3.10.2009

Broken- The Birth of My Third Son

In March 2008 we found out we were expecting baby #3. We had just moved to a new city, in fact we moved to our new house just days after getting that positive pregnancy test. It was an exciting time with so many new changes happening.
I had been in contact with a midwife who does homebirths and was opening up her own birth suite in the fall. I really wanted to birth with her, but at the time we found out I was pregnant, our insurance was debating whether to continue covering her. So we decided that until we knew if she would for sure be covered I would see an OB at the nearest hospital women's center. I'd heard great reviews of her and she was very nice. I did not like going there though. I always needed to bring my boys with me and every visit there was a very long wait to be seen, so I would be stressed out after an hour of waiting just to be seen for less than 5 minutes.
When I hit 20 weeks I let the midwife know that I'd probably be staying with the OB because changing providers after that would probably be too stressful. She promised to keep me updated on her status with our insurance company, so I'd have that information for the future.
At my 28 week appointment I went over my birth plan with the OB as well as the hospital's VBAC consent form. My OB was very accepting of what I wanted, but I was very put off by the VBAC consent. It honestly said that I understood that a c-section would be better but I had been informed of the risks and still chose a more dangerous option. Not in those exact words, of course, but pretty close. When I left that appointment I told me DH that I just was not comfortable there and would like to switch to the midwife if she still had a spot available.
So I contacted the midwife and she got right back to me and let me know that just that day she had received a letter from my insurance saying she would remain covered, and she still had an open spot in November even though every other month had filled up. It was like it was meant to be. We set up a time to meet in person.
Both DH and I felt very comfortable with the midwife and happy about the choice to switch to her. She was so caring and was also very good with my boys. They loved visiting her office with all the toys and movies and stickers. And because I'd been in contact with her since before I even became pregnant it wasn't uncomfortable to start seeing her so late in my pregnancy. She was always willing to answer my questions thoroughly and took the time to explain things like medical records and lab results. I was grateful that prenatal appointments where something to look forward to rather than dread.
As my due date neared I started getting nervous about when labor would start and all that. My whole pregnancy I'd had this nagging worry that I'd been lucky the last time and maybe wouldn't be so lucky this time. I tried pushing that out of my head and focusing on positive thoughts but still couldn't keep my fears from coming back.
According to my early ultrasound the OB had set my due date as November 12th, even though I knew my exact date of ovulation and according to that I was due November 16th, which is the edd I told everyone. I didn't want people freaking out if I went past the 12th.
November 11- I had an appointment in the morning. My midwife did a non-stress test, I think mostly for her own liability since she had no back-up OB she wanted to show that she was monitoring me once I hit "40 weeks". I had no problem doing it either, I got to lay on a comfy couch drinking orange juice and chatting with her while the boys played. It was of course fine. I debated with myself about getting my membranes stripped. I had it done with Jacob and it had sent me into labor that night, so I figured it would probably work again, but I was also wary of any kind of intervention. We finally decided to go ahead and do it.
This is the first part of my birth story that I wish I could go back and change. If I hadn't pushed my body into labor, maybe things would have gone differently. At the time I'd been so impatient to be done. I had not enjoyed the pregnancy as much as I had my first two and I wanted my body back.
I was about 2cm dilated when I had it done, just like with Jacob, and I was expecting that I'd probably go into labor that day or the next. After my appointment I started having contractions. They were sporadic at first, and easy to deal with. By around 5pm they were consistantly 3 minutes apart, but still easy to handle.
I had my sister dye my hair that evening and she couldn't even tell that I was having contractions. We went to my family's house for a few hours that night, with my contractions still coming every 3 minutes. I finally called my midwife around 10pm to give her a heads up that I was in early labor. She told me to just give her a call when I felt I was ready to head to the birth suite.
Just to clarify, even though my contractions were so close, they were not very intense and I knew it was early labor still. My labor with Jacob had also started out with contractions 3mins apart and taken 20 hours so I was expecting about the same.
November 12- At home that night I did not sleep much. I was too excited. This is the second thing I wish I could change. I wish I had taken the chance to rest as much as possible. I did lay down for a bit around 1am and got about an hour sleep between contractions before a very painful contraction had me hopping out of bed. After that they got more sporadic. I tried to rest some more around 5am and when I woke up around 6:30am they were almost gone. I only got a few every hour for the next 4 hours.

Around 10am I decided to go for a walk, despite the freezing drizzle coming down, so I bundled up my boys and set out around the block. Mistake #3. I should have let my body get some rest instead of wearing it out more. The walk did what I had hoped and got my labor going again. The contractions were still sporadic, varying from 2-11mins apart, but slowly getting more intense.

My midwife called soon after I got back from my walk to see how things were. I updated her on how things had sputtered out and told her I still thought I'd be having the baby that day or the next and would call her if things picked up.

DH had asked if he should go into work that morning and I told him to go ahead because it still seemed to be a while off. He planned to take just a half day, but by noon I told him to go ahead and stay the whole day, things were still slow. He didn't get home until later that evening. By that point I wanted him there to help take care of the boys because I wanted to concentrate on my labor more. I had been sitting on an exercise ball most of the day so I was getting tired of that and just plain annoyed at everything.

Around 9pm I called my midwife and told her about my contractions and how I was feeling. She said it was up to me as to when I wanted to go to the birth suite. I told her I thought that I should head in because maybe once I got to the place I was going to give birth I would be able to relax more and let things happen. She said that sounded great and she'd meet us there in a little while.
DH and I got the boys ready to go. We were taking them with us because we wanted them to have the option to see the birth if they were awake and wanted to be there. I updated my online friends that I was heading in. I still hadn't told my family because I wanted to get to the birth suite and make sure I wasn't just going to be heading home before keeping everyone up all night, but I forgot that my sister-in-law reads my blog. She called when we were on our way so I let her know I was in labor and invited her to come over if she wanted (she had been with me for my other 2), and she told me she couldn't this time because she had school in the morning, but her and my brother would come visit me and the baby the next day. I decided I might as well call my family and let them know as well. My mom and sisters were excited and said they'd come over.
We arrived at the birth suite at 10pm. I immediately got situated in the wonderful large soft birth tub while DH got the boys settled in the family waiting room with a Disney movie. At first I felt a little awkward sitting in a large bath in just a sports bra, but got over that pretty quickly considering I was planning on a bunch of people watching me push a baby out lol.
My mom and 3 sisters arrived around 10:15pm and we all settled in for a long night. My little sisters stayed with the boys. Jason fell asleep pretty quickly, but Jakey didn't fall asleep until nearly 1am. He kept wandering back and forth from the family room to me. He kept wanting to get in the tub with me but we were finally able to get him to fall asleep on the bed. My mom stayed with me the whole time, chatting nicely with the midwife. Every once in a while I would get out of the tub to cool off and walk around a bit. I walked the empty halls of the building the birth suite is in for a while, and another time I went to the little kitchen to find something to eat. I munched on some dried fruit that I didn't really like, and eventually settled for some graham crackers. I really wanted bread but the only bread there was frozen so the crackers were the closest thing to that. I mostly stayed in the tub though, drinking lots of water, munching the graham crackers and getting out once an hour to go pee. My midwife kept offering orange juice because she said it would help me have more energy, but I declined, instead just having ice water. Another mistake, I was going to need that energy and wish I'd taken the dang juice.
November 13- I felt I was handling labor very well. When we'd arrived my midwife had asked where I thought I was and told her that I was probably around 7cm because at that point I felt the same as when I'd gone to the hospital with Jakey and been 7cm. My midwife doesn't perform vaginal exams unless absolutely necessary (the membrane sweep had been the only prenatal vaginal exam I'd had with her) so she took my word for it and just let me labor however I wanted.
I love the tub. I hadn't been sure if I would because I'd never labored in the water before, but it was wonderful. It helped me handle contractions so well. With each contractions I would focus on breathing evenly and allowing my body to relax and open up. To get myself to not focus on contractions as pain I would instead imagine my cervix stretching open to let my baby out. I listened to my mom and midwife talk between contractions, and ignore them when once came. I found that as they got more intense it really helped to have a cold wet washcloth on my forehead. Those hours of peaceful labor where wonderful.
As the contractions got even more intense I started getting a little panicky, realizing again that it was only going to get worse before it got better. I was anxious to be done. I was exhausted for not getting much sleep in the last 2 days and just hoped that things would go more quickly. As I hit transition it was harder to relax and let my body work but I did my best to breathe calmly. Around 6am I finally started getting the urge to push during some of my contractions. Around that time I also had to start making noise. My midwife reminded me to make low deeper noises and told me to just do what my body wanted. My DH had been sleeping this whole time so they went to wake him up. He was surprised at how long he'd slept, which I thought was funny. Jakey also woke up himself, bright and early just like any other day, and came in and sat on my mom's lap.
At 6:15 I really started pushing. I was in pain and wanted that baby to come out. After a little while my midwife checked and found there was still a little lip of cervix left and held it back so I could push past it. Things at that point become a big blur to me. I pushed for a while in the tub, trying different positions including hands and knees and squatting, but when nothing was happening she had me get out and try pushing on the toilet for a bit. It was excrutiating to be in that position, though it helped when my midwife would push against my knees during the contractions. My water broke while on the toilet (perfect timing huh?) and that momentarily shocked me away from the pain. It was the first time I've had my water break on it's own and I was surprised at the intensity of it. I think I said, "Woah! That was weird!" and laughed a little.

Of course I stopped laughing once the next contraction hit and I was in even more pain. We moved to the birth room and I got on the bed and tried pushing on my side for a while. Then we tried on my back, my other side, hands and knees, squatting by the side of the bed, one knee up on the bed, etc. At one point my midwife reached in to push my pubic bone out of the way to see if that would help the baby move down. That was the most painful part, I screamed out. But it did no good. She got out her birth stool and I tried pushing on that while leaning back into DH, even though a seated position was so painful. I also stood with my arms around DH's neck for a while, hanging off him when a contraction hit. I could tell with every failed position that everyone was getting more worried about no progress being made.

During contractions I was in extreme pain and pushing as hard as I could. I also could hardly move my left leg because something was hitting a nerve, sending stabbing pain down my leg, and moving it hurt worse than contractions. Between contractions I was crying and praying and asking, "Why won't he come out?!" I blubbered that I was just so tired and it hurt so much. By that point I was fighting the contractions instead of trying to relax. I was just too tired to stay on top of them. I also felt like I couldn't breathe the whole time. During every contraction the baby's feet would shove up into my ribs and unless I pushed back against them I felt like I had to gasp for breath.

Finally at 8am I could hear my mom and midwife discussing a hospital transfer. I kept pushing as hard as I could, but that was the point when all hope left me. I just knew that a transfer would equal a c-section. My midwife talked to me and said she felt that there was nothing else we could do there and that we should probably transfer. She said that maybe they would be able to use forceps or a vacuum to help out when we got there, but I didn't believe it. DH asked me if I wanted to go to the hospital. I wanted to say no, but I just told him I was so tired and it hurt so much, and agreed to go. I cried as I hurried and threw on my clothes between contractions and grabbed my purse. We left about 8:15am. I remember standing in the parking lot as we headed out, hanging onto my dad through a contraction, then whimpering that I didn't want to get in the car because it would hurt.
My dad was going to drive us there so that my sister could use our van to bring the boys up. Everyone else stayed behind to get the boys up and all of our stuff loaded, while DH, my dad, and the midwife piled into the car with me. I sat facing the backseat just hanging off the headrest and moaning through each contractions, not caring that I was probably leaking fluid all over the seat. The midwife kept monitoring the baby (as she had all night) to make sure he was doing fine, and she made calls to the hospital so they would be ready for us.
The nearest hospital was only 5 minutes away but we chose not to go to that one because it is not covered by my insurance and it wasn't an emergency. Instead we headed to one about half an hour away that my midwife recommended. This was during morning rush hour traffic, so normally it would have taken even longer to get there. My dad drove like a mad man, breaking every traffic law, and got us there in about 15-20 minutes. He ran lights and stop signs, weaved in and out of lanes, even had one side of the car up on the sidewalk for a bit. Only he could drive that crazy and not get us killed lol. At one point he stopped at a cop that was monitoring traffic and asked if he could escort us to the hospital, but the cop refused! What a jerk. Luckily I was facing backwards during the ride so I didn't have to watch our crazy drive.
We finally arrived at the hospital, maybe around 8:40. DH grabbed a wheelchair and I got in it. He ran as fast as he could into the hospital, asking a lady at the desk where to take me. She ran ahead of us and we raced up to Labor & Delivery. I was afraid I was going to be tipped over as DH raced around corners and down halls. I kept muttering, "Please don't kill me!" between contractions.
We finally arrived at a room where they handed me a gown and monitor belt thing and told me to change. I hurried and shed my clothes and threw on the stupid gown between contractions and got into bed. They put the monitors on and by this point I was just hanging onto the bed rail for dear life, moaning and yelling. I barely felt any break in contractions while in the bed and had no clue what was going on around me. Things went so quickly. I had no idea who was in the room with me. Some guy came in to give me an IV and warned me that it would sting a little. I remember thinking, "Does it look like I care about a stupid prick?!" The first IV he did started bleeding down my hand so they had to re-do it. Someone told me they needed to put an internal monitor on, and I let them, not really caring anymore.
Then I remember them saying I needed a c-section right away. Something about the baby's heartrate. My midwife asked if we could try forceps or vacuum but they said no. They said there might be time for a spinal but they felt it would be better to put me under. A guy came over to me and quickly explained that they felt they needed to do an emergency c-section and would have to put me out and I consented. I had already resigned myself to the fact that going to the hospital meant having another c-section so I wasn't surprised, I'd just been waiting for someone to make the decision. He started saying something about the risks, and I just nodded thinking, "Yeah, I've done it before, I know."
I was actually grateful when they said they'd have to put me under because I knew it meant I'd be out of pain soon. They wheeled me to the OR, still clinging desperately to the bed rail and moaning, and hurried to get me prepped for the surgery. It hurt to unfold my body and allow the to strap down my legs and arms. I couldn't fight the pain that way and felt like I was engulfed in pain. I was begging them to just put me under. I think I was saying, "Come on!". They put an oxygen mask on at one point and for once it didn't feel suffocating, I was grateful for the air.
Finally they must have put me out because the next thing I remember is waking up in a recovery room. I think my mom and DH and a nurse were there. It was around 2 hours later and it was disorienting to go from extreme pain to quiet and much less pain and realize I'd missed 2 whole hours in the blink of an eye. They had given me a morphine drip but I was still in pain even after pushing the button many times so they gave me a shot of something else to help until the morphine kicked in.
I don't remember much right after I woke up. DH came over and showed me a picture of my baby. Little Nathan had a full head of dark hair, was born at 8:57am, 9lbs 3.8oz and 21.25" long. What a big boy! I only looked at the picture for a minute. Oddly, I felt no attachment to that baby in the picture. I hadn't witnessed his birth so it was like he wasn't real until I could see him. DH left to go be with him and my mom stayed and talked with me. My midwife had to leave soon after he was born because she had other clients to see, but said to let me know she'd be back later to check on me.
I was told that the reason they'd had to hurry and do the c-section was because his heartrate had disappeared for a few minutes and then when they found it it wouldn't go above 80. They also found that his arm had been wedged in front of his face, which is probably why he couldn't get his head under my pubic bone. And during the c-section they cut so fast and his arm popped out first and got nicked, luckily just a little scratch. My mom also told me about how much my husband loved me and how scared he'd been when he'd come back from filling out paperwork (at some point after we got there he'd been sent to register) and I was gone. He hadn't known about the c-section until I was already under. She says he was just waiting in the hall and crying until they brought the baby out and said I was fine and he got to go with the baby to the nursery.
About an hour after I woke up the took me to a postpartum room. I was excited to see it was much bigger that the rooms at the hospital I'd had my other two at. I was also strangely happy about not being all numb and being able to actually move my legs, unlike my first c-section. I started wondering where DH was and my mom went to find him. He was in the nursery with the baby, and finally got to bring him back to me at 1pm. It had been 4 hrs since the c-section.
Once my baby was finally in my arms I was so happy to see him. I'd felt an odd emptiness between the time I woke up and the time I saw him, like he didn't exist. But seeing him and holding him was wonderful. I was so in love. I immediately began to nurse him because I could see that he was hungry, and he latched on and went at it like a natural.
That first day I was so exhausted, I'd had hardly any sleep in 2 days and gone through a long labor and difficult end. I could barely keep my eyes open as family came to visit. But I felt ok. I told myself that I was okay with the c-section because it had been necessary. I already felt like I was recovering better than my first c-section too, I was able to get up and walk to the restroom that night without too much pain.
It wasn't until a little later that I was able to think through things and my feelings about the birth started getting worse and worse.

3.09.2009

What was the point of even trying?

Every time I think I'm starting to get over my feelings of sadness about my last birth, I read a birth story that just shoves it all in my face again. And it's all kinds of birth stories, from the one's that had every intervention under the sun and still had their "perfect" birth, to the scheduled c-sections, to the unassisted homebirths. All of them hit me in different ways, but they all make me feel like a failure.

A friend recently had her baby and I just read her birth story. She got an epidural at 3cm, some pitocin, and all the monitoring and IVs that go along with it. And her beautiful little girl came out just fine. My cousin had her baby today, she chose to be induced. As far as I've heard everything turned out just fine with that birth too. I am of course very happy for my friend and cousin, but it just makes me wonder what I did wrong?

I did everything I felt was best to insure a great birth with low risks of intervention or c-section. I labored at home for a long time, then went to a birth center with a wonderful midwife, labored in the tub to deal with the contractions, pushed in every position imaginable. I let my body do what is supposed to come naturally, and it failed me. I ended up under the knife again.

It just doesn't seem fair at all. And I know, life isn't fair, but what hope is there when I do everything I can for the best outcome and still get screwed over?

3.02.2009

TIME Magazine Article- The Trouble With Repeat Cesareans

Recently TIME magazine published an article called The Trouble With Repeat Cesareans. I was so happy to see an article that gave some good information on actual statistics and the way women are being forced to undergo surgery they don't really want because they feel there is no other option. VBAC is an option. It can be done and, although it has slightly more risk than a vaginal birth with no c-section history, it is not horribly irresponsible as many doctors and others make it out to be.

Reading that article is actually what pushed me get started on this blog. I know reading about other people experiences has helped me, and so I figured that writing down my own might provide some healing. The article also gave me some hope for my future births, but I know I need to handle my current fears and emotional scars before I can really be ready to think about having another baby.