. I had taken 2 bottles of castor oil a couple of ounces at a time with no effect other than totally cleaning me out intestinally. My OB, who was very supportive of me throughout this pregnancy (never a mention of my weight, very supportive of my desire to VBAC), was ready to induce when I finally went into spontaneous labor after a couple of nights of prodromal labor. I labored at home for about 3 hours, waiting for my husband to come home from work. When my contractions were coming about 5 minutes apart, we left our 3 year old son with my brother-in-law and his 2 year old boy.
My sister (a labor and delivery nurse), my husband and I headed for the hospital. I was 3 cm. dilated and partially effaced when I arrived at approximately 5 p.m. I was installed in a birthing suite. I was asked if an enema would be OK and I said yes, but turned down the option of being shaved. I felt good that my opinion was sought in these matters. When I was at about a 5 cm. dilation I asked for an epidural. I had had an epidural with my older son, who turned out to be a c-section following 26 hours of very dysfunctional labor. That epidural was fully effective, no problems getting it in, no nasty comments from the anesthesiologist, etc. This time the epidural went in fine but was only fully effective on my left side. The right side would be numb for a period of time, then would "wake up" prematurely. I kept the anesthesiologist busy trying to keep my right side numb, too. I was pretty comfortable from about 5 cm. to 7.5-8 cm. when they allowed the epidural to begin to wear off in anticipation of pushing. I was using Lamaze breathing and my husband and sister were taking turns coaching me (this was early morning hours by now, so they were both tired and standing in for each other).
Just a few minutes after I had been checked at 8 cm. I was having some pretty incredible urges to push, so my husband asked that I be checked again. To the nurse's surprise, I had gone from an 8 to a 10 in less than 10 minutes and was ready to push. I don't know why, but it never occurred to me that once ready to push I wouldn't just push that baby right out, which was what I did. After only 20 minutes of pushing, my 8 lb. 5 oz. son Christopher was born. My total labor time was about 14 hours, which is average for a first vaginal delivery. I did have an episiotomy, but my OB didn't just cut me as a matter of course. He watched carefully and when it was apparent that an episiotomy would really facilitate things, he did give me one after telling me he thought it would be a good idea and getting my permission. Again, I appreciated being consulted. I felt that this was a very good experience, the level of care was excellent. As soon as Christopher's vital signs had stabilized he was given to me to nurse and he roomed in my room most of the remainder of the time we were in the hospital.
Update: Susan's 3rd child, a boy, was born by elective c/s. He was transverse and had a true knot in his umbilical cord. He weighed 7 lbs., 1 oz. and was 19.75 inches long, with a lot of dark hair. "Even though I had a c-section, I am feeling really good and had no complications at all--epidural went great, postpartum care and recovery have been really fine...I have given birth 3 times as a BBW, both vaginal and c-section, and have gotten along fine each time. You all can, too."
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. Some of the doctors she saw after that for infertility treatments were also fat-phobic, but this time she stood up for herself and eventually found one that was not. Her VBAC was probably made possible by the great support she had from her OB, the flexible laboring protocols (including using water despite being on pitocin) she was able to negotiate, and the support of her doula and husband (research shows a doula cuts the c/s rate by nearly 50%). And of course, most importantly, it came about through her own determination and woman-power!
Birth Story
In retrospect, I realize there were many clues thrown out by my ob/gyn over the months of my 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.
Fast forward to 6 years later. I was 35 years old and finally expecting my second child after having battled secondary infertility for 4 years, and after having several miscarriages. Most of the battle regarding my infertility was dealing with fat phobic doctors who refused to treat me until I lost weight. Of the 5 doctors I saw regarding my infertility, one put me on 100 mg clomid the first cycle and didn't monitor me at all. I was given no information regarding what to expect, charting my temps or anything. I had extreme pain during that cycle and was told, "Oh we expect those things". So I went to another doctor. She found a huge cyst on my ovary, told me I needed to lose weight and put me on phen/fen. I lost 45 lbs or so. She referred me to an RE she worked with. He refused to put me on any more treatments until I lost another 45 lbs. I refused. He was the one who said, "If you really want a baby you'll lose weight." I had been on the phen/fen the maximum recommended and it wasn't effective any more. So, the RE refused to treat me and I refused to diet. I went to another ob/gyn who basically had the same opinion as the RE. I made an appointment at the local university hospital. Lo and behold, the RE staff there immediately identified my problem. I was able to get pregnant, but I would lose the baby before it even implanted.
See, I had been having regular 30 day cycles with occasional 35-40 day cycles. I had been keeping record and I could have sworn I was pregnant on those 35-40 day cycles. I had all the symptoms...swollen breast, nausea. But then the period had come. The other doctors all insisted I wasn't getting pregnant but because of my weight I had PCO. Well, this new RE, Dr. N., said, "Yeah you have PCO, but you are also getting pregnant and losing the baby." With an attitude of "you have the right to have a baby and you can have a baby....I'm going to figure out how to help you", he decided to simply try an assisted cycle with clomid, and after ovulation, progesterone.
On the first cycle we tried, I got pregnant!! I also carried that pregnancy to term. Dr. N recommended one of his recently graduated students for my ob/gyn. She was marvelous. Pro vaginal birth and size accepting, Dr. M saw my pregnancy as joyously as I did. I wanted a vaginal birth so badly. I had felt like such an idiot when I realized how duped I was by my first ob/gyn. His fat phobia and surgeon mentality had doomed me to a c-section right from the start and I was felt so ignorant for believing him and not seeing what was going on. I also felt the delivery and drugs after interfered with my bonding with the baby. I can honestly say, I felt like a zombie until we finally got home and I stopped taking the pain drugs. Then I fell in love with my son. But, I will always regret that he didn't get those first few days of love that babies thrive on. I wanted my next child to have that opportunity and I strongly felt having a VBAC (Vaginal Birth After Cesarean) would lead up to that.
Everything went well, with the exception of severe nausea on my part, until the 28th week when we discovered I had gestational diabetes. You know, I never realized how important it was to me that my pregnancy be totally normal and without even the mildest of complications. I cried when I found out I had gd. My numbers were mildly high, but consistently high. So, I was put on insulin and a diabetic diet. Complicating everything was my reactive hypoglycemia. This insulin resistance left me feeling nauseous all the time. I again felt a sense of failure. I was so mad at my body. I was so certain that it was my diet that caused the problem, even though in reality I had actually been following the ADA diet all along.
Well, somehow, between the needles and lancets, I managed to make it to 37 weeks. I was very sick from the gd and hypoglycemia and I was under a lot of stress due to both my parents being criticallly ill, my husband having to move 3 states away, and my trying to sell our house. Between the stress and the illness, my body was breaking down. I was swollen, though my blood pressure was fine. I had several episodes of false labor, 2 of which took me to the hospital. The baby's heart rate was running too high and I was dehydrating frequently from the vomiting. So, feeling I was doomed to a c-section even though my heart strongly desired a natural birth, I asked the doctor to induce me early and she agreed that the environment in my body was no long doing any good for the baby. Since we knew from the infertility treatments exactly when I had conceived the baby, we decided to deliver the baby on week 38.
I told my doctor I just wanted to plan a c-section as I was so certain the induction was going to end up in a c-section. However, she persuaded me to have a trial of labor and said, "I don't see any reason why you can't deliver this child naturally. It's your decision, but I'd like to encourage you to give it a try. If you get into it and want a c-section I'll go that route. But, I'd like you to try." So, I agreed to try. I have to admit, I had planned the whole pregnancy for a vbac. I was so certain I could do it, but when it got down to the wire, I was scared of a repeat of what happened with my first child. I was scared...just plain scared. After testing the amniotic fluid for lung maturity, it was determined the baby was ready to be delivered. Everything was perfect for his lung scores; so my doctor and I decided to go ahead with the induction beginning on the 25th. I was dilated to 2 cm and 50% effaced. The baby was at -3.
So, my husband "Rosh", my doula "Kathy" and I arrived at the hospital Sunday evening, and the doctor applied prostaglandin gel to my cervix. I started having irregular contractions right away. Since I had been having strong false labor for almost a month, it wasn't really surprising that I'd have at least some response to the gel. We passed a relatively boring evening in the hospital. Kathy and I walked the hallway and I rocked to try to get the contractions to going at a stronger rate. I was still dilated to only 2 and at 50% and -3 when the nurse checked me before the second application of p. gel. I asked for a mild sedative to help me sleep, because I knew I wouldn't be able to with all my excitement and agitation. I was given visterol.
So I slept all of 4 hours and was awakened to take my morning shower. My nurse was worried about my gd and my tendency to have insulin reactions, so she brought me a tray of food which included a muffin and scrambled fake eggs. I would later belch that egg throughout the active phase of labor. I didn't even eat the whole thing and it still came back to haunt me. At the 8:00 check and pitocin start-up, the cervix was still at 2, 50% and -3. Things didn't look too good for a successful vbac at that point. The -3 station was a repeat of my first delivery. But we plunged ahead anyhow.
I started having regular strong contractions almost immediately. They were strong and regular. I took a short walk with Kathy down the hallway. Then I took to sitting on the rocking chair and rocking. That rocking movement really seemed to help me deal with the discomfort. At around 9:00, my doctor's partner arrived and checked me. I was 4, 80% and -1 to 0!!!! He decided to break my waters. I wasn't so keen on it, but didn't feel like arguing with him. I felt intimidated by him, so I let him do it. The gush of warm water was just an amazing feeling. I was surprise a how much there was. Anyhow, at this point we had committed ourselves to birthing this baby one way or the other. I had figured I had relinquished myself to a repeat c/s.
Off and on, the nurse would prick my finger and check my bg levels. It was fluctuating wildly. So, she and the doc monitored it closely adding insulin or dextrose to the iv depending on my bg. I hated that pin prick. It just seemed so unfair when I was having to deal with the pain of labor, but I knew it had to be done. It was frustrating, but necessary.
It wasn't long before the contractions began to be long and hard. I was surprised it was going so fast, but boy was I hurting. The nurse then decided I should get in the bathtub for awhile. I don't know how long I was there...maybe 45 minutes...when I started begging for an epidural. The contractions were soooooooo strong. The nurse was patient and encouraging and very competent in finding ways to delay me from getting the epidural--"oh try leaning this way" or "how about we kneel for awhile?" Then I started getting more insistent (ok I BEGGED) and she said ok. She drained the tub and started the shower. She had me stand up and lunge with one leg on the tub edge. Then she poured the cool water over me. At this time I was having a very strong burning sensation that originated near the c/s scar. I finally begged a bit more and she then took her time drying me off and getting me and all my iv tubes into the nightgown. Finally she got me into the bed and left the room to find my doctor.
I kept begging for the epidural. I don't know how much time had passed, but it seemed like 74,568 years :^). Finally my doctor walked in the door. I think I exclaimed something like "Oh thank God you are here, can I have an epidural?" She held my hand and said yes. Phoebe disappeared to call the anesthesiologist. Dr. M. held my hand while I had contractions and she didn't let go until I kind her pushed it away on one very big contraction. She is a very compassionate doctor who is VERY pro-vbac and has one of the lowest c/s rates in the are...as did her partners and the hospital I was birthing at. I had chosen her because of her reputation and my RE's referral.
Anyhow the epidural guy finally got there and took his time getting the epi in. I was still 4, 80 and -1 to 0. I was really being a pain, too. I complained every single contraction. It hurt sooooo badly. I don't remember my first hurting so much. I hadn't had any pain intervention with him, but this time things seemed very bad. The contractions just didn't let up and they were sooooooo intense. I also felt intense burning and pain at the site of the c/s incision on my skin. Looking back, I think the internal pain must have centered at the internal incision. It just seemed concentrated right across the front just above the pubic bone. The nurse felt it was due to scar tissue tearing away with the contractions.
While the anes. was fiddling around with my back, I sat on the edge of the bed and rocked with each contraction. In retrospect, I think that must have really helped get things going. Finally the guy told me to hold still (HA!~!~!~) while he inserted the needle. I think it took several contractions, and I really did my darndest to hold still. Finally, I felt like my bladder was being pushed and I had no control over it. I told Phoebe I had to pee. She said in a very nurturing voice, "Go right ahead and let it go. Just relax and let it go." Well I did. There really wasn't a thing I could do to stop the drenching anyhow. After the initial flood, with each contraction I felt this push on my bladder and a little voiding. I began to feel like I just wanted to push my whole bladder out.
The epidural was in and I felt my left leg get tingly and numb. But nothing else went numb. The epidural was ineffective and had been placed in the wrong position. I had a dead left leg and lots of pain. It was exasperating. So, they were getting ready to get me back onto my back (I was still sitting on the edge of the bed), when I told the nurse something was pushing on my bladder. She suddenly got excited and said, "Maybe you are ready to push. Do you feel like pushing?" It dawned on me that that was the case and I grunted in the positive. So, she checked me. I was 8 to 9 cm!!!!!! I had gone through transition while waiting for the epidural and no one had even known. Now I had a numb left leg and the rest of me never did get relief, but I think that was the best thing that could have happened. it was time to push and the epi might have screwed that up.
By this time, though, I wanted a c/s. This is where I have to say THE BIRTHING TEAM MAKES ALL THE DIFFERENCE!!! Had I not had the doula, my wonderful nurse, and Dr. M. there to encourage me, I would have grabbed the scalpel myself!!! I begged Dr. M. not to let me go through what I went through with my first delivery. She promised she wouldn't. For each contraction, I bemoaned my inability to push the baby out with 2-3 pushes like some other women do. I whined and complained a lot, I think. I was being such a wuss, but it hurt sooooo much and the contractions were coming sooooooo quickly. Some other doctor was there and for some reason he actually did the delivery. I have to ask Dr. M. why that was, but anyhow she stood right there and told him what to do while she encouraged me and held my legs up along with Rosh, Kathy, and the nurse.
The nurse was marvelous...though I hated her at the time (contraction hatred). She insisted on my getting on to my knees and trying. It was in my birth plan and she was insistent that I give it a try. With my numbed left leg, balance was really hard and I got terrible muscle contractions in my back where I have an injury from 6 years ago. She had me turn from back to knees and knees to back. All the darned wires from the baby monitor and contraction monitor and IVs would get tangled up around me. It drove me nuts. That and the hair of my husband's beard tickling my shoulder when he'd rest his chin on my shoulder and count during the contractions...UGH!!
At one point I asked to see the head as it begins to crown. It was soooo cool, but I couldn't stand to look more than once because all I wanted to do was get that OUT!!! I couldn't stand any distractions. Even the encouraging and gentle comments from the doctor, nurse, etc. got on my nerves. I just wanted to concentrate. I told them to be quiet. My husband did the counting for me while I pushed. It helped to give me something to focus on. I wanted to groan, but the nurse told me to focus it inward. I wanted to tell her I'd focus it at her, but I really could feel progress being made after I put all of the air into the push. So, I focused. Interesting how you can hate the very people who help you when you feel so much pain.
Finally, about an hour and half after I began pushing, the head crowned and I felt the "rim of fire". Oh golly did that burn, but it was SUCH a relief to know the baby was THERE!!! I'm not sure how many contractions there were after that, but I think maybe 6. Finally the nurse said, "This next contraction and the head will be out." I didn't believe her, but I decided I was going to prove myself. So, with the next contraction, I pushed like you couldn't believe. Then "WHOOSH" this thing popped out of me and there between my legs with a gush of warm waters was the head of the tiny fellow. Oh WOW! What a sight and what a feeling. It was beautiful. I wanted to hold him. But I had to wait for the darn shoulders. The doctor told me I had one more push. I think I whined, " I still have to push", but as I whined that, the uterus gave one strong contraction, I didn't push at all, and the shoulders popped out!!! WOW! They did a quick check and handed the little guy to me. What a wonderful smell and touch and sound and and and....it was beautiful. He was beautiful.
Suddenly the nurse that I hated through each contraction (but who I realized was doing what I had wanted, btw) was the most loved creature in the world. I wanted to kiss DH, Kathy, the doctors and the floor!!! Fortunately for the others, only DH got the kisses. It felt so wonderful to be through the pain; it felt so marvelous to have my baby vaginally and to hold him and nurse him. I felt like I had won, liked I'd accomplished some grand and glorious feat. The doctors waited until the cord stopped pulsing to have DH cut the cord. The only thing I regretted was the long wait to get him to my face. I had to wait until the cord was cut. But, they honored my wishes that the cord be allowed to cease pulsing on its own.
They let me hold him quite awhile, then finally took him across the room to do the check and clean him up a bit. Oh, he smelled so nice with that amniotic fluid and vernix. Such a sweet and unusual smell. I regretted when they finally gave him a bath later. They bathed him right in the room. He never left my room. I labored, delivered and stayed in the same room the whole time. The nurses came in every hour for awhile to check his blood glucose levels due to my high blood sugar in the pregancy and during delivery, but he stayed within normal range and was handling things well. So, no intervention was needed in that regard. He nursed and slept and watched the world around him. I fed him and watched him sleep and observe. It was blissful.
So, that is my version of the story. I'm sure some things are fuzzy in my memory, but for the most part everything was just as planned once the labor got going. My big recommendation to anyone planning on a vbac, CHOSE A GOOD SUPPORT TEAM and MEDICAL TEAM. I never thought I would wuss out like I did, but I would have given into a c-section RIGHT THEN. Had it not been for a pro-vbac doctor, hospital, nurse, and friend, I don't think I would have had my vbac. Also, don't be surprised at how much you will resent everyone helping you during the birth. I think it just hurts so much that it is beyond our capacity to keep focused on the outcome. So I let them do that for me. AND THEY DID!!! Bless them all.
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 aumentation without any drugs, a very impressive accomplishment!
Birth Story
Baby #1: 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.
Baby #2: My second pregnancy I had a wonderful new doctor to whom weight was not an issue. I gained 42!! lbs. This doctor looked at my previous records and stated that he believed in a trial of labor and that was our plan. I was very nervous and made him promise that if I stalled during labor I could have a c-section. I was a week past my date when my water broke. My doctor has the 24-hour rule -- if not in active labor 24 hours after water breaking, then start inducing with pitocin. I went into the hospital in the middle of the night since I was having contractions. I wasn't even dilated yet so they gave me pain and sleeping meds to get some rest until they started the pitocin at 8:30 am.
They increased the dose every 15 minutes once they started. It was a very boring morning and I kept thinking when is anything going to happen. I was on a strapped-on monitor and didn't move around much -- however, I had no desire to do so, so this wasn't a problem for me. I think I could have had them remove it and only monitor me once an hour or so if I wanted to move around more. At 12:30ish they checked me, only 3 cms dilated but they put an internal monitor that they attach to the baby's head. Told me I had hours to go yet.
Between 1-2 pm I had a really tough time with contractions coming fast -- did my breathing etc. Had hubby get the doctor at 2 pm because I wanted my epidural and I was feeling a lot of pressure. Doctor came to check at 2ish and told me I was ready to push. (Note: I didn't feel so much an urge to push as a sense of tremendous pressure in the vaginal region). After three pushes, my second daughter was born at 2:19 pm. She weighed 9 lbs 1 oz , 1 oz more than the baby that wasn't supposed to fit!
I tore when head came out but didn't feel it. I also screamed when she came out, which really surprised me -- never would have considered myself a screamer!! I was stitched up after delivery. Never did get my epidural -- everything happened very fast at the end. So in retrospect, I had a really bad 1- 1 1/2 hours of labor. I felt really empowered after this birth -- I remember being in my hospital room thinking, "I want to do this again!" As BBWs we are told by most of the medical community that something is wrong with us, but my VBAC told me that my body is fine the way it is and can get the job done, thank you very much.
Other things I remember... I did have monitors that made it hard to move around but I had no desire to walk around. I wanted to sit up and would change my legs from tailor-sitting to lowering the foot of the bed so I could hang my legs down. I have heard that the pitocin makes the labor very intense and it seemed that way to me but then again I have nothing to compare it to. I am very grateful that I only had a difficult 2 hours as opposed to much longer. Also #1 was 9 lbs and #2 was 9 lbs 1 oz -- so much for not fitting through my pelvis!
Also in retrospect I had a much, much easier recovery from a VBAC than c-section and I had told everyone that my c-section was a breeze and I truly felt that way. I cannot emphasize this enough -- the stitches were manageable and being able to get around just about normally was great. Especially since I had daughter #1 to worry about. I was concerned about how she was adjusting and it was great to be able to get out of the hospital more quickly and be able to help her adjust (a lot of my anxiety pre-VBAC was about child #1 and how she would handle mom in the hospital , new sibling etc.). Given the choice I want a vaginal birth next time too.
Most of all, I trusted my doctor -- he was instrumental in helping me believe I could do this. He wasn't even the doctor who delivered my baby, but it was the nine+ months leading up to the birth when I felt his confidence and support -- I went to a group with 7 doctors and had met several others but in fact the nurses are more important during labor than the doctor who just pops in and out. I didn't want a doula or other person beside me and my husband -- we wanted to do this on our own as a team. I am very comfortable with a hospital environment because I like knowing that medical backup is available if necessary.
To prepare for VBAC, I took refresher lamaze class, did some reading, asked a bunch of questions. I'm a bit of a control freak and a lot of my fear was of the unknown -- labor, potential pain etc. I would have been happy repeating the c-section only because I knew what to expect. Despite having a c-section the first time around and having a very easy recovery, a vaginal birth is much, much easier to recover from.
Baby #3: I fully anticipated a repeat VBAC but if medical emergencies arose I would have been OK with that. I did have an earlier complication with a severe bleed at 14 weeks and a residual blood clot. Was on restrictions for 3 months but blood clot eventually disappeared and I went back to normal activity. This was in no way related to be a BBW, but rather just one of those things...and we'll probably never know why it happened.
This baby arrived 5 days early, which was a surprise because I was at least a week late with my two daughters. The evening before he was born I started to feel really lousy---hips hurt, had to pee all the time, back hurt, etc. My walk really became a waddle so I think he had dropped that night. The next morning about 11:30 I lost the mucus plug. I also began to suspect that my water had broken--not in a big gush but just a more or less constant dribble. I was also having contractions but wasn't at all sure if they were for real or Braxton-Hicks. So the doctor told me to come to the hospital to be checked.
We got to the hospital about 2:30 p.m. I knew as soon as we got there that my water had indeed broken as I was much more gushy. The water had meconium in it. They were very calm about that which surprised me since I thought that meant the baby was under stress. I moved to a L&D room and wandered around until 4:30 or so. The contractions got a bit closer together but weren't bad at all. I was 4 cm dilated, not completely effaced, so they decided to start me on pitocin to speed things up because of the meconium. We also had an internal monitor because we kept losing the contractions or the baby's heartbeat on the external monitor.
Contractions started getting bad about 5:30 or 6:00 and I requested a doula to come help since I had gone through all the breathing techniques I remembered. I also asked about pain relief and was given the option of stadol which is supposed to take the edge off the pain but not eliminate it and can make you dopey. They said no to an epidural because last time I went really fast from 3 cm to 10 cm so they didn't think there was time for it before I had to push. So I chose nothing and just kept with the breathing. The doula arrived at 6:30 and was great---got a hot rice bag for my back, rubbed my shoulders, helped my husband help me, and helped me focus my breathing. Also brought a birth ball, but I was beyond using it at that point.
I was feeling a lot of pressure and the doctor checked me again at 7ish and I was at 9 cm. They had me blow through a few more contractions and then I told them I wanted to push. I pushed through 2 contractions and then his head was out and they told me to stop pushing because they needed to suction his airway due to the meconium. That was about the hardest thing of all, but after what seemed like forever they gave me the go ahead and he was born at 7:20 p.m.! He was crying and crying, the best possible thing, and I was so relieved it was over. His apgars were 9 and 9. This was my second VBAC and I feel really lucky that it went quickly again.
A word about the doula--I had only decided the day before to use one after running into one when I was getting my hair cut. She asked me if I was considering it and I said no, in fact I thought it might seem intrusive and I didn't want my husband to feel pushed aside. She gently gave me some things to consider and I called the program at the hospital to see if it was too late to use one. It wasn't but I would have to use whoever was on call and not be able to meet her head of time. So that's what I did and it worked really well--we hadn't done a lamaze refresher this time and I was anxious and my husband wasn't sure what to do to reassure me and she helped both of us through it.
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 (induction, posterior, forceps vaginal birth; c/s for breech; home waterbirth VBAC)
Kmom's Notes: Franny had a posterior baby with her first birth that she did manage to have vaginally by flipping to hands and knees and the doctor using forceps. Still, not a peaceful birth. Her second baby was breech and came by c/s. These birth stories can be found on Cesarean, Supersize, and PCOS birth story FAQs.
In her 3rd pregnancy, Franny was told she would have to have a repeat c/s because her hospital no longer did VBACs. Instead she hired a good homebirth midwife and had her baby at home. She also had chiropractic care in this pregnancy, which may have helped prevent a recurrence of the fetal malpositioning the plagued the other births.
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.
Margie's Story (5 children; #4: c/s, insulin-dep. gd; #5: VBAC, insulin-dep. gd)
Kmom's Notes: Margie has 5 children; this is mostly the story of #5, her gd vbac. 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
Baby #5: This story begins with pre-pregnancy. This was a much planned for baby for a few years before she was even a sparkle in her Mother and Father's eye. I have four children, one of which I had Insulin Dependent Gestational Diabetes with. I wanted to have more children and knew that I would have to deal with this again. We got pregnant on our first try with In Vitro. Our previous son was conceived through In Vitro also. I found out I was pregnant and was very overjoyed. I was prepared for the pregnancy and hoped to make it better than my last. Even with Insulin-Dep. GD.
Only thing I wasn't prepared for was the onset was much earlier than my previous pregnancy. I began insulin at 12 weeks. My previous baby was born via C-Section due to Macrosomia. He weighed 11 lbs and 3 oz. I knew that if I kept with the diet and insulin that I would not have a huge baby. So on with the diet and insulin. My goal was to keep the baby's size down and hopefully go into labor on my own. I wanted to know what it was like to go into labor and not have pitocin. My three previous babies were either induced or augmented with Pitocin. As we were approaching the due date, all tests were showing that she was fine and not at all huge. I had twice weekly NST's (Non Stress Tests) and AFI's (Amniotic Fluid Index) tests. All were great. One nurse did however say that I had a decrease of fluid and was concerned. More on that later.
My due date approached and I asked if I could go another week in hopes that I would go into labor on my own. OB agreed. I thought for sure that I would have contractions and so forth, but by the next week nothing was going on. I had JUST gotten to 1 cm. Insulin-Dependent GDM has many risks. One is the function of the placenta could stop, resulting in placenta failure and stillbirth. That was why all the NST's. When it came time to decide if I would consent to an induction I reluctantly agreed, feeling that this was what was best for my baby. So Induction Day rolls around. I'm instructed to report to L&D with my orders in my hand at 7:30am Monday morning. I'm really apprehensive since my last induction was during a span of four days and I had a c/s anyway.
We get settled into my room. We meaning my husband, my Doula, and myself. They are very nice and sensitive to my needs with the monitors. The L&D nurse made sure I wasn't on them any longer than I had to be. She found out that I'm a clock watcher!!! I had my first application of P-Gel and asked her about my status. I'm 1 cm, 0% effaced, my cervix isn't too soft, baby is head down, and cervix is almost in an Anterior position. At the 2nd application I continued to have contractions on my own for several hours. This brought me to 1+ cm, -2 station, 30% effaced. An hour later the 2nd dose of P-Gel is given. With this exam I am 2cm, -2 station, 30% effaced. We are encouraged to walk the halls. We do so leisurely and this results in some contractions. So after all that walking I progress another centimeter. Monday night at 10:20pm I get another dose of P-Gel and we all get some much needed sleep for the next day. The contractions just about stop.
I am impressed with my nurse's sensitivity to my needs. I had drawn up a birth plan, but did not give it to them. They seem to be just as committed to me having a VBAC as I am. They all have studied my previous birth and remind me often that this is so much more different. After she got past -2 station, I relax. Cameron never made it past -5. Things certainly do seem different. At 4:15am it's rise and shine. I get back on the monitors for a test strip and the endocrinologist orders hourly Blood Glucose Tests. I think this was the most annoying part. He also orders an IV push of insulin as needed. At 5:00am the IV is started and pitocin is started at the lowest dose.
5:35am my water breaks. Remember, one of the nurses said I had such low levels of fluid. I change positions and noticed my water had broken. There is water coming out that is clear. I soak 2 chux pads. The L&D nurse has to rush to get more, I soak 2 more pads. She puts a towel between my legs as the water keeps coming. Every time I laugh, there is more water!!! I soak through another set of chux pads and another towel. Seems like enough water to me. We all cheer that my water broke on its own. Something's happening. Pitocin is steadily increased and contractions are going nicely in a pattern.
At 7:30am the new crew comes in. Our nurse ended up being the same nurse I had the day I had my c/section with Cameron. At first this worried me, but she reminds me that we have gotten further than we ever did with him and this is all together different. This relaxes me and we get ready for the hard work ahead. It's 8am and she checks me. I'm at 3cm 50% effaced, -2 station and my cervix is soft. The monitors around me are really irritating me. We discuss internal fetal monitors. One thing that I was most afraid of was the internal catheter to measure contractions. The nurse shows me that they are much different than they used to be. I had one nearly 15 years ago and the memory was terrible. I realize that they cannot effectively monitor the strength of my contractions with the straps. I'm a big woman and the baby is small. So I agree to the internal monitor for contractions so I will not be over stimulated on pitocin. That alone makes me fear for a rupture. In the 20 minutes that we discuss this and they place the monitors, I progress to 4 cm, 70% effaced and still -2 station. Contractions are 2 1/2 minutes apart and bearable. I can't believe how much the effacing is happening since this usually is the slowest part for me. I also had went from 4cm and 70 to 90 percent effaced to delivery in a matter of minutes with my previous pregnancy. I warn them. The contractions are really bearable and not at all painful. Just a force, but not really painful. They peak quickly and resolve quickly. The atmosphere is still very upbeat and we are playing Hymns on the boom box. This creates a very peaceful and serene atmosphere in the room.
I get my next exam at 10:00am. I have already progressed to 5cm, 80% effaced and still at a negative -2 station. I'm amazed at how easily everything is going. It just seems to roll along. In 30 minutes I progress to 6 cm, 90% effaced and she drops down to -1 station. Still the contractions have not changed or even seem to be that hard. In the next 30 minutes I again progress even further to 8 cm, 90% effaced and 0 station. They tell me I'm in transition. I'm amazed at how easily everything is going and even being in transition, I'm not in that much pain. While I was at 4, I was getting a bit apprehensive that the contractions would get harder to deal with and was asking about an epidural. My previous births were horrendous with the over-stimulation of pitocin. Sue talks me out of it and I agree to forge on through. So I'm at 8 cm and it doesn't' seem to be that bad. It's 11:45am and the OB is called. I am 9 cm, 100% effaced and zero station. The OB gets there and things start to halt. The contractions are getting harder and she isn't coming. I'm getting really concerned that I am some how unconsciously holding her back. They tell me she is posterior and is pounding on my cervix causing it to swell from 9cm back down to 6cm. At this point I am standing trying to get her to come down. I tried going to the bathroom and she still isn't coming down. Her heart rate drops severely and the OB nurses rush into the room. We are really scared at this point because it isn't coming back up. I'm laying on my side with oxygen mask on praying that she is OK. All sorts of things rush in my mind. I ask my husband who is an Elder in our church to give me an emergency blessing. He does and her heart rate normalizes.
I then get an epidural. The epidural doesn't take on a strip going along my belly and I can feel the contractions in a localized area. The Anes. tells me that this is called a window caused by the position of her head. They turn off the pit drip and I lay on another side to get the medicine to hit that awful nagging spot. Things settle down and I snooze. During this time DH gives baby a blessing by laying his hands on my belly. I didn't find this out til later. It's 3:00 and I'm at 10cm, 100%, and +1 station. They ask me to push. I have to say that I would make fun of the ladies on "A Baby Story" pushing through their epidurals. I now know that it is so hard to push. I haven't pushed in 15 years. I didn't practice this part!!! It was difficult to coordinate the pushing. No one counted in my face and I was really glad about that.
It's 3:15 and we have put the Hymns back on. She is slowly moving up and her head is crowning. I'm not sure at which point they called the OB. Her head is slowly pushing it's way out. The entire time her head is exposed the OB nurse is gently stroking her head. She is treated gently from the beginning and the tone in the room is quiet and not tense. She decides that she has had enough of the womb and her head pops out. No pushing from me. Then the body just slips on out. She is born and my first look at her is in amazement at her size. All of my babies are over 8 lbs including my 11lbs 3oz boy. She is really long and skinny. The OB walks in fully expecting to deliver a baby. He missed it and gets to catch the placenta. She cries and is cleaned off and placed on my stomach. I get to cut the cord. I couldn't see it and Bill took pictures. They ask me if it is OK to take her to clean her off. They are very quiet and gentle with her care. She is cleaned off and they assess her. She is measured and weighed. 7lbs 9oz. 19 3/4 inches long. Her Apgars are 8 and 9.
One nurse said I was bleeding pretty bad. They call the OB back in and he finds clots in my uterus causing it not to contract. They take care of this and the bleeding slows down. I am sat up so I can nurse, but when I am moved up I nearly pass out. My BP is extremely low. 99/34. They call the Anes. back in and she puts some medicine in my IV to get my BP up. I continue to have low BP the remainder of my visit. I am able to nurse her and the colostrum is able to maintain her blood sugar. She looks great. As soon as my epidural wore off we were back in our room getting to know each other.
Despite these little mishaps and having to get the epidural, the birth was very positive. I was able to have a VBAC. I did not submit a birth plan to the floor. I wonder if my doula did since everything I asked for was honored. I nearly got everyone I asked for. It almost seem too good to be true. During the entire time of my labor, a friend of mine is calling and being called to update my lists on my progress. I have an enormous amount of support and prayers during this time. This birth is a triumph. Not only that I got the most beautiful baby in the world, but that being diabetic I was able to make it post dates, I had a small baby, and she had no side effects of my diabetes. Most important that she was born a VBAC. She was at one point a twin. Her brother or sister was 10.2 weeks before he/she died in utero. We will always hold that precious baby in our hearts. But we say Welcome to the World to this baby.
Postscript: Breastfeeding does not go well, due to the anemia from all the blood loss after the birth. Additional factors may also include low thyroid levels and abnormal nipple shape. This was very disappointing but the baby did get the benefits of colostrum and some early milk.
Lisa's Story (diet-controlled gd, anticardiolipin problems, premature labor, VBAC)
Kmom's Notes: The GD diet this mother reports being given is highly questionable. Although women with GD must carefully control the amount and type of carbs they eat, they should not be forbidden from consuming carbs completely. The pregnant body (and the baby) need carbs and the nutrition available from carbs for optimal development and health. Furthermore, if carbs are lowered too strongly, the mother is forced to burn her own stored fat for energy, resulting in ketones, a kind of acid by-product. Some studies have linked persistent levels of ketones to neurological damage to the baby. This is why it is important for women with GD to monitor their ketones, especially if their carb intake is low.
The other notable thing about this story is that it highlights the ABSOLUTE importance of the proper size of blood pressure cuff. This mother was almost forced into an unnecessary cesarean because her blood pressure was erroneously recorded as dangerously high. The nurses used the wrong-sized cuff; they should have known that a large cuff was required for a large person. Note how much of a difference the correct cuff made in her blood pressure----from 180/104 with the standard sized cuff, to 114/63 with the correct-sized cuff. From dangerously high to completely normal.
ALWAYS check to be sure that medical personnel are using the correct-sized cuff when taking your blood pressure.
Birth Story
In my second pregnancy, I was 37 years old and weighed 256 lbs. when I finally got pregnant. He was conceived through IVF and was a frozen embryo transfer. The pregnancy was considered "high risk" due to my "advanced maternal age" and the fact that I had an anticardiolipin problem and needed to be on 2 shots of heparin daily thru the entire pregnancy. I was also on progesterone shots up thru week 11.
In week 26, I was diagnosed with gestational diabetes. I did not have that problem with my first pregnancy, 7 years previous. The gestational diabetes was diet-controlled. I could not have milk, fruit, fruit juice, or bread in my diet. My diet consisted of protein, veggies, and 1 splurge of a balance fat/protein snack at bedtime.
During the whole pregnancy, I had a level 3 ultrasound done monthly. After I was diagnosed with GD, I still had a level 3 monthly, but I also had nonstress tests done 2x week from week 28 on. According to all the ultrasounds, he was growing at a decent rate, but was a large baby. I was scheduled for a planned repeat c-section (my choice) in beginning wk 38.
Due to a fall, I went into premature labor at 34 weeks and was put on magnesium sulphate for 5 days. My 3rd day in the hospital flat on my back, they told me my BP was dangerously high (180/104) and they had scheduled me for an emergency c-section. They were preparing me even to the point of having the anesthesiologist come in and talk with me.
When my dr. got there to talk to me pre-op, he saw the BP monitor and cuff they were using. He flipped! They had been taking my BP with a small cuff. He went right out to the nurse's station, came back with a larger cuff and took my BP. It was NORMAL---actually a little low for me (114/63)!!!!! Surgery canceled!
I was released on Wednesday afternoon, got to sleep in my own bed 2 nights and went into full-blown labor on Friday morning at 5:30. By 6:30 my water had broken, back in the hospital by 7:30, and had my 6 lb. 6 oz. baby boy by 9:30 a.m. Never made it to my planned scheduled c-section, didn't make it to my last "refresher" lamaze class, didn't have time to make it to labor and delivery room (gave birth in the prep/waiting area).
Due to the heparin, they had a problem stopping the bleeding, and the one stupid dr. tried to "help" the placenta out by pulling the umbilical cord. After my dr. got there, he whisked me right into the OR, transferred me from the gurney to the operating table himself, I finally got my epidural I wanted, and he removed the rest of the placenta by hand, and stitched my small tear. He said the baby came down the canal so fast, I tore up high in the vaginal wall---nowhere near any possible episiotomy site.
My little man ended up spending 5 days in the NICU due to breathing problems. They never found out the reason why he stopped breathing immediately after delivery. The speculation is that he was born sooooo fast that his system was shocked. Due to the "precipitous" birth, I had to sign papers to be tested for drugs. My dr. laughed about it but said it was required by the state in such a fast birth. He knew I wouldn't even take a Tylenol or Sudafed unless I cleared it with him first.
akp's Story (failed induction, botched c/s, complications; fat-phobic doctor, HBAC)
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.
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
Birth #1: [Kmom note: A more complete version of her
c/s story is available on the CS story FAQ]
I have to start with my first birth because it leads into the struggles with my HBAC. My daughter was born via cesarean for many reasons, but mostly due to my being
306 lbs. at 40 weeks pg. I was told my baby was over 10 lbs. and that I did not have the hip structure to birth a baby larger than
7 lbs. I trusted my OB explicitly and believed that I couldn't do it. I also knew my only chance at help (mom) was flying in at
40 wks, 2 days pg and was only staying for two weeks. I asked many women and they ALL said cesareans were great and no big deal. The closest to a "don't do it" I got was the receptionist saying hers was tolerable. So, knowing I couldn't birth my HUGE baby (who was
9 lb, 12 oz--not huge) and that cesareans were no big deal, I went in for my failed induction, cascading interventions and finally was the last cesarean of the night for my OB.
My daughter was torn out of me, put through tests, given formula and spent time with my husband, with my mother and with my sister and her husband before I even got to see her. There is so much more to the trauma of the cesarean, but let's skip ahead. At my 8 week PP checkup, I told my OB that I was still in a lot of pain, was still taking Vicodin and didn't feel well. She felt something strange in my abdomen and sent me for an ultrasound, but that didn't find anything, so she told me that because I wasn't recovering from the surgery well because I was overweight. That if I had been in good health (not that there was anything wrong with me beyond being overweight and having PCOS/Hypothyroid--those 2 are out of my control and contribute to the weight) that I wouldn't feel like that and so on.
Skip forward again to 17 months PP. I was told that I had cancer and would die soon because I had a huge growth (the size of a 20 week fetus) that had gotten so large so fast, there is no other explanation. Tests after tests finally revealed that there was actually a lap sponge and surgical tape left within my abdomen from the cesarean. That was the cause of the "tumor" and 2 surgeries later, I was told that there "was hope" that everything would be fine, beyond the scarring and adhesions. 6 weeks later, I conceived E.
Birth #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.
Maddy's Story (2 c/s, 1 hospital VBAC, 1 home VBAC)
Kmom's Notes: Another posterior baby story. She used a combination of patience, homeopathic remedies, rocking the hips, and the 'all-fours' position to turn the baby, plus a tub to help cope with the pain in the meantime. Labor stalled at 6 cm, common with posteriors. But because they were willing to wait things out and not force the issue with pitocin, their proactive measures did turn the baby and resulted in a VBAC; in most hospitals this would have turned into another c/s.
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.
With Baby #3, I searched everywhere for a caregiver that would give me the benefit of trusting my body to do its job. I needed to move, I needed to eat, I needed to progress at my own pace. I called everywhere, and visited two local practices. One doctor took a look at my chart and told me, "You're overweight, you're out of shape, you failed at labor twice before, you don't progress, and you're going to end up being sectioned anyway. This is a waste of your time and mine." I picked up my jaw from the floor, and moved on...
I was ready to drive almost two hours to a midwifery practice, but one more doc was recommended to me, just across the state line (about 15 miles away). He was wonderful! He calls himself "a midwife in a doc suit," and it's *so* true. He truly believed I could do a VBAC, and was willing to work with me.
Because the first two babies were 9 pounders at 42 weeks, I consented to using a prostaglandin gel to see if we could coax a smaller baby to come at 40 weeks. For three days, I had three gel treatments a day, doses of castor oil, herbal tinctures, homeopathic remedies (pulsatilla and Kali Carb 30) to turn a posterior baby... I had decent labor during the day, went home at night--not too bad, except that by the third day, I was still only about 6 cm dilated--the same place I got stuck last time.
I consented to having my water broke, even though it was a bit earlier than I would have liked. My contractions completely stopped for almost six hours! They suddenly returned though, hard and heavy, at which point, I used a tub (what a lifesaver, especially in getting my own weight off of my back!), and a lot of hot compresses on my back. After three hours of hard back labor, the baby rotated around from her posterior position. Another two hours, and I had dilated the final 3 cm, and she was born!
It was the most wonderful, exhilarating experience of my life. I did it! I actually conquered the beast within, and my body worked as it should, to birth my baby. Funny thing was, even at 40 weeks, she was right at nine pounds anyway! But I did it, with no pain medication, no pit drip, no c-section!
My doc said, "You had the most functional dysfunctional labor I've seen... way to go!" I know I would have been sectioned eight times over anywhere else. The staff was so supportive, and no one made any of those horrible comments like the one nasty doctor had made. (I did want to take my baby and hold her in his face and say, "How's THAT for a waste of time?!?!")
Here I am, almost three years later, with a midwife (new to my area, and absolutely terrific!) who "doesn't see any reason whatsoever why I can't have a home birth." I'm still the same size, but I'm a different woman... I'm confident, I know my body can do it, and I'm looking forward to a great home birth!
Update: Maddy had her home VBA2C just recently! She had another girl, and this baby was 9 lbs. 11 oz. Below is her short version of the birth story.
I had labor off and on all week, so my midwife came Wednesday afternoon to see what we could do to get long and strong and steady labor. I agreed for her to strip my membranes, and things kicked in quickly then. From 7 p.m. to 1 a.m., I dilated from 5 cm to 9-10 cm. I would contract well for an hour or more, then they would slow down and I'd sleep for 45 minutes of so, with contractions spreading out to 5-10 minutes apart. Then my friends would get me up and get me back to work again.
I started pushing about 2 a.m., in the bathroom on all fours, then with one leg half on the toilet seat and me sort of crouching over, then standing....you name it, I tried it!! She was moving down but would NOT crown! My perineum is like vinyl, they said. ;-) She was "right there" for over an hour, and in spite of hot compresses and massage, she just wouldn't crown completely. So my midwife snipped (her second episiotomy EVER!!!), a tiny, tiny little snip, and let me tear from there.
I pushed her out slowly---her head stopped AFTER crowning, but before it was out, and I got a great look in the mirror, and FELT her head finish delivering!!! It was SOOOO cool!!! Then the rest of her came out, again with me feeling her descent and move out---one shoulder at a time...and then it was DONE!!!.....She nurses like a pro, and we're doing well.
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!).
Baby #2: M was born vaginally after a short (relatively!) labour of 4 hours or so. Contractions started, we went to the hospital, they said I wasn't dilated enough, we went home, we went back, my water broke, they let us stay. :) At that point I was dilated a mere 2 cm... the OB said, "She's gonna be a while, I'll be at home." M was born 30 minutes later. 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!
I was declared "untorn" and sent to my room; hours later when I was still bleeding I was declared "torn" and sent back down stairs to be stitched. Small tear; healing was a breeze compared to the c-section! No breastfeeding -- no milk; breast reduction surgery healed such that it wasn't possible.
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.
Sallette's Story (c/s, VBAC after long hard labor)
Kmom's Notes: Sallette had a very long, hard labor in her VBAC. She did an awesome job to keep going so long under such difficult conditions! It's difficult to tell but the relative highness of the baby, the back labor, and the difficulty dilating suggest that perhaps the baby's position was not optimal, but it's hard to know for sure. She's correct that most other doctors would've ordered a c/s during this long labor; sometimes instead of putting a labor on a time clock, waiting it out (with a little pain relief if necessary) can make all the difference. Because mother and baby were both okay despite the long labor, they chose to proceed anyhow, and she ended up with a normal vaginal birth as a result.
Birth Story
C/S 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).
VBAC Story: All night Monday I was having contractions AND my 22 month-old was up with what we thought was a cold. I had a doctor's appointment on Tuesday and was trying to wait until 9:30 a.m. for my appointment but ended up going to the hospital instead. They checked me and I wasn't dilated at all but was having contractions every 5 minutes but they were only lasting 30-45 seconds so they sent me home. [Kmom note: Some hospitals will not send a VBAC mom in labor home, which tends to lead to more intervention, pitocin, etc. Fortunately, this hospital was not one of these.]
Coped at home all day Tuesday and was lying down to go to bed around 9 p.m. Tuesday night and the contractions got really bad (everything had been happening in my back and I was starting to lose control), so back we go to the hospital. The nurses hook me up and check me; no dilation, no effacement, contractions 3 minutes apart and lasting 45 seconds to 1 minute. The doctor comes and offers me stadol and morphine to get me through the night which I agree to.
Wednesday morning they check me again. I'm just a fingertip and about 50% effaced. Contractions are the same. The doctor doesn't want to give me anything for pain for fear that it will stall things. I tell her I'll hang in there. My doula comes Wednesday morning and we spend the day getting me through contractions one by one. My DH is holding up really well also. My family practice doctor brings in her consulting OB just in case we have to do a c/s (family practice docs can't do those). She is willing to concede my wishes at every point but we need to acknowledge the reality of another possible c/s. Baby is way high, contractions are not bringing dilation or effacement despite changes in position, walking, everything you can think of.
At 6 p.m. I start having transition-type labor (that's what the doula tells me). Contractions 1-3 minutes apart, some lasting for as long as 2 minutes. I get in the shower, have hubby and doula punch and massage my back. After 3 hours I'm begging for drugs. Nurse checks me and I'm still at 1. She calls my doctor who says I can do the Stadol and morphine again (which wasn't very helpful the night before) or we can start looking at a c/s but she wants to come in and check me first. I'm about ready to cave at this point because the nurse is telling me that I won't get the morphine and Stadol "till bedtime."
Doctor checks me and I'm between 2-3 and about 80% effaced. I ask for pain medicine and she okays the epidural but reminds me that it may stall things. Dr. L (my DH called him the candyman) gives me the swiftest epidural in history. I think he knew how much pain I was in. I was standing bare-ass naked in a room full of people, moaning loudly (my favorite was FffOOOOOOOO, FFfOOOOOOOOOOOO) and could've cared less who saw me. They could have taken pictures for all I cared! The epidural was in by 10 p.m. and I was able to rest some but was still feeling quite a bit of the contractions. By 3 a.m. Thursday morning I had dilated to 5. The baby was down to-2 station so they broke my water. Also right before they broke my water I started having contractions in my butt and down my legs (not very common from what I hear) and again they were transition-type contractions. I was making my husband pinch my inner thighs as hard as he could (they are still black and blue). So my relief was short-lived.
By 5 a.m. I hadn't progressed much more and my contractions were becoming less effective (probably because of exhaustion), so they started a real low dose of pitocin. I was again begging for relief from the pain but there wasn't much to be done. They tried upping the epidural and ended up just giving me a little Stadol to make me forget in between. The doctor explained that the baby was probably in a position that was pressing on some nerves and that the pit might give me some stronger contractions that could move the baby and ease the pressure but it certainly wasn't possible for my contractions to get any worse and she was right.
By 7 a.m. I was starting to want to push during some of my contractions. I was fully effaced and about 7. Baby was still -2. Nurse suggested that I push when I feel like to see if I could bring the baby down and it worked. At 8:15 a.m. I was fully dilated. The doctor was called back again (she had spent the night at the hospital checking on me every hour or so) and I started pushing for real. At 8:57 a.m., E was born. The doctor even asked before giving me a small episiotomy because I started tearing. She cried when it was all over too and gave me a big hug.
I know I didn't express really well how respectful she and all of the nurses were and how supportive she really was of my decision but I think that if I had had another doctor I would've been sectioned for sure. The doula was terrific, DH was great, and I still can't believe that I got to hold my 9 lb. 2 oz. chunky man right after he was born and the cord was still pulsing. It was the most incredible experience of my life!!!!! I'm a little sore but I just had my first BM and it wasn't as bad as after my c/s. I'm sure there is all kinds of important stuff I'm leaving out but them's the facts.
VBAC Update: I had a third full-term pregnancy and a second VBAC. I was due Aug. 11th but in April I started having lots of contractions and by May 17th I was placed on bedrest. I was allowed out of bed 4 hours every day. It was extremely difficult and very emotionally taxing since I had a 3 year-old and a 15 month-old.
By the beginning of August I felt literally like I was losing my mind and at the end of my rope. I wasn't getting any sleep and had contractions all of the time. The doctor kept putting me off for an induction basically because my cervix wasn't ripe or dilated, but by Aug. 8th I couldn't take it anymore and basically broke down in the dr.'s office. So she agreed to try a couple of gel applications to see if we could get things started. The night of the 8th I went to the hospital for a gel application and then home for some rest. When I went back at 6 a.m. I was softer but no dilation so they did another gel application and let me rest at the hospital for a while. The dr. checked me at 1 p.m. and I was 1 cm, not considerably softer but my cervix wasn't so far back, and so she okayed me to start the pitocin. I was on the pitocin until about midnight and was about 60% effaced but still 1 cm. They turned the pitocin off so that I could get a shower, something to eat (they didn't let me eat all day), and some rest.
The morning of the 10th they started the pitocin around 6 a.m., I was a 'soft' 1 cm, and I was on pitocin again until midnight. At that time I was 2 cm and about 70% effaced. The morning of the 11th, they started the pitocin again at 6 a.m. and I was still 2 cm. They checked me throughout the day and by 1 p.m. there still wasn't much change. I was starting to get frustrated and exhausted. I had been having pretty strong contractions for two and a half days. The thought of c-section flashed through my mind and DH and I decided that if by Sunday morning I hadn't made considerable progress we would opt for the c/s. My first VBAC had been 48 hours of back labor so I knew that I had long labors but felt that by Sunday I would've done everything possible for ME to do at that point, that emotionally I was just too drained and didn't have any resources left.
At 3 p.m. they checked me again (the dr. had gone home) and I was 3 cm. At this point I asked for an epidural because again I flashed on my first labor and I was afraid I still had quite a ways to go and felt that managing the pain for 2.5-3.0 days was taking too much out of me and that I wouldn't be able to muster the energy to push (even though I have to say I didn't have as much back labor and it was considerably easier than my first VBAC). I was also very emotional and shaky and kept saying to DH, "Why am I getting freaked out, why am I so upset? The pain isn't as bad as the first time but I'm freaking out." It flashed through my mind that maybe I was hitting transition.
The anesthesiologist got there around 3:30 p.m. and by 4:00 p.m. I was getting some relief so the dr. decided that since I had gotten some relief they would break my water and put in some internal monitors. I was 4 cm and 80% effaced. At 5:30 p.m. I asked for a bolus [extra dose] because the contractions were really really strong and way down low in the front. (Again I kept flashing to my first VBAC and anticipating that it was just going to keep getting worse for a LOOOONG time. I don't know why I kept thinking that way, I guess to prepare myself for the worst.) At 6 p.m. I wanted to push, even through the epidural I could feel the urge to push. The anesthesiologist was very good; throughout I could feel contractions but had enough pain relief to take the edge off.)
I started pushing while they called the doctor. She got there about 6:30 p.m. and my vulva and labia were swollen quite a bit so she numbed me a little in anticipation of a small episiotomy. She had me pushing with my legs pushed back by DH and the nurse. She gave me a very small episiotomy and my daughter came into the world at 7:03 p.m. I knew that we were having a girl but I hadn't believed that it was true. (I have 2 boys and my sisters have 4.) I kept saying, "What is it?" and then, "My baby girl is here! My baby girl is here!" She was 8 lbs. 14 oz., 21 inches long, and had a 14 inch head.
So that was my glorious second VBAC. It was wonderful, and I think the key in both of my VBACs was having drs. who supported VBAC. I had very long labors both times; that seems to be how I'm built and if I didn't have drs. who believed in VBACs I know that I would've had c/s both times. The dr. told me later that if things hadn't changed by 9 p.m. that night she was going to have the c/s talk with me. My sister told me that I had lost the first argument with my daughter. I wanted her to come earlier and she came on her due date, when she wanted!!!
Jen S's VBAC (difficult c/s, then VBAC)
Kmom's Notes: Jen S. had a terrible experience with her first labor and birth, including a horrible c/s. She was determined not to repeat that experience again. For some women a c/s is no big deal or even a relief, but for some women they are truly traumatic. These are often the women who are the most highly motivated to seek a VBAC.
Jen notes that this baby was bigger than her c/s baby who was 'too big to pass through my pelvis'. This is a common theme in many VBAC stories; the doctors tell the woman that she is 'too small' or the baby is 'too big', yet the woman goes on to have a vaginal birth with a subsequent baby that is much bigger than the previous one. Usually a "CPD" diagnosis means instead that something was wrong with the baby's position so it couldn't fit through easily, or the mother's position was not optimal for getting a baby through. True cases of CPD do occur, but they are quite unusual. It's usually more of a positional problem instead of the mother being 'too small' or the baby 'too big'.
Birth Story
I was having lots of Braxton-Hicks contractions and this was so exciting for me because I didn't have any (or notice) with my previous child. Mostly they were tight and high in my tummy---making me feel like I couldn't breathe. Saturday they changed to being really low and also in my back. They hurt. I had them all morning and by 11 they went away. I had some more that evening but that was it. Sunday, nothing. Monday, they were high again. I enjoyed those contractions much better. On Tuesday, the low ones were back again and coming every 3 minutes. I knew I wasn't in labor because they only lasted 30 seconds and started to space out throughout the day. By this time, the day before my due date, I was done being pregnant. I was feeling like I would never go into labor. I had hit the "I will be pregnant forever" signpost.
I had an appointment with the midwife that afternoon. I was toying with whether or not I would be checked for dilation. It would be the first time I was ever checked. I decided I wanted to know. I was trying to figure out a way that she would tell me if it was good news (being effaced and dilated) and not tell me if I wasn't---to prevent me from getting discouraged--but I couldn't figure out how that would work, so we just went ahead and I prayed for the best. My cervix was very high, she could barely reach it. But she said my cervix was very soft and from what she could tell, I was 2 or 3. Okay, that's good news I guess.
I went home, went about my business and moaned to DH that it was never going to happen. We took a long drive to get my first child to fall asleep in the car. DH wanted to go by his office to grab his tape recorder so we could put it in our bad to take to the birth center. He wanted to tape her first cry. I assured him that he could just get it in the morning when he went to work. I wouldn't be in labor for at least another week!
We went home and went to bed. I didn't fall asleep until 12:30. I woke up with some more low contractions. They really hurt and I had to concentrate to relax through them. I didn't look at the clock to time them, I just tried falling back asleep. I think it was around 2 or 3 when they started. I didn't sleep well because they kept coming and waking me up. Finally I decided to get up because I couldn't sleep anymore. It was around 5:30. I went to the bathroom and I had lost my mucus plug. Good, I thought, I must be dilating! DH woke up when he heard me. I said, "You're not helping me! And I'm going downstairs." He got up and came with me. We had no idea if this was it or not. All I knew was that they hurt. We timed them to see what they were doing. 3 minutes apart, 45 seconds long. We decided to call our doula. She wanted us to call her just in case, even if it weren't the real thing. DH told her we didn't know if there was it so for her to not cancel anything for the day but we just wanted her to know.
Then we called the birth center. I was talking to the idiots at their answering service when I had another contraction and just gave the phone to DH. I couldn't do both. The midwife called back and spoke with DH. Then I called my other doula. She is getting her doula certification and needed to attend some births so I was letting her come. I spoke with her on the phone and told her I needed her to come over. I told her that during the night, as I was trying to get some sleep that I dreamed she was sitting next to me on the bed with a book about helping women in labor and that my dream helped me sleep for an hour stretch. It was a silly thought so I laughed. She said, "I can't come if you are laughing" and I said "I didn't mean to, please come."
DH was running around, making more phone calls. I t seems as if we had to call the entire world. I was starting to believe it was real labor, the contractions were just too strong and I couldn't even try to ignore them anymore. I lost track of time but all of this calling seemed to fly by. I was sitting on my birth ball and DH was pressing on my back as I rested my head on the back of a kitchen chair. I was moaning to get through each contraction. People started to show up around 6:45-7:15. We had my two doulas, my son's support person (he was coming to the birth) and a neighbor who really begged me to let her come and do something. She finished my quilt I had made for the baby that weekend and was running around the house cleaning. My son's support person was great. She just jumped in and got him up, dressed, made him breakfast and played with him.
I was in my own world now and couldn't pay attention to anything at all. It was only 7:30 at that point I think. I went to the bathroom again and lost a lot of mucus. I came out and we tried leaning on the birth ball, standing up and rocking, walking some. By 7:45 I was losing my mind. I could NOT relax anymore. I think I was screaming. I begged to lie down but nobody would let me (strict orders in my birth plan---if I got in bed, I wouldn't get out again). So I tried to lie over some pillows on the couch. Nothing was working anymore. I had DH squeezing my chest which seemed to help, two people putting pressure on my back, my son held a vibrator on my back and my neighbor friend heated up rice socks for my back. My back was KILLING ME!
The contractions were now one minute apart and I wasn't getting any breaks. I was saying I couldn't do it anymore and that I wanted to go to the birth center. I think it was almost 8 at this time. I tried some more positions but I know I was losing my mind. At 8:30 my water broke (all over my freshly shampooed carpet!!) and we were finally going to leave. Our car was only feet from the front door but it took forever to get to it. The ride there was the most horrible thing I have ever had to go through. I begged to get out of the car. DH said, "Do you want to walk to the birth center?" and I decided that I didn't. I was screaming and begging DH to run red lights and speed through school zones.
Finally we got there and the midwife and nurse were in the parking lot waiting for us. I remember them just smiling at me. We got inside and they wanted to check me. Somehow they did as I was standing there. I couldn't move. I was complete except I had an anterior lip. "Go ahead and push," they told me. I pushed on the birth ball at first. It hurt so bad. My back was what was killing me. When I pushed it hurt more. So I know I wasn't pushing effectively. I was holding back. Trying to push, but trying not to at the same time. They got me on the squatting stool. I did that for awhile, and then begged to get in the bed. I was so tired. I just wanted to fall asleep. They let me in the bed on my side with my leg in the air. That bed was SO COMFORTABLE! I tried to sleep in between contractions but they were coming so fast and on top of each other I couldn't do it.
They made me get up again on the stool. I tried it but I just couldn't relax in between so it felt like a constant contraction. I begged to get back in bed. I was starting to realize that if I would push the way they were telling me to that I could push through the back pain and wouldn't feel my back hurting during contractions with long hard pushes. But pushing that hard was very hard.
They checked me again at 10:25. We had been doing this since 9:45. I could feel how high the baby's head was based on how she checked me. But she said I was now complete, no more lip. I started to get serious about pushing. I could feel the baby moving down. This was great. Now I felt like pushing had a purpose, where before it was like pushing nothing. I felt the head start to crown and I just kept pushing. The burning didn't hurt at all, it was a good feeling because I then KNEW that I was doing it! The head came out halfway with one push. Then my contraction stopped and I couldn't push anymore at all until the next contraction came. Funny, but it was then that I had a long break between contractions! I remember wanting the next one to come so I could push. Next one came and I pushed out the head and the body.
They gave the baby to me but her cord was short. I wanted to announce the sex but couldn't lift her because of the short cord. So everyone had to wait until we cut the cord about 10-15 minutes later. I was SO tired I didn't really care. All I cared about was that I had my baby and that I wouldn't have to push anymore!!! By the way, I cut the cord. DH didn't want to.
I had a first degree tear. They fixed that up. Pretty soon, everyone left and the baby and I rested together in bed. We went home five hours after the birth.
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.
Kirsten Taylor's Story (c/s for fetal distress; coerced c/s for post-dates and macrosomia, Home VBA2C)
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.
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" VBAC 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!
Her first cesarean was an elective cesarean for breech after a failed external version. Her second cesarean was after a trial of labor (27 hours, all unmedicated) that was found to be a surprise breech. Her third cesarean was a year later (another 'failed' trial of labor), this one with the 12 lb. baby. She had labored at home ending in transport, this time after 30 hours of unmedicated labor (including 5 hours at 9 cm). It's impossible to say for sure, but given the malpresentations (breech) she'd had with the first two babies, and the 3rd labor stalling before completion, it's quite possible she might have had a malposition (posterior or asynclitic or compound) with the third baby.
In her fourth pregnancy, she actually found a doctor willing to 'let' her VBAC 'even' after 3 prior cesareans, 'even' after a prior very large baby, and 'even' in the face of significant pre-eclampsia. It was not an easy birth, yet despite a number of complications that seemed to make her dream of VBAC impossible, she kept trying and ultimately had the VBAC. 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
Friday morning I went in for my first appointment in almost 2 weeks. My BP was up (160/110) and I had protein in my urine. The doctor told me to go home and rest, do a 24-hour urine sample, and return to the hospital the next day for a BP check. Saturday at the hospital my BP was 170/111 but went down to normal as long as I was resting. They called my OB and he said I could go home but was on absolute bedrest until my Monday morning appointment.
By Sunday I was starting to freak out because I kept hearing toxemia horror stories from people. So I called my doctor. He said that if I were someone else he would have sent me in to be induced on Friday, but he knew that I would stay in bed and he knew that I really didn't want to be induced. He said he would have been happier inducing me but wanted to give me a few extra days to go into labor on my own (since I had told him it would be Sunday). He said that he had planned to tell me on Monday that I had until Wednesday to go into labor naturally. He also told me that due to the high BP I would have to stay in bed during labor which really upset me as all my plans for VBACing and avoiding pain meds involved walking and being upright.
DH was at a birthday party with the kids at the time so I told the OB that when he got home we would talk over possibly going ahead with the induction. Well, I went into labor at 4:30, shortly before DH and the kids arrived. The doctor called to check on me around 5:30 and said he wanted me in the hospital right away so he could monitor the BP. So there went another part of my birth plan---staying home as long as possible---out the window. I ate some eggs and milk and yogurt before I left because I figured they would starve me at the hospital, and we went on, arriving there around 6:30 p.m.
They checked me and found no dilation at all and a very posterior cervix. My water had also broken and my contractions were hard and difficult to manage almost immediately. I had to be hooked up to a fetal heart monitor, a contraction monitor, a BP cuff, and an IV for fluid and antibiotics for Group B Strep. All I could do was lie on my side. I was panicky and could not cope with the pain at all. After 7 hours of what certainly felt like hard labor to me, I had made NO PROGRESS at all. And due to the ruptured membranes, GBS strep, and high BP, the OB had said that if I wasn't progressing by that point I would need pitocin augmentation.
I have had 2 long and completely unmedicated labors before, and was able to cope with them by walking, changing positions, etc. When I had to get up to go to the bathroom I could see that I would have been much more comfortable upright. But lying down, I couldn't cope with the pain, and I couldn't imagine coping with the added pain of pit contractions. Also, everything was going so wrong that I felt sure I was all set for another c/s anyway. I thought to myself that it was ridiculous to suffer for 12 more hours only to end up with a c/s anyway. Also, my ideal birth had been so completely messed up by this point that an epidural didn't seem like much. So I said that if I had to have pit I was having an epidural too.
Bless my husband's heart, he was trying to do the right thing. I said, "I can't DO this anymore," and he said, "That's what the Bradley book said you would say. That's normal." I said it was normal when you hit the self-doubt signpost at transition but not at 1 cm. I said I was serious! And then he suggested I just try some pit contractions, but I was afraid that I would be in agony for hours if I had to wait until after the pit for the epidural. So I got the epidural first, then the pit. This was all hooked up shortly after 1 a.m. and then we rested for a while
2 hours later when I was checked I was at 7 cm. I truly believe this was one of the situations where the epidural was beneficial, since it enabled me to relax. By 5 a.m. I was at 9, and at 7 a.m. the OB said I could push. However, he also told me that my baby's head was big and that it was well behind the pubic bones. He said that all he could feel was bone and that the head would have to mold incredibly to fit through. Then he left the room and told the nurses (he told me this himself later) that I could push but to be ready to do a c-section at noon!
I myself did not believe I would be having a VBAC at this point, but I had a very supportive labor nurse. Of course, just to add to everything else, I had to push semi-sitting----they wouldn't let me get upright because of the BP. I had counted on squatting so I really did think that was going to be the last straw. Anyway, she held one leg and DH the other. We got in at least 3 pushes for every contraction. I was able to push effectively despite the epidural, or I would have had it turned off. I had no trouble feeling where to push.
For a long time his head did not move. She turned me on my side between contractions so the head could descend through the available space. There was very little resting time between contractions and pushing was very hard work! Finally, she had people come in and start setting up for delivery. When the OB came in he said, "I love it when I'm wrong." I still did not believe it would happen. But getting his head through the pelvis was the hard part, apparently. The next thing I knew, his head was out and I started to cry because I knew it was really going to happen. The rest of him was born really quickly---what a strange feeling!!
I had an episiotomy and 3 tears---one in the sphincter, one inside, and one near the urethra. The sphincter is the main place I have felt discomfort. I really did not realize a vaginal birth would be so painful afterwards! It does seem to get better faster [than a c/s], though.
The baby ingested a lot of meconium, so it was nearly an hour before I could hold him, although I could see him the whole time. And of course we were all dying to hear the weight, since baby #3 was 12 lbs. The neonatologist said he was sure that it would be more than 12 pounds. He was born at 9:01 a.m. on Monday, at 24.75 inches, with a 16 inch head, and at 13 lbs., 5 ounces!!!!!
My milk came in last night and he is an enthusiastic nurser. He's a sweet baby, very alert, talks a lot but rarely cries. He is already much-loved by his siblings.
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 first 6 months I developed severe allergies and asthma. I couldn't get out of bed without being out of breath. I coughed until I thought my eyes would pop out. I was on about 5 medications, which worried me a LOT. At about 7 months is just sort of went away relatively suddenly. Very weird.
My due date came and went. I was becoming more and more depressed because of the possibilities of inducement, the baby being too big, etc. Even though my providers hadn't mentioned these things yet, all the things that could sabotage my hopes for a natural birth were floating around in my mind. One evening 8 dates after my due date, about 10:30 p.m., I felt a little pop and thought my water had broken. About 10 minutes later came a little gush of fluid, but not even enough to wet the bed. I got up and went to the bathroom but there was only a little trickle and I felt a little contraction. I went to my husband and told him I thought my water had broken but I wasn't sure.
My DH got out his stop watch. We walked around and I was having small contractions but nothing I couldn't walk and talk through. I still had a slow trickle of fluid leaking so at around 11:30 we decided to call the midwife. She said to try and get some rest and see if things picked up, but to come to the hospital around 6 a.m. regardless of what was happening since my water had broken. We called the doula and the grandparents. I kept having contractions; they seemed to be close together but they weren't very strong so I sort of dismissed them. We tried to get a little sleep, but as soon as I laid down the contractions got harder and I had to start my yoga breathing. We timed contractions but they didn't really have a pattern at all. Around 1 a.m. I got too uncomfortable to lay down anymore so I got up and walked a little bit. Things seemed to me to be speeding up so we called the doula. She came and put us at ease right away. She thought I was still in early labor and should try to get some more rest. As soon as I lay down, I'd have to get back up---the theme of my labor. I decided to get in the bathtub to try and pass some time and relax. I told my DH to take a nap. I filled the tub with water as warm as I dared and turned on the jets----ahhhh heaven! I stayed in the tub for at least a couple of hours and just tried to control my breathing and relax, and I think I even dozed off at some point. By the time I got out of the tub I was using yoga sound to get through my contractions.
I waddled back to bed, had a contraction, and got back up. Things started getting more serious. A little while later we woke the doula. She had me sit on the birthing ball and helped me through some contractions. I was holding a lot of tension in my shoulders and she laid her hands on me there and was talking to me in her low, calm voice. She made me some toast and juice but I only managed to drink a few sips of juice. By this time it was around 5 a.m. I really felt like things were getting faster and felt an urgency to get to the hospital. I think my husband felt it too. My doula said she thought I was around 4 cm dilated and I was satisfied I'd done enough work at home. We prepared to go to the hospital, making all our phone calls, finishing packing our bag, etc. The grandparents took my younger daughter, and the older one went to the hospital with the doula. I expected the drive to be the worst part of my labor but it actually turned out to be one of the calmest moments I had during the entire labor. It was dawn and there was a thick, heavy fog. It felt like we were driving through a dream. I had my eyes closed most of the time and just concentrated on my breath, relaxation, and humming along with my contractions on an "O" sound, and also with a closed mouth hum.
We arrived at the hospital around 6:30 a.m. When I got there, the nurse told me I was fully effaced but only 2 cm dilated and the baby was at a -3 station. My first thought was, "Where are the drugs?" Needless to say, I didn't find the nurses' evaluation of my progress to be very encouraging. Fortunately, my mind didn't have time to dwell on that information because my body went into overdrive. Between the exam room and the L&D room, I had to stop for a half-dozen or so contractions and was making a considerable amount of noise. My nice controlled "O-O-O-O" ended up sounding like a very loud "O-O-OUCH."
We made it to the L&D room and the nurse wanted to hook me up for the 20 minute monitor strip and the heparin lock I had agreed to in case of emergency. At this point I was leaning with my contractions---on my DH, the wall, the bed, the birthing ball. It wasn't my intention to be difficult, but lying or sitting in bed was TOTALLY out of the question and the nurse was very anxious to get the monitor strip going. The doula suggested I sit on the birthing ball for the monitor strip. I tried that but couldn't really sit through the contractions. I ended up leaning against the cabinet the monitor was sitting on for about 10 minutes and making a lot of noise. I'm sure the nurse thought I was insane because I was only 2 cm dilated and all. DH was taking his job of birth advocate very seriously, going over the birth plan with everyone who walked in the room.
After about 10 minutes of ineffective monitoring and loud chanting of O-O-Os, I suddenly had an absolutely overwhelming urge to go to the bathroom. I expressed this to everyone. The nurse suggested I leave the monitor belt on and go use the bathroom. I said NO, take it off, I need to go NOW. The doula took my eldest daughter to the waiting room, as she wanted to be there but didn't want to see everything happen, and things were getting intense pretty quickly. DH asked me if I wanted to go to the bathroom by myself and I said yes so he left me there. Everything unnecessary for giving birth to a baby came out of my body.
My yoga sounds started changing. What started out as O-O-O was now ending up as a ferocious growl. I had a tremendous urge to push and the contractions were coming one right after another. I was still sitting on the toilet growling through my contractions, while DH was outside 'discussing' methods of IV insertion with the nurse. I didn't care. He checked on me to see if I was alright. I told him I didn't think I could do this anymore. He told me later that when I said this he was really happy because he knew that one of the signs of transition was self-doubt. (I just knew that Bradley book would come in handy!) He helped me back to the room where I ended up on the birthing ball again. I think more than one person was telling me to quit pushing, to blow through it. I couldn't have quit pushing if you had paid me a million dollars. At this point the nurse brought in release forms because I guess she was convinced she wasn't going to get her 20-minute monitor strip or an IV. I signed. My doula whispered to me that it was okay, I definitely wasn't at 2 cm anymore. Believe it or not, at this time we had only been at the hospital for about 1.5 hours.
My midwife arrived and said something like, "How are
things going?" I think I growled at her. She smiled and told me
I was doing fine. She wanted me to get on the bed so she could check my
progress. I asked her if I could stay on my hands and knees and she said
sure, we'll try it. I ended up on my knees, leaning up against the propped
back of the bed with my elbows. This is where I stayed for the rest of the
birth. I had
actually listened to a birth story in yoga class of a woman who used this
position, but never thought I would end up using it.
In retrospect though, I think it kept me focused and uninhibited because
I was totally oblivious to anyone else in the room besides Adam, Sabrina and
Sara.
The
midwife checked
me and not only was I completely dilated, the baby was now at +2 station. It was really happening.
This registered with me and I think I said something like, “The
baby’s really coming?” I was
too busy growling to really be all that excited about it.
The doula was talking to
me even though I couldn’t tell you what she was saying.
DH was crying now and
told me my how good I was doing.
I
was growling and pushing and growling and pushing.
The doula was soothing me
and rubbing the top of my back. The
midwife was putting warm compresses and some sort of oil or gel on my
bottom and rubbing the lower part of my back.
DH rubbed my feet a
little and watched in amazement as the first glimpse of baby started to appear.
My midwife told me I was
going to hurt my throat if I kept growling like that.
(Unfortunately, it was already too late for my throat.
I could barely talk for about a week after the baby came.)
She told me to bring it down. Bring
it down to the baby. I tried to do
that and then suddenly I could feel the baby moving down.
I could actually feel it – it was the wildest thing – all the sound
went inward and I could feel the baby moving down.
When each contraction ended I would feel the baby move back up a little
and I would think, “No – go down, go down.”
Then, as things progressed the midwife told me the baby was crowning.
She didn’t really need to tell me because I felt the RING OF FIRE,
which you read about, but cannot truly appreciate until you have experienced it.
At that point I was thinking, “Go back up, go back up!”
But there was no turning back now, the baby was almost here.
All during this period the nurse was still trying to check the baby’s
heartbeat with the doppler. I
can’t even imagine what we would have done if she couldn’t have found it.
I wanted her to just leave
me alone, but I was having to concentrate too hard and couldn’t really convey
that message.
The
midwife asked
DH if he wanted to help deliver the baby. He
was the first to touch the baby. My
baby’s first experience with the outside world was his daddy touching his
little head. With the position I was in (upright but leaning over), the baby
came out with his face pointing up instead of down, and the first thing the baby
saw when he came out with his eyes wide open was the same person who was
touching him, his daddy. After the
head was delivered the rest of the baby came within one or two more pushes and
it was amazing. All the pain was
instantly and totally gone. My
midwife announced, “It’s a boy!” and at 8:43 a.m. my son officially
entered the world weighing in at 8 lbs 6 oz (bigger than either of my c-section
babies).
I
turned around so I could see and hold my new son. DH kissed me and told me
how beautiful we were. I was too
shocked to even cry. All I could do
was look at the beautiful, naked little being that was still attached to my body
and say, “We did it, little man. We
really did it.” I think I said
that to everyone.
I
held the baby and DH cut the cord. I
held my baby while they cleaned him up and checked him out.
His forehead was a little bruised from coming so fast, but otherwise he
was perfect. [Kmom note: The bruised
forehead probably indicates the malposition!] I tried to nurse
him. It didn’t take him long to
catch on and I nursed him for a little while.
They brought me a warm blanket for the baby and we lay skin to skin
covered in a nice warm blanket for a while.
My doula went to get my
oldest daughter and tell her the good news.
The midwife checked me
out and - can you believe it – NO tears, no stitches required.
She did think my cervix might have a little laceration, so she had the
doctor check me out. Luckily, it
was only swollen. Our nurse was
quite impressed with us, I think, and let us have extra time in the
labor/delivery room with the baby before they took him to weigh, measure and
bathe him. She was a good sport and was very happy and proud for us,
even though I’m sure we were her nightmare patients. Everyone, including us, was amazed that we had only been at
the hospital just a little over two hours.
We were still signing release forms after it was all over with.
The midwife told me later
that when she arrived at the hospital and heard me (I imagine the whole
maternity ward could hear me) and checked my chart she told the nurse, “This
is either really, really good – or it’s going to be a REALLY long day!”
It was really, really good.
I
had a natural and pure birth. No
drugs, no IV, no monitor, no cutting of anything.
It was the most amazing thing I have ever done.
Was it easier than having a cesarean?
No – absolutely not. But
it was completely satisfying, and perfect, and exactly as God designed it.
I was a participant – not a spectator.
I did it. With the help of
three loving and wonderful people, I did it.
The recovery period was easier than a cesarean, no contest.
The birth was powerful and intense and that’s exactly how I felt when
it was all over: powerful and energized. After
being awake all the previous night, it was almost 24 more hours before I slept.
I went home the next day to be with my family.
I had the most perfect birth I could have dreamed of. It meant more to me than I can even put into words. It was the difference between giving birth and having surgery. But it was more than that. I didn’t have a horrible experience with either of my c-sections, so it’s very difficult to explain the psychological impact that they had on me. My quest for a natural birth was about being whole, instead of cut in half. It was also as much about healing the scar on my belly as it was about bringing new life into the world. It was about trusting myself and my body - and even God.
Honestly, I had expected to have a huge emotional response when the baby was handed to me right after delivery. I fantasized about that moment almost daily while I was pregnant. As it turned out, all I could do right after delivery was stare in amazement and shock at my baby. The emotional response came a few weeks later when I got a note from my midwife thanking ME for letting HER be a part of the birth. I had also gotten a call from my doula telling me how wonderful the birth was for her. To know that the birth had touched other people made me realize just how amazing it truly was. As I read my midwife’s note, all the tears of hope, joy, fear, and relief that I had been wishing and praying for during the last nine months washed over me. I thanked God and I wept.
Misha's Stories (PIH, induction, c/s, then 4 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, and another with a 10 lb plus baby!!
Misha is also another good example of how good chiropractic care can benefit some women. And she's an excellent example of how variable several different births can be, even in the same woman. From fast and easy to long and hard, she's experienced it all.
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.
Baby #2 (Samuel Nathan): Sammy was our 2nd term baby. I had had an unnecessary cesarean for my first, and that, along with a couple other things, shaped my decisions for his birth. We had been experiencing secondary infertility for 3 years when he was conceived, and had also lost 2 babies to miscarriage over those yrs. - one at 5 wks. and one at 11.5 wks.
During that period of time, my sister-in-law
(SIL) attempted a VBAC. She had a young, inexperienced OB, and had had a terrible first birth experience in a military hospital, with a very scary placenta
abruptio, ending in an emergency c/s. Sometime around term, she began experiencing some mild
contractions and went to the hospital. They tried to send her home but she and my brother refused to go b/c that was what had happened w/ their first
birth (she had begun abrupting in the car on the way home), so this time they were too scared to leave w/o a healthy baby in their arms. She eventually ended up with pitocin and an epidural, and during a fetal scalp sampling, it was discovered that the baby was low on oxygen, and an emergency c/s revealed a catastrophic uterine rupture. Mom and baby both lived and are healthy,
thank God (though no more babies for SIL).
I tell this story b/c it was a big part of my preparation for VBAC. For a long while after
SIL's rupture, I was not at all sure I was going to go for a vaginal birth. I was very scared of rupturing, and as yet did not realize the full impact that the interventions have on the uterus. I started talking to birth savvy friends, and began to lean more
towards VBAC. After becoming pregnant in fall '98, I joined the ICAN list and started to soak up info like a sponge. I began to feel more confidence, and less fear. Throughout my pregnancy, however, I was still hanging onto fear from the miscarriages. I was very afraid of losing this baby too.
As 40 wks. approached, I started really freaking out. My OB was a fairly decent, hands-off type, in practice by himself in a small town. He was very respectful of how educated I was on birth, and was fine w/ almost all of my birth plan requests. But the problem at this point wasn't him, it was me. I started envisioning a stillborn baby, this baby I'd been awaiting for 3.5 yrs. The night before my 41 wk. appt., he didn't move for an hour. I drank OJ, etc., nothing. I flipped out, and the next morning we decided to break my water the following day.
Ironically, contractions started during that night, and continued all the way up till I got to the hospital the next morning, so apparently he'd decided it was time as well! When I got to the hospital I was at 2cm. As my doc broke my water, he said "Feels like baby's posterior!" Alarm bells rung in my head, but it was too late.
Contractions were very mild, but regular, for several hrs. As the afternoon wore on, they picked up, and at one check I was 4cm. B/c of his posterior position, labor became pretty excruciating - my lower back was in agony during
contractions. I'd been coping by leaning on the birth ball on the edge of the bed, and dh putting heavy counterpressure on my lower spine, but it wasn't long before I had to just lay on my side on the bed, drifting in and out of awareness. I asked for something to take the edge off, and got Stadol every couple hrs. Around dinner time I was checked again and was heartsick to hear "4cm" again. About a half hr. later my doc came in and checked me himself and said "a good 5cm, stretchy to 6". Whew, that was more like it!
The next several hrs. are very hazy in my memory. The back labor was very painful and I think I sort of zoned out in order to deal w/ it. Finally at 2am I was complete, and began pushing. The back pain during the pushing was unbearable and I got a weak spinal at that point. It didn't help much, but eventually my doc was able to turn the baby in the birth canal. That helped a little, but the pushing was still going very slowly and painfully.
After 2 hrs. of pushing he was starting to crown, and at that point his heartrate started to bottom out after
contractions. Thanks to the ICAN list, I'd learned that late decels can genuinely be dangerous, so I knew they weren't just using this to justify more interventions. It was at this point that everyone started to bustle around and I heard my doc say to me, "It's a c/s or forceps - we gotta decide NOW." We chose forceps, and minutes later Sammy was out. He was blue and limp, and it was very frightening. They whisked him over to the isolette and gave him some O2 and massaged him, which got him going after a few minutes. I kept hollering out, "Is he ok? Is he
ok?" but no one answered. Turned out his first apgar was 6. It was a scary few minutes, but once they put him on my chest, I had time to sit back and realize, I did it! I cannot even begin to describe that feeling. "On top of the world" is an understatement. I felt like dancing around the room and shouting at the top of my lungs - it was the most
exhilarating feeling in my entire life!
In retrospect, I realize that my own fear led to me making choices that made for a very difficult labor and delivery w/ lots of intervention. I later read that Stadol can cause fetal and neonatal respiratory distress, and this caused me much guilt. After reading many birth stories, I feel that I was very lucky to have had a VBAC that time, mostly due to my doctor's patience and my own determination. But, on the positive side, it was a learning experience, and showed me how strong I (and any birthing woman!) could be!
Baby
#3 (Bridget Grace): When our 2nd child (VBAC #1) was 4 mths. old, we moved from MI to NC. Since it had taken 3 yrs. to conceive him, we were shocked to find ourselves expecting again when he was only 6 mths. old! In my heart I wanted a
home birth this time, but wasn't ready. I halfheartedly picked an OB group on my
insurance list, and went for one visit at 12 wks., mostly b/c I wanted the u/s they use routinely at 12 wk. visits to date pregnancies, b/c I wasn't exactly sure when this conception had taken place. It turned out that my dates were accurate w/ my suspicions. Anyway, after the u/s as we were talking to the OB, I pretty much came out and told him I knew a lot about birth and I was not going to agree to many of the routine things they do, and that I expected to be a partner in my care, not a patient. His response was basically, well that's fine to a point, but as soon as you start talking things that don't make sense, then we'll have a problem. I knew at that point that I would not be coming back. As we drove out of the parking lot I cried and told dh, "I can't do this. I can't fight my way through this pregnancy." His reply was, well, we'll just do whatever it takes then.
After combing the phone book, I came to find out that my insurance would cover the CNM practice in
45 min. away. They have a freestanding BC, but due to hospital/doc politics (read: B.S.) they were not "allowed" to do VBACs there. We would have to birth at
the hospital. Still, we were thrilled, and really enjoyed our visits there, getting along great w/ 4 out of the 5 midwives. What a world away from OB care!! The pregnancy continued fairly uneventfully.
Tuesday, Sept. 5th, I had a midwife appt. I'd had a little pink mucous that morning, so I had her give my membranes a sweep; I was
3cm, baby at -1 station. At 41w4d, I told her, in all seriousness, "This baby is never coming out." Through the afternoon continued to lose my plug
but still figured it was just the exam and that I had days more to go. 9pm, while reading bedtime story to
my daughter, noticed that I was having contractions that I had to stop and breathe a bit through. They were consistently about 10
min. apart, and continued that way till 2am when I laid down on the couch and managed to get a little sleep. They hadn't gotten any closer
or harder to handle so I didn't want to call and wake up midwife; I was still in denial that this could be the "real thing". I had told dh to just go to
bed and rest, if I needed him I'd let him know. Woke up during contractions a few
times, then woke up for good at 4:40 w/ more show. Contractions were now 6-9 min. apart so I told dh, maybe you'd better call in to work "just in
case." I was starting to think *maybe* this could be it.
About 6am I called mw on call and told her what was going on, she said call back when
they got to 5 min. apart. 7am I sent dh to McDonald's 'cuz all I could think about was their pancakes and
eggs. While he was gone, laid down to nurse my son back to sleep. About 5 min. after he left, while I was still
laying there w/ Sammy, I felt a pop and thought wow, what a weird baby movement! I unlatched him and got up, and immediately felt my panties get
soaked. Ok, I guess this really IS it, haha. Called mw again - this time call was returned by our favorite, J., who was now on call. Told her
contractions were 6-8 min. apart now, so we would probably go to the birth center first to have her check us, to see if we needed to walk around a
while before going to the hospital. Dh got home, and after that contractions got to about 3-6 min. apart, so we left as soon as my parents arrived and
called J. on the way to let her know we'd go straight to hospital instead.
Get into 8am traffic between Raleigh and Chapel Hill, and contractions widen out
again to 10+ min. By 9:45 we're all checked into our room, and contractions are few
and far between. J. and I agree it is probably "fight or flight." We get hooked up for a 20 min. strip on the monitor, and get my saline lock set up (GBS+). Everything looks great, so J checks me, 5cm. Yay! But - gotta get those
contractions going again. We walk, and walk, and walk some more. J. recommends nipple stimulation, so dh and I start trying that. A few tries
between walking, over a couple hrs. time, starts working. J. asks if I want to get into shower, might help relax and keep things going, and will work
as nipple stimulation as well. My room doesn't have a shower - there are only 2
rooms w/ showers, and they were taken when I got there. She goes to the desk and comes back w/ a triumphant look - got you a room w/ a shower! So
we move - which was great b/c my first room was little and dingy and prob. wasn't helping matters. This room w/ private shower was much nicer. After we switched rooms
contractions never slowed again except by a couple minutes each when I'd lay on the bed to be
monitored a few min. every half hr.
By this time it was maybe 3pm and things were getting more intense. Contractions were about 4 min. apart, and starting to spread around the sides of my back. I started to realize what most women mean by "back labor" - my back labor w/ Sammy was due to him being posterior, and was sheer hell b/c his head was smashed against my lower spine w/ every contractions. This was more like a muscular pain on the sides. MUCH preferable and more bearable! But still, started needing counterpressure on back during peaks. J. would stand behind me and stroke my hair and face, then during the worst would push in on my hips. After each contraction ended would say you're doing so great, etc. Dh would take turns when J's hands got tired. I started saying I can't do this anymore, so J. suggested shower again. That helped immensely. Dh stood behind me for counterpressure on back, and the heat from the water made it easier to cope. Finally got too hot and felt closed in by shower, so I got out again. Contractions had gone to 3 min. and I was 7cm now. It was maybe 4:30ish. I do remember laying on the monitor between contractions and saying very calmly to J. and dh, "I'm going home now, you guys call me when the baby gets here." J. laughed and said, lots of women say that towards the end, so that's a good sign! I said, but I mean it. LOL. Leaned over birth ball for a few contractions, then tried - briefly - sitting on ball. NOT! Made the pressure on my bladder/cervix/rear end unbearable. I made them pull me off quick.
At this point the back pain was becoming extremely hard for me to relax through - using the term "relax" very loosely, as much as one can relax in hard labor. What I mean is that I was really having a hard time not totally fighting against the contractions now. I was saying during every one, I can't do this, I'm done, I don't want to do this anymore. J. was being very encouraging, yes, you can, you're so close! But I knew I had reached my limit. She said, well, you can have an epidural -I did NOT want epidural. We talked about a shot of Nubain and decided that was the most preferable to me. It was very difficult for me to accept that this was the right thing for me to do, but I was getting out of control and knew I couldn't push effectively w/ the back pain. I was whining b/c I really didn't want pain meds at all - and I had come SO far! J got in my face and said this is your decision to make - an adult decision - you need to make it, and be ok w/ it. Either way. I don't want to hear you regretting it after, if you're going to do it, you need to decide that's the end of it. Oddly enough, this was great - it gave me the presence of mind in the middle of the pain to just get the decision over with. She had to check me first, 8cm - yippee!! So my L&D nurse gave me the first part in my lock, and the 2nd under the skin. It immediately took the edge off the back pain while still allowing me to feel everything else during contractions.
This was about 6pm. J decided she had time to run and grab a bite for dinner. Dh and my nurse were there w/ me. W/in a couple min. I started feeling these spasms through my pelvis and was grunting w/ them. When they talk about "pushing urge", I always figured I'd feel the head in the canal and feel the need to push it out, or something similar (I had not had a pushing urge w/ my first VBAC). This was more like the dry heaves, but lower - waves of muscle spasms that I could not stop. Nurse turns to me and says why are you making those noises - what are you feeling? I tried to explain but it was difficult, so she said, "I've gotta check you." She got down there quick and said, "Oh, you're complete, we gotta get J. back here NOW." She flies to the phone and barks at someone to get J.
Before I know it, J. is flying through the door and yelling over my roaring noises to stop pushing - I told her I CAN'T!!! She's trying to get the oil so she can support/massage the perineum. She's hollering over my noises that I need to try to get a little control or else she won't have time to help keep me from tearing a lot, but Bridget had other ideas. Finally she got ready, and by then the baby was crowning - definitely learned the meaning of the term "ring of fire"! It stung pretty bad, and all I wanted was for that to be over, so I really started working hard w/ the urges - I think I was growling get out of there! or something like that. Luckily I didn't have to worry about pushing through the ring of fire b/c my body was giving me absolutely no choice in the matter! During crowning J. said reach down there, feel the head - so I did, and it was all crumpled from the molding, very odd feeling, but wonderful. Her head came out after a few huge pushes, and J. said ok now you HAVE to stop pushing - the baby had a nuchal cord, not really tight, thank God. Once she got it free she said ok, push the body out; that stung as much as her head. She flipped the baby around and straddled her against her body (we did not know the sex yet and J knew we wanted to discover it ourselves) and just worked w/ her a minute to make sure she was going to cry well and stuff, suctioned her, etc., then after a minute she laid her on me and we saw that she was a girl! That was such an awesome moment! After the cord stopped pulsating dh cut it, which he did not get to do w/ our first 2.
My parents brought the kids in right away, that was neat, but I was bleeding pretty bad and my dad got queasy (wimp <g>). J told me to try to push the placenta out, b/c baby wasn't nursing yet and I was starting to bleed worse, so I did, it was quick and painless. I had a 2nd degree tear, which was pretty uncomfortable being stitched up, but wasn't surprising - I'd been 8cm at 6pm, and she was out at 6:31. No one, including me, had thought the baby was going to be particularly big - I didn't measure large, and everyone who palpated said, oh this baby won't be really big. Nurse asked what my guess was, I said around 8 lbs. - she said 9 lbs. 5 oz. and dh and I almost fell over! She had NO coning whatsoever, beautiful round little head full of black hair. It was fun making the hospital staff's jaws fall when they heard she was 9,5 w/ a 15 min. 2nd stage.
Postscript: We really loved the compromise between good prenatal care and old-fashioned midwifery, but unfortunately our CNM practice is no longer taking VBACs (due to BC staffing constraints in having to go to the hospital to attend them). So we will be planning homebirths from now on, as I will no longer consider returning to an OB unless medically necessary. I look forward to birthing my next baby in my big bath tub! [Kmom note: And she did! See the home VBAC waterbirth below.]
Baby #4 (Carina Rose): After weeks of prodromal labor I was beginning to despair not only of ever getting any rest, but of not knowing when "real" labor began. The contractions were painful, in my cervix, and hard to distinguish from the kind which started real labor with my last child. I was joking all the time with the midwife that I would probably wait till late in labor to call her because I just couldn't tell and didn't want everyone sitting around for a false alarm.
On Wed, Nov. 13th, I woke up and had some bloody show...The day passed with more show, but no baby. During that night, I was woken a few times at the tail end of a contraction---maybe every couple of hours or so. The next morning, at 41 weeks and 2 days, more plug and show, and contractions that actually kept going every 10-15 minutes even after my kids were up and distracting me. They continued that way all morning. I took a nap and they continued every 15-20 minutes or so. Just mild enjoyable early labor type stuff. The intensity was not telling me this might be "it"---only the continued regularity, so I still had no idea if I'd have a baby that day. Just before 4 p.m. I asked DH if he could leave early and pick up the digital camera from my parents' on the way home. I told him I didn't know if it was real labor but I couldn't concentrate during contractions and needed him to be here just in case things got more intense soon...He finally got home close to 6 p.m.
At that point the contractions were about 5 minutes apart, maybe 30 second for a long one. I was thinking maybe this might be the real thing, so I sent him up to get a couple last-minute things on the supply list. After he got back it became apparent that maybe his nerves weren't doing so well, bless his heart...I wasn't really needing any labor support still at that point but decided to call the midwife and let her know what was happening...She both figured she'd have plenty of time to get there. I decided I could use a little moral support, so I called my doula/apprentice midwife. By the time she got there, I was in the bedroom, leaning over the bed with my knees on the floor, low-moaning through short contractions about 3 minutes apart. The doula said that was totally fine, and she didn't want to get my hopes up but sometimes moms who go into that kind of pattern go very fast once things speed up. I was like, yeah, whatever, thinking I've got hours more to go.
The doula asked if I wanted to check the baby's heartrate; afterward I immediately started to have another contraction so collapsed down on hands and knees in the bathroom doorway while she called the midwife to find out how far away she was. It was probably about 8 o'clock at this point and we all still thought there was plenty of time. During this contraction on the floor, just as I was prepared for it to start going down, I felt a pop and the contraction restarted....My water broke, just a small amount, not gushing like last time. In retrospect I think that might be because the baby was already so low that she was acting like a plug. We started the tub running.
Almost as soon as I got in, things really kicked up. I tried the birth ball in the tub but couldn't stand the pressure from the way my legs were squatted down in order to fit the ball in. So I laid on my side for a few contractions; towards the end of those I started saying I can't do this, I don't want to do this. All I could think was OMG, I will NEVER make it another hour or 2 like this. DH came in at some time and asked the doula how long she thought it might be---she said maybe an hour or so, hard to tell, then she turned to me and said, "A will be here in plenty of time, I won't be catching tonight!" We laughed about it, haha. Then she suggested a position change since I was starting to have trouble dealing with things on my side. I went up on hands and knees again and laid my head/arms on a towel on the back corner of the tub (my tub is large and almost triangular in shape so I had lots of room to lean). After a couple of contractions in that position I was really getting agitated and start saying, "There's so much pressure, the baby's moving down."
After that I started to freak out. I started yelling, make it stop, make it stop! I can't do this, Oh God help me, etc. The doula was great, she just rubbed me, kept telling me only a few more second til the contraction is over. The pressure in my cervix and down thru my hips/pelvis/thighs was unbelievable and I was really worried that I was going to be in this agony for who knew how much longer. After a few of those "just give me an epidural now" contractions, I flipped back onto my side instinctively, and started hollering, "I'm going to poop!" I also noticed that there was NO break between contractions any longer---they were just bam bam bam one non-stop contraction. I kept saying, "I have to poop, I'm going to go," etc. and S said, it's okay, you're fine, etc. I think she was hoping I could hold on just a few more minutes till the midwife got there, and at one point asked if I could get back to the bed (she thought if I was out of the tub things would slow down)---I said I can't move! No way! I didn't really think at this point that the baby was coming. For some odd reason, I was just really upset that I was being forced to go potty in the bathtub in the middle of all this pain.
As the baby moved down further, the contractions stopped (blessedly!), although the pushing urge did not lessen at all. I HAD to get that kid out of there, and she was making it very easy. I had no choice in the matter. My 7 year old had gone to the living room to get DH and my 2 year old, and when I saw him I somehow found the presence of mind to yell, "Take some pictures!" A few pushes later, accompanied by frightening primal screams, she was crowning and I reached down and touched her head and asked, "Is that the baby?" I couldn't believe she was already coming! The rest of her just whoooshed out all at once and S brought her up out of the water onto my belly. Her eyes were open, and she was very quiet and alert, but making no noise and I don't think breathing yet. Her color was fine, so S started massaging her with towels and telling me to keep rubbing her, etc. In just a minute she started crying and then S said get the cord, at which point I realized was looped down around her neck and front like an upside down "U". So we undid that from her neck and she was fine. I looked at S and said I can't believe it's over, that's the fastest easiest thing I've ever done! We finally remembered to look between her legs and see what we had----it was a girl! The funniest comment came from our 7 year old; after everything was over and I was still in the tub, she looked at us and said, "I'm never taking a bath again."
I was still in the tub when the midwife arrived a few minutes later. She came in and oohed over the baby, looked to see what she was, then asked DH if he wanted to cut the cord. He said no, I cut the last one. So the midwife cut it, S took the baby, and we got me up and to the bed. The placenta came within 15 minutes, it was in great shape, the bag was very strong, no calcium deposits, etc. I had about 1" first degree tear along my old episiotomy scar (darn thing). We put a couple of stitches in it. Eventually the baby got weighed and all of us were surprised that she was "only 8 lbs. My last baby was born only 2 days later gestation and was over 9 lbs (both dates were very accurate!) This little one seems like a peanut in comparison.
Baby #5 (Asa Eloyse): A much different, much harder birth than the others, but ultimately, still a VBAC
Baby Stats: Boy, 10 lbs. 2 oz., 22 inches, 14.75 inch head
This was my 4th VBAC, 2nd homebirth. The pregnancy was a difficult one. I was very ill with "all day sickness" for about 16 weeks, and intermittently thereafter. [For a long time], my husband and I were living in different states, so I was coping with all 4 children on my own, plus the normal pregnancy fatigue/aches/pains, as well as heavy duty loneliness. We had decided to relocate back to our home state; I prepared for the upcoming move with some help, but doing most of the packing on my own, living in a state of near constant exhaustion and irritability.
At about 24 weeks, I was in a car accident with all of my children. We all walked away, thank God, but it was traumatic for all of us emotionally, and seemed to be the point at which physically I started falling apart. A few days after the accident I began experiencing a fair amount of pelvic and lower back pain, but was unable to get chiropractic care at the time. I was very disappointed - I'd finally started to feel good and had very few of the discomforts I'd experienced in other pregnancies. Once we were moved, it was much easier, having my husband's help again I was able to rest more and finally got myself to a chiropractor which helped *immensely* (although my pelvis consistently refused to hold an adjustment and was just basically messed up).
Despite all of this, as always dh and I were thrilled to be expecting again! I was very excited about meeting the new little person with whom we were being gifted. I had a much more difficult time connecting with this baby in utero than with my others, which I'm sure was due in large part to distraction and being so busy through most of the pregnancy. I was sad to not feel close to him; I wanted to, but there was so much going on that I was never really able to go inward enough to do so. Yet even without the stronger connection, I trusted that the baby and I would do fine once he was in our arms.
Once the move was over, we called a midwife on the list of homebirth midwives in our state and, luckily, didn't need to look further. We met w/ C (midwife) at her house and her birth philosophy closely meshed with ours, she was very generously willing to work with us on a payment schedule that fit our situation, and was happy to take us on at 34 weeks! It was almost as though God had put her in our path, because strangely, although her other months were pretty much full, for some reason she only had one other October mother, whose EDD was well ahead of ours. The only possible conflict was a state midwives' conference the last weekend of the month.
I think most moms would say the last month of pregnancy is, at the very least, somewhat uncomfortable. Mine all had been pretty wearing at the end, with the last couple also involving quite a bit of prodromal labor. This time the prelabor started at about 36 weeks. I hoped that since this was the earliest it had ever started, that perhaps it would bode for a slightly shorter pregnancy. It began fairly mildly, with a few hours of consistent, easy contractions each night just before bedtime. As the weeks went on it would sometimes continue in the morning, at least until I was up and around and taking care of the kids. The last week or so it had progressed to the point of requiring my concentration, only stopping for some hours in the middle of the day.
The final few weeks the pelvic discomfort and SPD also became very painful. [Then I also pulled some muscles around my ribs.] I kept going to chiro appts. and she did what she could but mostly it just had to have time to heal. So I rested a lot, took some Tylenol, and used a heating pad. I caught a cold, which left behind a cough that kept me up at night. As uncomfortable as I was, there came a point of such utter exhaustion and despair that my prayers turned the opposite way they had been going, which is to say I started asking to *not* go into labor because I knew it would be so much more difficult in that state. Eventually the cough faded, and I was back to the basic miseries of late pregnancy.
I turned 40 weeks on October 20. With all the prodromal labor in addition to how low the baby was, I was genuinely surprised to still be pregnant. As the day came and went I became more agitated. This was of course pretty ridiculous, especially in light of the fact that just the month previously I had written a piece all about the unreliability of "due dates" and how flawed the calculation methods are. Still, I had held out hope that for once, I would have a pregnancy that ended before complete and total misery set in. It was not to be....Those last couple of weeks it became difficult to even walk through the house - I felt so very heavy and awkward, and there was an enormous amount of pressure on my pubic bone - not abnormally painful, just felt like there was someone pushing down on it. It didn't really strike me at the time, but in retrospect I realize that it wasn't exactly the same as the usual SPD, and that may be why the chiro wasn't affecting it as much as I'd have liked.
The days passed and the contractions grew more painful, more regular, and more frequent. I did become more worried as the prelabor went on, that I would once again fail to recognize "real" labor....I went out for a bit that Thursday afternoon and while I was gone the midwife had left a message asking how I was and reminding me of the conference that weekend. I was stymied, as I honestly did not remember this at all....Anyway, Friday when I called her she was indeed at the conference, about 1.5 hours away. She must have heard the desperation in my voice because she immediately said she would come home if I wanted, even if just for a short checkup, and then go back if I wasn't in active labor before the morning. She got here sometime between 10 and 11pm. The baby was doing great, and I was about 2-3cm dilated. She was able to sweep the membranes easily, I hardly felt it. They (midwife and her dd) headed home, telling me to call if anything happened before 6:30 or 7am, because after that they'd go ahead back to the conference.
At about 8:00 I got up and went to the bathroom and found a large chunk of plug. A few minutes later I noticed there was a very owie cervical contraction.....several minutes later, another....then another....and another....well, ok, but this had happened before, so still I waited, getting breakfast for myself and the kids and just walking around picking up the house.....At just before 10, I called the midwife and she said she would come back. Then I called Gretchen and she would be leaving shortly as well, after feeding Maille [her baby]. I was very excited, a little nervous, but I did not anticipate that this labor would be much different/harder from the last, so I was mostly looking forward to the coming hours....
C arrived by noon and Gretchen shortly after...While waiting for everyone to get here, contractions had spaced out to perhaps 10-20 minutes apart. I could tell they were "real" compared to the prodromal, but they were taking their sweet time. Gretchen gave me a wonderful foot rub and tried the acupressure points on the ankles, which did seem to trigger more frequent activity. Once dh got home we were able to leave the kids with him and go out walking. That helped somewhat, but still, things didn't really pick up much...We decided that it might be best for all of us to try to rest since it looked like it might be a long evening ahead. C felt that once the kids were down for the night and it was quiet, that labor would kick into gear. Before she left I did request a check, just to make sure (yes me, Miss No V.E.s! well it was totally my choice, so it's ok). I was about 4cm, so obviously things were pretty safe for them to leave for a while. This was probably around 3:30 or 4pm.
After they left....I laid down in bed to look at email and rest a bit. I didn't sleep - I probably should have but I wasn't really tired, I was too excited....Contractions started coming more regularly again, every 8 or 10 minutes....eventually I decided I should call everyone back. By the time they got back, contractions were getting more painful but not much closer together. No one was "officially" timing them out loud but I kept looking at the clock because I was quite concerned that they weren't getting closer. They were definitely growing much more intense.....Surprisingly to me, sitting was pretty comfortable for a long while. This has *not* been a tolerable position for me in past labors, so that was yet another thing that was new and different. During some of this time, my midwife and her dd were trying to get some rest in case things went on through the night. Gretchen sat with me, keeping me in stitches half the time.....an especially handy thing when one is trying to ignore a ten pound bowling ball making its way down an ant hole. She was an absolute pro at talking when the distraction was desperately needed, and being quiet when she could tell I needed to concentrate (and then eventually I was so loud that I don't think anyone could have been heard if they spoke, LOL!).
I started out coping by low moaning, with the occasional reminder to keep it low. At first....[things] were manageable. Another first for me in this labor was that I had to pee a LOT. Every few contractions I'd have to go to the bathroom. As the night went on and the pain intensified, I started to dread going but of course I didn't want my bladder in the way either. Nearly every time I'd sit down on the potty I'd get "stuck" there with a contraction. Then dh had to pull me up and walk me back to the living room. Things went on......Around this time, kneeling stopped working. I tried laying down on my side, but it started to feel like something was "off", besides just the normal pain of labor. The burning in my cervix felt different, and I could not get settled in any position. Side-lying, kneeling, sitting, all made me feel like something was not happening right during contractions. After getting "caught" in the middle of the room on the way back from the bathroom with dh, I accidentally discovered that standing up w/ my arms on his shoulders felt slightly better than anything else. I know it may seem strange that I hadn't tried it, but again, in previous labors standing had been bad in late labor. Dh was very tired by this point so he'd be laying on the bean bag and all of a sudden I'd jump up at the start of a contraction and yell, "Get up, get up, get up!" LOL. Then I accidentally figured out that bouncing up and down (not leaving the ground, just my legs/body) also had a desirable effect on the pain. Very very odd, but whatever works.
As this went on, I finally realized that I was indeed feeling a different pain. At first I'd thought it was still cervical pain from dilating, and for the first time during a VBAC labor, I actually thought about the scar and for a split second thought, "What if that's scar pain?" I only worried about it briefly, but I was surprised even at the time, because it just wasn't something that even crossed my mind at all during the three previous VBACs.
What I finally figured out was that this was pain on my pubic bone. Contractions made it feel like it was going to break. I had never felt this during labor before; it wasn't pleasant. Sometime in here, I asked to be checked again. I was really afraid I'd be a 6 or something, so it took me a while to decide to request the VE, but I'd gotten to the point where I had to know if this wretched pain was actually doing anything. It didn't feel like it was because of all the strange "off" feelings during contractions....C said I was 7, stretchy to 9. I was sort of relieved, but part of me was screaming NOOOO - how can this be?? How could my last labor go soooo fast and easy and now it feels like I have to be drawn and quartered for every measly little centimeter??
At some point someone suggested I lay down for a while.....The contractions stayed spaced out, possibly even went a little further apart, I don't know. But they were no less horrible and still something felt odd during them. I slept between them (and am told I was snoring, LOL). I don't know how much time passed....Gretchen had to leave about 4:15am.....I was disappointed for both of us, but I was ok with it because I didn't want Maille [her baby] to be upset without her. And the truth is I really didn't feel like the baby was coming soon, I didn't know what would happen. I just felt suspended in time.
Shortly after that, or before, I don't actually know, dh came in and laid with me. At one point I felt a gush of wet and called to C, "I think my water broke". I still don't know if it did..... After I came back from the bathroom from checking that out, I couldn't lay down again. I tried kneeling on the bed but that was equally horrible. By this time, not only was my pubic bone feeling crushed during contractions, my whole pelvis/hips were feeling like they were being smashed with hammers as well. I wanted more than anything to believe that meant the baby was moving down but I knew it didn't really feel like that yet, and although I'd felt a bit pushy/grunty with a few contractions, it wasn't uncontrollable by any means, and I had not felt anything close to the baby "thunking" down through my pelvis like the last time.
A few more contractions...more misery....then, a lightbulb! I said to dh, you know, it feels like the baby is not getting under the pubic bone. It feels like the head is just smashing on top of it. I asked C what I could do to help the baby get their head under. She said, well I hate to say this, but laying back usually helps that. Ah - the one thing I had not tried, because of course we all know how conducive lithotomy is to birth, right? I didn't really want to lay flat on my back. Luckily C was already ahead of me and brought the birth stool to the bedroom (I had originally planned to birth in the l.r.). She put it against the bed and I leaned back against dh. Within a few contractions I could tell that things were changing. Good, and bad....the pain/breaking apart feeling in my pelvis multiplied by about 10x. I started feeling totally out of control - unfortunately I was not in lala land as with my last birth - I was just going wild with the pain, but very aware of what was happening. I was screaming, begging God for help, yelling "I'm breaking apart, my pelvis is breaking in half" etc. During a break between contractions (which were still not very close, although perhaps a bit closer than before), I asked C to check and see where the baby's head was. I didn't feel uncontrollably pushy but something was going on and I wanted to know if I could try to force the baby out *now*. She said I was 9.5 with a lip. She didn't want me to push too hard in case I swelled, but I wasn't worried about it - I think I sensed that the "lip" was really just a bit left because once the baby had gotten under the pubic bone it was taking a few more contractions to get the rest out of the way.
After that everything kind of ran together. My pelvis was splitting in half, the baby was moving down, I was screaming and swearing and begging for God to get me through; it really wasn't my best moment. The pain was unbelievable. Even after my short, intense labor with the last baby, I couldn't have imagined the pain. I was desperate to get away from my own body. At last I could feel the baby right there, and just shoved and pushed and kicked and fought as hard as I could to get it over with. C was saying reach down and touch the baby's head, and I think I said something like, NOOO - I don't want to, I just want it done! LOL. I don't really remember, but that's what I was thinking. Pushing was not as easy with this birth as with my others. Although, I didn't feel a lot of crowning pain, and I only pushed for 8 minutes, it felt like an eternity and it felt like a very big effort. I finally felt his head "pop" all the way out. The body is typically very easy, but this time it felt almost as bad as the head. I didn't feel that big relief filled "whoosh", it felt big and lumpy and uncomfortable. I didn't stop feeling the cracking apart sensation in my pelvis til he was all the way out.
And there he was, all the way out, up on my tummy, all slimy and warm - finally a reward for all that work! It was wonderful, he was so quiet at first, just looking around. I peeked under his leg because the curiosity was killing me! A boy! I couldn't believe it. I hadn't had any strong intuition either way, but I think I really expected a girl because I wasn't sure we could even make boys anymore, LOL. After a few seconds he did cry a bit, then became quiet again. It was a wonderful moment.
The *minute* he was out I became very uncomfortable on the birth stool. It was as though my senses had instantly returned and I became aware that my rear end and legs were hurting, and there was a draft down there <laugh>. Sometime in here I asked if I'd torn. I certainly hadn't been careful about it, but she'd been using hot cloths to support the perineum, and said that I had stretched beautifully and only had a little crack. C wanted me to get the baby latched on so we did so briefly, and then somehow I got up on the bed, with the help of dh and C, and settled in with my little big guy. C was very attentive to making sure he nursed again right away, both for the bf'ing relationship as well as for the placenta. He was a pro and had no troubles latching at all. The placenta came in 12 minutes, with only a brief moment of discomfort when some membrane got caught up a bit inside. We were able to dislodge it finally with C working it a bit and me pushing. Whew, freedom! We waited a while and when the cord had stopped pulsing, I cut it. Ok, I have never cut any of my babies' cords, so when blood squirted out on my arm and nightie I jumped! Wow, that was weird! Interesting though. The baby nursed for about an hour or more, then I wanted him weighed. C checked him out and then put him in the sling for the scale. 10 lbs. 2 oz.!!! I couldn't have been more shocked. I'd measured right on all along and did not have a feeling that he was big. I looked large but I'm a plus-sized mama to start with, and just by palpating my belly I had no idea that he would be any bigger than maybe 8 or 9 lbs. I was very proud of myself, LOL!
About 1.5 hours after he was born, C made up the herbal bath and helped us to the bathroom. This was also something I'd never done, and ahhhhhh, did it feel good. I didn't know how Asa would react, being that he was very irritated at being taken off the breast, but it was just amazing the minute he hit the water he was totally silent, just looking around. Really neat. We only stayed for a few minutes, then we were both tired and ready to head back to bed. After we got there, I noticed some gushing. C kept massaging my uterus trying to get it to go back down; it seemed to want to keep popping back up to my belly button. I was a little frustrated by the bleeding, started to get a bit concerned. Finally I asked her if she had anything and she gave me a tincture (she does carry pit but thankfully we didn't end up having to use it). She was going to head home but instead stuck around a couple hours in case the bleeding became problematic. After a while it seemed to slow, so she and her dd and grandson finally were able to go home.
I was still on the post-birth high for the rest of the day. I wanted to sleep but I couldn't. At one point I got up to go to the bathroom and felt something coming out. I got to the bathroom and lost an orange-sized clot. I was a bit alarmed but this had happened to me before so I didn't think it was anything serious. Actually, after this, the bleeding seemed to really slow down and afterpains kicked in full force, so I think it helped to be rid of it. Later, my in-laws came to see the baby, and brought dinner and took the other four children to go trick or treating (he was a Halloween baby), which allowed us a bit of rest and quiet.
Lisa H's Story (elective cs for macrosomia; "failed" TOL c/s; insulin-dep GD, hospital VBA2C)
Birth Story
This vba2c was a long time coming, and I worked so hard to achieve it. Therefore, much of this story actually took place way before I ever went into labor.
Baby #1 - Born January 2000
With my first pregnancy, I was “measuring big” at the end, so after an ultrasound predicted an 11 lb baby, my CNM & the consulting OB recommended that I have a scheduled cesarean. They told me about the risks of birthing a big baby (shoulder dystocia, tearing, etc.) and that an induction probably wouldn’t work anyway. My 9 lb, 10 oz daughter was born at 39 weeks by scheduled cesarean section. I never labored, and no one told me the serious risks to me, to the baby, and to future pregnancies. My daughter had some breathing issues and extremely low blood sugar, which I now think were the result of her being born too early. She spent 4 days in the NICU. Quite honestly, I wasn’t that upset about the cesarean. I trusted that it was the best thing for us, and I was a bit relieved to be able to avoid the “pain of labor.” I was in pain for awhile after the surgery, but I recovered relatively quickly.
Baby #2 – Born September 2004
During my next pregnancy, I found ICAN and learned a lot about vbac and normal birth (and that’s when I started to get upset about my first birth!), and I hired a doula. I traveled to another town to get midwifery care from a CNM (since I couldn’t find a midwife here who would take me as a patient), and I planned a hospital vbac. I fully expected to have a vaginal birth this time. I thought that if given the chance, my body would know just what to do. Once I got close to my “due date,” the consulting OB strongly recommended another scheduled cesarean because of my insulin-dependent gestational diabetes and my age (I was 36). I declined.
At 40 wks & 1 day, my water broke. 30 hrs later, I was only dilated to 2 cm, exhausted, and in serious pain. I allowed myself to be coerced into a cbac by Dr. Evil. My perfectly healthy 7 lb, 13 oz son was born at 40 wks & 2 days, also by cesarean. Based on the pain I was having, my lack of progress, and the marks on his face when he was born, I’m guessing that he was malpositioned during labor. I am still angry (I’m sure I always will be) about how I was treated by Dr. Evil and disappointed about the cbac, but I was happy to have worked so hard and to have given this baby the gift of labor. I had no regrets about having pursued a vbac, even though it ended in another cesarean. But sadly, I felt slightly “broken.” My recovery from the surgery was harder than the first time, but I didn’t have any unusual problems.
Baby #3 – Born January 2007
When I got pregnant with my 3rd baby in 2006, I assumed I would try for another vbac. My research told me that a vbac was just as safe or safer than a repeat cesarean, and I did not want to be recovering from surgery while taking care of 3 kids, including a newborn. I just didn’t think I could voluntarily get up on that operating table again unless it was a dire emergency. The challenging search for a health care provider began!
I would have preferred midwifery care, but I could not find a midwife to attend the birth because of the previous 2 cesareans plus the gestational diabetes. I interviewed and/or called every single OB practice in town plus several family practice doctors. Some practices wouldn’t even schedule me an interview without me actually transferring my care to them. Several OB offices just said no over the phone because they “don’t do vbacs after multiple cesareans.” I tried to meet with the one OB in town with a smaller practice, but he wouldn’t see me even to give me a second opinion.
When I could get interviews/consultations, I took in my own research summary of why I felt a vba2c was safe (including a lengthy bibliography) and a copy of the Landon 2006 study concluding that vbac after multiple cesareans should remain an option. Some OBs were nice, but still said they couldn’t help me. Some were rude and demeaning and lied about the risks. A family practice doctor said he wanted to help me, but without a previous vaginal birth, his OB consultants “would never allow it.” One OB said yes in our meeting, but then called me later that day to tell me no. I was shot down over and over again. I even considered signing up for a repeat cesarean with one of these OBs. I was so discouraged and emotional, and I just didn’t know if I was capable of continuing this fight.
At this point (about 20 wks along), I scheduled an appointment with Dr. Reasonable from my previous midwife/OB practice. They had already told me no over the phone, but an ICAN friend had used this same OB for her vbac and highly recommended her. I figured that I had nothing to lose. This doctor understood my desire to vbac and said that she would be willing to take me as a patient! Of course, she still wanted to put some ridiculous limitations on me during labor because of the vbac, but I figured that I could deal with those things when the time came. (And I knew that I would stay at home for as long as possible during labor.) I transferred my care to her immediately.
The rest of my pregnancy was relatively uneventful. I got to see Dr. Reasonable for every prenatal visit, which not all practices around here “allow.” (Most practices make you rotate through all the different doctors in the office.) I feel that it helped me emotionally to see someone every time who actually believed I could do this. I did have insulin-dependent gestational diabetes again, but my blood sugars were very well-controlled with diet and insulin shots. My endocrinologist believed that with well-controlled blood sugars, there was no additional risk to the baby. The baby was measuring “the right size,” and I was Group B Strep negative. I declined ultrasounds to check the baby’s size, and I declined vaginal exams. I took a Hypnobirthing class to prepare for labor and to deal with my birth baggage and my fears. I went to the chiropractor for regular adjustments. We hired the same doula that we had last time. I read positive birth stories and surrounded myself with supportive people.
On a Friday (38 wks & 3 days), my water broke at 12:30pm (standing in a fast food restaurant… lovely!). Over the next 24 hours, we tried many to things to get labor started… acupuncture, rest, massage, walking, chiropractic, eggplant parmesan, Hypnobirthing, and a nasty mineral oil concoction recommended by my Hypnobirthing instructor. It was “against the rules” to stay away from the hospital this long once my water had broken, but I was completely comfortable with it. I didn’t have a fever, I was Group B Strep negative, but most importantly, no one was sticking their hands in me to do vaginal exams. I knew the risk of infection was low. As time went on, I felt like I would never actually go into labor. About 26 hours after my water broke, I pulled out the big guns and drank castor oil. I drank it from a measuring cup in the Walgreen’s parking lot, which was about the most disgusting thing I’ve ever done in my life. I still get nauseous just looking at that particular measuring cup. After that, we walked some more, and then went home to wait.
I spent some unpleasant, but brief, time on the toilet, and then around 5pm on Saturday, I had a contraction. Within 15 minutes, I knew I was in labor. I went from no-labor to full-blown-can’t-talk-through-them contractions in about 45 minutes. I tried to use my Hypnobirthing to relax, but it was really hard. (I remember thinking, “Screw Hypnobirthing! This isn’t working!” But in retrospect, I think it was VERY helpful.) Within a few hours, I begged my husband to take me to the hospital so I could get an epidural. I assumed that I wasn’t dilated very much since this hadn’t been going very long, and there was no way I could do this for another 10, 15, or 20+ hours. (I know now that this is a normal reaction when nearing transition.) When our doula arrived, she agreed that it was time to go to the hospital because she noticed that I was doing some involuntary pushing. I didn’t realize what I was doing at the time, but I was happy to head to the hospital because I thought I’d be getting that epidural. We spent 45 miserable minutes driving to the hospital then got checked in.
The good news.....I was checked by a nurse at 10pm, and I was dilated to 7cm! I was thrilled that I was this far along. It didn’t even occur to me to ask for pain medication, and the nurses were respectful of my birth plan and didn’t suggest it. The bad news....The on-call OB was none other than Dr. Evil. I asked for another doctor or a midwife instead, but there was no one else. I decided to just deal with him the best I could (it’s not like he spent much time in our hospital room). I received a hep-lock and was hooked up to the fetal monitor, but that late in the game I was okay with it. I tried to walk around the hospital room, but I felt most comfortable laboring in bed. At 11pm, Dr. Evil checked me, and I was dilated to 9cm. (This is when he suggested a cesarean or an epidural, but I had no problem yelling, "No!”) At 11:45pm, I was complete!
Pushing felt great. The pain lessened, and it felt like I was accomplishing something. After an hour of pushing, I started to get a little worried. After 2 hours of pushing, I was terrified that the doctor would suggest forceps or vacuum or cesarean, but I kept pushing. This part was REALLY hard; I was so tired, but I could also tell that the baby was moving down. At one point I could reach down and feel his head, so I knew he was almost out! Around 2:00am, Dr. Evil wanted to cut an episiotomy because he “could get the baby out faster,” which I declined. At 38 weeks & 5 days gestation and after 38 hours with broken water and 2 and a half hours of pushing, I delivered my 7lb, 5 oz son Gavin! We did it! Holding that wet, slimy baby on my chest is a memory I will always cherish. I don’t love my other children any less, but I will always mourn that their first minutes of life were not spent the exact same way.
During the delivery, I sustained a 3rd - 4th degree tear. I suspect that the tear had something to do with the way Dr. Evil stuck his hands up in me to grab the baby. And then he had the gall to give me the I-told-you-so lecture about how an episiotomy would have prevented the tear. Lunatic. The fact that I was able to delivery vaginally with that particular doctor felt like such a victory. He had bullied me during my 2nd birth, but this time I stood up to him, and it was so empowering. I was nervous that he would be the one at the birth, but that turned out to be part of my healing process.
The recovery from my vba2c was easy. It’s difficult to express the huge difference between my cesarean recoveries and my vaginal birth recovery. With a vaginal birth, I felt connected with my baby and with other birthing women and had a “vbac high.” I was the best, proudest, happiest version of my real self with a sore bottom and a few stitches. With my cesareans, my entire body felt injured. It took ages to physically feel like myself again.
I think many things contributed to my ability to have a vaginal birth this time. I was more educated and more determined. The Hypnobirthing class and the chiropractic care were so helpful. I had a great support system in my ICAN friends, my husband, and our doula. It was valuable for me to see the same supportive OB at every prenatal appointment even though I didn’t know what doctor would be there at the time of delivery. Arriving at the hospital so late in labor was beneficial too. If I had gone in soon after my water broke, this story most likely would have had a very different ending. And of course, luck played into it as well. I gave birth 9 days before my “due date.” If I had been “overdue,” there would have been lots of pressure to have another cesarean. But most of all, I had more trust in how my body works. Apparently, my water breaks a few days before I give birth. That’s what is normal for ME.
My baby is now seven months old, and I have been completely healed from my tear for months & months. I am so grateful that I was able to experience a vaginal birth. I think it was the healthiest thing physically and emotionally for me and my baby. This birth has helped me heal a great deal from the births of my first 2 children. Some of the healing was because of the vba2c, but a large part of it was because of the journey. I worked as hard as I possibly could to do what I knew was best for me and for my family. I don’t think I’ve ever worked so hard for anything in my entire life, and I feel great about that.
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. It took us almost 5 years trying to conceive with Brendan (2 ½ at the time of this birth), so we were happily surprised to have another on the way so soon! From the beginning I felt it must be a girl, since I had much worse morning sickness than in my first pregnancy. I also craved chocolate, which I don’t normally! A 24-week ultrasound “confirmed” my suspicions…yes, it showed a girl! We called her Molly.
It was a hard pregnancy for me, beginning with the morning sickness, then itchy hands and feet, a painful hernia until about 6 months, heat rash, SPD, hemorrhoids, and more. In addition, it was very stressful trying to decide on a birthplace and care provider since I was convinced that a VBAC was healthiest for me and my baby. My options within the medical community were less and less promising, and I hoped for a peaceful birth without having to fight for it. After researching and interviewing, Jeff and I decided on a homebirth with a midwife.
When we met Juliet, we were impressed with her calm demeanor and wholesome, realistic approach to birth. We felt immediately comfortable with her. nor e impressed with her calm demeanor and wholesome, realistic approach to birth. We felt that she was neShe even came to our house to do prenatals, and it was such a treat not to have doctor appointments throughout the pregnancy! I did visit an OB one time for an ultrasound. I did not plan on going back, but the atmosphere within the office further convinced me that I did not want to birth in a medical environment. Later in my pregnancy, I worked hard on Optimal Fetal Positioning, even giving up my beloved recliner, because I was worried about a difficult labor with a posterior presentation. Planning a homebirth, I wanted to give myself every chance for a complication-free birth, and especially reduce the odds of a painful labor. I went on a long search for a pregnancy-trained chiropractor, and received excellent care for my SPD and other alignment issues during the 2nd half of the pregnancy.
Around 37 weeks, I felt the birth must be imminent, since that’s when I’d had Brendan! Then, I patiently waited until 40 weeks, but when that came and went, I started losing patience. I struggled on miserably until 41 weeks, having started and stopped labor several times already. I was adamantly opposed to any kind of induction, fearing another c-section caused by “failure to wait”. I felt that if labor had not picked up on its own, the baby might not be in a good position, and induction might commit her to a delivery in a bad position - and all of the issues that entailed.
My EDD was Nov. 4th. Starting on the 2nd, I had several rounds of serious contractions. Jeff even stayed home from work one day! Friday morning, Nov. 12th, I had my first bout of active – pattern labor. I had 3 hours of contractions 4 min. apart and 60 sec long, from about 7 am. I was disappointed when they fizzled out, gradually stretching farther and farther apart. I was in a lot of pain from my hemorrhoids, and needed lots of help. Jeff stayed home from work again. I was miserable, crabby and frustrated. Not a good day.
When I finally got to sleep, I had only 2 hours or so before the contractions kicked up early Saturday morning. Again, an active labor pattern! Juliet (the midwife) was moving that day, and I just knew I was gonna wreck her plans! I got all excited again. After 5 hours of really intense contractions, lasting 90 seconds and only 3 minutes apart – fizzled again. What was going on? I had called so many people to tell them to stand by, only to have to call and tell them (again) that nothing was happening now. I was so sure. The increasing intensity and closeness had me convinced! But this time I didn’t have to wait until morning for another round. Although they spaced out to 30 min apart through the day, contractions came back slowly to 20 min apart, 15, 10…Finally, by 11 pm, they were only 4 minutes apart and lasting 60 sec. again. They were the most painful yet. I had to stand up each time one came to manage them. I could not relax and was getting scared that something might happen before anyone arrived. So I called my doula, Ann, at 2 am.
She came out around 3:30, but contractions were already spacing out before she arrived. I just couldn’t believe it. I was still contracting at least every 10 minutes, and it was so helpful to have her there to help me through them. They were so hard. By 8 am we were all exhausted, and decided to try to lie down. I was able to sleep in spite of a few waking contractions. At 11 am, Ann left to go home. Jeff and I slept the rest of the afternoon. A few times I woke up with a monster contraction that made me moan & cry out in my sleep! But nothing consistent. Eventually, they quit all together. So we went through the evening…Brendan was at Grandma’s the whole day, which helped me rest, even though I missed him and felt bad that he was gone. Jeff went and had dinner with them, which gave me some quiet time alone. Later that evening, I missed Brendan terribly and started to cry. We had him come home, and the family stayed and visited a little. It felt good for all of us to sleep in our own beds that night.
I felt so good Monday, I thought I could do this forever! Ha ha… It was the first day in a week that I had no pain and no contractions to work through. What a relief! Juliet came out for a check/prenatal around 2 pm. The baby was in a good position and was very reactive, which we were happy about. I had Juliet do an internal check, which showed I was 80% effaced and 1 cm dilated. She could barely reach my cervix and was not able to sweep my membranes, which was all right with me. Even with the check, I felt very crampy a few hours later, and was almost sorry we had done that. Jeff worked Monday and Tuesday, so I had Brendan on my own. But Grandma helped me out for several hours, and I was able to nap both days. I was so glad that Jeff would be home again Wednesday and Thursday.
Wednesday was a hard day. I was a day shy of 42 weeks! I’d had more prodromal labor each day, and I was tired and hurting. I could barely walk from all the pressure on my bladder and pelvis. Jeff went to a movie that night, and I had a meltdown, crying because I just couldn’t stand to be pregnant anymore! I was so, so uncomfortable. When he got home, we packed up Brendan and went out for Chinese food. It was nice to get out as I had been stuck at home for days!It was the first day in a week that I had no pain and no contractions to work through. What a relief! But we came straight home afterwards. I made some cheesecake bars before bed, just to have something to do, even though it was very hard to stand up that long. Finally we got ready for bed around 3 am and wouldn’t you know it – more contractions. I had no way to know that this was the beginning of my actual labor! I had a glass of wine and tried to sleep. No luck. I went to the bathroom and was very excited to notice some pink mucous on the toilet paper! Finally, finally, there was some progress that I could see! The contractions were pretty spaced out, but started getting closer together. I stayed up watching TV, unable to sleep.
By 7 am Thursday (42 weeks and my birthday!) they were again about 4 minutes apart, sometimes 3. I was able to handle them with breathing. Through the morning I had more show, called my birth team to put them on notice, and started to feel very sleepy. Jeff went to the store for some last minute things. Brendan woke up at 11:30 so I called Grandma, who came and took him. I couldn’t even think about nursing him! I laid down to try and rest, while Jeff made a pot of chili, picked up the house, and inflated my pool. Contractions spaced out a bit, which allowed me to get a little rest. But they were still quite hard and obviously dilating my cervix, as I continued to have more mucous. They continued all day and evening, in patterns from 4 to 8 minutes apart. I had to call my birth team several times to let them know things were staying the same. I was getting discouraged. After midnight, Jeff went to bed. The contractions didn’t allow me to sleep. Around 4:00 am, I had been laboring for 24 hours, been up for over 36 hours, and I was exhausted. I was desperately missing my son, who had to stay at Grandma’s over night for the first time. I was crying from frustration, praying, and even posting on the ICAN list asking for prayers. I planned to wait until 8 am and then call Juliet, my midwife, to come out and check on me. At 5:30 I got a little break and fell into an exhausted sleep, waking every 10 min or so for a giant contraction. At 7:30 my Mom called, and I was awake and going again.
I called Juliet right at 8 am. I told her I wanted her to come out. She was planning on a prenatal for me at 11, but I told her to come as soon as she could. I was just completely frustrated. Honestly, except for the duration, nothing felt that different from the tedious episodes I had been dealing with all week. I just felt like it would go on forever. But within minutes of me talking to Juliet, contractions picked way up in frequency and intensity. I told Jeff to fill the pool! I couldn’t get comfortable. Right away, I knew there was no going back. I got in the pool when there was only a few inches of water in it. I ran the hose over my belly and the warm water felt soo good. But the water started to get cold and we turned it off. I stayed in the pool for about 30 minutes, but I could not handle a contraction sitting down. Getting up took me out of the water. When I got out to use the bathroom, I never got back in. It was too much trouble!
Within an hour I was starting to lose control. After an unbearably painful contraction, I threw up. I couldn’t believe it. No one had arrived yet. I told Jeff to call Juliet and see where she was. I didn’t want to have this baby by myself! I think she was surprised, because I had just talked to her a few hours before and nothing new was happening. She was 20 minutes from my house. We also called our doula, who was at another birth. She sent her backup, Vicki, who happened to be the instructor from our hypnobirthing class. I was happy to have her wisdom and experience. I am afraid I didn’t impress her very much, though! Labor from here on out was pretty much a train wreck!
I barely remember Juliet arriving, around 10:30. I was already lost, at the mercy of these unbelievable contractions. Somewhere in the next hour, Vicki arrived, as well as the midwife’s assistant, Jen. I latched on to Vicki’s hand, while Jeff applied amazing counterpressure to my hips and sacrum. I didn’t have back labor, per se, but my hip joints felt like they were coming apart! No one else could give me any relief…I needed those big, strong hands of my husband’s. Boy, did I give him a workout! I would tell him “Squeeze! Higher! Now the middle! Lower!!” Sometimes when a contraction started I would just wail, “Honey, SQUEEZE!!!” The doula joked later that she would re-name the double-hip squeeze the “Honey-squeeze” when she taught her classes. I tried to lie down a few times, but this position didn’t allow for the counterpressure I needed.
Most of the time I stood next to the bed, leaning over the birth ball which was on the bed. There was no relaxing, no control, no rest – just pure survival. I screamed, yelled, begged for help, cried, prayed…for 5 hours! Juliet checked me at 12:30 and said I was 7-8 cm. (This was the first time I let her get near enough to check me! But I had to know!) She said, “No wonder, sweetie…you’re in transition!” “No kidding,” I thought! I kept saying, “I can’t do one more of these! Somebody please help me. DO SOMETHING!!!” Later they all laughed because everyone WAS doing something, holding my hand, squeezing hips, rubbing my back, etc. All I wanted was a little rest. I kept begging for a rest!! They said contractions were about 3 minutes apart, but it certainly didn’t feel that way. I couldn’t rest between them, either. They kept telling me to relax my bottom. What??? Not even remotely humanly possible.
Honestly, I would have had an epidural 20 times over if I had been in the hospital. I probably would have gone to the hospital if I thought I could have made it to the car, or survived the ride. I kept thinking it had to be almost over, even when it wasn’t. I was really scared because it was so much worse than I ever imagined. I didn’t know anyone could live through something like that. It shocked me when the midwife and her assistant were calmly sitting in my living room, reading and talking, while I screamed like a banshee in the next room. Like this was NORMAL??? I still don’t think it was normal. Vicki said later that they were the hardest non-induced contractions she had ever seen. All three attendants granted that I broke the record for most noise made in labor. Ooh, good for me! Again, I never expected that. I am a really quiet person and expected to moan or cry, but….not this!
I was dragged to the bathroom a couple of times. Laboring on the toilet didn’t help. One time they had me try sitting backwards leaning on the back of the toilet. That was the worst. I felt trapped and started flipping out. Finally, as I was going to the bathroom for at least the 10th time, I started making grunting sounds. My midwife didn’t recognize them, because, as she said, I had made so many different sounds the whole time! My doula said I started babbling in my own “language”. I didn’t notice this but I think it was when I was trying to talk but the grunts were taking over. It felt like trying to talk when you have the wind knocked out of you. After the contraction, not realizing I was pushing, I said, “Do you think the shower would help?” Yes, they all agreed, so I tried to get in the shower and sit on the birth ball! It was a joke! I couldn’t get up. I might have been in there for about 2 contractions. Jeff had to get in the shower and stand on the corners of the tub and pull me out. Then I knew I was pushing.
I told everyone that I was pushing. We went back across the hall to the bedroom and Juliet checked me again. Yes, I was complete. It was almost 3 pm. I did not really choose which position to push in, but just collapsed on the bed in exhaustion. So I ended up lying on my right side, which I had been wanting to do all day! Oh, it felt so good. Contractions spaced out enough that I could really rest in between. Then when they came, they weren’t very painful anymore. I pushed hard with each contraction, but it was infinitely easier than any of the labor I had just been through. I could feel the baby moving down with each push. My water broke about halfway through the pushing, but leaked out slowly as baby’s head was already in the way. Pretty soon, I could feel the stretching part. Jeff went down to hold up my leg and watch the birth. I kept wanting to put my leg down, and everyone kept saying, ”No, no, no!” The head was already coming. Juliet used oil and hot compresses to ease the crowning. I felt a bit of a stretch, but not the ring of fire I had been so worried about. I didn’t even realize when I had pushed out the head. Juliet asked me calmly if I was getting another contraction. No, I replied happily. I didn’t know that they were waiting for me to push out the rest of my baby! They had asked me if I wanted to touch the head, or watch in the mirror. I am sorry to say that I declined both options. I was so exhausted that I wasn’t that interested. I really regret that now. With the next contraction, I pushed the baby out. I thought that I had pushed out the head and body with that one push. I was really surprised later when they told me about the time in between. What a wonderful feeling…I can’t describe the relief!
I rested a minute while they worked on the baby. I was so tired that I didn’t immediately realize that the baby was not breathing and had no heart rate. They just said that he needed some help, and handled everything so calmly that I didn’t have time to be frightened. Juliet did a mouth-to-mouth resuscitation, some chest compressions, vigorous rubbing and a little slapping. I only saw the part where she was holding him up patting his back and bottom. He pinked up quickly and started to make some little sounds. (His apgars were 5 and 9.) It was then that Jeff pointed out that this baby was not “Molly” as we were expecting! The ultrasound had indicated a girl. What a surprise to find we had a beautiful boy! It was one of my favorite moments of the birth.
Benjamin Jacob was born at 3:29 pm, after 37 minutes of pushing. He weighed in at 9 lbs. 5 oz., and was 20 inches long. The placenta followed within just a few minutes. Juliet tucked Benjamin in next to me and we tried to encourage him to nurse, to help with his respirations. Although he wasn’t interested right away, he was alert and looking around. He received a little oxygen for the first 20 minutes or so. After we had plenty of time to meet and hold our new son, it was time for me to get checked. I had a minor 2nd degree tear and a skid mark, neither of which was particularly painful. It turned out that I had a partial placental abruption, and baby had aspirated some blood on the way out. It was not known whether this or temporary cord compression caused his delayed breathing. I did not have any major bleeding, although they had me drink an herbal cocktail just in case. Eventually, I was helped up and got into the shower to clean up. I couldn’t believe I felt so good after all I had just been through! I got dressed and sat in my recliner while Juliet did the newborn exam. I held my sweet new son while close family started to arrive. The birth team cleaned up our room and left everything tidy. It was the best moment when my little 2 year-old son came home and met his baby brother. He was happy to see the baby, but only until he saw his bedroom. “There’s a swimming pool in my bedroom!” he shouted, and never gave baby another thought. Imagine being 2 years old and coming home to find a swimming pool in your room! (We had set up the birth pool in there.) It was better than Christmas!
Later Juliet told us that when she checked me at 7-8 cm, the baby’s head was still not engaged. He must have dropped down quickly when the time was right. She admitted she had been really worried at that point, envisioning a long pushing stage. As it turned out, he came out perfectly LOA, and it appeared that positioning was not an issue in the labor. I had felt that he was LOA even during the long days of prodromal labor. So, I will probably never know what caused that.
There is still so much to process from this birth. I was completely traumatized by the labor for several days, and didn’t even feel that excited about having my longed-for VBAC. I couldn’t see signing on to do that again. Part of me thought, if I pushed him out that easily, I could have done that with an epidural, right? Then I thought about the moment of birth. The crisis was handled in a calm, professional, and humane manner. I warmed him with my body, spoke to him and nursed him when he was ready. Surely, in the hospital, baby would have been whisked off to NICU and I would not have held him for who knows how long. As it was, I went to bed in my own room with my new baby that night, and we all came out fine. I couldn’t put a price on that.
And a week later, holding my son, I realized I had bonded with him in a way I could not even compare with my c-section baby. It took me a year and so much pain to get to the same place with my first-born! Benjamin looked at my face, and turned to my voice within the first days, while I cried for months when Brendan would not look at me. How can I compare physical pain and emotional pain? It is a question I don’t have an answer for yet. I just know I survived. Everything worked. I don’t know if it was “supposed” to feel like that, or if it would be like that again next time. I don’t know if exhaustion or fear played a part. Nothing happened as I expected it to, and I have had some grief over that (days of Jeff’s vacation lost to prodromal labor, an out-of-control labor, packing up all the little pink clothes, and more….) There is an unmistakable joy over everything, though, and I am so thankful for that. It’s a new feeling for me. I am thrilled that Brendan has a brother to grow up with. I know my baby is healthy and has had a good start. No interventions or drugs, and plenty of good breastmilk from the beginning. He is round and happy and loved. And, thanks be to God, I am not pregnant any more!!! It was a hard pregnancy and a hard labor, but it’s done and we made it.
Brandy's Story (c/s for "CPD"; c/s for failed induction; postdates home VBA2C)
Kmom's Notes: The fat-phobic doctor Brandy sees in the beginning of this pregnancy thought she "would be lucky" to get to 37 weeks because of her size. This is ironic since Brandy actually had the opposite issue; she went "overdue" instead and was almost forced into a repeat c/s because she went "late." This is a common issue for women of size; studies show our pregnancies tend to go longer, probably because our cycles tend to be longer too. But most "due dates" do not take our longer cycles into account.
Brandy gave birth past 42 weeks; imagine how badly her baby would have been affected if she had had a repeat c/s at 37 weeks like the doctor wanted. The baby would have been 5 weeks too early!! But of course, any problems they would have then encountered would probably have been blamed on her size.
Women can give birth just fine even well past their due date. Although there are some risks to consider when going "overdue," there are also risks involved in inducing or doing a c/s instead, though doctors tend to discount those risks. Many women gestate longer than average and their babies are just fine, but it's important to find a caretaker who is truly comfortable with letting a baby arrive on its own timetable as long as it seems to be doing well.
Birth Story
My husband and I have always wanted to have a bigger family.
However, although we love our children dearly, their births were very traumatic.
If you can imagine going into what should be one of the most exciting times of
your life with fear of what the hospital bureaucracy was going to do to you,
then you can know where we are coming from. We were left fearing the very people
that are suppose to take care of us. N had spent one useless week in NICU
because of “policies and procedures,” and we spent our entire time at the
hospital with both children feeling like prisoners desperate to escape.
We began talking about having another child when my daughter turned one. DH was
so excited and eager. Several days before I could test he gave me a very special
gift. I have the same baby book for both N and I, but it was discontinued. He
began looking for a copy of it in April, and he kept it to give to me when I was
pregnant. I cried because I could not believe what an incredible gift it was. It
was not something I had discussed with him, just something he noticed. DH is
like that though. He is very romantic and always paying attention to details
like that.
Since I have a history of ectopic pregnancy that left me with only one tube and
ovary, I need to have an ultrasound at the beginning of the pregnancy to be sure
that the baby is in the right place. I made an appointment with an OB/Gyn who
marked herself as “natural childbirth friendly.” All was well.
What happened next blew me away.
The doctor, Dr. B., wanted to do a pap smear. I would normally
not object, but I had one just two months prior to that exam in her office. It
seemed pretty useless. I was told the pap was required. Then there were extra
swabs out, and I asked what they were testing for, to which I was informed yeast
infection. I explained that I did not want that test. I was told it was policy,
and I could not decline the test. (I later learned that I was lied to, since
that is a test for Sexually Transmitted Diseases. No wonder insurance premiums
are high… I have no need for that type of test.) Although I was irritated, I
complied.
Dr. B comes in the room, and I mention that I want to have a
natural child birth. She immediately begins talking down to me as if I was an
idiot, and explains that it is way too dangerous, not to mention all my problems
that I bring to the table. You see, I am overweight. I guess she thought I was
not aware of that when I came in to see her, so she took every opportunity to
point it out to me. I have never in my life been treated as disrespectfully or
as much as a moron as I was in that visit. Dr. B was convinced that I was a liar
about the ectopic drama, that I was unable to walk a block, and despite my
protests that I was neither she was convinced that I was a gestational diabetic
and had problems with PIH (Pregnancy Induced Hypertension). She looked at me
like I was nuts when I said that I thought my large babies were caused by having
a large father, and that they continued to be big once out of the womb as well.
She discussed setting up my c-section for 37 weeks; because there was no way
that someone my size could go beyond that mark, and “we would be lucky” to
make it that long in the pregnancy.
I spent the next several hours crying. I did not make a follow up appointment,
but I figured that regardless of what decision I made, this was probably as good
as it was going to get. I knew that if that was my option, I was not going to be
seeing a doctor. I had full confidence that I could walk into any ER and get a
c-section if I wanted one. The same could not be said for a vaginal birth, which
seemed like a distant dream.
I am now thankful to the Lord for that horrible appointment. I had wanted to try
a midwife or do some alternative to the traditional system, but it did not seem
possible. Now that I knew I could not continue to go the other route, it was
much more possible. My husband also became much more interested in the
alternative, after seeing how badly I felt after that appointment.
I had a very dear friend named Delilah who talked to me after that horrible
visit, and told me about a midwife who was a friend of hers who would take
VBACs. I had contacted one midwife prior to the Dr. B visit, and she did not
take VBA2Cs. I had assumed that was how it would go with all midwives, but she
directed me to someone who could help. Her name was M, and she had a birth
center. DH and I immediately thought she was great. She was not worried about me
trying for a VBA2C, or that I was overweight. She thought we would do great. Her
optimism really brought a part of the excitement of the birth process back to
us, because she offered us some hope that we could do this. We just loved her,
the center, and the idea that we actually had a chance to do things differently.
M wrote us the sweetest note about how she knew we would have a great delivery,
and was the first person to find Sarah’s heartbeat.
Tragedy struck, and M was killed in a car accident. Although we
did not know her well, she had already worked her way into our hearts. She had
given us hope that we could have a normal delivery, and the Lord had used her
mightily in our lives. We could not imagine what her family was going through,
and our hearts just broke for them.
M’s partner J took us as one of her patients, for which we were very thankful.
It was so hard to think of someone so young and beautiful with a family passing
away, and then we were sad that we might be back to where we started as well.
(Although we were much more upset for her family’s loss, as we had faith that
the Lord would provide a way for us.) J began seeing us when we were about 18
weeks pregnant.
At 20 weeks we had the standard sonogram appointment. The lady who did the sono
was not very friendly. She saw a fibroid that was keeping the placenta
from attaching properly to the uterine wall, and was on top of my prior
c-section scars no less. We were so scared. We did not know, until we began to
research at home that this was a danger of having a section. We also did not
realize that with every section the chance of this condition (known as Placenta
Accreta) increases. That was an eye-opening experience. We were never told the
dangers of having sections. We asked, but we were not told that this was yet
another side effect. The doctor, who did my first two sections, first for CPD,
and the second for failed induction, knew we wanted a larger family, but said
that he personally had done 5 sections on one person, so we did not think that
having them was dangerous. Not true. The danger of placenta accreta increases
dramatically with each incision. Furthermore, we learned after the first section
that ectopic pregnancy is a danger as well. We learned that after a miscarriage
and subsequent removal of my left tube and ovary.
At first we were both just so scared and so upset. It did not seem possible that
we were having yet another side effect from having a section. After a day or two
I really began to have no fear. None. I really felt in my heart that everything
would be fine, and I could not explain it but I felt it was the Lord granting me
the peace.
The day of our level two [sonogram], Delilah went with us to the
appointment. DH and I were afraid we might be emotional and not think through
all of our questions properly. Delilah is one of the most detailed and
knowledgeable people I know. She is also one of the most compassionate and
caring believers that I have met. Delilah prayed for us, and we shared a few
laughs before getting started.
The girl came in to do the sono and asked if we had any
questions. We told her we were hoping to see if we were having a boy or a girl.
She saw almost immediately and said, "It’s a girl!! DH and I looked at
each other and at the same time, said, it’s Sarah! As she was scanning, we
were able to see so much detail. I cried at seeing her heart beating because it
was so clear and so beautiful. Watching her move around was such a gift. We
asked if she saw any problems and she said no, but the doctor will be here soon.
The doctor came in, and was so much nicer than I expected. We also had a laugh
with him early in his visit, because I asked him about his published works in
the Journal of Perinatology. He was very surprised I knew about that, and I told
him I look up all my providers. He thought that was pretty funny, and said I was
the first patient who had ever said that. He reviewed the images that the
sonographer had taken, and then went to scanning on his own. After he was
finished he said, your placenta is nowhere near your scar site, and you do not
have a fibroid. We were stunned. We still had the last sono on tape, and you
could see the growth under the placenta. The doctor said it could have been a
weird contraction of the uterus, but it should not have lasted the entire sono.
He had no explanation at all that was adequate. I choose to take it as a
miracle. We left there praising God, and thanking Him for His graciousness, and
provision. Delilah, when she prayed for us, told us to pray boldly. It’s safe
to say none of us expected that answer though!
Our next big pregnancy milestone was taking childbirth classes in January. We
learned how making one choice often means making other decisions inadvertently.
Such as getting an epidural means consenting to pitocin, a bladder catheter, and
a fetal scalp [monitor]. We had not really thought of that before.
In February, at the request of J, I began seeing a chiropractor to help get
Sarah into a proper position. I cannot stress how skeptical I was at going this
route. I was convinced it was a waste of money, but I thought, I will do it,
since it was requested of me, and I don’t believe it will hurt anything. I met
the doctor, and she was really sweet, and I felt convinced that she believed in
what she was doing. She ran a few tests, and it showed a few things that were
not correct, and then told me I should come three times a week. It was going to
be expensive!! But we had the medical care account so I thought okay, I will do
this.
Boy, was I surprised when I told her about my tailbone, which had
hurt since N was born, and she believed she could correct the problem. She
explained that usually the bone doesn’t break in labor (what I had been told);
rather, it gets bent out of shape and causes pain. She said that had it been
broken it would have healed, and then I would not be in pain, but being bent out
of shape, it could cause pain indefinitely. So, she pushed my tailbone back
where it belonged. I have not had pain in my butt since!! DH asked me afterwards
if it was worth the over $500 we were going to pay out of pocket to go to the
chiro, and I explained that I would have paid much more than that to have my
butt fixed! He laughed and agreed. I am now a big fan of chiropractics. Oh, and
when Sarah was transverse, she flipped head down within a week of getting my
adjustments. I felt like my lesson here was that maybe the Lord was teaching me
to be more open-minded. I hope it is a lesson learned.
In March, DH and I ended up having an off-handed conversation about birth, where
I told him that I thought I would like to have a home birth. He is so amazing!
DH told me that he had felt that way for some time, and was going to discuss it.
I was so amazed that I married such a wonderful guy, and so excited that we were
on the same page and going to have Sarah at home!
The next big surprise for March came toward the end of the month… I was given
a surprise shower. I was so emotional, because no one had ever done anything so
nice for me before. I was surrounded by people that I just loved so much…. All
these amazing friends that I had made, and I had the best time. After the
shower, DH gave me a special letter that he had written with a prayer. He never
counts it enough to write them, he always reads his letters to me too. What a
gift. I will treasure these memories for all my life. And I praise God for
giving me such a wonderful husband and beautiful friends!
One of the other issues we were having was with our
midwife. I started to feel like we were making her nervous. It was not something
I could really pin down, but I thought maybe because we were a VBA2C. However
that seemed unlikely because she was once in our shoes. I don’t really know
what started to cause these doubts to creep up in my mind, but they were there.
DH was getting less content and more nervous as our due date approached, because
he felt like we were going to have to grapple somewhat with our care provider.
She is a loving and wonderful woman, but she seemed to vacillate between '
everything is great' to ' this pregnancy is not going so well.'
I had no complications with the pregnancy. My glucose was
wonderful, my blood pressures were great, I had gained a relatively small amount
of weight, and I was doing what I was told. However, one of the herbs that I was
asked to take, on one occasion, made my blood pressure go up and caused some
swelling. I am not a big pill taker, herb or not, so I was not too concerned,
since I knew it must be the cause of the elevated BP. Immediately after quitting
the herb, I returned to normal. This did not seem to go over well, and I started
feeling like I was reassuring my care provider that all would be well on one
visit, and then she would be happy the next visit. It was very odd.
Luckily she had a student C ( who was about to graduate) working
with her, and I always felt like she was on my side. She was always very upbeat,
and when we asked about doing a home birth, she was clearly so excited that you
could not wipe the smile off her face. She always made me feel better, and I
always felt like she was listening when I spoke. C was also so sweet because she
so badly wanted to be at our birth. We were so excited to have her there too!
As my LMP due date approached and went, I was not worried. The ultrasound due
date (4-27) came and went, and she still wasn’t here. That was okay. However,
this is when the questions start coming. “When are you going to have that
baby?” “You’re STILL pregnant?” Those questions… booming from friends
and people who check you out at the store. At this point, I was taking Evening
Primrose Oil orally and vaginally, as well as taking the herb that originally
raised my BP in order to start labor. I was walking, sitting on my birth ball,
going to the chiro, eating spicy foods, and doing just about every thing
you could think of. Every night I was going to bed thinking this could be the
night that I wake DH up to tell him I am in labor.
At 40 weeks 3 days I allowed the only check I would have before
labor. J checked me and I had a very anterior cervix that was mushy. I was
dilated to a two. YES! I was making progress and I was working. Although I
consented to this check, I was so grateful to not be getting checked all that
time. I really liked not having to take my clothes off and go through the whole
checking process. It was so freeing just to say no. I thought it would be hard
not knowing, but it really was for the best. When I did get checked it was to
confirm what I already knew, and to give my midwife a chance to see where I was.
Although admittedly this check was just a check and really meant nothing in the
whole scheme of time, it was good mentally for me to have this one done.
On the day that I turned 41 (by sono) weeks, I lost my mucus plug. I was also
having prodromal labor. I would contract every 15-20 minutes and it would go
most all day and end at night. The contractions were never that bad, and they
did not bother me, other than they never seemed to bring on labor! I
started having bloody show two days later, so I knew that my cervix was changing
then too! Now, if I would just go into labor… I went through the weekend with
no labor.
Monday, May 8th
J was not worried when we went past the 4-27 date. (I lied about my LMP to give
myself an extra week.) In fact, she said that she would let me go past the 42
week mark. However, when we hit the 41 week mark with no baby, she started to
get concerned. The biophysical profile test that she had said I would need after
42 weeks she wanted at 41 weeks. I took the first BPP at 41 and 3 days.
Everything was great. Sarah was doing really well, she scored a 6 out of 8,
which we were told was a great score.
We took the results to the office, and J was not
impressed. In fact, it seemed to really build her concerns. In a move that
seemed really unusual for J, she and her partner started getting onto me in the
open front office. We were the only clients there, but I was really unnerved by
this. I felt like I was being tag-teamed. When we arrived at the office, I was
contracting and having bloody show. By the time we left, both had stopped
completely.
J was very concerned that I had not gone into labor, and told me that I needed
to do something to bring it on. This language somewhat surprised me because I
thought that labor was not in my hands. She told me that the sono I had was not
as good as having a radiologist-read scan so I would have to go back and do one
the next day, and then maybe even the day after that, as long as the results
were good. But that I would have to have the baby before I turned 42 weeks. I
was told that I needed to take castor oil, have sex, continue the EPO, and let
her strip my membranes. I told them I would think about these things, and let
them know.
There was so much pressure at this visit. I never dreamed I would
feel the pressure of the clock before I ever went into labor, and that is
exactly what I was feeling. (This was one of my big labor fears, that I would
have to have the baby by a certain time or I would be sent to the hospital for a
section.) I cannot write down how scared and uncertain I felt after this visit.
When I called Delilah, I was in tears. I did not know what to think or do still,
but eventually I knew that things would be okay. I felt very lifted up by
prayer, and I was weak and bruised, but far from beaten. I told Delilah to
please keep having her prayer warriors lift me up.
We went to bed that night with a few decisions made. One, I would not have my
membranes stripped. I had Group B Strep, and I did not want antibiotics which
might or might not spare Sarah the infection. We would think about the castor
oil later, and we were not doing it before we went to bed or the next morning.
Tuesday, May 9th
The funny thing about the 9th of May is that this was the day
that C returned from her graduation from midwifery school. So, she could be at
our labor after all, which if I had to go later that seemed like a great thing
to hold out for! We knew that the phone was going to be ringing asking us to
make a decision, and DH without my knowing called up J and told her we would not
make any decisions that day. We were going to the zoo and spend time together as
a family; we were not going to do the BPP. He felt we were justified in the
decision since the first BPP was so good.
We had a great time at the zoo. J called [afterwards] and was really upset that
we did not do the BPP. After that, DH took the phones off of the hook. I think
every ounce of strength I had was gone by the end of Tuesday. I cried, DH cried,
and we both prayed. This was the hardest day of the entire pregnancy.
I was asked a question by someone unexpected, and it hit me very hard. The
question was when was I going to give up? When was the magic date? The answer
was simple, I had no clue, but I could not take many more days like Tuesday. I
was going to lose my mind if I did. I was beginning to think that maybe I was
going too far, but I always came back to the BPP from the day before… how
could she be so healthy, and then not be? She was moving around, and I knew in
my heart that she was fine. At this point I was required to take fetal movements
three times a day. I did them more like five times a day, and she was always
hitting her number of movements within 30 seconds. These were not the signs of a
baby in trouble. DH and I just held on, and decided that we would pray and take
things one day at a time. We were both so exhausted that we just went to bed.
As an interesting side note, there was a girl online who had been fighting
being induced and although she lived in New Zealand where the midwife standard
of care is used, she was well past her due date and getting frustrated. She kept
insisting on not being induced, but finally went in for induction and ended up
with a c-section. I was really sad for her; I think I was identifying with her.
She and I were the last on the board of April Moms that I knew of. I guess you
could say, then there was one.
Wednesday, May 10th
What a difference a day makes! When I got out of bed, I felt really good. I felt
so strong, almost like I could fly. DH was very beaten down, and it was clear on
his face, but I kept telling him all would be okay, and that we would have this
baby very, very soon. I could feel it. I told him that all the prayers people
were praying were lifting me up. My optimism even spread to DH.
We went and did a second BPP in the middle of the day. This
turned out to be a blessing. Our scanner for the day was so nervous about doing
this scan and doing it correctly that he took measurements multiple times! The
good news was that I was fine and so was Sarah. She had great fluid levels, he
saw fetal breathing motions, and all her parts were accounted for and
functioning great. She had an estimated weight of 9lbs 12 oz. The scan had taken
about an hour and a half because he was working so hard at doing a good job…
When I got up to leave I had a contraction, and he said, "We were all
afraid you would go into labor and have your baby here." I laughed!! I said
if that was all it took, I would have come here weeks ago!
Delilah and her apprentice/daughter V came over later that
afternoon, which was great. We all knew that on Friday I was going to exceed my
midwife’s protocols. So, if I did not have Sarah by then, I was going to have
to do something else. The conversation about options went on for quite some
time, and it was good to get all the cards laid out on the table.
That night DH and I went to bed feeling good, but knowing that we had one day to
go into labor. I had a feeling we were not going to do that, but I was
optimistic that everything would be fine.
Thursday, May 11th
When I woke up on Thursday, I did not feel as high as I did on Wednesday, but I
knew I was still lifted up. I knew I would not go into labor. I knew that Sarah
was going to come in the Lord’s timing. I had quit taking the herbs, and I was
not doing anything artificial to bring on labor.
That morning I spoke with J and she had to lay her cards out on the table, and I
felt bad, but I know that she was disappointed in me that I would not take the
advice of castor oil, herbs, stripping, etc. I did not think that making myself
as sick as a dog was the way to go into labor. What if I had a long labor, and
nothing left to give because I was so sick? What if it had an effect on Sarah
and or put us both in danger? What if it wasn’t time for her to be born yet? I
thought N’s induction might have worked had he been in a better position and
ready to be born. I had dilated quickly, but he was in an awful position. J’s
point was that I was headed to a section the next day if I did not have her and
was it worth it to put all my eggs in those baskets. I knew that I would not
willingly lay on the table at that point. Not with Sarah doing so well.
Really, wasn’t that the question…When would I give up? I can’t tell you
how many times I was asked this question in various forms. When will you end
this, Why won’t you just have a section, A section's not that bad… and my
favorite, Why won’t you put your baby first? I was frequently made to feel
like I was so selfish for holding out, which is ridiculous. Sarah was doing
great. I felt like I was being made out to be a bad mother for waiting. I think
it is important to say until I felt that the Lord was leading me on that path,
and as long as all the tests said that Sarah was fine, I was not going to
willingly lay myself down and have my body violated at my own request. If Sarah
was ever in any danger, I would have been the happiest section patient ever
operated on. I really believe that holding off was in Sarah’s best interest.
C-sections are a wonderful option for women and babies in danger, but not for a
perfectly healthy baby and mother.
After talking to J, I was very upset. I knew what she would say, and I knew she
was in a difficult position. Her protocols required her to give my care over. I
understood, and I knew it was coming. I went to the chiropractor for an
adjustment, and Dr. M did some additional pressure points. Her husband Dr. P did
acupuncture. On my prior acupuncture visits the whole procedure was pretty pain
free; this time that was not the case. He was determined to bring on
contractions, and he kept upping the TENS unit (adding electrical stimulation
to the acupuncture needles); I was very uncomfortable… but I was having
contractions. I was at the office for about two hours. Poor DH and Delilah were
worried, and DH even called the office to see if I was okay. Everyone knew I was
upset.
When I came home Delilah told me about a midwife she called and
asked about me hypothetically. The midwife, M, had already called her back and
asked why the hypothetical client hadn’t called her. Before I could get off
the phone with Delilah, J called, and I could sense her disappointment in me, as
well as at the situation that we were in. I called Delilah back, had a good cry
over the situation, yet again, and we agreed that I would get off the phone,
refresh, pray and call M.
M was such a pleasure to talk to. I said, “Hi, I am the hypothetical patient
that Delilah told you about!” To which she replied that she had been waiting
on my call. We both laughed. She was not at all concerned about my having
had two prior sections, as long as I realized what the risks were, and she was
not worried at all that I was starting my (ahem) 42nd week. (Again, I was not
telling that by LMP I was 43 weeks.) The first thing that she said that made me
take a huge deep breath was after I made a comment of falling out of the norms
by going late. She immediately corrected me and said, you fell out of the
averages, not out of normal. I don’t know how I did not fall out of my chair
when she said that. Tears of joy came to my eyes, and I told her, you are so
right. We spoke for quite some time, and agreed to meet in her office the next
afternoon.
After we spoke, I called DH and told him I really, really liked her, and that I
was confident that we had a care provider. Then I called Delilah, who upon
hearing my voice, said I can hear your relief. She was right. I was so relieved.
I had a back-up plan, and I knew that I could go ahead and gestate in peace now.
It was like having a huge burden taken off of my back. I felt like it was okay
to go into labor. However, that was the first night that DH and I went to bed
and I told him tonight would not be the night. I knew I needed the rest, because
Friday was going to be another hard day.
Friday, May 12th
Friday was the day that I needed to meet with J in order to get my discharge
from her practice. I knew it was coming, and I was outside her protocols.
I knew the Lord would give me the strength to do what I needed to do and the
grace to handle J with love and mercy… like I expected her to treat me too.
When I arrived I was surprised to see C there. Friday was not a
day she worked, and I knew she was there out of support for me. What an amazing
gesture, and she will never know how the Lord blessed me through her. I brought
up that I knew J was here to discharge my care, and I told her that I
understood. She asked me if I was going to go to an OB or hospital to have a
section. I said no. She explained that she thought that I was making a mistake.
I said I know that you do, but I don’t believe that I am making a mistake.
She then asked me the million dollar question…When will you give up? I gave my
truthful and usual answer, “I don’t know.” She explained that every day I
was past due increased the chances of bad things happening. I explained that I
had read up on post- maturity syndrome, and that I was aware of the dangers. J
went on to share information that did not necessarily correspond with what I had
read completely. I then said, “Well, no one is pregnant forever, and I know my
body will go into labor when it is time.” (Immediately Isaiah 66:9 came to
mind," Do I bring to the moment of birth and not give delivery?" says
the LORD. "Do I close up the womb when I bring to delivery?" says your
God.) J’s answer to this was surprising. She said that not everyone goes into
labor, and that I could be one of them. She had seen it many times.
At this point I realized that we had a core philosophy difference. I did believe
that given time my body would work. I had no idea why I had not gone into labor
like the averages said I should, but I did not think it was my time yet. She
thought that my body had failed. The big problem that I had here was that she
had experience, and I was going on theory. That is one of the things that made
C’s being there so special. It was okay for me to stand up and make this
stance because I was not alone, operating on theory. There was someone else
there who was standing up with me; someone with experience and ability, and who
shared my philosophy. I was able to stand firm, and lovingly disagree with J.
Finally J had me sign a document to absolve her of any poor
decisions that I made from that point forward. I knew that the language would be
strong, but I did not agree with the paper that I signed, and I felt like it was
scare tactics. However, I signed my name. I did it quickly and quietly, and just
wanted to leave then. I only signed that form for J’s peace of mind. If anyone
else had requested that of me, I would have refused. I did give J a hug,
promised to bring Sarah to see her, and thanked her for all the help and care up
to that point. It was clear that we both disagreed with the other’s decisions
that day, but I know to the core of my being that that visit was not easy for J,
and that she was giving me the best care she could. C and I said quick
goodbyes in the parking lot, and I verified that she would be willing to work
with M on my birth. Her smile was amazing!
At this point I was off to go meet M. We spoke to each other for almost two
hours. She shared birth stories with us that made me cry. She explained
that going 42 weeks wasn’t abnormal, and that she herself went almost 44 weeks
with her daughter, and that her mother went beyond 44 weeks. She told us how
much she loves doing VBACs because women appreciate so much more the gift of
natural birth when they have had the alternative. We just loved M, and DH was so
relaxed with her. They were joking together and I thought wow, this is great. We
were completely at ease with her.
Toward the end of the visit, she wanted to check heart tones and gave us a heart
monitor in case my water broke at home. This way we could monitor for problems
such as prolapse right after. I asked her if she wanted to check me and she said
nope, not if you are strep b positive. I was so excited! Another thing we were
on the same page about. When M checked Sarah’s heart rate, she had to place
the monitor very, very low. She asked if this is where it was normally heard and
I said no. She said she is into your pelvis if the heartbeat is gotten that low.
She did not think that CPD would be a problem. This was not something I could
fully register with more than a giggle right then. From this point forward there
were a lot of things that I couldn’t fully understand or appreciate until
hindsight.
As we were leaving, DH handed over the credit card for our down payment, and I
ran to the bathroom. M was actually going to do our birth. I was so calm and so
excited. I felt like I could dance. Amazingly enough, the bloody show returned.
Maybe we would be calling M in the middle of the night….
Saturday, May 13th
The next morning I woke up, and almost immediately began having contractions.
This was nothing new. In fact it had been going on during my waking hours for at
least 10 days.
I called Delilah to vent my frustration. She assured me that it was normal to do
this, and told me the story of the Little Engine that Could. Each time I did
this, I was getting somewhere, and to keep thinking I can. Eventually I would
get over the hill and all the children would cheer because I had the candy and
toys. The visualization made me laugh, and for whatever reason stuck with me.
After [a birthday party], Delilah called and asked how I was doing. I explained
that I still thought this wasn’t labor, but the contractions were getting much
closer together, like 5-7 minutes apart. [When Delilah arrived], I asked
if she would help wash the table off. DH teased Delilah about our getting the
platinum doula services. She was cleaning our house… would she mind mowing the
yard? Delilah laughed, and declined to provide the mowing services. She thought
we might need her help today and she did not want to smell bad.
I still disagreed about being in labor, but gosh those contractions were coming
quickly, every 3 minutes. D thought I should call M to give her a heads-up.
But I had thought so many times this might be labor and every time I was wrong.
I did not want to embarrass myself in front of this new midwife. Finally Delilah
said, “Do you mind if I call her?” I agreed. I nearly cried even then
because I just knew I was making too much of this. But I was having a hard time
controlling my emotions, and I was on the verge of tears.
When Delilah called M, she asked her if she had her birth supplies. It never
dawned on me that she might need extra supplies and more of a warning. Luckily M
was close by with her student and she had all her supplies. She was surprised
that I was having contractions since she had talked to me earlier and I said
nothing about them.
M and her student arrived. M had a huge smile on her face and
asked me if I thought we might have a baby today. I told her, I don’t know. I
wondered if she would check me and tell me if I was in labor or if this was more
of the prodromal labor-ish stuff. She said sure, and that while she was at it,
she would do a pelvic assessment. When she checked me on the bed, she said,
“No need to do a pelvic assessment, your pelvis is perfect fine since your
baby is already down, you are dilated to a four, fully effaced, and have a bulgy
bag.” I immediately began to cry. MY BODY WAS WORKING! I WENT INTO LABOR ON MY
OWN!!!! I had not done anything to bring on labor, but the time was at hand.
PRAISE GOD!!!
Delilah called C, and she was on her way to assist with M! YEAH! Things were
starting to move right along. M took my blood pressure and it was 104/60. I was
so relaxed! It’s great being at home! Don’t get me wrong, the contractions
were causing me to take notice and breathe. But I was so excited and riding so
high.
I decided to take a shower. I asked M if it was okay, and DH said, "Brandy,
this is your house, and your decision. If you want to take a shower, then take
one." While in the shower, the contractions really kicked it up a notch.
They were almost unbearable. I felt nauseous, weak, and like I could not keep
doing this. What a huge change! The water felt great on my back, and the cold of
the shower wall felt great on my forehead, but the contractions had really
gotten so close together it felt like they were on top of each other. Standing
had always made the contractions worse, but wow. This was really intense! I got
out of the shower and asked if I could be checked again. I thought it’s time
for this baby to come out now!! M checked me and I was a 5. DH was really
pumped, and I was like what??? Only a five?? I had a miniature panic in my head
thinking, " I can’t do this."
When I laid down, the contractions were still coming, but were more bearable. DH
had the big fan going, and he cuddled me, Delilah was offering verbal comfort,
and making sure I was comfortable. C was there answering too and rubbing my
legs. I was really afraid I was going to blow this opportunity. But as I laid
down, closed my eyes and things got quiet, the only person I was aware of being
there was DH. Things were quiet, and I felt like I was regaining strength. The
contractions were coming, but laying down on my left side they were less
intense. This break really helped me get my thoughts back together, and I prayed
for strength and wisdom. I opened my eyes and I was so surprised to see Delilah
still there. I had really phased out, and only knew DH was there with me. She
was sitting on the floor reading the Bible, and she read to us a Psalm that she
was reading and praying for us. It was a beautiful moment.
After she finished, I asked if I could have my birth ball, since
I wanted to sit rather than lay down and slow things down. I was under much more
control by God’s Grace and it was time to get down to business. Delilah and C
came in the room, and DH helped me get on the ball. Periodically throughout all
of this they would come in and take the fetal heart tones, but I don’t know
how often. Time was pretty meaningless. I remember thinking as the contractions
were on top of each other on the birth ball that I could not do this for another
12 hours. The contractions had gotten to where they were just on top of each
other. They were not impossible to ride through, but some really were so
painful. I was thinking in between how different this was than pitocin
contractions. Pitocin had the contractions right together, but the pain with the
pit was so different, and so much larger than these contractions. It was helping
me deal with the contractions I was having to think about that.
I suddenly felt a popping sensation, and I thought my water must have broken.
Turns out I was wrong, but Delilah said you should get up and go to the
bathroom. I had been having trouble getting urine out, and it had been a while
since I went to the bathroom. I agreed, but when I stood up, I started
pushing!!!
The sensation for me was very overwhelming. I wasn’t sure I could move, and I
was amazed at the power going through my body. M came in to check me, and told
me I was complete except for a cervical lip. She said she could break my water
to help the lip disappear and I all but begged her to break my water. She told
me to get up on the bed... M broke the bag of water. DH stood next to me, and
Delilah got on the other side of the bed to help comfort me. Delilah also got
cool rags, and made sure the pillows were in the right spot for me to be as
comfortable as possible. I looked at the clock for the first time and took in
the time. It was 8:10pm.
I had said that I did not want to be told when to push or
how to push, unless it would keep me from tearing. M and C were great. They told
me that I should avoid pushing unless I could not help it since I still had the
cervical lip. They said that the lip was disappearing with little pushes. Once
the lip was gone, they told me to push, but take my time about it.
Once I began pushing, M and C were putting warm compresses on the perineal area.
THAT FELT SO GOOD. It made it so much easier for me to calmly push, and felt so
good in between the pushes. As I continued to push the feeling became less
overwhelming and much more empowering. I could hear DH praying for me, and
everyone assured me I was doing great. I was having a hard time believing she
was coming out though. I kept asking DH over and over if she was really coming.
I was sweating like I have never sweated in my life, and I felt like I was
grunting so loud with each push. I was sure I was scaring my kids! I am told
that I was not that loud, but in my brain I was really, really loud. I continued
to pray in between contractions, and even once “yelled” for the Lord to help
me. He certainly did.
I continued to ask DH repeatedly if she was really coming. I was afraid that I
was not doing things right. Finally, Delilah tells me that they can see her
head, and M invites me to feel her head. I was sure I did not have the ability
and strength to do that, but I asked DH to look. He said he could see her head,
and it gave me renewed energy to draw from. I was actually pushing out my baby.
I started to enjoy the pushing as much as a person can when they are at that
stage. M would tell me when to stop to avoid tearing, and I started to recognize
the sensation and stop before she said to. She would point to different areas on
my perineal area, and tell me to relax/melt that part. I have no idea how, but
when she touched it, I was able to relax that area. (Later she told me that she
had read that from a famous midwife’s book, and she did not know how it worked
either, but it did.)
Finally they tell DH come down here to catch your daughter. I was so excited,
and I just could not believe that my husband was about to catch our baby. Her
head was totally out, and I needed to push out her shoulders and body. She had
not made a noise yet, and I was told there was quite a bit of meconium. I
finally gave a last push, and I felt her body come out of my body.
I JUST DELIVERED OUR BABY. I could not believe it. DH was
laughing that Sarah had more of a controlled fall, and was kissing me and
telling me how beautiful she was. I kept waiting for her to cry though. I was
getting scared, and M told me that she was great, she just wasn’t ready to cry
yet. She was still getting the cord blood and was going to be fine, but we would
not be able to harvest the cells because she needed them. Since we had the
meconium it was ideal that she start breathing on her own, rather than suck in
the fluid. M and C got out the syringe and asked Sarah to please not make them
do that to her. She immediately began crying. What an amazing noise!!
I started to cry and said, “CPD my ass!!!” (What an incredibly crass thing
to come from my mouth at such a beautiful moment!) I could not believe that I
had just given birth to our daughter. The tears were just flowing. I also made
mention of the Little Engine that Could and told Delilah that that children were
cheering.
I wanted to see Sarah and I needed to flip over. Since she was
still attached, this was going to be a little tricky, combined with the fact
that there was meconium all over. As I was flipping over, the placenta came out.
I apologized! I had never felt another contraction and was not aware it was
coming! I was appalled that I could be so unaware of the placenta coming out!
Sarah was so beautiful, and reminded me so much of N. She looked so much like
him when he was born. DH cut Sarah’s cord, and she began to nurse. It was so
awesome! I was so thankful to everyone for being there, and for making her birth
so beautiful. I was so humbled, and amazed, and just felt so much disbelief that
I had just had our daughter. We called our moms to let them know.
I took an herbal bath. DH took Sarah to meet N and I. They
were a little surprised but very excited by their little sister. M did a quick
check on me. My bleeding was great, so there was no need for any kind of pitocin
shot. My uterus was feeling like it should, and was shrinking like it needed to.
But the best news of all was that I did not have any kind of tear or even a skid
mark. I was so amazed. M did not think I did, but the exam conclusively showed
she was right. I was sure I didn’t tear as well since I was not in pain, and
when I went to the bathroom there was not any burning. Amazing!
After that, it was time for Sarah to get the newborn exam. Delilah went around
asking how much everyone thought she weighed. I thought she was in the seven
pound range. She seemed so small to me. M laughed out loud when I gave that
guess. DH guessed 9 lbs 12oz, and it was my understanding that almost everyone
else was thinking over 10lbs. She was 9lbs, 8oz., 20 inches long, and had a
14.25 inch head circumference.
She was healthy as could be, and it was great fun
to be able to watch and ask questions while the exam was going on. No one was
taking Sarah out of my sight without asking me first. I was just amazed. After
the exam, I got Sarah in her first diaper, and got her dressed. I was in a state
of disbelief. My baby was right there, and I was STANDING, laughing, and getting
my daughter dressed.
After the exam, I was told I had to eat before they left. I had pizza and juice.
It was really good. They finished up paperwork, and sure enough, they were all
gone. I sat there with my older children asleep, DH fading fast, and little
Sarah crashed out. I was so wide awake and I felt like dancing. I knew I needed
to sleep, but I had to sit and take in my life. What an amazing gift this day
had been.
I am still so thankful to the Lord for the Grace I was shown. I had the most
amazing birth that ever occurred. I really believe that, and I praise God!
Syeda's Story (2 c/s for frank breech babies, VBA2C)
Kmom's Notes:
Birth Story
Monday night, my BH [contractions] changed character; I had 2 before bed that actually hurt a little, and I felt them in my back. I hopefully told my DH that we might be wakened by labor that night. I felt more contractions each time I woke for the bathroom, but woke in the morning still pregnant. Tuesday I was full of hope and energy. My kids were in preschool and daycare and I thought I could finish all those jobs that I needed to finish before going to the hospital. I was looking forward to the jihad (struggle) of real labor finally starting. My doula and I agreed that I would probably have the baby before Wednesday night. I accomplished a lot that day---3 loads of laundry, cleaned the kids' room, checked their bags...for their stay at Auntie's house, a big pile of yucky dishes cleaned....
Early...Wednesday morning, I [woke to finish folding the laundry]. I woke DH at dawn when it was time for the early-morning prayer, then I went back to sleep until the kids woke up. Sweet DH took the kids to work...all day as we were sure it couldn't be much longer. There was brownish goop on the t.p. all day and painful contractions in my back, but they never got regular or stronger. By late afternoon I was getting tired and discouraged. I tried nipple stimulation a couple of times. It really got the contractions going, and maybe 3 min. apart, as long as I kept it up. At that point I wasn't ready to do nipple stim until my labor became self-sustaining. I also wasn't ready to tolerate the moaning contractions nipple stim caused. I knew that if I had that kind of contractions without the nipple stim I could tolerate them, but the nipple stim was distracting to me. Also, I knew I had a NST the next morning and I really hoped to deliver before that.
Thursday morning a very, very tired me was still pregnant, still having painful irregular contractions, and feeling like time was running out. I considered myself officially 42 weeks. I wasn't really worried about the baby, I just wanted to pass my NST so I didn't have to think about the OB suggesting CS or induction, my greatest fears. DH and I want more children and I know it would be difficult, at least, to find a dr. who would attend VBA3C paid by Medicaid.
We 'passed' the NST but only after DH started talking to the baby. One of the reasons I picked this hospital was the newborn hearing test. Now the test was proved unnecessary because clearly baby could hear Baba just fine. How about that---not even born yet and Baba is already 'the sun and the moon' to this one too.
From curiosity I allowed an internal. She thought I was 2 cm and 90%, but admits she may have stretched me a little, without asking or explaining (1.5 to 2 cm). This must be why this was the MOST PAINFUL internal I have EVER had. I could kick myself for shouting OW instead of STOP, esp. after hearing, "I'm going to make sure you go into labor today." When the OB was finished I felt so violated and embarrassed to have let it happen. Thank God my DH had gone to the waiting room, no telling what he would have done. At home later, I wrote the ICAN support group online, thank you all very much for your support.
Later, Thursday afternoon I realized that I had been feeling pressure against the inside of my right hip. I assumed that it meant baby was malpresented, so I did some lunges hoping to knock baby loose. I waited until after Friday worship before I tried blue cohosh; guess what, no contractions. I quit the cohosh in the evening and the contractions stepped up to OOOOHHHH contractions. I suppose this change should have alerted me to impending birth, but it didn't occur to me at all. The contractions didn't feel any different. Early Saturday afternoon more cohosh, but no contractions. I took a nap late in the afternoon and slept through the next dose of cohosh. SURPRISE, the contractions returned. It never occurred to me that cohosh could stop my contractions. I must have had the dose wrong. DH called from work. Someone had given him tickets for the 7 p.m. Shriner's Circus. He and the boys would be home after. I told him to enjoy himself, knowing that if I needed him I could call his cell phone. I called my doula in the early evening and told her I was thinking of going to the hospital just to check and see if I had made any progress. She offered to give me a ride when she heard some of those contractions. I wanted to wait for DH and the boys to return. I still doubted that the baby was imminent. The boys returned around 9 p.m. I told DH I wanted to go get checked. I fully expected to return home later that night in spite of the contractions I was having, after all this had been going on for almost a week already.
We parked as close to the ER entrance as we could. OK, picture me, a 42 week/2 day Muslim woman, covered Saudi style. I wished I was more comfortable with Unassisted Childbirth, especially after 9/11. OK, prepare for the worst, but expect the best. At the desk I showed my tummy and was reminded which elevators to take to L&D. I looked at the wheel chairs as I walked past, thinking, "Oh, I don't need one of those." My labor seemed to be on hold at this point.
There were at least 4 nurses at the desk when we arrived at L&D. I told them I was in labor and I just wanted to check and see if I had made any progress. In triage, I answered "I don't know" to all the usual questions. "When did this start? How far apart are the contractions? Water broken yet?" After I had given my sample and changed to a hospital gown, the nurse checked me. "You seem to be about 6 or 7 cm." "YAAAAAH! This will be over soon." (Picture me dancing on the inside.) We settled into a nice room across from the OR. I didn't care, I knew I was going to deliver just fine. This was about 10 p.m.
I was hooked up to the monitor to give them their reassuring strip. I called my doula to let her know we were staying. Baby's [heart tones] were great but my contractions didn't show at all. I leaned back to relax...When my doula showed up I had been on the monitor for about 45 minutes and was ready for a bathroom trip. She got them to let me loose so we could try to speed up my contractions. Labor seemed to still be stalling. I think I wasn't quite settled in yet. She and I walked down the hall and back, hey, just in time to be monitored AGAaaaaaAIN. My bad luck, the only position they could get clear tones was laying down (protocol every 15 min). My good luck, the MW from my OB's office was on call. I really like her, she's very warm (guess whose b-day is the same as baby's).
We watched Saturday Night Live as I labored. My doula said she had never seen anyone as far along as I was and still laughing and joking. Whoever was closer (doula or DH) applied pressure to my back when a contraction started. I think I had been there 2 or 3 hours when I realized I was feeling pressure against my right hip again. I did lunges to swing the baby more to the left; it seemed the right thing to do. My OB, MW, and labor nurse were in and out, just watching.
Somewhere, I assume between 1 a.m. and 2 a.m., I was up trying to decide what I wanted to do next when I had a sudden urge to pee. When I wiped myself I saw lime green on the paper. I knew instantly my water had broken. I saw 'something' in the toilet when I stood up. "There's merconium," I told the collected crowd as I exited the bathroom. At 42 weeks 2 days I knew it was very possible, but I never really expected to see it and it scared me. The nurse did a test for amniotic fluid, of course it was positive. Nobody freaked out over the merconium, so I let it go.
My contractions picked up at this point. I became serious shortly thereafter. My memory of this part is very fractured. I am in the bathroom. "This is transition, right, it's almost over," my doula agrees with me. Walking from the bathroom I look at the TV as one of SNL's actors makes a joke; I laugh hysterically half-crying, thinking, "This is not THAT funny." I have to look away to stop laughing as I notice a contraction building. I try pushing in the bathroom without telling anyone, thinking, "Is it time to push yet?" I remember a contraction where I put my face to DH's chest and just scream until it is over.
"What do you want to do now?" the question comes through the air as I pace by the bed. I'm lost. "I don't know," I say. I walk, I squat, I search for what I need. I am back in bed, (monitoring?) I am on my left side having a contraction. Dh is pushing on my back and the doula is pushing down on my hip. DH's hand is in the wrong place. I reach to move it and my elbow connects with his head. "Sorry, move your hand HERE. Better." "Make du'aa (supplication), say "ya Allah," think of all the sins you're paying for, "ya Allah," "ya Allah," I breathe. I feel better.
MW says, "You're almost there but you're more dilated on the left than the right." A voice in my head says, "You heard her, roll over so you can dilate better on the other side," so I do. I hear her as if from far away, "You're 9.5 with a lip." I can see her hands 'down there' doing something. "Oh well, it doesn't hurt." I let it go.
3 a.m. Doula asks, "Why don't you try hands and knees?" It sounds good so I try. PAIN explodes in my rectum. I fall onto the bed on my side. "God it hurts," I think, then I'm pushing or trying to. A voice in my head is saying, "Don't take too long to push or you may run out of energy." I'm on my right side, someone lifts my leg. My legs are out straight, someone is holding the top one up. "This is not working, "I think, "What am I doing? There should be pressure on my feet." Between contractions I roll onto my back searching for somewhere to put my feet, something to push against. My feet are guided into the stirrups and one of the leg supports is in place. I'm trying to push; those #%$ stirrups are too far away. I try to escape over the head of the bed during the next contraction. I'm not really thinking, I'm just doing. MW's voice from so far away, "No, you have to come this way, towards the foot of the bed." My hands are pulled down to the handholds near the bottom of the bed; the other leg support is in place. This is what I was looking for. More disembodied words, "Curl in when you push. Yes, that's the way." Through a veil I hear how well I am doing. With the next contraction I move my feet to the near edge of the leg supports. I am 'squatting' on my back and PUSH, pulling with my hands. I feel it working. Doula takes my hand, "Here, feel the head." My hand is moved to this spongy, wet, hair covered thing coming out of me. "That's not what I thought it would feel like." Another contraction. I grab the handhold again and PUSH. I know I'm almost there.
3:17 a.m. PUSH, so slippery, oooohhh wow, the pressure is gone. I melt with relief. MW closely followed by DH announce, "It's a girl!" There's a baby on my tummy. "It's a girl?" I ask the air. I hadn't let myself think this one might be a girl, I've wanted one for so long.
My jihad complete, I want to move on to BF, but this new world is too interesting to Darling Daughter. The nurse takes her. MW suggests a push to deliver the placenta. I push; there is a big gush. "Well, that wasn't the placenta," I think. A few minutes later it plops out with a small push. I wait while the MW sews up my 2nd degree skid mark. The early hour catches up with me, I'm getting sleepy. DH asked, "What do you want to call her?" "Huda," I reply firmly. Huda, meaning guidance from Allah.
If you had asked me immediately after the birth if I wanted to do that again, I would have said NO! But by 2 weeks postpartum I was not only ready, but excited at the prospect, in spite of all the monitoring....
It was important to me to see how well my body could perform, given the chance. I've seen I'm not broken, and it's beautiful.
Christie's Story (septate uterus, 2 c/s for breech or transverse babies; home breech VBA2C)
Kmom's Notes: A septum can cause problems with a pregnancy, most notably a tendency towards "malpositioned" babies because babies don't have as much 'room' in-utero. Because modern OBs no longer know how to do breech births, this means that these women most often end with cesareans and it can be difficult to get a VBAC.
Despite all of Christie's efforts to get baby to stay head-down (external version, moxibustion, chiropractic care, etc.) her baby was breech again when labor began. Fortunately, she had found care providers who were more comfortable with breeches in case the baby didn't turn. All went well and she and her baby had a lovely VBAC.
Birth Story
Baby #1: My first birth, in 2001, was a planned c/s I was hoping to avoid for breech/transverse. I worked diligently with all methods I knew of to turn him, and had successfully turned him (albeit to transverse) by the time my water broke and I went into labor. I am ever grateful for the days of pre-labor and the hours of early labor that my son and I shared, but will always mourn the loss of bonding caused by the hours of separation in the hospital for routine procedures. I believe it still affects his attachment to me to this day.
Baby #2: My second birth, though it is hard for me to call it that, was a planned VBAC. I had researched more about turning babies and hired a doula, again doing everything I knew to avoid a c/s. She also remained breech/oblique, despite the addition of techniques such as moxibustion (an acupuncture technique). The GD diagnosis really threw me psychologically, and I think also contributed to my acceptance of defeat when the OB offered no other solutions to turning her, other than a version at *39* weeks and the agreement for an immediate c/s if that did not work. For what it's worth, I question the GD diagnosis to this day, given that my glucose levels were quite good during both my second and third pregnancies.
Baby #3: Despite three external versions (one of which was successful),
moxibustion, Webster Chiropractic care, ice packs, music, breech tilts, hypnosis etc, my little boy was breech when labor began at approximately 39 weeks.
I never felt like I had given birth to either of my [prior] children and absolutely hated the surgeries. Being tied down, and paralyzed from the spinal were absolutely terrifying to me and triggered the feelings of helplessness I had felt when I had been sexually abused as a child. Moreover, even after my daughter was born, though overjoyed to have my son and daughter, I was devastated to not have achieved what I considered to be a rite of passage for women. I had always pictured myself giving birth naturally, medication-free, to my children. So many women take that opportunity for granted. I found it amazing that I had been criticized on many an occasion for wanting to give birth vaginally, when cesareans were “so much
easier.”
The comfort with and skill level of attending breech vaginal births were one of the first questions I asked prospective
midwives [when planning for the birth of my 3rd child]. I was blessed to find a midwife who is a former ICAN leader, with over 20 years experience and comfortable and experienced with breech vaginal deliveries. I also had another midwife, her partner, in attendance. The four of us (they along with my husband, Andy, and I), had agreed to proceed with a breech home birth as long as I continued to show progress and the baby was doing well as assessed by
FHTs {kmom note: fetal heart tones]. This was based on research that indicated that when labor in a breech birth was not progressing, it was indicative of a problem that would necessitate a cesarean.
On Saturday, March 11, I began feeling heaving abdominal and cervical sensations. I also had the distinct feeling that my water could break at any moment. Sure enough, I woke up early Sunday morning (1 a.m.) lying in a puddle of amniotic fluid and vernix. I was excited and called the midwife and then tried to rest. Contractions began at about 2 a.m. and were about 6-8 minutes apart and very manageable.
Contractions began to pick up around 9 a.m.—they were consistently 3 minutes apart and starting to get my attention, though still quite manageable. S, one of the midwives, came and checked me, and forgot we had agreed for me not to know how dilated I was (I was 3 cm).
Andy and my son set up the birth tub. I got in, but didn’t stay long, as it wasn’t comfortable and it was quite a production to change from wet to dry clothes.
At this point, having the kids around was a welcome distraction, and I was still able to be amongst everyone and manage the contractions (still 3 minutes apart). The worst part was actually shoulder and upper back pain that must have been from tensing up during contractions. By late afternoon/early evening, I began feeling the need to pace/circle my house during contractions (had been managing them sitting up, just pausing during my conversation). I started getting frustrated when the kids and/or their toys would get in my way while circling/pacing and was ready for everyone to leave. Instead, Andy and I went upstairs to lie down and listen to the CD I had made of music that inspired/relaxed me. I treasure these moments. It was a wonderful time to connect with the man who has supported me all of these years and given me the gift of (now) three wonderful children.
The midwives checked me and I was “on the edge of transition” (later they told me I was 6.5 cms and completely effaced). So, I was making progress, just a lot slower than we all thought would be the case. I hopped in the shower, and that helped immensely.
At this point, I decided to listen to the Hypno-birthing Affirmations Tape. This was very reassuring. I was still feeling somewhat discouraged by the length of labor, though, so my wonderful husband, pulled me into our office, sat me in a recliner and began reading my Blessingway emails from my ICAN (International Cesarean Awareness Network) friends. It was just what I needed, to be reminded of all the love and strength supporting me from all over the world.
We stayed in that room to labor, as I was as comfortable as one can be “on the edge of
transition.” We both dozed on and off as my contractions and noticeable moaning allowed. The midwives told me later, that my contractions spaced back out to 6-8 minutes apart during the night, allowing me to get some much needed rest.
My daughter called for Daddy at 1 am. Andy went upstairs and fell asleep, so I was left to labor alone. After awhile, remembering that the midwives had expected a relatively short labor, I began to get discouraged that it was already over 24 hours. I remember thinking that I had accomplished enough by laboring as long as I had and even had passing thoughts of transferring, but as soon as I realized this would mean a c/s, I quickly found the strength to continue!
I decided I would feel better being near the midwives, so I went into the room where they were sleeping to labor there. They continued to check on me hourly, which at least gave some comfort. My son’s heart rate was consistently in the 130s, like the ECVs, he seemed to have no problem dealing with labor. This was of course, very reassuring.
After the kids got up and out of the house (my son to preschool, my daughter to my mother’s), the midwives suggested I get in the pool, but I wanted none of it. I got into the shower instead. Aiming the warm water on my belly really helped the contractions be more manageable. When Andy came back, he accompanied me on my laps around the house, which was so nice. I also walked up and down the stairs as much as I could to help the baby drop down.
I tried the exercise ball, and while there, asked the midwives how I will know when to push. I was very discouraged that I wasn’t feeling the urge, even though, earlier, the midwives had implied I was completely dilated. It was especially nerve-wracking because I know how important it is to push a breech baby out quickly. Interestingly enough, although it was always a concern of mine in pregnancy, the thought of Uterine Rupture only occurred to me in passing when I would feel some twinges of adhesion pain. But, from the research I had done, I knew that’s what it was, b/c they were minor, associated with movement and would pass.
We went upstairs at 12 pm. The midwives checked me and told me that I could try “practice pushing” if I wanted to. While I did, J pushed on my son externally to help get him more centered, as he had again drifted to an almost diagonal position. I tried various positions, hands and knees, birth stool, semi-sitting, etc. and nothing was comfortable.
Pushing was a great fear of mine, because I have always had trouble communicating to my body what I want it to do, and again, I knew it was of the utmost importance to push the breech baby out quickly. Intellectually, I know that I am a large-framed person and I doubted that head entrapment would really be an issue, but it still worried me some.
At one point, my midwife, S said, “You aren’t going to get the baby out pushing that way” (taking breaks during a contraction). She didn’t mean for it to, but this really played into my fears of not being able to push correctly. At this point, my wonderful husband said to me,
"Think about the email you will get to compose to ICAN; start writing it in your
head.” He knew just what to say to give me hope! I told them I was worried and getting frustrated, so they suggested I shower and then rest with Andy.
The contractions were much stronger at this point, and the shower didn’t even take the edge off. I was still very frustrated with pushing and not feeling the urge, so S and J suggested that Andy and I lay down together again to rest. Later, S told me that I always progressed when Andy and I spent time lying together. I thought this a wonderful testament to our relationship.
The contractions were hard to handle lying down, but I was somehow able to doze between them. After only a few minutes, I had a monster contraction and literally jumped out of bed. When this would happen, I always headed straight for the bathroom, where I would usually have contractions one on top of the other. I heard S say to Andy in her mother tone, “I thought she was
resting.” Both midwives were downstairs at this point. I asked him to ask
them if I should push if I felt like it (and I did) and they said “Sure.” I reached down and felt into my vagina and felt something, which I guessed to be a foot.
Andy went and got the mirror and flashlight and sure enough, a foot was emerging. I could see the wrinkles on the sole of his feet—so exciting! I began grunting and involuntarily pushing at this point and suddenly, heard the midwives rush up the stairs. The sound of their feet stomping up those stairs is one I will never forget! It was really getting exciting! I was going to do this!
The midwives quickly set up the birth stool and moved me from the toilet to it (figuring I didn’t want to have him on the toilet). By the time I stood up to move, his foot was hanging down. Just a few pushes (and about 7 minutes) later, and our little Ryan joined our family! It was absolutely amazing!!!!!!!! I had been worried my body wouldn’t know how to push, but it knew exactly what to do!!!!
As soon as he was out, I began bleeding quite heavily, and the midwives very calmly moved me to the floor. They kept asking me if I was there with them, and I was getting annoyed, and told them of course I was. Later they told me that I had lost all the blood I was “allowed” to lose and they were worried I would lose consciousness. I was just elated with my baby, the birth and my body and annoyed to be lying on the uncomfortable hardwood floor!
I do feel some sadness when I think of the way my other two children entered this world, especially my daughter, who was in almost the exact position that her brother was in (almost diagonal). I have slightly more peace with my son’s birth, given that he was transverse and my water had broken, making a version unsafe according to my research. But, again, I didn’t know then what I know now and I don’t think I would have appreciated Ryan’s birth nearly as much if it weren’t for the first two births.
It is amazing to me how far-reaching the impact of this beautiful birth has been. I truly feel like a different person; more at peace than I was before. I look at life with a lot more joy. And, I feel much more “whole” as a mom. I think a part of me didn’t feel right even giving myself that title before, since I hadn’t really given birth to them. Sad, but true.
I can’t thank the women of ICAN enough and I plan to do what I can to give back as an ICAN Chapter Leader.
Devaskyla's Stories (SROM, induction, cesarean with seroma; unassisted home VBAC)
Birth Story
Baby #1:
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.
Baby #2:
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.
About 10pm on Thursday, I went to take a shower (aka hiding out from my mom phoning to find out what was going on). While I was in there, I also scrubbed the tub a bit, since it had been driving me nuts for days. Near the end of my shower or just after I got out, labour suddenly kicked into high gear. From every twenty minutes or so (we weren't really timing, except for one or two contractions occasionally), contractions moved to 15 minutes, then 7, then 2, in less than a couple of hours.
Sometime around 3/4am on Friday, I started getting pain in my back, too. Until this point, all the contractions had been in a band extremely low down in my belly. Once they started hurting in my back too, I just couldn't take anymore and decided to try sitting in the tub and using the sprayer during contractions. Unfortunately, we only had one and it didn't stretch very far, so either my back or my belly got sprayed, and it was very difficult to get my back without standing up, which I didn't want to do. My husband put a pillow in the tub with me and I alternated between sitting up and leaning back. Sometimes one seemed to work, then the next time it would make it hurt worse.
I finally got my husband to put the plug in (I couldn't reach and didn't really have room to move) and let the tub fill while I used the sprayer. Once there was enough water, my husband started using a cup to pour it over my back during contractions while I sprayed my belly. The pouring didn't really do anything to lessen the pain, but it did give me something that briefly distracted from it, which was nice.
By around 7 or a bit later, I'd been out of the tub for while and the only way I could endure the contractions was to push during them. I don't know if I was fully dilated or not and I didn't feel what I would call an "urge", but the pain was manageable when I was pushing and excruciating when I wasn't.
Sometime after I started pushing, my husband checked me and said it felt like the baby's head was jammed against my bones. I think the baby must have been stuck for awhile, because on several pushes my husband and I noticed that my stomach was bulging out, which it didn't do when I pushed later, after he was unstuck. I spent several contractions on my hands and knees, no idea how long, but when husband checked again, he said it seemed like the baby was even more stuck and had moved back. I decided to try lying on my back for awhile to see if that made any difference.
I don't remember if I did it because I remembered someone mentioning it, because it felt better or because husband had written to the ICAN list and a couple people mentioned it to him, but I started arching my back during the contractions, occasionally alternating with sitting up and leaning forward, which seemed to also make it hurt a bit less.
The arching seemed to be working, but I couldn't really do it very well due to the problems with sciatica I'd been having for months (I was going to be going to the chiropractor that week, but never went because of the leaking). I had some pillows and a cushion under my head, so I got rid of the pillows, which helped me arch a bit better and I heard a slight sound kind of like bone on bone.
I knew then that the arching was probably making a difference and I wanted to be able to do more of an arch, so I left my cushion where it was and slid so that my head was on the floor (our bed was just a mattress on the floor). I then planted my feet on the bed and used the cushion to help me get a bit more arch. After a few times of this, there was a loud, several second long, sound of bone on bone. I didn't feel anything, but I must have subconsciously noticed something, because I don't recall doing much, if any, arching after this point.
During all this, my husband and son were in and out of the room and shortly after my husband came and lay down on the bed next to me. I seemed to be getting a bit of a break between contractions at this point, though they were still extremely painful. My husband was so wiped, he fell asleep for several contractions. At some point, they must have eased off enough that I was able to sleep briefly, too. I have no idea how long we slept, my husband seems to think he only slept about 20 minutes, but he actually fell asleep twice, once was when I was asleep too, so it was probably longer than that. I woke up and dealt with a few contractions before they got bad enough that my moaning woke my husband up.
I continued labouring in the bedroom for awhile. My friend, J, called around 12:30 to see how things were going. We had planned for her to come watch our son if needed and maybe offer some reassurance to husband (since she had had a VBAC herself), but our son was doing really well and my husband had been coping pretty well, too, until it seemed like things were dragging on forever. She managed to reassure my husband some. Around 1pm, my son fell asleep on the couch in the living room, so my husband no longer had to go back and forth between us.
By this point, I was just thinking about the next break between contractions, they hurt so much. When I was between them, I just enjoyed the relief and didn't worry about the next one, didn't think about anything. There were several points, and this was one of them, when I really, really wanted my husband to just call the ambulance and let them make the pain stop. I really didn't believe I could take it anymore, but I did. [The first time I felt like that was when I was in the bath and started pushing the first time. I also felt like I couldn't take it anymore around when I was arching my back, especially before I figured out that doing that would help.] Changing positions didn't seem to help at all, but I kept trying anyway. I alternated lying down on my back, my sides, kneeling against a pile of cushions, sitting on the toilet, leaning against the wall and hanging onto my husband.
I decided to try the tub again for awhile. I don't know exactly what time that was, probably about 2:30 or 3. I think it helped a bit. I started pushing some again while I was in the tub, but I couldn't really get comfortable in there and had to keep moving around. My husband was completely exhausted and in agony, so when he talked to J again, and she offered to come over, he was very willing to have her. She had to get someone to watch the kids and then she got stuck in traffic, so she didn't make it here until about 5, at which point I was back in the bedroom and I'd been pushing again. Just before she got here, husband checked me again and the top of the baby's head was only about a knuckle in. I can't tell you how relieved I was that I was actually making progress this time. I couldn't feel him moving down at all, but obviously this time the pushing was working and he hadn't gotten stuck again.
When J got here, my son woke up and my husband stayed with him for a bit while J came to support me. I was pushing on the toilet when she got here and didn't really want to move, but I also didn't want to have the baby there, so eventually I moved back to the bedroom. I alternated pushing in kneeling, hands and knees and reclining positions. I couldn't get enough leverage in either of the first two positions and it was taking forever. Knowing I was so close, I really wanted to get it over with.
When the head was visible and not really sliding back anymore, I switched to a mostly sitting position, with a huge pile of pillows behind me. J told my husband she didn't think it would be very much longer, so my husband and son came into the bedroom, too. We had promised our son that he could watch the baby be born, but he didn't want to be around the rest of the time.
J suggested that I plant my feet on the bed against the bed to try to get a bit more leverage. I did this for quite awhile and the baby was very slowly moving down more, but I still felt like I wasn't getting anywhere. J then suggested that I try holding my husband's hands, since I kept grabbing at my arms to try to use my whole self to push. Holding my husband's hands really helped with the pushing, since I really yanked on him and I actually started feeling like I was making progress.
I reached down to feel the baby's head and there was quite a bit out. I couldn't understand why it was taking so long to get his head out, but after he was born I realized that what felt like it must have been all of his head above the eyes was actually only about the top half of his head, it had moulded so much.
I kept pushing and I started screaming with every push. I'm not entirely sure why, since it didn't hurt that much, it just felt like the right thing to do. Really surprised we didn't have anyone coming to check on things here (apartment). I was determined not to tear, so I regularly paused between pushes for things to have time to stretch. It was uncomfortable, but I figured it was better than recovering from a tear, especially since I had no one to sew one.
It was really weird how I was thinking rationally, but I wasn't able to articulate anything while I was labouring.
I finally felt his head come out and knew that one or two more pushes and I'd be done. The cord was around his neck loosely, but I just couldn't handle having anyone's hands there long enough to unloop it, so I just pushed the rest of him out into my husband's hands and J unlooped the cord. Then I got to hold my new little boy! He let out a little whimper and pinked up right away. We didn't suction him at all since he obviously was breathing fine on his own.
I found out later that he had come out facing my right hip and he hadn't rotated at all after his head was out, he just came straight out the next time I pushed.
My husband got a towel to cover him and I sat there and held my new son for quite awhile, at least an hour. J left right away, since she had only planned to come over for a little bit to give my husband a break and she had to get back to her kids.
Eventually my tailbone started really hurting from the way I was sitting, so I got my husband to come tie the cord. He tied it off with a couple of shoelaces that had been boiled and then cut it with a pair of scissors that had also been boiled.
The placenta still hadn't come out, so I got my husband to tie the cord again closer to my body and cut it short so I didn't have to have it dragging around until the placenta decided to come out. My husband took our new little boy and I went to have a shower. I was a
bit woozy, though, so I sat down in the tub and used the sprayer to wash myself.
Eventually we had some nuked chilli for a very late supper, around about 9:30. After that, I went to get ready for bed. I went to the washroom and the placenta came out, about 4 hours after the birth. It really stung coming out because it was huge. We were all too exhausted to deal with it, so we put it in the fridge overnight, and then froze it. Eventually, we'll be getting a tree and planting it at my mom's place.
We weren't expecting the baby quite so soon, so we had no diapers. We just kept the baby wrapped up in a towel until the next day, when my husband went and bought some diapers. We didn't dress him or bathe him until Monday morning, when I gave him a quick sponge bath to get rid of the little bit of blood that was still on him. Except for a tiny bit in the creases, all the vernix got rubbed into his skin, like it's supposed to be.
We weighed him by putting him in a sling and hanging it on a fish scale the day after he was born and he was 8lbs 8oz. His head was 35cm and he was about 19 1/2 inches long. Really hard to measure, though, since he was so curled up and not at all happy about me trying to straighten him a bit. :) It turned out that the fish scale was off by quite some way, since when I took him to the health nurse at 10 days old, he was only 6lb 12oz.
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!
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!
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.
Pam K's Story (false gd diagnosis, induced for suspected macrosomia, c/s; postdates induction, c/s, 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 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 40 wks. 6 days, 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. She 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. B
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 n ot 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, the baby was easily delivered, screaming all the way and promptly peed on everyone and everything. I was able to see him briefly and DH 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 DH bring the baby over as soon as possible. She had him hold D 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. DH called immediate family members, then I sent him home for sleep. D 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.
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!
Balek's Story (history of DVT, 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!!
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!
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.
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): At 39.5 weeks pregnant with my second child, I was unexpectedly risked out of a planned homebirth for the condition of "unstable lie" and referred to an OB for "shared care" with the midwife and a hospital delivery. Having previously experienced a failed induction followed by a traumatic emergency cesarean section, the idea of giving birth in the hospital environment terrified me. A momentary glimpse of the surgically equipped delivery room opposite the hospital's birthing rooms generated feelings of extreme anxiety and panic, and the birthing rooms were without comfort for the laboring woman---no showers, tubs, chairs, squat bars or rails; nothing but a bed and a monitor.
The OB berated my midwife for even considering a homebirth with a VBAC and then laid out his plan for induction before 41 weeks to avoid a big baby. He patronizingly dismissed my concerns about the increased risk of a uterine rupture from using pitocin in a VBAC and told me that since I had poor uterine muscle tone, I was unlikely to go into labor spontaneously with the baby's head not engaged----but just in case I did, I was to rush to the hospital immediately due to a high risk of a prolapsed cord. In his mind, my normal healthy pregnancy was an obstetric disaster just waiting to happen, and it was clear I was being set up for another cesarean section.
My options to change location, caregiver, or hospital within Ontario Canada were almost non-existent at such a late stage in my pregnancy, but it was apparent from the OB's disrespect for my midwife and dismissal of my valid concerns that failure to comply with his induction plan would leave me vulnerable to emotional abuse, whilst submission to his plan would result in medical mismanagement of my VBAC. In a state of shock and despair, I posted to the ICAN list that it was my intention to schedule an elective c/s rather than travel down the induction road to fetal distress and another emergency c/s under general anesthesia.
A midwife saw most post to the ICAN list and believing that she and her husband, a well-known doctor, healer and writer, would be able to help me, she invited me to visit her in Vermont, USA and have some birth-related hypno-therapy, after which I would have the option to give birth at their home or return to Ontario. I trusted my intuition that I would be safe with this midwife I had never met in person, and was convinced that hypnosis was probably my only hope of overcoming my trauma and achieving a hospital VBAC. So at 40.5 weeks pregnant, we left Ontario and drove for 9 hours across the border to Vermont.
My new midwife confirmed that the baby's head had engaged, and noted nothing abnormal about my uterine muscle tone during contractions. During the first week I had 2 hypno-therapy sessions to help me deal with the unresolved trauma from my previous birth experience and to visualize having a normal labor and birth. We celebrated Thanksgiving with the midwife and her family and I had 2 more hypnotherapy sessions to help me continue envisioning a natural labor and birth and encouraging labor to start.
Meanwhile, my mother had arrived from England and was waiting back at our house in Canada, so I began to feel anxious not to leave her alone very much longer. I was now at 41.5 weeks and didn't want to go past 42, so on the Monday after Thanksgiving, I started encouraging labor with a series of natural induction techniques. I played my hypnotherapy tapes, visualized labor starting, took Evening Primrose Oil, drank red raspberry leaf tea, took pulsatilla, used acupressure and nipple stimulation and black and blue cohosh. Eventually I took two doses of castor oil, 4 hours apart, and finally, labor began.
By evening I was 2 cm dilated and having regular contractions, 2-3 minutes apart. I didn't want to labor in the birth pool, as I had originally planned, but by the early hours of Tuesday morning, I was 5 cm dilated and fully effaced and really pleased to be in active labor. I spent a lot of time lying down and resting in between rocking and swaying on the hallway railing. By Tuesday morning, I was cold and shaky and a bit pushy and wondering if I was in transition. But my cervix was still only at a stretchy 7-8 cm and the baby hadn't descended. Unfortunately, at this point, the midwife's husband had to fly off to work in another state, and she had to call in a back-up midwife to assist her.
Tuesday lunchtime saw me still at 7 cm but the back of my cervix had swollen and my contractions were spacing out. Hoping to reactivate my labor, we decided to rupture the membranes and I took some more blue and black cohosh. 3 hours later, I remained stuck at 6-7 cm because my cervix had swollen all the way around, although it was still very stretchy and the midwife was able to manually dilate it to 9 cm through a contraction. All afternoon, I jumped in and out of the shower, but there was no further dilation. On Tuesday evening, the midwife strongly encouraged me to try nipple stimulation and squatting during contractions. I was very resistant to squatting because my fat legs make it so difficult but I knew my contractions needed to be stronger and more regular. So throughout the evening I squatted during contractions, using the hallway railing for support, getting into a regular rhythm, and making wonderful deep moaning and groaning noises. By 1 a.m. I had been stuck around 7 cm for almost 15 hours and the back-up midwife thought we should go to the hospital. However, the baby's heart rate had been consistently healthy and reactive and I was not willing to go.
The primary midwife suggested manually dilating my cervix and holding it open during a contraction, whilst I tried to push the baby down past the cervix. She was able to dilate it to 10 cm with just a lip and I managed to push the baby down to a +2 to +3 station [almost crowning---kmom]. In fact, she was even touching the baby's ears, but we just weren't able to sustain this position long enough for me to push the baby all the way down. At this point, my contractions became really spaced out and I could see that my midwife was becoming physically unwell. We knew that she needed to take some medication and get some rest, so everyone agreed to lie down for a while, with the assistant midwife continuing to monitor the baby's heart rate periodically for us. My contractions continued to be strong but very spaced out throughout the night, and by morning, my cervix was back to a stretchy 7 cm again. It was then that the assistant midwife told us she needed to leave, even though my midwife was still unwell, and for the second time I started feeling cold, shaky and pushy, as if I was in transition. My cervix was extremely painful and I was scared that it would swell up even more if I pushed before I was fully dilated so I got down in the hands and knees position and physically held my lower belly up to raise the baby up off my cervix.
With our midwife still sick and the assistant midwife ready to leave, we agreed that the safest course was to transfer to the hospital so that the baby could be monitored regularly and hope that the midwife would be sufficiently recovered to join us later at the hospital in time for the birth. Our midwife arranged for us to go to her local hospital under the care of an OB she knew and trusted, and whom she felt would be sensitive to my previous traumatic birth experience and sympathetic to our natural birth wishes. We checked in to the hospital around 11 a.m., when I had been in active labor for over 36 hours.
The consulting OB suggested that I sleep for a few hours and recommended an epidural to help me rest. I was tired and in pain after 3 hours of trying not to push on a painful swollen cervix, so this sounded like a reasonable suggestion, especially as we wanted to buy time for our midwife to recover and rejoin us later. I had a very low dose epidural, and finally the sharp pains in my cervix went away, which was such a relief. The monitor showed that I was having one large contraction followed by 2 or 3 small irregular ones, so I also agreed to some pitocin augmentation to help regulate the contractions.
During the day, the hospital was so busy that no one bothered us as we rested and slept, gathering our resources for the birth. I completed a checklist of my wishes, including letting the epidural wear off before pushing, no episiotomy, no immediate cord clamping, baby exam on my chest, and no eye drops. The pediatrician refused to waive their cord clamping protocol because she was convinced of the necessity for vigorous suctioning at the warmer, so we declined to have her attend the birth, and fortunately the OB offered to do any necessary suctioning himself.
By early evening my swelling had subsided and I was again progressing slowly and surely to completion when a new resident came on duty. After examining me he said, "Everyone says you're at 9 cm but it only feels like 8 cm to me. I'm planning to insert a uterine pressure catheter to measure the efficacy of your contractions, and then I'm going to prepare you for a cesarean." I was pretty dumbfounded by this but my husband immediately got on the phone to our midwife who was just leaving for the hospital, and then he tracked down the resident and told him in no uncertain terms to stay away from me for a minimum of one hour, and to not do anything to me without first obtaining the doctor's approval. When the resident responded, "But I am a doctor!" my husband clarified, "No, I mean the attending physician!"
So my hero husband protected me from the resident until our midwife arrived to advocate for us directly with the consulting obstetrician. Finally, around 8:30 p.m. the attending physician came in, checked me and said, "You're complete, you can begin pushing whenever you're ready!" The epidural was turned off, and reminded of my birth plan by my midwife, I got into my knees with my arms draped over the raised bed head. For the third time, I was experiencing the shakes and chills of transition, but this time my body was truly ready when the pushing urge began. A while later I heard that the doctor was in the room behind me and yelled, "NO EPISIOTOMY" to remind everyone of my wishes.
After 30 minutes of pushing, I changed to a semi-reclining position, so that they would be able to lay my baby on me. After about 15 more minutes of pushing, out came our daughter. With her cord still attached, she was laid on my chest with warm towels over her, and we bonded----boy did we bond! She cried a little until I cuddled and talked to her and covered her in kisses, and she was wide-eyed and alert. It was a very precious experience that I will never forget for as long as I live, and my husband and I both had tears of joy and relief streaming down our faces. She was born around 10 p.m. on Wednesday, weighing 7 lbs. 13 oz., a whole pound heavier than she looked.
While we were bonding the two doctors started getting busy down at my perineum. Because I had requested no episiotomy, they stood back and did nothing when the head crowned. This caused a second-degree tear when my daughter's head just popped out unsupported. They started repairing the tear before the placenta was even out, but they had forgotten that the epidural was no longer in effect, so I felt their stitching and started protesting with loud ouches, "Hey guys, whatever you're doing down there, it HURTS!" It wasn't unbearable pain, but I wanted to make the point I was aware of their stitching. After the cord was cut, they were also going to pull on the cord to get the placenta out, but again, fortunately, my midwife was watching closely and she immediately got me to give a couple of big pushes and expel it myself.
At 11 p.m., about 45 minutes after the birth, we notified the hospital that we were checking out by midnight, but they weren't really convinced this was possible until they saw me get up and use the restroom, get dressed in my street clothes, and sit in the rocker to breastfeed my daughter while we waited for the paperwork. In the end, we got home to the midwife's house around 12:30 a.m. where she cooked scrambled eggs and toast, and we weren't away from my son for a single night.
I had an unusual 48 hour long labor, with 36 hours at home and 12 hours in the hospital. I know that I would not have been permitted to labor this long in the hospital before being diagnosed with "failure to progress", and would have been fighting interference the whole time. It was hard to endure being stuck at 7 cm for over 15 hours, and discouraging to bounce back from almost complete to 7 cm twice. I realize this was an extremely exhausting labor for my support people.
It was never my goal to have a homebirth per se; I just wanted the freedom to labor naturally without interference, and to have a safe and gentle, non-surgical birth. That was the goal that this generous Vermont midwife and her husband helped me to achieve, so we will be forever grateful to them for making this possible. Lastly, I could not have done it without my husband, whose loving support, encouragement, and protection went far beyond my expectations and hopes. This VBAC was an incredibly healing experience for our whole family.
Stephanie2's Story (c/s due to placenta previa; hospital VBAC with 12 lb. baby!)
Kmom's Notes: This mom had a VBAC with a 12+ lb. baby!! They were ready to do another c/s, but her OB showed up and put a stop to that. She was able to have great mobility during labor and pushing, which seems to be important with a big baby. Giving birth on hands and knees in particular may help get a larger baby out more easily, and some believe it may help prevent shoulder dystocia. So, being fully mobile when a big baby is suspected may be especially helpful and should be pursued whenever possible.
This mom also has PKU. I asked her to summarize what that means for those who don't know, and this is what she wrote:
PKU is a genetic disease where your body cannot process phenylalanine. This protein can crystallize on the brain if there is too much in the body and cause permanent brain damage. Early detection is SO important because if gone undetected for as much as 4 months it can cause PERMANENT mental retardation. (There has not been a case left untreated for a year where the child reached an IQ of 50 or higher.) When pregnant, breastfeeding, and as a small child you pretty much get NO protein of any kind (think vegetarian, no milk, rice, potatoes or meat), and you take a protein supplement with the amino acids minus the phenylalanine.
PKU can also cause a higher rate of birth defects, so PKU moms often have numerous, extensive ultrasounds. But with modern PKU food supplement formula, many women with PKU have healthy pregnancies and healthy babies.
Birth Story
First Birth: Cesarean due to Placenta Previa
In my first birth, I had placenta previa (where the placenta covers some or all [in my case only some] of the cervix). C-sections are pretty much mandatory for this complication, which I am ok with, as my son was healthy and I was able to keep my uterus. He was also macrosomic (10 lbs 13 oz). He doesn't have PKU, but is a carrier.
Second Birth: VBAC
My gynecologic care was non-existent because I have never been treated fairly by doctors because of my size, in my opinion. So when I started having problems (no periods, excessive body hair, and killer cramps when I did have a period), I finally saw a doctor who was "fat friendly." He almost immediately diagnosed PCOS and ran some tests to confirm it. He referred me to an Reproductive Endocrinologist and I worked with him as well as my OB-GYN to achieve pregnancy. Before even talking about fertility treatments I was adamant about considering VBAC, and came in with tons of research about it.
I was started on Metformin immediately and given the morning-after pill to induce a period. Then I did a 3 month follow-up of Yasmin. After another 2 months of normal periods he gave me 2 cycles of clomid which failed, and on the third go-around the stick turned pink.
All of this time I was on a Low Phenylalanine diet. As an adult this protein poses little problems to people with PKU but when pregnant or breastfeeding it is extremely important to keep these levels low, because even though your own brain is formed and generally unaffected by the protein crystallization, your unborn baby's brain is still susceptible.
Pregnancy itself was fairly uncomplicated, and because I was very careful with my diet, I was able to avoid diabetes or pre-eclampsia. [At one point they did think he might have hydrocephalus (water on the brain).] I was devastated, I had been taking pre-natal vitamins and drinking plenty of OJ to prevent this. (I have a sister w/ moderate Spina Bifida.) Come to find out it was either a mistake on the ultrasound or it healed itself.
I went into labour and arrived at the hospital. Check-in was great (we have swipe cards here), but my labour room was horrible. The bed was too high, the stirrups too narrow, and the gowns AND pressure cuffs were too small. They were ready to put me under general and wheel me into the OR when my OB showed up. He was pissed and stopped everything. My labor was progressing normally. I hit 10 cm within 8 hours.
I went into hard labor and had horrible throbbing stabbing pains in my lower back (back labour?). I rolled onto my side and this was alleviated. After 6 more contractions I got into the hands and knees position and delivered after only two more contractions. I did have some tearing, but required no stitches. Yes, he weighed 12 lbs 4 oz and was 23½ inches in length.
As far as being open to VBAC they did have an O.R. on stand-by just in case. I would not let them do internal monitoring but they did do the external belt monitoring. There was one instance where we thought we were heading [towards a cesarean] but my son must be scared of knives too because he tucked his head just in time. Through all of labor they were also doing ultrasounds.
I received EXCELLENT care from my doctors, but the hospital staff lacked some common manners. After my Dr and my husband tore into them, they changed rapidly. I would have like to have my baby at a different hospital but due to being high-risk, (PKU, VBAC, and previously macrosomic baby) I had to be at a level III. After delivery I was sent home in 2 days; I received decent care for those 2 days.
As far as PKU goes, the baby and I both have PKU. [Because of that we did not breastfeed.] There is some research as to breastfeeding being ok, as levels of phenylalanine are MUCH lower in breast milk than in formula, but being as how I have it too, there isn't enough research to be able to justify breastfeeding, in my opinion. Since formula is good enough and known not to harm him, I couldn't justify that risk. I am hoping before my next child there is more definite research to this as I would like to breast-feed, but I need more info.
My baby boy is wonderfully healthy, despite a nurse trainee feeding him standard formula TWICE. I am not happy with the hospital BUT my doctors gave EXCELLENT care. And despite having a caesarian, being obese, and other medical issues I was able to have a relatively normal healthy vaginal delivery.
Alexia's 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 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...
At 1am on Tuesday, November 4th, I got up to use the restroom, and discovered that I had what seemed a broken water sac. I hadn't fallen asleep yet, and was a little dismayed that labor might be starting when I was tired. I called my midwife, who asked me some questions and then told me to go back to bed. I tried, but it was no use. I called my mom to let her know also, then I went downstairs to fold laundry and do what I could around the house. My 23-month-old, Natalie, woke up and was upset so my husband and her came downstairs with me and promptly crashed on the couch. The contractions had been coming all evening, but after I felt the gush of water I knew they were different. I didn't bother timing them.
I called my mom and asked her to come keep me company, since Natalie needed Jorge. In hindsight, I should have taken something and gone back to bed and called no one! But being a first-time labor (Natalie was c-sec with no labor) I had no idea what I was in for!
I labored all night, easy contractions that felt like menstrual cramps but I could breathe through without too much trouble. I continued losing water with each contraction - it was a light pink color. My midwife called me to check on me (or I called her, I really can't remember) about 8am and said she would come check on me. She arrived around 9 and did not do a check - she said that it really seemed as if my water had broken, it was obvious I was still in early labor and there was no point in introducing anything into the vagina. Seemed OK with me. She told me to rest and to walk. I was so tired when she left again that I laid down and tried to sleep. I woke up with most contractions but slept until 11, and then slept again until 1pm. Little did I know this was the only sleep I was to get! I found my husband and asked him to walk with me outside - it was a cold, crisp, sunny day. We walked around the block and around some other streets, for about 30 minutes. I walked
through some contractions, and had to stop and hold on to him for others. They were coming very regularly at about 4-5 minute intervals. As soon as we came home and sat down with my mother and sister, though, they slowed down again. So I ate something and we set out again, this time for about 20 minutes. The contractions came harder and every 4 minutes. We returned, and again - back to 7-8 minute intervals. By now it was after 4pm though, and starting to get dark.
My midwife came again to check on me, and this time she went ahead and did an exam. OUCH! it hurt. I was only at 2 cm and 50% effaced. I tried not to be disappointed...after all, it had seemed too easy so far and I never had gotten beyond that with Natalie. I labored here and there and everywhere around the house, eating toast and yogurt and lots of water with lemon. We had a snafu with my family at this point...my mom had been taking care of Natalie all day and had had no sleep either, due to my 1am call. She invited my little sister over to help her with my daughter, and I had not wanted anybody in the house once labor started getting serious - and the pain were getting stronger. I told my midwife this and she felt that if my mom would not listen to me, that she should talk to my mom. Whew! Blowout. It ended in my mom leaving in a whirlwind talking about not being wanted, my little sister leaving with tears in her eyes, and the midwife following. I had told my mom that
of course I wanted her here for the birth, that she was just real tired and it would be better for everyone if she slept when she could. She told me my friend who is a doula and birth photographer would be there around 7:30 - only a half hour away. That seemed bearable.
This whole scenario really distressed me and I cried after they all left. I felt guilty and responsible, but also angry because I had been so clear that I wanted no one in the house...it was really hard for me. I had to really concentrate on letting it go, welcoming my new baby and trying not to be distressed that my family was up in arms at such a
poignant moment in time. I called my doula friend and as I had suspected, she had actually told my mom she was leaving a town 2 hours away at 7:30! So I braced myself for some alone time. It was a real paradigm shift for me - I began to realize that this was my birth and I may HAVE to do it alone. The contractions became stronger and I began having to vocalize through some of them...at first I was doing OK but then I began to worry. My midwife had gone to a function about an hour north, and said she would check in around midnight. That seemed fine, because we thought my doula friend would be here...
But she (my doula friend) called in a panic a bit later, and said she had a blowout on the freeway! She would have to get the tire changed etc. and wouldn't be here until at least 11pm. I felt so bad for her, at night on the freeway. I told her to keep safe and again braced myself for the time alone. I was surprised that instead of embracing that time, fear began to creep in. I think it is because the contractions became significantly stronger during this time.
My husband couldn't really be there for me because he was taking care of Natalie...who was doing well, but not where she could hear me vocalizing with some of my contractions, "oooouuuch!" So, I called my midwife again and asked her if she could come back. She said things were wrapping up where she was and she would head back down. It would be 45 minutes to an hour.
The time went by quickly and she was there before midnight. I was glad, as the contractions were getting stronger and stronger. Finally, she needed to get some sleep and asked me what I thought about calling my back-up doula. I did that, only to find out that she was at another birth! So we went back to square one. Around this time, my first doula/friend called and told me she had gotten home OK, but just couldn't come down at this point. She asked me what I thought about her partner, if she could make it. I said great! as I know this lady and like her a lot. She called back and said her partner unfortunately wasn't available because her husband had to work and she had no one to watch her children. Wow.
I was in enough pain to want my mom at this point, but as a support to me...not as a caretaker for Natalie or anything else. I thought that if she had gone straight to bed when she left, she might have gotten 6 or so hours of sleep and might be willing to come back. With Natalie in bed and the house quiet, I could just ask her to stay with me. I decided to call, and if she said no we could just find another option. She was hesitant, but said she had gone to bed and gotten some sleep, and she would come.
I kept laboring, but I was screaming with each contraction. Amanda (my midwife) was asleep on the couch downstairs. My mom arrived and I could hear her puttering around in the kitchen, getting herself some tea. She came upstairs and was like a different person - it was wonderful! She was soft and supportive and prayed with me through some contractions. She told me to close my eyes and talked about heaven and gave me some great visualizations. It really helped. This went on until the midwife came up after about an hour and a half to check vitals. She asked me if I wanted her to check me and I decided I needed to know. I was at a 5. I remember it was 2:20AM. I was encouraged...this was much farther than I had ever been before. I was also thinking that had I gone to a hospital, I would already be being prepped for a c-section, since it had been over 24 hours since my leak started. How dumb; we were fine, our temp normal, heartbeat and bp totally normal - baby totally
healthy. She went back downstairs and I labored like this through the night, with my mom supporting me and Natalie asleep with Jorge. During this time, my lower back/sacrum area started to be super painful with each contraction, and so my mom was giving me counter pressure...that helped a lot.
By the time it was light, I was really miserable. I got in the pool a few times during the night...it was wonderful to have it. It did not make my contractions any less painful, but it was wonderful to relax in the water during my "breaks". After a while, Amanda came back up and my mom went downstairs and I could hear her making food for people. By this time, I was totally crazy during most contractions...Amanda called her assistant and she became part of the total scene. About 1PM (I am not positive on the time) my doula/friend arrived...just in time for Amanda to check me and see that I was at a "stretchy 8". I was encouraged but sooo tired, and I was screaming through every contraction...focusing was out the window, along with breathing and whatever else I was supposed to be doing. I remember around this time, Amanda said to me,
"Well, this is probably as strong as the contractions are going to get." and I replied something along the lines of, "Good, because I can't take
much more!" I was still joking between contractions, as I had been the entire time...I guess it was just my way of dealing with it.
Well haha - she and her assistant traded off doing some back massage and double hip squeezes while I labored on the bed on all fours with my rear end in the air...kind of undignified, but I was in so much pain I just ignored the indignity (I was naked). Finally, Amanda asked me what I thought about breaking the rest of my water sac. She explained that it was bulging out 4" out of my cervix, and was preventing the baby's head from really engaging strongly. The leak had made the sac mushy - it was not nice and tight and therefore was not breaking with the pressure, just acting like a weak cushion. I have never thought AROM was a good idea, but I could see in this case how draining the sac and letting the baby's head engage would push open my cervix so I could be complete. Plus, I was exhausted and faster sounded better at this point.
I laid down, and all I can say is, I have never experienced anything more painful in my life up to that moment. I did OK at the beginning, but then I began screaming...not just yelling, but truly screaming. It took a few minutes, because the sac was so slack it was hard to hook. Finally, the gush came and I started to cry - I was broken. I began to feel hopeless, but was just glad it was over. My doula friend laid on the bed with me and talked soothingly, and I began to feel a little better.
Then my next contraction hit. I truly thought I was going to die. Not get any worse...yeah, right! Oh my God, I could not deal...I screamed and writhed and cried...and then I threw up everywhere. Talk about instant transition...from that point on, the labor became a blur of pain and exhaustion. I began to feel hopeless, pretty bad...I was beyond fear, just tired and felt like the contractions weren't really going anywhere, doing anything. They no longer felt constructive, they just HURT. This went on for about an hour and a half. They asked me if it helped to push and I tried a little and it didn't make any difference. Position didn't help, nothing...they would ask me how I felt and I would say, "I don't know, it just hurts." I could feel their frustration with this statement, especially when they asked me where and I would pretty much gesture to my entire lower body. I *was* having blood and fluid come out with most of the contractions at this point. This was a bad
moment in my labor...I spent a few contractions just with my husband and I would look up into his eyes and cry...I felt so hopeless. He was very compassionate, and he would well up with tears too. I absolutely HAD to have counterpressure with my contractions, and he would hold my hands while I pushed against him with all my might and screamed.
Amanda checked again and said there was a tiny lip...not much of one. I never thought I would do this, but I asked her to push the lip back through a contraction. Supposedly this is very painful, but at this point I couldn't imagine anything *more* painful...I just wanted it to be over. She did this through a few contractions - my pain-meter was maxxed out so if it actually hurt *more*, I don't remember. Then I began to push. It was around 4pm. They were checking vitals constantly it seemed like - and my breaks between contractions were only what seemed like a few seconds sometimes. It really annoyed me when they checked fetal heart tones, but I knew they had to. A few times when they took too long (it was mostly the assistant doing it at this point; Amanda was helping me) and a contraction would start up, I would fling her hand away and yell, "No!"
Finally I began to push in earnest. First on my feet, then I felt like I was going to collapse, so I went down on the bed on all fours. After a while my knees hurt and I went in the other room, and tried it there because the bed was lower to the ground and more comfortable to sit on. They got that bed ready with a shower curtain because the *other* room had been the "birthing room" we prepared. they kept asking me if I wanted to have the baby in my room. I was not very helpful; I was crazy with pain and exhaustion. I would just say,
"Yeah, I don't know, whatever," and go back to screaming. I finally went *back* to the "birthing room" and leaned over the bed frame with my upper body and stayed on my knees. I stayed like this a long time, holding my mom's arms and pushing against her with all my might. I was sweating so much that I couldn't open my eyes. They kept trying to get me to lift my upper body so they could pad the bed frame with a cushion - I was pushing against it
with my upper chest and breasts sooo hard. I kept telling them I was too tired, I couldn't. In between contractions, I would just lay on the bed frame. They began to worry I wouldn't have enough strength to get through, so they brought
Gatorade and basically force-fed it to me between every contraction. I am convinced this is why I did not pass out with exhaustion. Amanda came back around to my head to show me how much of the head she could see with every contraction...an attempt to encourage me I am sure. I was so tired...every contraction was a reach beyond my own strength.
Finally my knees hurt too bad and I rolled over on my back. I pushed like that for several contractions, and they would tell me they could see the head, and "all that hair" etc. Finally I asked Amanda,
"Please just tell me if the head at least is past the cervix." She laughed a little, and said, "oh yeah, WAY past." Then, when I could listen, she explained that with every contraction there were 3 pushes: The first one got you back to where you had been with the last one, the second one past and the third was the most important, where you made actual progress. I listened and I tried so hard...but everyone knew I would never get her out on my back. I could actually feel her head progress and then slip back with every contraction, and I was so discouraged. I could not get her past my tailbone. They kept saying, you have to get off your back, you have to get in the pool, don't you want a waterbirth? Even my husband said, "Honey are you sure? You really wanted your waterbirth"
and I kept saying, "I don't care, I don't care..." With each contraction my legs were shaking so hard I couldn't control them and then my muscles would seize up and I was getting so exhausted.
Finally, I heard someone say, "You are not going to get the baby out like this. You have to get in the pool. Come on, we will roll you over." And all the sudden that seemed okay. I had not been able to imagine sitting up and moving, even with help; the baby was in my vagina and I just could not move. But I said, "OK" this time, and they grabbed my arms and literally rolled me into the pool, which was next to the bed. I
splashed in like a giant whale and immediately felt better. My mom sat in front of me and supported my upper body and I began to push with everything I had in me. A few of these and the burning started - I knew it was the "ring of fire". Another big surprise...I had thought it would burn in my perineum, and I am sure it did...but it burned UP, and I started crying and screaming that my clitoris was ripping. It hurt so bad. Amanda said she would try to support it...I could feel her stretching out and supporting my perineum. Once I stopped pushing and she
said, "Bonnie, you have to push through it, you have to" and I would say, "I can't I can't" and she would say very authoritatively, "YES, YOU CAN" and I would pray and push. I was so far beyond my own strength, I would just pray, God please help me push and I would hold my breath and then scream as it burned like I had sat on the sun itself. Finally, I felt a kind of pop and Amanda said, "wait wait quit pushing" and she checked for a cord. A second pop quickly followed. I figured her head had come out and I still needed to push out the shoulders, but she said, "keep
pushing," and then I heard, "Grab your baby Bonnie, pick up your baby!" and there she was, in the water in front of me. I picked her up and looked at her, and I just couldn't believe it was over, and I had done it. God really did it, because there is no way I could have pushed in my own strength - I was way past my own capability.
I sat down in the pool and began to shake...I had not an ounce of strength. I literally could not keep my own legs from floating to the surface. My vagina was pulsating with pain and it surprised me that it hurt so badly. I heard, "Talk to your baby, Bonnie." And so I did. I offered her the breast but she just wanted to look at me. She did not cry at all...this was concerning to the midwife and I could hear some sideline conversation about it, but I knew she was OK. It did not bother me at all. After about 5 minutes, Amanda said, "Aren't you going to check and see if it is a girl?" and I felt the cord and said, "It's a boy?!" and everyone laughed. I was so tired...how silly, the cord was even still attached! I felt it was a girl and I said, "Ruby Isabella Naomi" (although we did change the order of the names later to avoid confusion, since we planned to call her Naomi). My sister brought in Natalie, and she got to see/touch the new baby. She kept saying, "baby,
baby"...it was a precious moment.
I pushed a tiny bit, and felt cord slither out. Amanda felt and said the placenta was right there, all I had to do was push. I asked her if I could wait, "just a minute". She said sure. I finally pushed it out and then they cut the cord (Jorge did it) when it was all closed up and gave the baby to Jorge...they had him take his shirt off and carry her skin-to-skin with a towel over her. During this time they had prepped my bed, and so they helped me stand up and walk to my bedroom - about 15 steps. I could not believe how weak I was. I could barely stand up, let alone walk. It wasn't really pain (other than my vagina), it was simple exhaustion. I was shivering really bad too. They had me drink more gatorade and my sister went to make me a sandwich - I was so hungry. At this point, my doula left as she was already late for something but had stayed because the baby was so close to coming out.
They got me situated in bed, but then I said I had to pee. I couldn't sit on the toilet so I tried standing up in the shower. I tried everything - even turned the light off, but I just couldn't pee. Finally I couldn't stand up anymore so I gave up. They asked to check my bottom and very gently inspected me. There was blood everywhere and it was falling out of me every time I moved, so I assumed I was ripped from stem to
stern.
Amanda looked up from examining me, and said, "Here's the deal: your perineum is intact." I said, "What???" I could not believe it. She said I had a few labial tears up by my clitoris, and a few tiny tears down by the perineum, but nothing that was serious at all. She said I could let it heal on its own, or they could kind of match up the skin and "tack it together" to be sure it healed in the right place. I thought about it and opted for the tacking...I knew they would take much care to do it right, and I did not want to risk infection - I am very prone to vaginal infections. So, they took the
anesthetic and even though she told me each time she would stick me, it HURT! Not that bad, you see...but after what I had been though, any more pain was like, well, salt in the wound. I was a real baby. My sister sat beside me holding Naomi and my hand, and once she was like,
"You are going to have to let go a little" because I was squeezing her so hard! It seemed to take forever.
I was laying there, eating my grilled cheese sandwich, and nothing had ever tasted so good! I had to pee sooooo bad though, and every second it was getting worse because they had made me drink so much
Gatorade after the birth. I began to whine incessantly...and I kept asking Amanda, "How much longer?" And she finally snapped, "I don't know, Bonnie!" I said, "I am sorry I am whining, but I have to pee soooo bad." They told me the reason I had not been able to pee was because my urethra had been swollen shut. They said that almost all the swelling had gone down, and I should be able to pee when they finished.
Thankfully, I was able to pee when they finished and felt much better after. I even took a short shower and felt like a new person. Amanda went over post-partum stuff and I finally got to sleep - after a second grilled cheese sandwich! I didn't call anyone until I woke up about 6 hours later. I remember asking my midwife why the birth stories never told you how bad it hurt, and she said, "Because people forget." I couldn't imagine forgetting.
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.
]
SanQ's Story (2 inductions then cesareans, Home VBA2C)
Birth Story
Mountain Summit-My HBA2C story
Where should I start? My first two sons were born via cesarean section, induced with pitocin. For my first birth, I trusted that my
doctor and the hospital knew what was best. I had planned on a natural birth,
and took Lamaze. I went overdue (42 wks) and was induced. The contractions were
quick & on top of each other, I labored this way all day & around 7 pm that
night he was born via c-section, and rushed off to the NICU in a helicopter across town. He was in about 2 weeks, with a collapsed lung,
heart murmur & meconium pneumonia. They told my husband that he might not live
24 hours, and if he did he would have to be transported to yet another hospital for
surgery. I also had some problems (anesthesia does not work well for me-I
became fully awake as I was being sewed up) and needed to be given blood. I
remember being left in a recovery room alone and freezing, no blanket or anything to cover me. I called for what seemed hours for my
mother, as I was coherent enough to know that my husband had left with my son. We were
blessed that night, his murmur closed fully & he was getting better. Rarely
has he been sick since. I truly believe now that his not being ready to be
born, added to the pitocin induction did this to him.
For my second birth, I did a little research, and was exposed to the book Spiritual Midwifery for the first time. Wow-they still birth at home? I picked a female ob gyn that had had a vbac herself, and had midwives in her practice. I saw the midwives & I saw her. I picked a hospital again because at the time I felt it was safest. Again I planned on a natural birth. This time while walking on the beach, I fell on my bottom on some slippery rocks, and went into labor by myself, again at 42 weeks. Went to the hospital and was induced again to speed things up. Luckily he was born, although via c-section again, without any problems, just a bit jaundiced. At this point I did not want anymore children, and considered tubal ligation. My ob talked me out of it, and put in an IUD.
A couple years pass, we moved to the Pacific NW and I met quite a few women who had their babies at home. I just thought this was the neatest thing ever, but still was adamant about not wanting anymore myself. I became close friends with a woman (S.) who had both her children at home, and was expecting her third. I learned more about homebirth from her, and then finally looking around on the internet, and reading quite a few books. Last summer I felt a presence, a soul that wanted to come into our lives. I had not had this feeling before with my boys, and it was too strong to ignore. I got my IUD removed and we started trying right away. I still wasn't sure about the whole homebirth thing, for me anyway, too risky. I don't remember just where I first learned about HBAC, and trying after 2 c-sections, but I still was nervous. All the what ifs really came into my head.
Well I got pregnant fairly soon after having my IUD removed, and was worried about how far along I was (I am a bigger woman) so I went to an OB. Large, huge mistake. I was high risk when I walked in the door. I told OB of plans to homebirth, as him being my backup (I had 2 midwives to interview that did hbacs) and whoa that was a mistake. I had high blood pressure that first day. (also had with my 2nd) I weighed 268 lbs-another risk. All I can say about that day is I have never felt so broken. In tears I called S. told her what happened, she told me to take a warm bath, calm down, light a candle, etc. Dh and I also talked quite a bit this day, I finally calmed down enough to decide not to go back. I interviewed both midwives, and again picked someone who had also had a cesarean, and then gone on to birth her other 4 children at home. From the beginning, I felt completely at ease with her. Every blood pressure reading from then on, (done at my home) was normal. Imagine that.
I exercised, ate well, saw a chiropractor and a prenatal massage therapist, took some supplements & drank a prenatal tea that tasted like dirt daily. I read tons, joined the ICAN email list, and a few other homebirth-oriented lists. A few issues came up for me (from the c-sections) and every time, I had support unimagined in my previous pregnancies. I read many, many, birth stories, imagined what mine would be like, and did some birth art. Also,this pregnancy we went on hikes quite a bit, and I began to associate this pregnancy & birth like a mountain, with many paths leading up. My midwives, C. & G. & S., my friend (& other support person) and my dh were incredible. They had such faith in me, and were so empowering. I felt so strong.
The last week of my pregnancy, I was feeling worried about going over again. Even knowing that my midwives were not the intervening type. Thursday I lost my mucous plug, and Friday after feeling a couple times like I was leaking something while on the phone with S. telling her I needed to go to the store to get a fishy net for the birth tub, my water broke! It was classic, down the legs and all that jazz. I couldn't believe it! I told dh, called S. back & told her, and then called C. She told me to take some vitamin C and garlic caps, and drink lots of water, and she would bring me some herbs. At this point, I was having mild contractions, but they were way far apart. In fact, that night I ended up sleeping fairly normal, although after 12 am I kept waking up during my contractions. Even then they were about 15 min apart.
Around 7 am the next day (Saturday), I called C. and told her what was happening. I told her that while they still were pretty far apart, and irregular, they were getting stronger. She told me she would be there in a little while, and so would G. My friend/support S. said she would be there around 12-1 pm which I was fine with, because things were going so slow. My boys were still at the house, and beginning to irritate me. (I previously thought I wanted them there) They left with friends around 12 or so. Dh was there, cleaning, making lunch for all of us, bringing in the tub, he was taking care of everything. He was also in charge of the music, which actually ended up being only 3 cds, playing over & over. One was Indian sitar, another was ambient, and Krishna Das, and Mermaid (song) by Sade. That song just makes me think I am swimming in the ocean. He was amazing.
The rest of the (hot!) day passed, G. & I took a walk around the neighborhood, I drank more water & watered down Recharge than I ever had in my life to this point. When I was at home, I paced around a lot, bounced on my birth ball, and sat in a hard chair. It was so peaceful, I really enjoyed the company, and we talked & laughed a lot. It was really one of the best days ever. S. & I took another walk (this time backyard) and then we all sat down on the shady side of the house. I kept contracting, I had a pillowon the grass, and another on the chair, and I would kneel there with my head in my hands. Dh later told me this time was the most at peace he has ever felt. I moved back into the house, because I kept needing to go to the bathroom, and hung out in the living room for a while. One of my favorite laboring positions was dancing with my dh, I would hold on to him and sway my hips, he felt so sturdy and it was very loving. Even with the midwives & my friend there it was very intimate, and we felt OK kissing & just generally loving each other.
I should mention that I called my family back east when my water broke (they did not know my plans to homebirth) and they kept calling, wondering what was going on. I ended up telling them that I was sent home because labor stopped. That pretty much stopped the calls, but then my dad called around 4-5 pm. After this things kicked up a notch. Funny, eh? Also I told S. my worries about holding everyone up. I kept feeling like nothing was happening, and that I should tell them to go. She said things were happening, and for me to relax. I told S. to put in the Rainbow meditation (hypnobirthing) tape so I could rest a bit, as I was getting tired (It was time for my daily nap, ha ha ha) I was able to relax a little, but had 2 contractions I couldn't ignore (I think I waited too late to use my meditations) and decided to get up again. We did use the affirmations, my dh told me lots of the script he made up (involving the ocean waves) and the breathing (4-8 & J breathing).
At this point I also asked if we could fill the tub, as things were getting intense. After all this, things got mindless for me. I think subconsciously, or consciously I wanted to feel every bit of this birth. S. had brought a fabric painting of Sheila-Na-Gig! and it was by the birth tub in my dining room. I have a wood rail all the way around and made a miniature altar (I already had a bigger altar in my living room that had been there since the beginning of my pregnancy) I also read my tarot cards a couple weeks prior to the birth and pulled the Ace of Pentacles-Pure contentment, attainment, prosperity, bright prospects-both material and spiritual. Wow. I had on the rail a small wooden Akua, African Goddess of birth, pregnant women & children, my Grandmother's locket, and a small wooden mermaid nursing a baby mermaid. I had so many things on my other altar, but these meant the most to me, as focal points. My youngest son had also picked me some flowers, among them being a wide open pink rose, which also took my attention.
Ah! The tub was filled! My midwives, C & G, S., and my dh were in a circle around me by the tub, I would get bits of things they would say to me-incredible, empowering, loving words that helped between mindless contracting. I felt my body opening, I felt my baby moving down-what a marvelous feeling, and totally new to me. My contractions were on top of each other pretty much at this point, I kept shifting in the tub, sometimes holding on to my dh while in the tub (dancing) Normally I am a fairly inhibited person, but all that went out the door at this point, I got really loud too! I live in a historic district, the houses are pretty close together, and before the birth I worried about being loud-this evaporated too! Ha ha! Then C suggested I sit on the toilet again, to get baby further down-that was rough, moving from the tub into my bathroom-I had to walk (when I could-the contrax were happening all the time now) with my legs spread way out-crablike. I sat on the pot, did a contraction/push then during a break stand up, hold on to dh then squat & push again.
At some point, I moved to the bed-don't ask when-I just ended up there! I was propped with pillows behind, so MW could check to see where baby was, a few pushes later she was crowning! She told me to touch the head-I was in complete disbelief!! No way!! But I reached down and sure enough, it was there, wet & full of hair! I really hated being like that in the bed-the whole time pushing it was best when I could get my legs spread far apart, usually on hands & knees or squatting. So I moved onto my hands & knees, way far apart, kinda like a frog. Not too long after this her head came out all the way, but then her shoulders got stuck! It continuously burned! Wow! C. did some maneuvering, I pushed a few more times (my contrax slowed down then-grr--but I kept pushing anyway) and felt the rest of her body slip out-felt like a big fish!
I don't remember who said it was a girl-but I just couldn't even speak. My dh started crying at this point (I never did, I just remember complete elation & surprise) and telling me it was a girl. Had a bit of getting her going with some oxygen, talking to her, rubbing her feet, then finally a cry! After all this she latched right on, nursing like she always had! There was a short cord, and a large heart shaped placenta. It came out pretty quick after, then I bled a bit, C gave me some herbs, and some Chinese herbs that I sucked through a straw that were rather nasty. I did end up tearing, in two places, I did not really notice. 6 stitches is a tiny thing for this incredible healing experience.
I never once during labor worried about my scar or rupture. My midwives didn't check my blood pressure once during labor, there were no interventions. I feel reborn, and completely high on birth, still. I did it, I finally reached my summit.
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.
Jen's Stories (SROM, induction, c/s; VBAC; VBAC with GD)
Kmom's Notes: This birth story just goes to show what the research shows; that spontaneous labor is very important in improving success rates for VBAC trials of labor, and especially when the mom has GD. The hardest part is keeping the doctors from insisting on inducing early and/or doing an elective cesarean at term.
Birth Story
My Birth History:
This was my third pregnancy. My first ended in a C-section (water broke at 39 weeks, Pitocin induction, 20-hour labor, epidural, 3 hours of pushing, posterior baby – 8# 8oz.), and my second ended in a VBAC (spontaneous labor at 40 weeks 6 days, got to hospital at 6cm dilation, no meds, 8-hour labor, 90 minutes of pushing, posterior baby turned ROT just before complete, 2nd degree tear – 8# 10oz.). I did not have gestational diabetes in either of my previous pregnancies. I was tested at 24 weeks though, failed the 1-hour and had to take the 3-hour both times. They encouraged me to walk around between blood draws, as long as I showed up every hour, I could do whatever I wished. I think that made the difference in me passing it.
And now my 3rd pregnancy/birth story:
At 30 weeks of pregnancy, I took the 1-hour and 3-hour glucose tolerance tests and failed them, resulting in a diagnosis of gestational diabetes. I met with a diabetes “educator” (I use the term loosely, I think they were following out-of-date diabetes rules) and started checking my sugars. I was supposed to have a fasting number between 60-90, and one hour post-meal numbers at or below 130. As long as I was conscious of what I ate and exercise, my levels were all within acceptable range.
I would exercise briefly twice a day – a quick walk down the street and back with the kids after breakfast, and another short walk with the dog after dinner. I had a brief period of high fasting numbers (between 94-98), and my doctor wanted me on insulin. I refused. Then I figured out how to get the fasting number down by trying a few tricks on Kmom’s website. I found that if I ate two proteins and one carb for my bedtime snack, ate it at 10 pm, and tested in the morning at 7:30 AFTER my shower, my number was always at or below 90. One week, my belly measured 3 cm “too big” so Jan (my OB) sent me to ultrasound, baby measured 1 week “ahead”, the same as he had at my 20-week ultrasound. After that, my belly measured right on. My doctor wanted me to start non-stress tests at 36 weeks, but I delayed them until 39 weeks.
At about 34 weeks of pregnancy, my husband Dan and I interviewed a homebirth midwife. I had been so stressed out by how my doctor wanted to manage things (she had said that they induce all GD moms at 40 weeks, and since I was a VBAC, there would be no induction, but that they would need to do a C-section), that my husband suggested I call a midwife, and we would meet with her. It was wonderful, and we decided to have a homebirth with Paulette.
At 39 weeks, I had my first nonstress test. Baby passed it. At 40 weeks, I had a second NST, and baby was sleeping, so the doctor sent me in for a biophysical profile. Baby scored 8 out of 8 on the BPP, and measured 8# 1oz. My doctor mentioned that she didn’t want me going past 41 weeks (although she didn’t say why, but it didn’t matter to me – I assume it was because of the GD). I went home to my husband and we decided that would be my last appointment with her.
The nightly contractions started about a week before my due date (10/19/04 was the due date). I would contract most evenings, they would intensify if I laid down. I would try to sleep at about 10:30, at which point I would tell my body, “That’s enough now.” It seemed I was just not mentally ready to have the baby yet. My due date came and went, as expected, since I went past my EDD with Adam (my second baby, first VBAC).
The night before labor began (40 weeks, 4 days), we had dinner at my in-laws’ house. My sister in law rubbed my belly and said she thought something was going to happen very soon. I was contracting, and they were getting painful, but it was nothing new. That night, I felt contractions all night long – definitely unusual, since before, they would quit when I fell asleep. I could feel the contractions in my dreams, and occasionally one would wake me up. They were only about 20-30 minutes apart.
In the morning, I got up at 6:30, and went to the toilet several times with loose bowels. I kept expecting to see bloody show, but I didn’t. I woke Dan at 8 and said, “I think today’s the day.” He got the kids up, dressed, and fed while I was in and out of the bathroom some more. At 8:30, I called the midwife and told her what was going on. She asked if I thought she should start heading our way (a three-hour drive), and I said “I think so. I’m not entirely convinced it’s labor yet, it might just be poop.” She laughed and said she would leave very shortly. I told her “At this point with Adam, I had about six hours left until delivery.” She said she’d call when she reached Minot (halfway point, 90 minutes away).
Dan had me get in the shower right then. And in the shower, it hit me that it really WAS labor – I was needing to lean against the shower wall and “breathe” during contractions. I was handling them well. I could feel them in my back, but happily, it was NOT “back labor”! Throughout all this activity, baby was very active, assuring me that he was fine in there.
I tried to eat some toast and drink some low-carb orange juice but I couldn’t finish it. I wasn’t very hungry. I wanted to stay nourished and keep my blood sugar up though, and I hadn’t eaten since the night before. I was intent on getting the bed sheets washed, dried, and put back on the bed, so I did these things, and had Dan put the plastic sheeting over the top. I would walk around between contractions, and then slow-dance with Dan during the contractions. They quickly became more intense, and I got out my birth ball. I found so much relief in lying across the top of my birth ball, swaying during contractions.
My parents came and got the older boys at about 9:45. As soon as they left, I started making noise with contractions – long, low moans. Things were getting more intense, and I had Dan try to call Paulette. She must’ve been in a dead spot though, because there was no answer. From that point on, he tried calling her every few minutes, and never did reach her. I moved from the birth ball to kneeling in front of the couch, and making a LOT of noise with contractions. It was becoming more high-pitched, and I started to feel like it was getting out of control. I do NOT like that feeling. In hindsight, I believe this is when I would’ve been 7 cm or so, entering transition. I had Dan heat up my rice sock, but it never made it out of the microwave. I had him applying intense counter-pressure on my lower back, and then taught him how to do the double hip squeeze, which was exactly what I needed. He was excellent.
Around 10:30 I think (who looked at a clock?), I told him “I think my water is thinking about breaking.” I didn’t really know what to do, and a few contractions later, it broke. I went into the bathroom and stood in the tub. The pain was real intense, I removed my pants and underwear (I had put a pad in, since I wanted to remain dressed, and I knew my water would break at some point!), and saw a light green pad. I started to cry and hollered, “There’s mec! There’s mec!” [Kmom note: mec = meconium, baby's first bowel movement. It can sometimes indicate fetal distress.] It was only light mec, but it distressed me. And the midwife still hadn’t called to say she’d reached Minot. I was very upset, and cried. I told him we needed to go to the hospital. He really tried to convince me it was OK, but within a few contractions after my water broke, I knew things were going to happen fast. I said we needed to get to the hospital now. My husband really wanted us to stay home and have the baby on our own, but I just didn’t feel right about it. At this point I started to really want drugs, and I said so, several times. I knew in my head that meant transition, but I didn’t really care, I just wanted to feel better.
So between contractions, I walked to the Suburban, no bags or anything. As soon as I got in the truck, a contraction hit, and boy oh boy, I knew we needed to get there FAST. I told Dan I was feeling pushy, and that it was common for multip moms to get their babies out in just a few pushes. He drove like an ambulance all the way to the hospital: speeding like crazy, lights flashing, horn honking, while I SCREAMED with each contraction. I was pushing! I felt powerless to stop it. On the way, I started to feel the “Stage 2 Sleepies” – a feeling I felt while pushing out Adam – the desire to close my eyes and nap between contractions. A little over halfway there (it’s usually a 20-minute drive, but I think we made it in less than 10), I felt his head duck under the pubic bone and it scared me enough to figure out how to NOT push, and breathe instead of scream with the contractions. I did not want to have the baby in the car. I was hoping people would see my license plate (“DOULA”) and realize what was going on – they must have, because people moved out of our way!
Dan ran into Admitting, and they told him to go park in the ambulance bay. He did, and a doc and nurse came around with a wheelchair. I got in as soon as I could. Dan said, “She’s pushing.” The nurse said, “Well, she needs to stop.” LOL! He said, “She’ll push if she goddamn well wants to!”
We finally got up to a room. I took off my pants and underwear and climbed onto the bed. Dan took his “spot” – the same spot he had with Adam, kneeling on the floor next to me, on my left. His knees hurt, so he asked for a pillow (I have a gardening pad in my doula bag for that very reason – but we left it at home!). The nurse, Penny, who I knew and liked from doing births (I’m a doula, but you’ve probably figured that out by now), told me my doctor, Jan, was in surgery and couldn’t deliver, so I would have her husband. I was disappointed, but at that point, I didn’t care too much. She held the monitor to my tummy (with my permission) and took a quick listen to the baby, his HR was in the 130’s, holding strong. I asked for drugs again. My husband asked if I wanted a narcotic, and I said, “No, I don’t want an IV! I just want to be numb from the boobs down!” Pretty irrational, but if you’re familiar with women in transition, it’s completely normal! I made Penny chuckle.
I had gotten so good at holding back from pushing, that I felt like I didn’t have to push anymore. I had Penny check my cervix, and I was complete but with a rim. She said if I felt like pushing that I could go ahead, and the rim would probably move. I had a contraction and forced myself to push. I knew I didn’t have to, but I really wanted the pain to end! I pushed twice. Then I felt a gentle hand on my leg, and it was Jan! I was so thrilled she made it. If I couldn’t have Paulette, then Jan was almost as good.
I really got down to business with pushing after that. I pushed two or three times with the next contraction. I remained on my left side, gripping Dan’s shoulders and screaming in his ear (it took two days for the ringing to go away – I felt SO bad!) while I pushed. I couldn’t believe the head wasn’t out yet! I could feel it, and it really hurt – worse than Adam’s head. It really burned, but I pushed through it because I wanted it to END. Finally the head was out! I think they suctioned just a bit, and then I pushed the rest of his body out. It felt amazing! I forgot about how I wanted to deliver the baby myself, and how I’d wanted the big mirror to watch everything. Jan handed me my baby immediately, and my husband reminded everyone not to tell me the gender. As soon as the baby was in my arms, I looked–-another boy!! I called him by his name right away (Mason Everett), lifted my shirt over my head, and laid him against my skin. I was so thankful to not be in pain anymore, and I laid there with a silly grin on my face, relishing this, my very last baby. The last time I would ever feel a little, yet weighty body slither out of me, and hold a slimy, precious newborn in my arms. It was a moment I won’t ever forget!
I latched him on several minutes later, and he nursed like he’d been doing it for a week already. I pushed my placenta out, and Jan said I had just a little skidmark, and asked if I wanted a stitch or two. I left it up to her medical opinion, and she decided to put a couple in. Mason weighed 9# 1 oz. and was 21 ¾” long, with a 14” head.
They checked his blood sugar 1 hour after birth, 2 hours after birth, and 4 hours after birth, and all three times it was above 40 (their “cutoff” for low blood sugar in newborns), so he didn’t need his sugar checked anymore after that. I was nursing him every hour and a half, to help my milk supply come in quickly, and also to keep his blood sugar stable.
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.
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.
Kmom's Story (c/s, 'failed' TOL c/s, VBA2C)
Kmom's Notes: This is a summary of my VBA2C stories only. I had a 'failed' VBAC with #2, but still elected to try for a VBAC with #3, so a lot of this story has to do with the difference between pregnancies and what I did to work towards VBAC and why. For further details on the other two births, really long and excruciatingly complete versions of all of my birth stories can also be found on my website under "Kmom's Birth Stories".
Birth Story
Baby #1:
My first baby was born by a horrific c/s after a very medicalized pregnancy and a difficult induction. The anesthesia didn't work right at all and I felt the surgery intensely. I didn't have a c-section, I had a vivisection. It was horrible. My baby and I were separated for quite a while, we had difficulties getting nursing started, and I had Post-Traumatic Stress Disorder, including flashbacks and nightmares about the surgery for quite a while afterwards. (More on this story can be found in the CS stories or in the Kmom stories.)
Baby #2:
My first c/s provided a very strong motivation (!) for me to pursue VBAC in my second pregnancy. However, I had limited resources for VBAC preparation and still had not fully grieved or processed the trauma of the first birth, which I feel definitely influenced my second birth. Despite laboring naturally with #2, we ended up with another c/s. The baby was in an undiagnosed posterior position and became 'stuck', so despite dilating easily, we pushed for almost 5 hours and still ended up with a 'failed' trial of labor. Fortunately, this time we used 'spinal' anesthesia, and this c/s was a good experience, if not my desired birth. In fact, I wonder if maybe I needed to have a 'good' c/s in order to start healing from the first awful experience. But it was still disappointing and not easy to recover from. (This story can be found in the CS stories or the Kmom stories also.)
Baby #3:
Although we definitely wanted 3 children at least, I found it difficult to make the decision to start a 3rd pregnancy. I felt extremely limited by the provider/birthing choices that seemed to be available to me, so I delayed trying to conceive. In the meantime, I went to one of Nancy Wainer's workshops on Healing and Grieving for birth experiences. That was the start of the breakthrough for me. Although I did not fix everything that weekend, I began the difficult process of opening the wounds and processing the grief, and much of the groundwork for my later healing was laid then. Within a few months, I felt far enough along in the process that I was mentally ready to try to conceive again. I began interviewing caregivers, and entered the pregnancy with hope and optimism (although that optimism wavered at times during the pregnancy!).
I continued the healing process by taking several workshops/classes with Birth Works (a childbirth preparation course), and these really furthered the healing process. In particular, they had me relive the horrific experience of feeling the surgery in my first c/s, and although that was very difficult, it helped reduce the power that experience had over me. It also clarified for me the nature of that fear, how it related to my other personal issues, and why it resonated so strongly in my life. So while I was terribly afraid of re-experiencing that awful event, in the long run it was greatly freeing to do so, and allowed me to release the emotional bondage from the experience. I mention these things prominently because I'm convinced that for me, VBAC preparation was not simply a matter of physical preparation and education about birthing choices. For me, emotional preparation was also KEY to achieving a better birth experience.
There were two main differences between my second birth (my 'failed' VBAC) and my third birth (my 'successful' VBAC). First, I learned a great deal more about baby positions and their influence on labor and birth, something that had been a problem for me twice previously but had gone undiagnosed and discounted as a cause for problems. I actively sought out information about preventing or changing malpositions, carefully used a number of these techniques, and selected providers that were extremely familiar with the problem and ways to help fix it.
Second, I actively sought to emotionally process my previous births and overall issues in my life. This meant taking several workshops, reading any VBAC book I could get my hands on, doing some hypnotherapy to help me deal with fears and visualize a better birth, journaling to help my emotional processing, and even doing some therapy sessions with a counselor to help continue to heal the abuse and body trust issues from my past. I don't think that my VBAC would have happened without the intense concentration I gave to this emotional preparation. For some women, VBAC is solely about physical issues, but for many of us it relates to the underlying issues basic to our lives, and represents a beautiful opportunity for healing in our lives. VBAC actually becomes the vehicle for emotional growth and healing.
As far as the actual pregnancy goes, it was fairly unremarkable. Although I had never seriously considered homebirth for me, I researched it to represent it fairly on my website, and wound up being impressed by the research stats on it! I ended up choosing it for me, which is a huge turnaround from the way I viewed birth in my first pregnancy. We chose carefully the tests and procedures that seemed reasonable to us while declining others, and were very proactive about diet, exercise, and stress. Because of my age and a history of mild gestational diabetes in my first pregnancy, we chose to monitor my blood sugar daily with a home glucometer and to take the gd screening test to be sure all was well. As in my second pregnancy, I once again tested negative for gd, but we still treated me as borderline gd and were very careful with diet, etc. In addition, I walked one or two miles most every day, and also did water aerobics/swimming and pregnancy yoga several times a week.
Given my history of malpositions, I researched the "Webster In-Utero Constraint Technique," a chiropractic treatment that was reputed to be very effective in turning breech babies (and other malpositions). I searched for a chiropractor in my area familiar with the technique, but was unsuccessful until the pregnancy was almost done (almost 36 weeks). I had had a great deal of sacro-iliac pain, some sciatica, and lots of pelvic discomfort, but after one treatment with the Webster Technique, I felt like a new woman! The chiropractor said that my pelvis/sacrum was extremely out of alignment and that sometimes this can cause the soft tissues (ligaments etc.) to torque the uterus unevenly, which then can cause the baby to assume unusual contortions in order to fit comfortably inside. Sure enough, although the baby had been consistently posterior throughout the whole pregnancy (36 weeks!), he turned to anterior for the first time ever within ONE HOUR of me getting the chiropractic adjustment and stayed there the rest of the pregnancy.
My pain significantly lessened after the treatment, and follow-up treatments also helped my body to re-align itself properly. This pain had been with me for nearly 5 years since my first pregnancy, and every doctor and chiropractor I had seen in the interim had failed to even take the problem seriously, yet this chiropractor had resolved the problem quickly, and I am convinced that this was one of the STRONGEST factors that physically helped me towards a VBAC as well. I would encourage any woman who has had a problem with baby malposition in the past to look into this technique (see other parts of my website for further info) and see if it's right for her.
As far as labor goes, we decided to encourage the baby to come at 38 weeks. Although induction usually LESSENS your chances at VBAC (and this is clearly borne out by research), my midwives felt that I might be helped by it. I had grave misgivings at first but got talked out of them; eventually coming to believe that this was my only real choice. This was a difficult decision to make, and ultimately, with time, I did come to feel like it was a HUGE mistake, but you make the decisions with the information that you have at the time. Right or wrong (and I now do think it was wrong), we decided to move forward with the induction.
The first part of labor was intense but not overly hard; it was nice to spend it at home and not rushing to the hospital. As labor intensified, we got into my tub (which had really speeded up my second labor). Between the tough contractions, though, we did manage to relax some, and we even sang through part of labor ("Come Unto Him All Ye That Labor" from The Messiah and "Dona Nobis Pacem"). I have great memories of this part of labor!
However, despite very intense contractions and having started the labor already dilated to 3+ cm, dilation stalled at around 5 cm, even after hours of contractions. This is often a sign of baby malposition, but the midwife thought the baby was anterior. I began to get discouraged. We decided to break the waters to bring the baby's head down more fully onto the cervix. Labor became EXTREMELY intense then, and was VERY painful and difficult to cope with. A recheck after a few hours showed little progress still being made despite the tremendous contractions.
I began to question staying at home, since labor was SO painful and no progress was being made; I also had an inner feeling that something was 'wrong' somehow (my second labor had been relatively easy and quick despite the baby's posterior position---all the pain and lack of progress this time made me very uneasy). I became very emotional, started wondering about a repeat c/s, and at the very least wanted to transfer to a hospital for more monitoring and an epidural. But when I mentioned this to one of my midwives, she became very dismissive of my pain levels, of my feelings, and derisive of the idea of transferring. She became very unpleasant and almost abusive in her attitude toward me. I became extremely angry that she discounted my feelings and was derisive of my perceptions.
She felt that I must have scar tissue on my cervix from having previous c/s at full dilation and wanted to manually stretch the cervix. However, by this time I had lost all trust in her and refused to let her try this. It just didn't feel 'right' to let her do this. She wanted to not just stretch the cervix the cervix through the adhesions, she wanted to fully dilate me by HAND. This seemed very dangerous to me, with a lot of potential for internal damage. I said no. She refused to take her hand out and was going to do it anyhow, which to me was inexcusable. We fought and I finally got her to take her hand out without doing any manual dilation. I never let her near my cervix again.
My other midwife was very supportive emotionally (despite feeling that I should try the manual dilation) and I greatly appreciated her support. As a compromise, I got back in the tub and labored another 2 hours, despite very intense pain levels and an increasing sense of disquiet. Finally, I told my first midwife I was transferring to the hospital no matter what she thought. She yelled at me but I didn't care. It's not that I felt safer at the hospital (I didn't), but that something told me I needed to go. I was upset with the first midwife, plus I really felt I needed some pain relief (and I'm not a fan of epidurals). Furthermore I just did not feel "safe" with that midwife anymore, and I knew I needed to get out of there. So I "fired" the first midwife, got dressed, and got into the car. I made DH take me to our local hospital. Even though the hospital was only 5 minutes from my house, it seemed longer!
I initially wanted to just have a c/s and get it over with, but after considering carefully, I elected to go in and try an epidural first as a last-chance effort towards a VBAC. We left the midwife I was upset with at home to be with our sleeping kids until my in-laws could arrive, and took the midwife we were happy with to the hospital for moral support.
At 4:30 a.m. or so, we arrived at the maternity ward and started setting up for the epidural. I had TREMENDOUS back labor by then and needed very intense counterpressure on my back (OWWW!). The pain was truly excruciating and I was glad I'd be getting some pain meds. Although we will never know for sure, it is quite likely that the baby once again was malpositioned, although he was still officially anterior. My guess in retrospective is that he was in a compound presentation (with his hand or arm by his head, probably with his elbow over his face, which puts tremendous pressure on the sacrum and causes nasty back labor).
The hospital bed had a section that drops for deliveries, and this was accidentally in an uneven (not level) position. As they had me scoot into position for the epidural, my hips shifted unevenly on this, and suddenly I had a tremendous urge to push. I could NOT sit still for the rest of the epidural, so they could not complete the process. The needle was in my back and everything (ick), but I never had the chance to get any drugs because suddenly I was pushing. What probably happened was that the particular hip movement I made on the uneven bed caused the baby's arm to drop away from his head, and with his position resolved, he moved quickly down into my pelvis. This arm-by-the-face position is notorious for being extremely painful but resolving quickly if the right movements are made.
At this point, we gave up on the epidural. (I was really bummed at the time, considering the pain, but in retrospective am glad we didn't end up with one.) I was checked and found to be nearly dilated, but with a stubborn cervical lip all around. The OB on call had not arrived yet, so the nurse offered to manually move the lip over the baby's head. That hurt like heck but was quick. After this we were fully dilated and pushing.
They had me pushing in the "C" position----back rounded, pulling knees towards the head, chin to chest. The baby's head momentarily stopped descending well; my midwife thinks his head hit my pubic bone and stopped progressing. We pushed that way for a while with no progress. I kept wanting to arch my back to push and the nurses kept telling me not to do that. Finally, against the nurses' wishes, my second midwife lowered my bed so that I was more flat and could arch my back to help the baby move under my pubic bone. For me this seemed to have been the key to getting the baby through the pelvis and out. After she saw that it helped and that my midwife knew what she was doing, the nurse stopped fighting us, despite my home midwife not having privileges at that hospital. If the nurse had continued insisting on a rounded back/chin-to-chest position, I don't know if the baby would have been able to get out.
I vividly remember the midwife telling me to touch my baby's head as he crowned (this was one of my greatest desires and I am so grateful she remembered), but I kept telling her I couldn't! My hands were supporting my hips and bottom off of the bed as I arched my back and I couldn't take them away during a contraction. As soon as we could, we found a way between contractions for me to move my hand briefly down there and feel the baby's head as it came out where it was supposed to! That was a GREAT feeling, very magical. I didn't have long to enjoy it (since I needed to put my hand back to help get in the best position), but it was an amazing feeling I will always remember.
The baby was born within a 12 minutes or so of starting to push. Because he was born so quickly, it was not fun to get him out, and my bladder got pretty bruised along the way. Also, at the very end, the baby's heart tones began to drop a bit, so they made me push very forcefully and between contractions in order to get him out quickly. Pushing between contractions, before the shoulders have turned, is generally not a good idea, and his shoulders did try to stick a little because of that. But in the end, he did not end up getting stuck. Arching my back even more strongly was just what I needed to do to give him enough room to finish turning his shoulders and come out. With a great scream from me (it was VERY intense!), out popped my baby, and I had a VBAC!
The baby was indeed just fine, and although I didn't get my fantasy birth, I did get to hold him shortly after he came out, while still attached to me. That certainly never happened after my c/s; IT WAS WONDERFUL and was worth every minute of pain, although I wasn't crazy about the pain part!. My husband declined to cut the cord, so I got the great symbolic privilege of cutting the cord myself, which I loved. This was the first time in 3 births that I actually got to SEE my baby right after birth, to hold him while still naked and goopy from baby juices, to see the cord and the placenta etc., to nurse the baby right away there on the table, to be the FIRST to hold my baby and bond with him, to look into his eyes RIGHT after birth and connect with him immediately. It was an AMAZING feeling. It's hard to describe just how much it meant to me.
The doctor did not arrive in time for the birth; she was about 2 minutes too late! Although she was great about handling an unexpected homebirth transfer, I was just as glad she wasn't there for the actual birth. Because we pushed the baby out so fast, I did tear slightly, and needed 3 small stitches. That wasn't a lot of fun, but let me tell you, 3 small stitches (even 'down there'!) were a heck of a lot better than 6-7 layers of stitches from a c/s! I had significant bruising and swelling of my bladder area from the quickness of the birth and the pain meds for the sutures, so I ended up having trouble peeing after the birth and needed a catheter for days afterwards. That was a major drag, but so many other things were better about the VBAC that I put up with it, and everything did end up returning to normal.
So although this VBAC birth was not a very easy one and some parts were a pain, I still absolutely feel that the VBAC was FAR better than a c/s. I had a lot of fun in the first couple of weeks, noticing all the ways in which recovering from a VBAC was easier and vastly superior to recovering from a c/s ("Look, I can sleep on my stomach already!" or "Look, I can cough without pain!" or "Look how easy it is to get out of bed!"). My husband got a kick out of my delight in those minor but so-telling details. :-)
In the end, even after all our care to avoid a baby malposition, we did end up with a compound presentation of some kind, but at least this was a type of position that was more easily resolved (compared to a posterior). Once the baby's hand/arm was moved down, he was born in just 12 minutes, a great relief after pushing for 2 hours the first time and 5 hours the second time! And what a joy it was to know that my body had actually 'worked right' after all, and to have those precious memories of holding my baby right away in my arms.
If I had had to have another c/s, I would have been very sad and disappointed, but I really would have been okay in the long run. I didn't see this birth as a "pass/fail" activity. For me, the baby and the JOURNEY towards his birth was the most important part. Getting a VBAC was the bonus----a really wonderful and enjoyable bonus, mind!---but not the main part. VBAC is not the right choice for every woman, but it can be a path of tremendous personal growth, even after a disappointment. I am so glad I didn't give up after my first 'failed' VBAC, and I would encourage other women who are so inclined to persevere also. I feel I am a much healthier person as a result of this journey, and I have taken many steps on the path of healing. And I have a sweet, precious little bundle to boot!
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. 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 the 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. 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!!
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 minus the billing fees (very reasonable). Our insurance company says explicitly 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 clean 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 then 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 home midwife knew just what to do and did it without harm to any of us. She had equipment to help if baby had shown problems, but none of it was needed because of her skill in helping baby out non-traumatically.
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. I asked my midwife about this directly. 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, so neither pelvic size nor baby size was really an issue. She just liked to have her arms behind her back, and to this day, she likes to sleep and walk around that way. 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 so had a catheter for a while, and I was sore as heck in my stomach and abdomen for a few days. That was no fun, but at least I didn't have surgery to recover from while I was sore. 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. 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-ish" 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!!" And it shows that fetal position is much more important than fetal size or pelvis size. Also, pelvic alignment sure helped a lot in birthing a big baby too.
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, given my "advanced age," 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, of not being able to adequately care for my older children---- nor did I want to risk the problems associated with multiple repeated 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. And it made going for more VBACs worthwhile too.
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 and the product, and that the process can be more than something to be endured, but a vital part of the JOY and sacredness of a new baby too.
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