Monday, June 27, 2011

From Natural To Cesarean to VBAC and Homebirth: My Journey Through Birth Stories

My mother must have told me my own birth story a thousand times, mostly upon request.  I was her 3rd birth; she definitely knew what she was doing by then.  She would have considered homebirth, but didn’t feel comfortable in the living conditions she found herself at the time.  I was the very first baby born in the brand new birthing room at St. Joseph’s Hospital in 1979.  Her doctor, a family practice physician I would continue to see into my teens, sourly grumbled through the entire labor and birth.

“How do they expect me to deliver a baby in the dark?” He obviously was not a fan of the new fangled soft lighting.  When it was all over, he came to my mother’s bedside, laid his hand on her forehead, and said, “You did much better than I did.”

After being strapped down to a cold, steel table and drugged without request in her first birth, and almost delivering in the hallway in her second, Mom was ready to take control with her third.  With the help of Lamaze training and the very effective nails-in-husband’s-thighs technique, she birthed a perfectly pink and healthy baby girl.  She birthed naturally and un-medicated, all while trying to block out the bitching baby catcher.  And then – as she never failed to end the story – she walked back to her room.

The Birth of My First Daughter

I have no doubt that my own birth story played an important, albeit subconscious, role in the decisions I made as I planned my first birth.  I knew immediately and instinctively that I wanted a natural birth and all of my choices incorporated that goal.  Since there was no birthing center near me, and I was terrified of homebirth, I chose to birth in a hospital.  But I chose a certified nursing midwife as my caregiver instead of an OB/GYN.  I researched pain management techniques, read Natural Childbirth the Bradley Way by Susan McCutcheon-Rosegg, and attended a Bradley birthing class with my partner.  I bought Birthing From Within by Pam England and Rob Horowitz, but I honestly couldn’t get through the rather long first section on birth art.  I toured labor and delivery at the hospital and wrote a birth plan to go into my chart. 

Through my research, I learned about things like c-section rates and VBAC’s (vaginal birth after cesarean) for the first time.  And having already experienced painful and debilitating surgery in my past, I was pretty terrified at the thought of medical intervention, especially considering I would have a newborn baby in my complete care. 

But as I do with most things that frighten me, I rationalized that if I thought too much about it, those negative thoughts would make it happen.  So I tried not to think about it.  I conveniently skipped those chapters in my birthing books and bypassed those articles in my parenting magazines.  I tried to visualize only the natural birth I desired.  And then… of course…

Laboring the first 12 hours at home went pretty smoothly, especially since I naively didn’t recognize the back labor as labor for quite a long time.  When I arrived at the hospital, all my feelings of calm and control went flying right out the window, along with any confidence I had in my abilities to birth my baby.  After the student nurse got my heplock in (on the 5th stick) I was forced to stay in bed and be monitored for an hour.  After a while, another nurse came in and authoritatively announced, “Ok! Lets get you in the tub!”

I didn’t particularly feel like getting in a standard sized bathtub where I had to lay on my back, but since I was just starting to enter transition, I didn’t have the strength or ability to say no.  As I write that, I’m smacking myself in the forehead and saying, “Doula! Doula! Doula!”

After about an hour in the tub, I hit the wall, and asked for drugs.  I had a contraction as I walked back to my room and stopped to bend down and lean against something in the hallway.  It seemed easier to handle in this position, so I lingered there waiting for the next contraction to take hold.  But before it could, I was hurried by the nurse to get back in my room because the anesthesiologist had already been paged.  I spent the next half an hour or so laboring on my back in bed before he showed up to administer my epidural.  I then endured the accompanying catheter, baby monitor, oxygen mask, and IV.  During this entire time at the hospital – about 6 hours total – I dilated 2 centimeters.  And that’s when it got really scary. 

I started feeling some intense pressure but was only 7 centimeters.  Then, according to the baby monitor around my stomach, my baby’s heart rate went into tachycardia.  It would race, and then flat line, race and flat line.  Within an hour after my epidural, and without confirming with a fetal scalp monitor, I was being strapped down to a table and prepped for an emergency cesarean section.

After 24 hours of labor, exhausted, in pain, and terrified of what was happening to my body, I focused my attention on Chuck’s eyes, the only part of his body showing through his paper scrubs, and tried to listen intently as an OB/GYN, assisted by my CNM, cut open my stomach and pulled my baby girl from my uterus.  She was not pink and healthy.  She was grey and she was not breathing.  Her one-minute apgar was only 5 out of 10. 

My head started to fog over as I anxiously waited to hear my baby cry.  I looked out to catch a glimpse of her in the sea of blue scrubs, but I couldn’t find her.  I heard the words “meconium” and “intubate,” but everything felt so far away.  Finally, after an agonizing few moments, Danley Jolynne began to cry and I saw Chuck’s body shake with laughter.  Then everything faded to black.

I was bleeding heavily and freaking out pretty badly at the thought of my body being split open.  I was put under and started on a pitocin drip.  It would be another two hours before I was finally able to hold and nurse my beautiful baby girl.  It would be another month before I could stand up straight without any pain.

The Aftermath of An Emergency C-Section

I was, of course, overjoyed with my baby Danley.  I tried to find solace in the fact that it was a good outcome – mom and baby were both fine.  That’s what everyone kept telling me so that’s what I thought I should be feeling.  But the problem was, I wasn’t fine.  I was physically and emotionally scarred.  I was devastated that I was unable to do what millions of other women, including my own mother, had done without intervention.  I felt like a failure, a defective.

My one hope of salvation came in the realization that I would be able to try again with my next birth.  I could just have a vaginal birth after my cesarean (VBAC).  That hope was cut down at my six-week checkup with the obstetrician who had preformed my c-section when he told me that no OB or hospital in New Mexico would allow me to even attempt a VBAC.  His answer to my emotional pleading why? “It’s policy.”

I was crushed.  Defeated.  My whole future started changing before my eyes, and in my postpartum, emotional state, I questioned whether I would even want more children.  I had endured three terrifying and invasive surgeries in my lifetime and could not fathom volunteering for another one.

But as my strength came back to me, so did my logic.  And my stubbornness.  Who the hell was this guy? Was I going to let some doctor – some stranger – make choices about my own body? What is going on in this society when women are being stripped of their right to choose? What did my mom and thousands of other women fight for in the 60’s and 70’s women’s movements?

I was determined to prove them wrong.  I would make my own choice when I had another baby.  I had come full circle and was once again ready to take control of my own birth.  But this time, I wouldn’t push my fears aside and avoid them.  I would confront them head on.

I started listening to as many birth stories as I could, the good, the bad, and the ugly.  I learned that we all had the same fears, obstacles, joys, and sorrows.  And I finally started to see that as mothers, all we really want are healthy babies.  That is why we fight so hard for our births – we want healthy babies and healthy mamas.  In the end, I found that incredibly helpful, knowing that I was making my informed decisions based on the health of my baby and myself.

I took advantage of a college women’s studies course assignment and dove head first into a VBAC vs. ERCS (elective repeat cesarean section) research project that encompassed a ten-page report with a dozen peer-reviewed sources.  I discovered that my instincts had been correct all along.  I found no evidence that the risks of a VBAC were any higher than the risks of an ERCS.  In some cases, outcomes were actually better with VBAC, especially when it came to patient satisfaction and informed consent.  I now had the cold hard facts I needed to make up my mind.  I was going to attempt a VBAC and since it wasn’t going to be happening in a hospital and I certainly didn’t want an OB/GYN as my care provider, I was also planning a homebirth.

But now for the fun part: getting pregnant.  Chuck and I decided that after 5 years together and one child, it was about time we got married.  We planned an October wedding and would start trying for our second child immediately after.  But, the best laid plans….

Tragedy Rears It's Ugly Head

Five months before the wedding, my mom was diagnosed with cancer and given four to six months to live.  She had obviously had it for some time and was already unable to care for herself.  So I dropped out of school, threw all the wedding plans into Chuck’s lap, and moved Mom in with us so I could care for her.  She knew she would never get a chance to meet the baby we were planning, so she crocheted a blanket for her unborn grandchild. 

Mom’s goal was to make it to the wedding, and she did.  But she deteriorated very quickly after that, and entered hospice care.  Chuck and I stuck to our plan and started trying to get pregnant, but with the added stress in my life, it just wasn’t happening.  Mom lasted almost two months more and died on December 9, 2009.  On January 1, 2010, while back in the town where I was born and raised, to bury my mom, I got pregnant.

The Birth of My Second Daughter

Once again, I immediately started planning my birth.  I found a new midwife with gaggles of experience in homebirths who was willing to take on a VBAC.  I felt the need to have other women present for support, considering I would be doing this without my mom.  I asked my friend Staci and my friend and massage therapist Cheryl to attend the birth.  I made sure Chuck was on board with my plan and we talked about what I would need from him at the birth. 

I dragged out my copy of Birthing From Within and engrossed myself in it.  Ironically, it was the best decision I could have made.  I didn’t even skip the birth art section and actually ended up making a few drawings and a clay sculpture.  Through the wisdom and encouragement of that book, I learned to completely trust myself and the decisions I was making.  I would write no birth plan.  I would practice no specific pain management techniques.  I would allow my body to lead me through this journey I knew it was ready to make.

I also learned to trust the decisions I had already made.  Birthing From Within finally helped me over the last hurdle I had in accepting my first birth.  Two simple words made all the difference: cesarean birth.  Once I stopped referring to my first birth as a c-section or defining it as a surgery, once I started defining it as a birth, all the feelings of inferiority, weakness, and defection faded away.  I birthed my baby.  I may not have pushed her through my vagina, but I still birthed my baby.  I was in labor for almost 24 hours, most of it un-medicated.  I was strapped down to a table and sliced open while I was awake.  Two hours after that, I was sitting up nursing my baby in a broken bed that wouldn’t move up to support me.  Nothing about my first birth was weak or defective.  I was strong and I birthed my baby.

With this new knowledge and confidence, I would no longer fear another cesarean birth.  I knew, that if it came to that, it would be a necessary and life saving procedure that would be in the best interest of both my baby and myself.  I rocked that first cesarean birth, and I could do it again.

On the morning of September 14th, I woke up with the urge to squat.  I squatted all day.  I squatted on the bed, I squatted on the chair, I squatted over here, I squatted over there.  I visualized my baby in perfect alignment in my pelvis.  My body must have been trying to tell me something, because I started to have light contractions that evening.  They were just gentle squeezes in my uterus, the first of many new feelings I would experience with this birth.  After a brisk walk, I decided to get as much sleep as possible and went to bed.

Labor Begins

I woke up on the 15th still having mild contractions but they were now regular and coming more quickly.  After discovering I’d lost my mucous plug we decided it was time to call my midwife.  Katia came over and, upon request, gave me my first vaginal exam of my pregnancy.  I was effaced some and dilated very slightly.  Katia seemed doubtful when we talked about the rest of the day.  It could be today; it could be tomorrow, or the next day.  But I knew she was wrong.  I knew my baby would be born today.  Today was my mom’s birthday.

After another walk, I put Danley down for a nap and decided to try and take one of my own.  I knew I would need all my strength soon.  An hour or so later, I woke up when my water broke, something else I had never experienced before.

“Eck, it just keeps coming out! I’m leaking! I’m leaking,” I laughed as I tiptoed to the bathroom like I had an invisible beach ball between my knees.

My contractions immediately became much more intense and closer together.  Looking back on it I feel like I skipped a couple of stages and went right to transitional.  I called Katia, Staci, and Cheryl.  Katia came right over.  Cheryl would come in a little while.  Staci, who was three hours away, started the trek down.  I put on my comfy nightgown and my trustee Grey’s Anatomy DVD, and started walking around my bedroom. 

When a contraction would squeeze my uterus, I would stop and lean over the bed or the bathroom counter, supporting myself on my arms.  It was very similar to the position I instinctively went to in the hallway at the hospital.  Cheryl or Chuck would rub my lower back and I would breathe loudly and deliberately.  I felt as if every breath was getting me one step closer to birth.  Every single breath was a strategic move along our journey. 

In my first birth, I was stifled and quieted.  In this birth, I freely used my voice to help me through the pain.  Yes, that’s just a nice way of saying I screamed like a banshee through the entire birth, but it tremendously helped me maintain control and a sense of power in my labor.  Instead of trying to ignore the pain of labor, I let that pain flow through me and out my mouth in the form of yelling. 

I also instinctively kept my eyes closed through most of the contractions.  Since contractions were right on top of each other, I had my eyes closed through most of my labor and birth.  No one tried to tell me to focus on something or to stop using my energy to squeeze my eyes shut.

When things started to get tough, I found myself before the mirror with my husband supporting me from behind.  We stood together, our arms bent at the elbow, holding hands.  During the brief break in between contractions, I would lean back against his body and rest the back of my head on his chest.  I would take in his familiar and comforting scent while I continued to breathe heavily.  When a contraction came, I released the strength in my legs and dipped my pelvis back and forth.  At first, Chuck tried to do the move with me.

“No,” I murmured to him and shook his hands.  “Stay strong.”

He stood erect and took on most of my weight and I continued my pelvic dips.  I had been on my feet and mobile for almost two hours straight.  While it was definitely one of the most painful two hours of my life, it was also two of the most exhilarating.  I look back on those two hours and I remember feeling calm, peaceful, strong, and powerful. 

Fear Does Not Mean Weakness

I started to get tired and felt a moment of worry.  Only two hours and I’m already feeling tired? Katia suggested I get in the shower, but I instinctively resisted it.  I think I was remembering how it felt to be told what to do in my first birth so I resisted her help, even if it was what was best for me.  I sat down on the bed and started doing an odd sit up while holding on to Katia’s hands.  I expressed my fear to her in short, monotone sentences. 

“I’m scared,” I said.

“Of what?” Katia asked.

“Of her coming out,” I said.

She gave me encouragement and told me to open my mouth.  Like a baby bird trusting his momma to feed him from her own mouth, I opened my mouth and Katia placed a few drops of liquid on my tongue. 

“What’s that?” I asked.

“It will help your fear,” she said.

Katia again suggested I get in the shower.  Obviously her experience and instincts saw that my body needed a change.  This time, I heeded her advice and got into a hot shower while my husband sat next to me.  I had two contractions, I think, and my scream changed slightly as I experienced my first ever urge to push.  Katia was there in a moment and I was guided out of the shower and onto the bed that had been prepped only moments earlier.  As I climbed up into bed, I pushed my head into the mattress and started to wail.  But don’t think suffering wail here, think Lucille Ball wail. 

“What’s wrong?” I could hear the chuckle in Katia’s voice. 

“THERE’S NO WAY SHE’S GOING TO FIT THROUGH THERE!” I yowled.  “HOW DOES ANYBODY ACTUALLY THINK THIS IS POSSIBLE?”

I can thankfully testify that the power of the body is in fact stronger than the power of the mind, because while my mind filled my thoughts with fear and doubt (however comical) my body was telling me, “you’re doing this – right now.”

Without any coaching of how, when, or how long to push, I pressed my face in the mattress, stuck my ass up in the air, and pushed with my contractions.  Chuck lay opposite me, his face close to mine, holding my hands.  Every time I pushed, I could feel her head peaking out and with each small break I would feel her head slowly retract back up the birth canal.  I remember feeling comforted by the predictability of that movement.  This is how it should be.

After a good night’s rest, a leisurely morning, three hours of labor, and five minutes of pushing, I birthed a perfectly pink and healthy baby girl.  She let out a yelp to let us know she was breathing, and then was calm.  I finally stopped screaming, rolled over onto my back, and opened my eyes for the first time in hours.  The first thing I saw, was my baby being put onto my chest, her umbilical cord still connecting us.

“I did it,” I cried.  “I really did it.”

“You really did it,” everyone else cried.

Only after the cord stopped pulsating was it cut and I birthed my placenta immediately after.  Within minutes of birth, I was laying comfortably in my own bed with my baby, nursing, warm and cozy on my bare chest.  Poor Staci arrived just moments later.  Scarlett’s one-minute apgar was a 10.  No other interventions would occur until a couple of hours later when she would be weighed and measured and given vitamin K.

The Lessons of Births

Right after Scarlett was born.
It was, by general definition, the perfect birth.  And while it was one of the hardest experiences of my life, I look back at it with nothing but good feelings and absolutely no regrets.  I even feel like I have gained confidence in myself as a mother because of my birth of Scarlett.  I have more confidence now to listen to my instincts, because I had such a positive experience when I did that in birth. 

Scarlett’s birth gave me the experience I craved, the closure I longed for, and the most beautiful way imaginable to celebrate my mom’s birthday.  From natural, to cesarean, to a VBAC at home, I wouldn’t change a single line of my birth stories.  And I will continue to tell those stories to my two beautiful daughters, hopefully, most of the time, upon request.






***This post was originally written under my previous blog name, Zen and the Art of Cloth Diaper Maintenance.***

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