Thursday, May 28, 2009
Cool!
I'm on 5 VBAC/birth related yahoo groups. It's been a great support. Today a woman posted that she had a successful HBAC (home birth after cesarean) after four cesareans!! Her husband caught the baby and the midwife arrived 20 minutes later.
Tuesday, May 26, 2009
Processing
Thanks to everyone who took the time to read my long story. I wrote it originally to process everything that happened. I would almost have to rationalize to myself how it came to be that I had the repeat c-section, and it felt better to write it all down. It was plain ol' discouragement that led to the repeat. That is why now I want to do everything I can to encourage women to birth normally. It's like I want to make up for my mistake. But also I always have loved birth and wanted to be a part of it.
I have reread my story several times since I posted it. I still am processing some things, and it's surprising to me how much this time of year is bringing back the memories. Audrey will be a year next month. She is the best baby ever and I love her like crazy! Would I love her more if I had given birth vaginally? No, I don't think it's possible to love her more than I do now. While the way you give birth may affect some initial bonding, I don't think it affects how you love your children. But I do know I would feel a lot more confidence in myself, and I would probably feel more fulfilled.
I've told people before that the best day of my life was my wedding, followed by the boys' birth, followed by kayaking with whales in Alaska. While Audrey is one of the best things to ever happen to me, her birth was probably one of the hardest and saddest days of my life. I still am looking forward to her birthday and a chance to celebrate her, don't get me wrong. I've heard of c-section moms who don't even want to celebrate the first birthday. I'm not that extreme. But I hope my next birth (because I do want another child) can be added to my list of "best days of my life."
I have reread my story several times since I posted it. I still am processing some things, and it's surprising to me how much this time of year is bringing back the memories. Audrey will be a year next month. She is the best baby ever and I love her like crazy! Would I love her more if I had given birth vaginally? No, I don't think it's possible to love her more than I do now. While the way you give birth may affect some initial bonding, I don't think it affects how you love your children. But I do know I would feel a lot more confidence in myself, and I would probably feel more fulfilled.
I've told people before that the best day of my life was my wedding, followed by the boys' birth, followed by kayaking with whales in Alaska. While Audrey is one of the best things to ever happen to me, her birth was probably one of the hardest and saddest days of my life. I still am looking forward to her birthday and a chance to celebrate her, don't get me wrong. I've heard of c-section moms who don't even want to celebrate the first birthday. I'm not that extreme. But I hope my next birth (because I do want another child) can be added to my list of "best days of my life."
Friday, May 22, 2009
Factors leading up to Audrey's birth
Many months ago I wrote down the story surrounding Audrey's birth. I've already posted the birth story, and now I'll share the factors that lead up to her birth. Again, this is long, and I didn't write it with the idea of sharing it, so it is a bit personal, but I feel like I want to share it. I feel embarassed sometimes when I tell people that I had a repeat (also called "elective" but that makes it sound like I wanted it) cesarean, especially since I am such a believer in natural birth. So I feel I have to explain all the reasons that had it come to be that I gave up. I was reading in Birthing From Within and she talks about the "Web of reasons" that were woven in to her life to lead to the cesarean. This is my web of reasons. It wans't one single thing, but lots of little things compiled together.
The second part of my story is Audrey's birth, here .
Factors Leading up to Audrey’s birth
In my Human Development class during my freshmen year of college, we saw a birth video titled “The Miracle of Life”. I fell in love with the miracle of birth at that time. I cried as I watched it. I thought to myself, “This is what I’m meant to do”. I’m not sure if I felt that way about experiencing birth myself or assisting with births as a career. I think it was a mixture of both. It certainly influenced my decision to pursue nursing as my degree. That video was probably the strongest factor in that decision, as I hadn’t thought of nursing until then.
Although at the time I still felt unsure about nursing (and I still do) I feel that my vision for wanting to be involved in women’s health is clear. Looking back, that video was the beginning of my vision.
In nursing school I LOVED the labor and delivery rotation. We were taught by nurse midwives who infused the midwifery model of birth into our classes, and therefore our thinking. I really had a respect for the natural process of labor and birth. I am so glad that I had that exposure to birth from that perspective.
During my clinical rotations I saw both the medical model and natural, or midwifery, model of birth. Utah Valley Hospital was more medical, but Orem Community hospital, where I spent 4 months, had midwives who delivered there. Though all births were special, the natural births I was able to help with were certainly more meaningful to me. However, I also saw how many people with epidurals were able to relax and enjoy their birth more than those in intense pain. But without a doubt, the ecstasy of the experience was more intense with natural birth. It was a little strange to have people preparing for the birth of their baby by watching reruns on TV or playing card games to pass the time, as there really was no work to do if you were laboring with an epidural.
I did see some c-sections, including one emergency from a prolapsed cord (which came because the doctor ruptured the waters), and I wasn’t entirely turned off from them. It was neat for me to be involved in a “procedure”, but I didn’t feel like I was really involved with birth.
One of my first natural labors I helped with was for another BYU student. She had a beautiful labor, and I must have been a good help because she later found my email address on BYU intranet and wrote me telling me what a wonderful labor and delivery support person I was. That was a treasure.
I also helped my friend Catherine with her labor and delivery. I took her to her appointments, helped her find the best midwife, and was with her during the birth. It was a beautiful experience. She was walking the halls for much of her short labor. Then fifteen minutes before her baby was born she returned to her bed, and with a few low grunts, she pushed her baby out with his hand right up to his head (nuchal hand).
I was also pregnant at that time. I had started my pregnancy with a midwife group that included one of my nursing professors, but they couldn’t take me once they found out I was expecting twins. That was disappointing. At that point I became a “high risk” pregnancy and saw an experienced obstetrician, Dr Judd. I liked him, for he was easy going, funny, and experienced. He told me that he would do a vaginal delivery as long as the first twin was head down.
The last few months my boys both turned breech. I was disappointed, but I had time to adjust to the idea that I would have a c-section, and when the time came I wasn’t really feeling bad about it. In fact, it was rather nice to choose the date of their birth. We chose Dec. 18th, because it was my grandma’s 90th birthday and because it was the day after Jason’s finals. I was 39 weeks and one day from my LMP. The Dr. had wanted to do the C-section at 37 weeks, but I wanted to wait for labor to naturally start, for I felt that was when my babies would be ready. He did an amniocentesis at 37 weeks and found their lungs weren’t mature, so I got my way and was able to go to 39 weeks. He told me that any longer was like being “overdue” since I had twins, and to ensure the health of the babies they should be delivered then.
Near the end, I remember having an ultrasound and the sonographer saying that the boys were actually in more of a transverse lie than simply breech, and if that is the case, a c-section was absolutely necessary. Even though I was never checked for dilation, I had a feeling I didn’t ever dilate because when the Dr. tried to put my IUD in 2 months later, my cervix was so tight that he had great difficulty getting it in. That wasn’t a fun experience.
Although I had quite a medicalized birth and pregnancy, I was happy with the outcome because I had two beautiful boys that might not have lived (nor might have I) if medical technology couldn’t have given us the option of a cesarean.
I’ll never forget the pain of standing up the next day after my surgery. Oh how it hurt!! I could hardly walk. The pain was very intense those first few days, but I healed very quickly and soon the breastfeeding pain was worse than the post-op pain. I didn’t have any lingering pain or numbness around my incision after I completely healed up, which took about a month or two.
Dr. Judd told me at my 6 week check up to find a practitioner who would be willing to do a VBAC should I choose one or to do another c-section should I choose one. He knew I wasn’t going to be living in Utah for my next birth, so that’s why he said that. With his easy going attitude, I felt that it would be easy for me to choose a VBAC for my next birth. And there was never a question in my mind that that is what I wanted. I had had a positive cesarean experience, but saw no need to have another since my reason for the cesarean was simply because my twins were not in good position for a vaginal birth, and not related to any lingering condition.
As a side note, I shouldn’t say my c-section was a positive experience. It wasn’t what I had ever pictured my first childbirth experience to be like. No one in my family had ever had a c-section. It was a bit unreal. Physically, I felt nauseas through out the surgery and started dry heaving half way through. It also did hurt a lot with all the pressure the doctors were putting on my uterus. I felt like my insides were being ripped out (which in a sense they were). I also had a lot of referred pain both before and after in my shoulders and chest. I did however have a very kind anesthesiologist who set up mirrors for me so I could watch them deliver my boys. I can still picture a little foot floating up as my uterus was opened up. The doctors were chatting through out the procedure, until they had trouble getting Nathan out. Then it became serious and quiet as they worked on getting him out of the small incision they cut. Dr. Judd actually used forceps to get him out. He later called him a “moose” because he was so big, especially for a twin (7 lbs 13 oz).
When they first showed James to me, all wrapped and cleaned up, I said “I think I’m going to throw up” because indeed I was. With all that physical motion going on with my midsection, and the drugs in me, I was just feeling awful. They didn’t even bring Nathan to my side because I was quite out of it. The worst part of the c-section was that they immediately took the boys down to the floor below me to the nursery for observation. I’m not sure why they did that. Immediately after my surgery I wasn’t really ready to hold them or breastfeed them anyway, but I still wanted them near me.
After an hour passed I started asking about them more insistently and getting anxious to see them. I found out that they had given James some formula, which still upsets me to this day. I was very adamant about breastfeeding, and I didn’t want to have my children have any of that fake milk at the hospital, ESPECIALLY as their first feeding. I had told Jason to follow them to the nursery and make sure they didn’t get formula, but Jason couldn’t withstand the protocols. They had checked the boys’ blood sugar and James’ was one point below normal—39 vs. the cut off of 40. It’s so ridiculous it still makes me mad. Why didn’t they just bring him to me to nurse if his blood sugar was low? Then the boys were “cold” because they had been given a full newborn bath and had to stay under the warming lights for a while.
After a little more than two hours (which seemed like eternity) they finally brought me my boys. I’m sure it would have been even longer had I not really been insisting and getting angry that it was time to see them. When the nurses brought them to me in their little Santa hats all bundled up, any negative thoughts disappeared and I was so delighted to see my beautiful, healthy, twin boys. I was quite proud of myself for being able to carry them inside me for so long, for they were big and healthy and robust, much bigger than most other sets of twins, and with absolutely no health problems. So overall, the c-section was a fine experience, not great and with some frustrations, but not terrible either. And I had two beautiful boys. What more could I want as a first time mom? Jason and I always felt incredibly blessed to have twin boys right from the start. What a joy it has been.
Anyway, as decent as the C-section was, I had no doubt in my mind that I would have a vaginal birth next time. I knew the beauty, the power, the spirituality of such a birth and I surely would have it. From Dr. Judd’s advice that I could choose either experience next time, I thought it would be simple as that: me saying that I wanted a vaginal birth. I asked around about midwives here in Illinois and found out there weren’t as many as in Utah, even though the population is much greater. A friend recommended hers and at my first visit I really liked her. However, she was dismayed to tell me that the doctors they work with recently took away their VBAC privileges. She was frustrated by the situation I could tell. This was my first indication that VBAC wouldn’t be a simple as I thought. Here this midwife couldn’t practice in a way she felt comfortable and I couldn’t choose a provider to do what I wanted. She recommended that I definitely find a midwife to do my VBAC because a doctor will set up all sorts of restrictions that will reduce my chance of a vaginal birth. She looked in her directory of midwives in Illinois and recommended some that were in Willowbrook. I didn’t put it together at that moment, but those were Michelle’s midwives, and she just loved them. However, I felt Willowbrook was too far for me to drive. I don’t know if things would have been different, but I wish I would have gone with them.
Instead I looked online and found another midwife that worked in Bolingbrook, which was closer to where I lived. OMG women’s health had two midwives and a doctor in the group. I saw Beth, one of the midwives for my appointment and she said she can attend a VBAC birth, as long as everything is looking normal. I didn’t immediately take to her like I did the other midwife, but she seemed nice, and I thought that because she was a midwife she would be supportive of my VBAC. At that visit she couldn’t get my IUD out, and neither could the doctor, so I needed to have it surgically removed. They would perform the surgery in about a month. I thought she was really sweet to me at the hospital when I had my IUD surgically removed. It was a little scary because it was my first time undergoing anesthesia as well as my first time in a hospital besides the boys’ birth. After they easily removed my IUD, I felt committed to them. Besides, I had made up my mind that I didn’t want to drive farther than I already was.
Beth did an early ultrasound to make sure there was only one baby. I was quite happy that there was only one. Jason was a little disappointed, but I was relieved to have a normal pregnancy and birth with only one. I had a 20 week ultrasound that showed my growing baby was a girl! I was so happy. How lucky am I? Twins boys and then a girl. In addition, she looked perfectly healthy and the placenta was in an ideal location for a VBAC according to the perinatologist.
I should say at this point that I had a lot of confidence in my uterus. I was not worried about the scar rupturing. I read a book called Pushed: the Painful Truth about Modern Maternity Care in the US that validated my desire for a VBAC. The book showed how the decrease in VBACs and the increase in cesareans (currently at 31% nationwide) are not based on safety or science but other issues. I also read research supported information on the web about the chances of the scar rupturing, and I knew that statistically I was doing a very safe thing by pursuing a VBAC. I didn’t even allow myself to think about the scar rupturing. I just knew it wouldn’t be an issue for me.
During this time Beth, my midwife, became ill so I started seeing the doctor. He was fine, but my visits were very brief, and I felt very little connection to him, since he wouldn’t be delivering my baby anyway. I also saw the other midwife, Penny, and really liked her. She said she had a c-section with her twins and then a VBAC. So we were in the same boat, and that made me feel good.
I started asking people that had natural birth experiences about their birth, including my sisters-in law, Kristi and Liz, who have had all theirs natural, and several other friends, including Cecilia who had hers at home. I read the Bradley Method book and a hypnobirthing book. I asked Jason to read the Bradley Method book but he never got around to it. We had checked it out from the library so we didn’t have it for good. I had sent it with him to read for a week long business trip but he didn’t get around to it then either. This really bothered me, although I didn’t tell him that at the time. The Bradley Method, after all, is HUSBAND coached childbirth, and he didn’t even make it a priority to read it. I can’t totally blame him though, because I tried to remain easy going about the whole thing, and wasn’t very insistent, for I knew that sometimes the more rigid and uptight one becomes about birth, the more upsetting a failed plan can be.
I should have signed us up for a childbirth class in a natural method, but I felt that it was too expensive and inconvenient to find the time and a babysitter for the boys, and I also felt that I truly didn’t need one. I could read books and get the same knowledge, plus I had a lot of knowledge due to my interest in labor and delivery and my experience as a student nurse. The other thing I didn’t do was hire a doula, and this was pretty much solely because of monetary reasons. I suppose I also had a bit of the “I don’t need it” attitude, but when I saw the prices of $500 or more, I didn’t think I could afford it.
I had a good friend, Lajuanna, who was supportive of natural birth, who told me that she would help me in any way, including being a support person at my birth. I was very touched and thankful for this. I wasn’t sure if I would actually feel comfortable having someone I knew see me so exposed, or that I wanted a friend to take Jason’s place, and another issue was I didn’t want my mom feeling bad that I had a friend at the birth and not her, so I told her I would think about it. In the end, I decided I would like to have her there for the birth. I told Lajuanna that if she was in town, I was going to call her when I started labor.
Beth returned to work, and I saw her near the end of my pregnancy again. At my 38 week appointment she suddenly informed me that they wouldn’t use pitocin on me to induce me. I was okay with that because I knew being induced would decrease my chance of a successful VBAC anyway. I asked her how long they “let” woman go past their due date and she said “7-10 days, but in your case, I’d say 7 days”. Even though I was very against getting induced, I was dismayed that my pregnancy would result in a cesarean should I not start labor on my own.
I had been having a lot of Braxton hicks contractions the last few months of my pregnancy. After reading my hypnobirthing book, I was trying to visualize my cervix opening. I would often feel little pains or twitches and I pictured my cervix beginning to dilate. I was anxious to find out what was happening “down there”. She checked me at that 38 week appointment. The good news was the baby was definitely head down. However, I was not really dilated at all, she said a “fingertip” and the baby was really high up. I was kind of discouraged, especially combined with the information that my pregnancy would end in cesarean if I didn’t give birth in three weeks. But she told me I was just where I should be for now and not to worry about it, because a lot could happen in three weeks.
I was still disappointed, but I tried to focus on the positive. I had Jason read me some of the affirmations from my hypnobirthing book. It was so soothing, peaceful, and special to be lulled to sleep by his gentle voice telling me to visualize the baby come out of my body, visualize me bringing it to my breast, and to visualize the special-ness of a new family being formed.
I was a bit nervous about labor and delivery since it would be a completely new experience, but most of all I felt excited and ready to meet my baby.
At 39 weeks I went in for another visit. Beth said we would talk about my birth plans at this visit, so I brought my hypnobirthing book because I wanted a lot of the things it talked about in this book. However, she never brought it up, and I guess I didn’t want to be pushy by bringing it up. I think that was a clue that she either didn’t believe I would go into birth or didn’t care about my birth plans. For some reason birth plans seem to really bother a lot of obstetricians who like to be in control, but I thought a midwife would want to hear what I wanted for my birth experience. She checked me again at that visit and essentially I hadn’t really changed. She called my cervix a “one and a half”, but still high and only slightly thinned. How frustrating! I asked her if I if I could have more time to let the baby come on it’s own should I go past due, as long as the baby was doing well and I was feeling good. She said we could probably wait until June 24th (12 days past due) because they had a surgery that day anyway, and we could do the c-section then.
I left the appointment feeling a lot happier about the extended date. I still cried a bit thinking about how my baby didn’t really show signs of coming, but I just felt better about waiting. I felt like I wasn’t under so much pressure. I felt some peace, and I think it could have been the Spirit giving me assurance that it would be good to wait.
Then my due date came. I had an appointment on that day with Beth. Beth told me that Dr. Daube said I couldn’t go past 41 weeks, so the c-section was scheduled for “Next Thursday, June 19th, at 10:30 AM”. I can still here her voice saying those devastating words. That was extremely disappointing and discouraging. Here my c-section was already scheduled!!!! It makes me upset now just to think about it. I had a non stress test and the baby looked great, but once again I hadn’t dilated any, the baby hadn’t dropped, and I was essentially looking the same as I had two weeks ago. I cried all the way home from that appointment, knowing that if I didn’t go into labor in 7 days, my pregnancy would end in a c-section.
I tired doing things to bring on labor. I had been trying to walk more and be upright, and had tried sex, which is fun but not too easy at full term. I tried to stimulate my nipples by rubbing them, but that was uncomfortable, and it needs to be done for a long time to be efficient. I kept saying “Tomorrow I will do castor oil, take a long walk, pump with a breast pump, and have sex. That will get this baby out”. But I never did do all those things at once. I just spent so much time walking! I walked several miles each day. It was quite uncomfortable. All it did was give me aching feet.
On Father’s day, June 15th, three days past my due date, I was having a lot of contractions and actually thought I was in labor. Plus all along I kept saying “She’s just waiting for Father’s day to be born”. I thought perhaps it was coming true! I wanted to give Jason a baby for his Father’s day gift. As I was having contractions I was SO happy! Some of them even hurt! Jason and I went for a brisk, longish walk in the arboretum. I was hungry and probably dehydrated, but I was happy. Nancee even gave me a pen and paper to record my contractions while I was at their house, and for a few hours they were coming every 4-5 minutes. Then we had a delicious, large meal for Father’s day, and my contractions completely stopped. I had called my mom earlier saying I was having a lot of contractions, and she said “I think you’re in labor”. On our way home from the dinner I called back and said “Don’t get excited, the contractions have completely stopped.”. I was very down.
That following week was honestly one of the hardest in my life. I cried so much! Even thinking about it now, two months later, I get teary eyed. Every morning I would wake up and say to myself “Well, I slept right through that night; I’m still here; no labor, no baby.” The Monday after Fathers day I cried so much. I literally cried all day. I cried because I wasn’t in labor. I cried because I realized my dream of a vaginal birth was slipping away. I cried because my boys were calling me names. I cried because things just weren’t going as I planned. I feel in a way I was mourning my birth that I wanted.
After being so very sad that Monday, the next day I felt more peaceful. I didn’t want to feel so sad about not having a real birth, so I started to accept my inevitable c-section. I started thinking about how the recovery wasn’t so bad, and how maybe it was better because then my vagina wouldn’t be harmed in anyway with a tear or an episiotomy. I was quite afraid of damage to my perineum, especially when I would hear people say they “tore”. It just sounded so awful. One lady from church said she refused to have a second c-section when her doctor scheduled it, so she told him “You can schedule it but I’m not going to come." Then she told me: "My babies were big and ten days late so I tore all over the place”. “Yikes!” I thought. “That doesn’t sound appealing. I’d rather just have what I know and keep things down there safe.”
Of course I still wanted vaginal birth. I knew it couldn’t be that destructive because people still had children after their first babies. And I knew that better birth practices lead to an intact perineum.
So on Tuesday I went in for my appointment. To my surprise, I saw Dr. Daube. He knew I wasn’t happy about having a cesarean section scheduled for two days from that time. Dr. Daube came in and said “I don’t know why Beth chose that date for the c-section. We can wait if you want”. What??? Beth had said he said that I wasn’t “allowed” to go past 7 days. So who was telling the truth?
He said, “We don’t like to do surgery on someone who doesn’t want it”. Had I been told this from the beginning I could have possibly held out! But after having gone through such turmoil from thinking I wouldn’t have my vaginal birth, his allowing me to wait almost didn’t seem possible. I think being told different things made me break down my resolve to have a VBAC. Just as I had gotten somewhat used to the idea of a c-section because I had no other choice, he tells me I don’t have to! The toying with my hopes was almost worse than just having them dashed!
We discussed the issues about waiting and what the risks are. He basically didn’t say anything specific or anything backed up by science about the risks of being overdue, just said that there’s the risk of uterine rupture in a VBAC (duh) and that 42 weeks was as long as I should wait, but I could wait until then. He told me of course that I may just end up with a long labor and then a c-section. Again, not encouraging words. He told me that there wasn’t really anything I could do to bring labor on. He said he wished he had a magic pill, then said “Well, actually we do: Pitocin, but we can’t use that on you”. Honestly as much as I was against induction, I would have preferred that to an automatic c-section. He checked my cervix and I was the same as I had been, in fact, he said Beth saying that I was a one and a half was “generous”.
Still, I left that appointment feeling slightly encouraged that I could wait. He told me he would cancel the surgery but that I should come in for an appointment that day that the surgery was scheduled. If I still wanted, I could have a c-section, but if not, I didn’t have to. After such an emotional day previously in which I essentially gave up and mourned my VBAC dream, I didn’t know if I could build that hope up again without the guarantee that I wouldn’t have a c-section. Plus it meant my pregnancy would continue even longer, which meant more discomfort, more waiting and wondering, more people asking “when are you due?”
Months later, when discussing all that happened with my mom and talking about what I could have done differently, I determined that I should have made up my mind right then and there to wait to 42 weeks when he gave me the chance. But I was just too vulnerable and emotional then. Still, here the doctor was giving me permission. I felt grateful for that, because most doctors these days don’t allow VBACs to go even one day past their due date, some even insist that a woman must spontaneously go into labor before her due date. Someone I know had a due date slightly behind mine and was also trying a VBAC. However, her doctor said she had to go into labor five days before her due date or else she would have a cesarean. She never went into labor and had her baby before I had mine, actually that same day I met with my doctor. Her doctor said her uterus had a tear, so it was a good thing they did the cesarean. That little event put some fear into my mind, and for the first time, I did start worrying about a rupture. I wasn’t deeply worried, but I did start to think that somehow being over due would contribute to it.
I wanted to check out the Bradley book again from the library to read about how going overdue can be normal, and I tried to find stuff online, but I had so little free time with taking care of the boys, and things just were happening fast, so I never found information that could have been encouraging. I was trying to coordinate with my mom when she could come out, which would have been so much easier if I had just decided on a date for the c-section. Jason had already started taking days off work, so I felt like he was already using his paternity time. I felt that EVERYONE wanted me to have the baby. And I couldn’t stand waking up each morning being depressed that I wasn’t in labor. I couldn’t stand the thought of waiting around another weekend and going to church again and having everyone ask “You’re still here?” I felt like I was the only person to be past due, when in fact it’s very normal. Normal or not, being overdue is the pits. Anyone who has experienced it can attest to that.
I started to feel that something was wrong with my body. Maybe I wouldn’t ever go into labor. Maybe my cervix and uterus of steel, which did a great job of holding in my full term twins, was just so strong it wouldn’t let go of a baby when it should have. I thought that maybe because my uterus had stretched out so much with the boys, it didn’t have the ability to deliver just one baby. I began to think that because my cervix was so closed, thick, and high that if I did go into labor it could be an awful one. I also started to get afraid that this baby would get too big if I kept waiting.
In addition I was in discomfort, though it wasn’t terrible. I just had tired feet from walking a lot and an aching back from standing so much. But, oh how discouraged I was! The next day I was at the park with some friends from church and of course we were talking about my situation. One of the ladies looked at how high my baby still was—really she was up in my lungs still—and said “I hate to tell you this but I don’t think you’re going to go into labor”. When she said that comment I thought “Gee, Thanks!” but then I realized she was probably right, even if it was a rude comment. She told me about how her sister was three weeks late. I remembered another older friend saying she was three weeks late (This day that almost never happens because of routine induction at 41 weeks). I was probably going to be one of those people that did go to 43 weeks. Since my doctor said 42 weeks was the final cut-off to how far he would let me go, I realized it would be pointless to wait another week just to be in misery and emotional turmoil. I started to believe, perhaps correctly, that labor wasn’t any time soon. I still hadn’t decided if/when I would agree to a c-section, but my resolve to wait continued to wane.
Let me just also say that the due date is a date you constantly think about the whole pregnancy. That’s the most common question strangers and friends ask: “When are you due?” So for nine months, June 12th is the date I have in mind for having my baby, no later. The thought of waiting until late June or even early July for the baby to come on its own, seems inconceivable because it’s so different than what I was planning. Not to mention it was impossible, since June 26th was 42 weeks and the latest my doctor would “let” me go. (Though I technically could not have been forced).
After so much indecision and wondering what I should do, I felt that I needed to make some decisions. I decided that if I had made absolutely no progress at my next appointment, I would just go ahead and schedule the c-section. On Thursday, June 19th, 41 weeks, I had another appointment. This time I met with Penny, to my surprise. I thought I would meet with Dr. Daube, who I actually liked better at this point because he told me I could wait until 42 weeks. Penny was very sweet. She checked me and again, no change. I asked her if she thought I would go into labor. She said you really can’t tell, but when I pressed her, she said “Clinically, no, it doesn’t look like you will go into labor soon”. I had spent the day before walking around the zoo exhausting myself, and thought, “If this doesn’t make any change in my cervix I’m giving up!” I told her that and she said it really doesn’t have to do with being upright, that someone could be sitting around the last month and still go into labor early. So then again I felt like I had no control, that my body just wouldn’t do what I wanted it to.
I discussed my history of how I went full term with the boys with not a hint of real labor, and how I believe that I never even dilated. I thought at the time it was because there wasn’t a head pressing on my cervix, but in discussing it with her I thought it was just because my cervix was made of steel and didn’t dilate. Then she said “To be honest, my VBAC was harder than my c-section”. Talk about discouraging! I totally believed her because I’m sure she really was telling me the truth to make me feel better about not getting my VBAC. I started thinking about my fears again: uterine rupture, tears, hemorrhoids, painful sex, etc. I reminded myself that the c-section wasn’t so bad. I could have it scheduled, put on lots of makeup so I could look pretty in my pictures, and I would have a pretty baby with no cone head. Those are the few pluses of a cesarean. I asked Penny what cesareans are like at this hospital and if they take the baby away from the mother. She explained that immediately after taking the baby out, Dr. Daube comes around the curtain to show me my naked, wet baby, then hands the baby to the neonatologist, who examines, dries, and wraps the baby. After that they will hold the baby right up to my face and it won’t leave my side the entire time unless there is a problem. That sounded so much nicer than at Utah Valley where they automatically take the babies down to the nursery for check ups after cesareans. So I thought, “I’ll have my baby with me the whole time, it will almost be as special as a vaginal birth”.
She got out the calendar and said we could talk about some possible later dates for the c-section. I did want to discuss a few dates, but I said. “Well, since I’m not changed at all, I’m thinking about just doing it tomorrow (Friday) and not waiting through the weekend.” I was hoping she would tell me to wait, but I am not exaggerating when I say that she jumped up and said “I’ll call the hospital and Dr. Daube and see if they can fit it in!” She immediately left the room. I heard her schedule the surgery, and she came back and said that tomorrow at 8 AM I was scheduled to have my baby.
If I had even one single person encouraging me to wait, I would have. But here she even jumped up (practically in joy) and immediately went with tomorrow when I mentioned it. Everyone was telling me it was my decision, including Jason, and no one told me I had to have the c-section, but not a single person said “You can do it. Your baby just isn’t ready yet. Being seven days past due really isn’t a serious situation. You can have your VBAC. Your body and your baby know how to do it”. The only person I felt who was disappointed in me scheduling the c-section was Lajuanna, but she didn’t explicitly tell me to wait it out because she didn’t want to make me feel bad. Plus I’m sure no one wanted to be responsible if something bad had happened as a result of my waiting it out. Overall though, I felt everyone was happy that I decided to have the c-section. Even my mom, who had six vaginal births, told me a few weeks earlier “I don’t like thinking about my daughter in labor.” “But mom,” I replied, “I want to be in labor!” Somehow people have the idea that c-sections are safer. They are more predictable the vaginal births, and safer in a few instances, but they are certainly not safer.
I knew the risks of a c-section from my reading, but not once did my doctors of midwives tell me the risks, or that I was doing the safer thing by wanting a VBAC. I had to sign a long VBAC consent form that listed all the dangers of VBACs. But VBACs are safer than a planned repeat cesarean. I knew that! I knew that cesareans had risks!
In the end, I believe my health care providers got what they wanted: an easy, scheduled, predictable birth. Perhaps Beth didn’t want me to go past 41 weeks because that meant I might have my baby that weekend, perhaps interrupting her Saturday night plans? I know that’s cynical but I think that may have played a small role.
After we scheduled the c-section, the appointment immediately ended and I went to an Ultrasound at the hospital to make sure everything was all right. Everything looked absolutely perfect. We still were expecting a girl, she looked incredibly healthy, the fluid level looked fine, and her weight was guessed to be around 8 lbs 6 oz. It was exciting to see our baby and think that we would have her tomorrow, but I still was crying uncontrollably in the car ride home. I kept thinking about how Ben posted the picture of Liz just after she had Jared and titled it “Wonder Woman”. I was crying thinking how I wasn’t a wonder woman. I was just a passive bystander in my birth. I was mourning the loss of that important female role—to birth the child that my body grew. I feel that pregnancy, birth, and breastfeeding are the supreme acts of womanhood, and here I was missing out on the most dramatic and beautiful one. Also I think I was crying because I had some sort of premonition that I was making a mistake. I almost felt like calling and changing my mind, especially since she checked out perfectly on her biophysical profile (the ultrasound) but after having been indecisive for all that week I felt like I couldn’t change my mind once I made the decision. How I wish I wouldn’t have ignored that sadness and doubt! Perhaps it was even the Spirit giving me a “stupor of thought”, for my mind felt jumbled and uncertain.
When I called my mom to tell her my decision, she said “I think you have made an excellent decision.” She was planning to fly in that night so she could be there for my c-section.
Jason and I hung out at Jason’s parent’s house for much of the day as we celebrated Erik’s birthday, so that got my mind off feeling sorry for myself. I wasn’t feeling good about the c-section, but I was feeling good about having a baby. I was even starting to get excited as I packed the hospital bag. I got out my cute newborn outfit for my baby to come home with. We went out to Carrabbas that night with our boys in celebration of the big event that was happening tomorrow. We had gone out to Carrabbas with my parents the night before my boys were born, so it felt almost like a tradition. I took a lot of belly pictures to document my last night of being pregnant.
We stayed up a little too late that night for having such an early morning, but it’s hard to sleep when there’s so much about to happen. I wrote in my blog, spoke with a few of my siblings, and cried some more. Here’s some of what I wrote in my blog:
".......Maybe she does just need another week or two. Maybe it's not my cervix of steel but that my babies do need more time in utero. Instead she's going to go suddenly from her warm water home to a cold bright room and stranger's hands. That's what makes me saddest. I wanted her to come to my arms right away. I start remembering how they took the boys to the nursery after my c-section and I didn't get to see them for about two hours, and I still get upset about it. At least it sounds like we'll get to stay together if everything is fine with the baby and I. Hopefully I'll be able to nurse her fairly soon and that will go well.I just hope I'm not as emotional as I was this week! I am scared for the baby blues to come when I already have been on such an emotional roller coaster.I feel like I could write pages more of my thoughts and feelings, but it's getting late and we have a very early morning tomorrow. I really am so excited to have my baby. It will still be a wonderful event and so special to have her. I've been so obsessed with the birth itself that I haven't hardly thought about caring for another baby. Another child coming into my life will last forever, but the actual delivery won't.I still love labor and delivery. I hope I can still be involved in it somehow in my life. Maybe I will still even go into labor in the next 8 hours! I did some acupressure points just to give it one last chance. But if not, I know I am so blessed just to have a baby, and I will be so happy to see her and hold her tomorrow in less than 12 hours! (Of course now I'm crying again thinking how I'll miss her kicking inside me and being a part of me--will my emotions ever level out!!)Time for me to stop and go to bed!!....."
I asked Jason to give me a blessing that night, and he did. I don’t remember too much about the blessing now, just that it brought some peace and comfort, and he blessed me to have a grateful heart. Finally, in exhaustion, we went to bed.
Friday, June 20th we woke up at 5:00 and got ready to go to the hospital. I put on a lot of makeup to look pretty in my pictures. I was going to live up my c-section the best I could. Our friend Susie came over to watch the boys when they got up. It was a beautiful morning, the first day of summer, and I was feeling a reserved sort of happiness. It was special to be meeting our baby girl, but also sad because I was giving up a dream. I pretty much knew that I was giving up the fight, that this c-section meant I would “have” to have another should I become pregnant again.
The hospital was quiet and peaceful at that time of the morning, and Hinsdale is such a beautiful area. I was feeling okay about everything. There certainly wasn’t the bounce of excitement in my step like there was when I went in for the boys c-section however. I remember feeling giddy, excited, and nervous for that event. This time I felt like I was just going through the motions, doing something I didn’t want to do. I did want to have my baby girl with me safe and sound, and I was willing to give up my dreams of a vaginal birth to get her here. I heard many times during the last week when I trying to accept a c-section that a healthy baby is the important thing. Of course that’s what I wanted too: my beautiful healthy baby girl in my arms and at my breast, safe and sound. Though as it happened, she wasn’t delivered safe and sound.
The second part of my story is Audrey's birth, here .
Factors Leading up to Audrey’s birth
In my Human Development class during my freshmen year of college, we saw a birth video titled “The Miracle of Life”. I fell in love with the miracle of birth at that time. I cried as I watched it. I thought to myself, “This is what I’m meant to do”. I’m not sure if I felt that way about experiencing birth myself or assisting with births as a career. I think it was a mixture of both. It certainly influenced my decision to pursue nursing as my degree. That video was probably the strongest factor in that decision, as I hadn’t thought of nursing until then.
Although at the time I still felt unsure about nursing (and I still do) I feel that my vision for wanting to be involved in women’s health is clear. Looking back, that video was the beginning of my vision.
In nursing school I LOVED the labor and delivery rotation. We were taught by nurse midwives who infused the midwifery model of birth into our classes, and therefore our thinking. I really had a respect for the natural process of labor and birth. I am so glad that I had that exposure to birth from that perspective.
During my clinical rotations I saw both the medical model and natural, or midwifery, model of birth. Utah Valley Hospital was more medical, but Orem Community hospital, where I spent 4 months, had midwives who delivered there. Though all births were special, the natural births I was able to help with were certainly more meaningful to me. However, I also saw how many people with epidurals were able to relax and enjoy their birth more than those in intense pain. But without a doubt, the ecstasy of the experience was more intense with natural birth. It was a little strange to have people preparing for the birth of their baby by watching reruns on TV or playing card games to pass the time, as there really was no work to do if you were laboring with an epidural.
I did see some c-sections, including one emergency from a prolapsed cord (which came because the doctor ruptured the waters), and I wasn’t entirely turned off from them. It was neat for me to be involved in a “procedure”, but I didn’t feel like I was really involved with birth.
One of my first natural labors I helped with was for another BYU student. She had a beautiful labor, and I must have been a good help because she later found my email address on BYU intranet and wrote me telling me what a wonderful labor and delivery support person I was. That was a treasure.
I also helped my friend Catherine with her labor and delivery. I took her to her appointments, helped her find the best midwife, and was with her during the birth. It was a beautiful experience. She was walking the halls for much of her short labor. Then fifteen minutes before her baby was born she returned to her bed, and with a few low grunts, she pushed her baby out with his hand right up to his head (nuchal hand).
I was also pregnant at that time. I had started my pregnancy with a midwife group that included one of my nursing professors, but they couldn’t take me once they found out I was expecting twins. That was disappointing. At that point I became a “high risk” pregnancy and saw an experienced obstetrician, Dr Judd. I liked him, for he was easy going, funny, and experienced. He told me that he would do a vaginal delivery as long as the first twin was head down.
The last few months my boys both turned breech. I was disappointed, but I had time to adjust to the idea that I would have a c-section, and when the time came I wasn’t really feeling bad about it. In fact, it was rather nice to choose the date of their birth. We chose Dec. 18th, because it was my grandma’s 90th birthday and because it was the day after Jason’s finals. I was 39 weeks and one day from my LMP. The Dr. had wanted to do the C-section at 37 weeks, but I wanted to wait for labor to naturally start, for I felt that was when my babies would be ready. He did an amniocentesis at 37 weeks and found their lungs weren’t mature, so I got my way and was able to go to 39 weeks. He told me that any longer was like being “overdue” since I had twins, and to ensure the health of the babies they should be delivered then.
Near the end, I remember having an ultrasound and the sonographer saying that the boys were actually in more of a transverse lie than simply breech, and if that is the case, a c-section was absolutely necessary. Even though I was never checked for dilation, I had a feeling I didn’t ever dilate because when the Dr. tried to put my IUD in 2 months later, my cervix was so tight that he had great difficulty getting it in. That wasn’t a fun experience.
Although I had quite a medicalized birth and pregnancy, I was happy with the outcome because I had two beautiful boys that might not have lived (nor might have I) if medical technology couldn’t have given us the option of a cesarean.
I’ll never forget the pain of standing up the next day after my surgery. Oh how it hurt!! I could hardly walk. The pain was very intense those first few days, but I healed very quickly and soon the breastfeeding pain was worse than the post-op pain. I didn’t have any lingering pain or numbness around my incision after I completely healed up, which took about a month or two.
Dr. Judd told me at my 6 week check up to find a practitioner who would be willing to do a VBAC should I choose one or to do another c-section should I choose one. He knew I wasn’t going to be living in Utah for my next birth, so that’s why he said that. With his easy going attitude, I felt that it would be easy for me to choose a VBAC for my next birth. And there was never a question in my mind that that is what I wanted. I had had a positive cesarean experience, but saw no need to have another since my reason for the cesarean was simply because my twins were not in good position for a vaginal birth, and not related to any lingering condition.
As a side note, I shouldn’t say my c-section was a positive experience. It wasn’t what I had ever pictured my first childbirth experience to be like. No one in my family had ever had a c-section. It was a bit unreal. Physically, I felt nauseas through out the surgery and started dry heaving half way through. It also did hurt a lot with all the pressure the doctors were putting on my uterus. I felt like my insides were being ripped out (which in a sense they were). I also had a lot of referred pain both before and after in my shoulders and chest. I did however have a very kind anesthesiologist who set up mirrors for me so I could watch them deliver my boys. I can still picture a little foot floating up as my uterus was opened up. The doctors were chatting through out the procedure, until they had trouble getting Nathan out. Then it became serious and quiet as they worked on getting him out of the small incision they cut. Dr. Judd actually used forceps to get him out. He later called him a “moose” because he was so big, especially for a twin (7 lbs 13 oz).
When they first showed James to me, all wrapped and cleaned up, I said “I think I’m going to throw up” because indeed I was. With all that physical motion going on with my midsection, and the drugs in me, I was just feeling awful. They didn’t even bring Nathan to my side because I was quite out of it. The worst part of the c-section was that they immediately took the boys down to the floor below me to the nursery for observation. I’m not sure why they did that. Immediately after my surgery I wasn’t really ready to hold them or breastfeed them anyway, but I still wanted them near me.
After an hour passed I started asking about them more insistently and getting anxious to see them. I found out that they had given James some formula, which still upsets me to this day. I was very adamant about breastfeeding, and I didn’t want to have my children have any of that fake milk at the hospital, ESPECIALLY as their first feeding. I had told Jason to follow them to the nursery and make sure they didn’t get formula, but Jason couldn’t withstand the protocols. They had checked the boys’ blood sugar and James’ was one point below normal—39 vs. the cut off of 40. It’s so ridiculous it still makes me mad. Why didn’t they just bring him to me to nurse if his blood sugar was low? Then the boys were “cold” because they had been given a full newborn bath and had to stay under the warming lights for a while.
After a little more than two hours (which seemed like eternity) they finally brought me my boys. I’m sure it would have been even longer had I not really been insisting and getting angry that it was time to see them. When the nurses brought them to me in their little Santa hats all bundled up, any negative thoughts disappeared and I was so delighted to see my beautiful, healthy, twin boys. I was quite proud of myself for being able to carry them inside me for so long, for they were big and healthy and robust, much bigger than most other sets of twins, and with absolutely no health problems. So overall, the c-section was a fine experience, not great and with some frustrations, but not terrible either. And I had two beautiful boys. What more could I want as a first time mom? Jason and I always felt incredibly blessed to have twin boys right from the start. What a joy it has been.
Anyway, as decent as the C-section was, I had no doubt in my mind that I would have a vaginal birth next time. I knew the beauty, the power, the spirituality of such a birth and I surely would have it. From Dr. Judd’s advice that I could choose either experience next time, I thought it would be simple as that: me saying that I wanted a vaginal birth. I asked around about midwives here in Illinois and found out there weren’t as many as in Utah, even though the population is much greater. A friend recommended hers and at my first visit I really liked her. However, she was dismayed to tell me that the doctors they work with recently took away their VBAC privileges. She was frustrated by the situation I could tell. This was my first indication that VBAC wouldn’t be a simple as I thought. Here this midwife couldn’t practice in a way she felt comfortable and I couldn’t choose a provider to do what I wanted. She recommended that I definitely find a midwife to do my VBAC because a doctor will set up all sorts of restrictions that will reduce my chance of a vaginal birth. She looked in her directory of midwives in Illinois and recommended some that were in Willowbrook. I didn’t put it together at that moment, but those were Michelle’s midwives, and she just loved them. However, I felt Willowbrook was too far for me to drive. I don’t know if things would have been different, but I wish I would have gone with them.
Instead I looked online and found another midwife that worked in Bolingbrook, which was closer to where I lived. OMG women’s health had two midwives and a doctor in the group. I saw Beth, one of the midwives for my appointment and she said she can attend a VBAC birth, as long as everything is looking normal. I didn’t immediately take to her like I did the other midwife, but she seemed nice, and I thought that because she was a midwife she would be supportive of my VBAC. At that visit she couldn’t get my IUD out, and neither could the doctor, so I needed to have it surgically removed. They would perform the surgery in about a month. I thought she was really sweet to me at the hospital when I had my IUD surgically removed. It was a little scary because it was my first time undergoing anesthesia as well as my first time in a hospital besides the boys’ birth. After they easily removed my IUD, I felt committed to them. Besides, I had made up my mind that I didn’t want to drive farther than I already was.
Beth did an early ultrasound to make sure there was only one baby. I was quite happy that there was only one. Jason was a little disappointed, but I was relieved to have a normal pregnancy and birth with only one. I had a 20 week ultrasound that showed my growing baby was a girl! I was so happy. How lucky am I? Twins boys and then a girl. In addition, she looked perfectly healthy and the placenta was in an ideal location for a VBAC according to the perinatologist.
I should say at this point that I had a lot of confidence in my uterus. I was not worried about the scar rupturing. I read a book called Pushed: the Painful Truth about Modern Maternity Care in the US that validated my desire for a VBAC. The book showed how the decrease in VBACs and the increase in cesareans (currently at 31% nationwide) are not based on safety or science but other issues. I also read research supported information on the web about the chances of the scar rupturing, and I knew that statistically I was doing a very safe thing by pursuing a VBAC. I didn’t even allow myself to think about the scar rupturing. I just knew it wouldn’t be an issue for me.
During this time Beth, my midwife, became ill so I started seeing the doctor. He was fine, but my visits were very brief, and I felt very little connection to him, since he wouldn’t be delivering my baby anyway. I also saw the other midwife, Penny, and really liked her. She said she had a c-section with her twins and then a VBAC. So we were in the same boat, and that made me feel good.
I started asking people that had natural birth experiences about their birth, including my sisters-in law, Kristi and Liz, who have had all theirs natural, and several other friends, including Cecilia who had hers at home. I read the Bradley Method book and a hypnobirthing book. I asked Jason to read the Bradley Method book but he never got around to it. We had checked it out from the library so we didn’t have it for good. I had sent it with him to read for a week long business trip but he didn’t get around to it then either. This really bothered me, although I didn’t tell him that at the time. The Bradley Method, after all, is HUSBAND coached childbirth, and he didn’t even make it a priority to read it. I can’t totally blame him though, because I tried to remain easy going about the whole thing, and wasn’t very insistent, for I knew that sometimes the more rigid and uptight one becomes about birth, the more upsetting a failed plan can be.
I should have signed us up for a childbirth class in a natural method, but I felt that it was too expensive and inconvenient to find the time and a babysitter for the boys, and I also felt that I truly didn’t need one. I could read books and get the same knowledge, plus I had a lot of knowledge due to my interest in labor and delivery and my experience as a student nurse. The other thing I didn’t do was hire a doula, and this was pretty much solely because of monetary reasons. I suppose I also had a bit of the “I don’t need it” attitude, but when I saw the prices of $500 or more, I didn’t think I could afford it.
I had a good friend, Lajuanna, who was supportive of natural birth, who told me that she would help me in any way, including being a support person at my birth. I was very touched and thankful for this. I wasn’t sure if I would actually feel comfortable having someone I knew see me so exposed, or that I wanted a friend to take Jason’s place, and another issue was I didn’t want my mom feeling bad that I had a friend at the birth and not her, so I told her I would think about it. In the end, I decided I would like to have her there for the birth. I told Lajuanna that if she was in town, I was going to call her when I started labor.
Beth returned to work, and I saw her near the end of my pregnancy again. At my 38 week appointment she suddenly informed me that they wouldn’t use pitocin on me to induce me. I was okay with that because I knew being induced would decrease my chance of a successful VBAC anyway. I asked her how long they “let” woman go past their due date and she said “7-10 days, but in your case, I’d say 7 days”. Even though I was very against getting induced, I was dismayed that my pregnancy would result in a cesarean should I not start labor on my own.
I had been having a lot of Braxton hicks contractions the last few months of my pregnancy. After reading my hypnobirthing book, I was trying to visualize my cervix opening. I would often feel little pains or twitches and I pictured my cervix beginning to dilate. I was anxious to find out what was happening “down there”. She checked me at that 38 week appointment. The good news was the baby was definitely head down. However, I was not really dilated at all, she said a “fingertip” and the baby was really high up. I was kind of discouraged, especially combined with the information that my pregnancy would end in cesarean if I didn’t give birth in three weeks. But she told me I was just where I should be for now and not to worry about it, because a lot could happen in three weeks.
I was still disappointed, but I tried to focus on the positive. I had Jason read me some of the affirmations from my hypnobirthing book. It was so soothing, peaceful, and special to be lulled to sleep by his gentle voice telling me to visualize the baby come out of my body, visualize me bringing it to my breast, and to visualize the special-ness of a new family being formed.
I was a bit nervous about labor and delivery since it would be a completely new experience, but most of all I felt excited and ready to meet my baby.
At 39 weeks I went in for another visit. Beth said we would talk about my birth plans at this visit, so I brought my hypnobirthing book because I wanted a lot of the things it talked about in this book. However, she never brought it up, and I guess I didn’t want to be pushy by bringing it up. I think that was a clue that she either didn’t believe I would go into birth or didn’t care about my birth plans. For some reason birth plans seem to really bother a lot of obstetricians who like to be in control, but I thought a midwife would want to hear what I wanted for my birth experience. She checked me again at that visit and essentially I hadn’t really changed. She called my cervix a “one and a half”, but still high and only slightly thinned. How frustrating! I asked her if I if I could have more time to let the baby come on it’s own should I go past due, as long as the baby was doing well and I was feeling good. She said we could probably wait until June 24th (12 days past due) because they had a surgery that day anyway, and we could do the c-section then.
I left the appointment feeling a lot happier about the extended date. I still cried a bit thinking about how my baby didn’t really show signs of coming, but I just felt better about waiting. I felt like I wasn’t under so much pressure. I felt some peace, and I think it could have been the Spirit giving me assurance that it would be good to wait.
Then my due date came. I had an appointment on that day with Beth. Beth told me that Dr. Daube said I couldn’t go past 41 weeks, so the c-section was scheduled for “Next Thursday, June 19th, at 10:30 AM”. I can still here her voice saying those devastating words. That was extremely disappointing and discouraging. Here my c-section was already scheduled!!!! It makes me upset now just to think about it. I had a non stress test and the baby looked great, but once again I hadn’t dilated any, the baby hadn’t dropped, and I was essentially looking the same as I had two weeks ago. I cried all the way home from that appointment, knowing that if I didn’t go into labor in 7 days, my pregnancy would end in a c-section.
I tired doing things to bring on labor. I had been trying to walk more and be upright, and had tried sex, which is fun but not too easy at full term. I tried to stimulate my nipples by rubbing them, but that was uncomfortable, and it needs to be done for a long time to be efficient. I kept saying “Tomorrow I will do castor oil, take a long walk, pump with a breast pump, and have sex. That will get this baby out”. But I never did do all those things at once. I just spent so much time walking! I walked several miles each day. It was quite uncomfortable. All it did was give me aching feet.
On Father’s day, June 15th, three days past my due date, I was having a lot of contractions and actually thought I was in labor. Plus all along I kept saying “She’s just waiting for Father’s day to be born”. I thought perhaps it was coming true! I wanted to give Jason a baby for his Father’s day gift. As I was having contractions I was SO happy! Some of them even hurt! Jason and I went for a brisk, longish walk in the arboretum. I was hungry and probably dehydrated, but I was happy. Nancee even gave me a pen and paper to record my contractions while I was at their house, and for a few hours they were coming every 4-5 minutes. Then we had a delicious, large meal for Father’s day, and my contractions completely stopped. I had called my mom earlier saying I was having a lot of contractions, and she said “I think you’re in labor”. On our way home from the dinner I called back and said “Don’t get excited, the contractions have completely stopped.”. I was very down.
That following week was honestly one of the hardest in my life. I cried so much! Even thinking about it now, two months later, I get teary eyed. Every morning I would wake up and say to myself “Well, I slept right through that night; I’m still here; no labor, no baby.” The Monday after Fathers day I cried so much. I literally cried all day. I cried because I wasn’t in labor. I cried because I realized my dream of a vaginal birth was slipping away. I cried because my boys were calling me names. I cried because things just weren’t going as I planned. I feel in a way I was mourning my birth that I wanted.
After being so very sad that Monday, the next day I felt more peaceful. I didn’t want to feel so sad about not having a real birth, so I started to accept my inevitable c-section. I started thinking about how the recovery wasn’t so bad, and how maybe it was better because then my vagina wouldn’t be harmed in anyway with a tear or an episiotomy. I was quite afraid of damage to my perineum, especially when I would hear people say they “tore”. It just sounded so awful. One lady from church said she refused to have a second c-section when her doctor scheduled it, so she told him “You can schedule it but I’m not going to come." Then she told me: "My babies were big and ten days late so I tore all over the place”. “Yikes!” I thought. “That doesn’t sound appealing. I’d rather just have what I know and keep things down there safe.”
Of course I still wanted vaginal birth. I knew it couldn’t be that destructive because people still had children after their first babies. And I knew that better birth practices lead to an intact perineum.
So on Tuesday I went in for my appointment. To my surprise, I saw Dr. Daube. He knew I wasn’t happy about having a cesarean section scheduled for two days from that time. Dr. Daube came in and said “I don’t know why Beth chose that date for the c-section. We can wait if you want”. What??? Beth had said he said that I wasn’t “allowed” to go past 7 days. So who was telling the truth?
He said, “We don’t like to do surgery on someone who doesn’t want it”. Had I been told this from the beginning I could have possibly held out! But after having gone through such turmoil from thinking I wouldn’t have my vaginal birth, his allowing me to wait almost didn’t seem possible. I think being told different things made me break down my resolve to have a VBAC. Just as I had gotten somewhat used to the idea of a c-section because I had no other choice, he tells me I don’t have to! The toying with my hopes was almost worse than just having them dashed!
We discussed the issues about waiting and what the risks are. He basically didn’t say anything specific or anything backed up by science about the risks of being overdue, just said that there’s the risk of uterine rupture in a VBAC (duh) and that 42 weeks was as long as I should wait, but I could wait until then. He told me of course that I may just end up with a long labor and then a c-section. Again, not encouraging words. He told me that there wasn’t really anything I could do to bring labor on. He said he wished he had a magic pill, then said “Well, actually we do: Pitocin, but we can’t use that on you”. Honestly as much as I was against induction, I would have preferred that to an automatic c-section. He checked my cervix and I was the same as I had been, in fact, he said Beth saying that I was a one and a half was “generous”.
Still, I left that appointment feeling slightly encouraged that I could wait. He told me he would cancel the surgery but that I should come in for an appointment that day that the surgery was scheduled. If I still wanted, I could have a c-section, but if not, I didn’t have to. After such an emotional day previously in which I essentially gave up and mourned my VBAC dream, I didn’t know if I could build that hope up again without the guarantee that I wouldn’t have a c-section. Plus it meant my pregnancy would continue even longer, which meant more discomfort, more waiting and wondering, more people asking “when are you due?”
Months later, when discussing all that happened with my mom and talking about what I could have done differently, I determined that I should have made up my mind right then and there to wait to 42 weeks when he gave me the chance. But I was just too vulnerable and emotional then. Still, here the doctor was giving me permission. I felt grateful for that, because most doctors these days don’t allow VBACs to go even one day past their due date, some even insist that a woman must spontaneously go into labor before her due date. Someone I know had a due date slightly behind mine and was also trying a VBAC. However, her doctor said she had to go into labor five days before her due date or else she would have a cesarean. She never went into labor and had her baby before I had mine, actually that same day I met with my doctor. Her doctor said her uterus had a tear, so it was a good thing they did the cesarean. That little event put some fear into my mind, and for the first time, I did start worrying about a rupture. I wasn’t deeply worried, but I did start to think that somehow being over due would contribute to it.
I wanted to check out the Bradley book again from the library to read about how going overdue can be normal, and I tried to find stuff online, but I had so little free time with taking care of the boys, and things just were happening fast, so I never found information that could have been encouraging. I was trying to coordinate with my mom when she could come out, which would have been so much easier if I had just decided on a date for the c-section. Jason had already started taking days off work, so I felt like he was already using his paternity time. I felt that EVERYONE wanted me to have the baby. And I couldn’t stand waking up each morning being depressed that I wasn’t in labor. I couldn’t stand the thought of waiting around another weekend and going to church again and having everyone ask “You’re still here?” I felt like I was the only person to be past due, when in fact it’s very normal. Normal or not, being overdue is the pits. Anyone who has experienced it can attest to that.
I started to feel that something was wrong with my body. Maybe I wouldn’t ever go into labor. Maybe my cervix and uterus of steel, which did a great job of holding in my full term twins, was just so strong it wouldn’t let go of a baby when it should have. I thought that maybe because my uterus had stretched out so much with the boys, it didn’t have the ability to deliver just one baby. I began to think that because my cervix was so closed, thick, and high that if I did go into labor it could be an awful one. I also started to get afraid that this baby would get too big if I kept waiting.
In addition I was in discomfort, though it wasn’t terrible. I just had tired feet from walking a lot and an aching back from standing so much. But, oh how discouraged I was! The next day I was at the park with some friends from church and of course we were talking about my situation. One of the ladies looked at how high my baby still was—really she was up in my lungs still—and said “I hate to tell you this but I don’t think you’re going to go into labor”. When she said that comment I thought “Gee, Thanks!” but then I realized she was probably right, even if it was a rude comment. She told me about how her sister was three weeks late. I remembered another older friend saying she was three weeks late (This day that almost never happens because of routine induction at 41 weeks). I was probably going to be one of those people that did go to 43 weeks. Since my doctor said 42 weeks was the final cut-off to how far he would let me go, I realized it would be pointless to wait another week just to be in misery and emotional turmoil. I started to believe, perhaps correctly, that labor wasn’t any time soon. I still hadn’t decided if/when I would agree to a c-section, but my resolve to wait continued to wane.
Let me just also say that the due date is a date you constantly think about the whole pregnancy. That’s the most common question strangers and friends ask: “When are you due?” So for nine months, June 12th is the date I have in mind for having my baby, no later. The thought of waiting until late June or even early July for the baby to come on its own, seems inconceivable because it’s so different than what I was planning. Not to mention it was impossible, since June 26th was 42 weeks and the latest my doctor would “let” me go. (Though I technically could not have been forced).
After so much indecision and wondering what I should do, I felt that I needed to make some decisions. I decided that if I had made absolutely no progress at my next appointment, I would just go ahead and schedule the c-section. On Thursday, June 19th, 41 weeks, I had another appointment. This time I met with Penny, to my surprise. I thought I would meet with Dr. Daube, who I actually liked better at this point because he told me I could wait until 42 weeks. Penny was very sweet. She checked me and again, no change. I asked her if she thought I would go into labor. She said you really can’t tell, but when I pressed her, she said “Clinically, no, it doesn’t look like you will go into labor soon”. I had spent the day before walking around the zoo exhausting myself, and thought, “If this doesn’t make any change in my cervix I’m giving up!” I told her that and she said it really doesn’t have to do with being upright, that someone could be sitting around the last month and still go into labor early. So then again I felt like I had no control, that my body just wouldn’t do what I wanted it to.
I discussed my history of how I went full term with the boys with not a hint of real labor, and how I believe that I never even dilated. I thought at the time it was because there wasn’t a head pressing on my cervix, but in discussing it with her I thought it was just because my cervix was made of steel and didn’t dilate. Then she said “To be honest, my VBAC was harder than my c-section”. Talk about discouraging! I totally believed her because I’m sure she really was telling me the truth to make me feel better about not getting my VBAC. I started thinking about my fears again: uterine rupture, tears, hemorrhoids, painful sex, etc. I reminded myself that the c-section wasn’t so bad. I could have it scheduled, put on lots of makeup so I could look pretty in my pictures, and I would have a pretty baby with no cone head. Those are the few pluses of a cesarean. I asked Penny what cesareans are like at this hospital and if they take the baby away from the mother. She explained that immediately after taking the baby out, Dr. Daube comes around the curtain to show me my naked, wet baby, then hands the baby to the neonatologist, who examines, dries, and wraps the baby. After that they will hold the baby right up to my face and it won’t leave my side the entire time unless there is a problem. That sounded so much nicer than at Utah Valley where they automatically take the babies down to the nursery for check ups after cesareans. So I thought, “I’ll have my baby with me the whole time, it will almost be as special as a vaginal birth”.
She got out the calendar and said we could talk about some possible later dates for the c-section. I did want to discuss a few dates, but I said. “Well, since I’m not changed at all, I’m thinking about just doing it tomorrow (Friday) and not waiting through the weekend.” I was hoping she would tell me to wait, but I am not exaggerating when I say that she jumped up and said “I’ll call the hospital and Dr. Daube and see if they can fit it in!” She immediately left the room. I heard her schedule the surgery, and she came back and said that tomorrow at 8 AM I was scheduled to have my baby.
If I had even one single person encouraging me to wait, I would have. But here she even jumped up (practically in joy) and immediately went with tomorrow when I mentioned it. Everyone was telling me it was my decision, including Jason, and no one told me I had to have the c-section, but not a single person said “You can do it. Your baby just isn’t ready yet. Being seven days past due really isn’t a serious situation. You can have your VBAC. Your body and your baby know how to do it”. The only person I felt who was disappointed in me scheduling the c-section was Lajuanna, but she didn’t explicitly tell me to wait it out because she didn’t want to make me feel bad. Plus I’m sure no one wanted to be responsible if something bad had happened as a result of my waiting it out. Overall though, I felt everyone was happy that I decided to have the c-section. Even my mom, who had six vaginal births, told me a few weeks earlier “I don’t like thinking about my daughter in labor.” “But mom,” I replied, “I want to be in labor!” Somehow people have the idea that c-sections are safer. They are more predictable the vaginal births, and safer in a few instances, but they are certainly not safer.
I knew the risks of a c-section from my reading, but not once did my doctors of midwives tell me the risks, or that I was doing the safer thing by wanting a VBAC. I had to sign a long VBAC consent form that listed all the dangers of VBACs. But VBACs are safer than a planned repeat cesarean. I knew that! I knew that cesareans had risks!
In the end, I believe my health care providers got what they wanted: an easy, scheduled, predictable birth. Perhaps Beth didn’t want me to go past 41 weeks because that meant I might have my baby that weekend, perhaps interrupting her Saturday night plans? I know that’s cynical but I think that may have played a small role.
After we scheduled the c-section, the appointment immediately ended and I went to an Ultrasound at the hospital to make sure everything was all right. Everything looked absolutely perfect. We still were expecting a girl, she looked incredibly healthy, the fluid level looked fine, and her weight was guessed to be around 8 lbs 6 oz. It was exciting to see our baby and think that we would have her tomorrow, but I still was crying uncontrollably in the car ride home. I kept thinking about how Ben posted the picture of Liz just after she had Jared and titled it “Wonder Woman”. I was crying thinking how I wasn’t a wonder woman. I was just a passive bystander in my birth. I was mourning the loss of that important female role—to birth the child that my body grew. I feel that pregnancy, birth, and breastfeeding are the supreme acts of womanhood, and here I was missing out on the most dramatic and beautiful one. Also I think I was crying because I had some sort of premonition that I was making a mistake. I almost felt like calling and changing my mind, especially since she checked out perfectly on her biophysical profile (the ultrasound) but after having been indecisive for all that week I felt like I couldn’t change my mind once I made the decision. How I wish I wouldn’t have ignored that sadness and doubt! Perhaps it was even the Spirit giving me a “stupor of thought”, for my mind felt jumbled and uncertain.
When I called my mom to tell her my decision, she said “I think you have made an excellent decision.” She was planning to fly in that night so she could be there for my c-section.
Jason and I hung out at Jason’s parent’s house for much of the day as we celebrated Erik’s birthday, so that got my mind off feeling sorry for myself. I wasn’t feeling good about the c-section, but I was feeling good about having a baby. I was even starting to get excited as I packed the hospital bag. I got out my cute newborn outfit for my baby to come home with. We went out to Carrabbas that night with our boys in celebration of the big event that was happening tomorrow. We had gone out to Carrabbas with my parents the night before my boys were born, so it felt almost like a tradition. I took a lot of belly pictures to document my last night of being pregnant.
We stayed up a little too late that night for having such an early morning, but it’s hard to sleep when there’s so much about to happen. I wrote in my blog, spoke with a few of my siblings, and cried some more. Here’s some of what I wrote in my blog:
".......Maybe she does just need another week or two. Maybe it's not my cervix of steel but that my babies do need more time in utero. Instead she's going to go suddenly from her warm water home to a cold bright room and stranger's hands. That's what makes me saddest. I wanted her to come to my arms right away. I start remembering how they took the boys to the nursery after my c-section and I didn't get to see them for about two hours, and I still get upset about it. At least it sounds like we'll get to stay together if everything is fine with the baby and I. Hopefully I'll be able to nurse her fairly soon and that will go well.I just hope I'm not as emotional as I was this week! I am scared for the baby blues to come when I already have been on such an emotional roller coaster.I feel like I could write pages more of my thoughts and feelings, but it's getting late and we have a very early morning tomorrow. I really am so excited to have my baby. It will still be a wonderful event and so special to have her. I've been so obsessed with the birth itself that I haven't hardly thought about caring for another baby. Another child coming into my life will last forever, but the actual delivery won't.I still love labor and delivery. I hope I can still be involved in it somehow in my life. Maybe I will still even go into labor in the next 8 hours! I did some acupressure points just to give it one last chance. But if not, I know I am so blessed just to have a baby, and I will be so happy to see her and hold her tomorrow in less than 12 hours! (Of course now I'm crying again thinking how I'll miss her kicking inside me and being a part of me--will my emotions ever level out!!)Time for me to stop and go to bed!!....."
I asked Jason to give me a blessing that night, and he did. I don’t remember too much about the blessing now, just that it brought some peace and comfort, and he blessed me to have a grateful heart. Finally, in exhaustion, we went to bed.
Friday, June 20th we woke up at 5:00 and got ready to go to the hospital. I put on a lot of makeup to look pretty in my pictures. I was going to live up my c-section the best I could. Our friend Susie came over to watch the boys when they got up. It was a beautiful morning, the first day of summer, and I was feeling a reserved sort of happiness. It was special to be meeting our baby girl, but also sad because I was giving up a dream. I pretty much knew that I was giving up the fight, that this c-section meant I would “have” to have another should I become pregnant again.
The hospital was quiet and peaceful at that time of the morning, and Hinsdale is such a beautiful area. I was feeling okay about everything. There certainly wasn’t the bounce of excitement in my step like there was when I went in for the boys c-section however. I remember feeling giddy, excited, and nervous for that event. This time I felt like I was just going through the motions, doing something I didn’t want to do. I did want to have my baby girl with me safe and sound, and I was willing to give up my dreams of a vaginal birth to get her here. I heard many times during the last week when I trying to accept a c-section that a healthy baby is the important thing. Of course that’s what I wanted too: my beautiful healthy baby girl in my arms and at my breast, safe and sound. Though as it happened, she wasn’t delivered safe and sound.
Monday, May 18, 2009
At least some people are talking
Thanks to my Dad who forwarded me this great article from the LA times on c-section issues. It was in the business section so focused a lot on the costs of c-sections. C-sections cost 2-4 times that of vaginal birth. C-sections make up 31% of births. Birth is a huge sector of health care. Therefore, one MAJOR way to reduce health care costs in this country (which is a crisis) is to reduce c-sections. One of the best ways to reduce c-sections is to employ more midwives and less intervention. We have too much intervention in this country. All this intervention isn't helping us either. We're quite far down on the list for maternal mortality and infant mortality compared to other developed countries. Yes, I do need to acknowledge that interventions are life-saving at times, and we are very blessed in this country compared to childbirth in poor nations, but we could be better. And to do better, we need to do less at birth.
Anyway, read the article--a journalist says is better than me!
Childbirth, Can the US Improve?
Anyway, read the article--a journalist says is better than me!
Childbirth, Can the US Improve?
Memories of Audrey's birth
May is a beautiful month. I love it here. I'm having a lot of memories from last May when I was very pregnant with Audrey and still hoping for a VBAC. It's gotten me thinking about her birth story. I wrote down a long version several months ago (as well as a long version of the experiences that led me up to her birth) but I'll just post her birth story now. It's really long, so I don't know if anyone would actually want to read it, but I do bare my soul so that's always interesting to read :)
Also, here is a picture of Audrey in the NICU. I know it's not a pretty picture, but sometimes I wish I could show it to people because this picture to me represents the effects of an unnecessary c-section.
I think perhaps if everything would have gone perfectly with the c-section I wouldn’t be having such a hard time with my failed VBAC. But who knows, because I never wanted the repeat c-section anyway. So here is what happened with her birth.
I lay there on the operating table, absolutely helpless and contributing nothing to the birth process. I could tell they had begun the operation, not because they told me or I felt anything, but I could smell the burning flesh as they were cutting me open and cauterizing the blood vessels that were bleeding. It’s a disgusting smell. I mentioned that and so the anesthesiologist told me he could put some oxygen tubes around my nose so I wouldn’t smell it. I said that would be preferable. I felt some tugging after a while. I asked how things looked down there and Beth, my midwife said, “They look good. You hardly have any scarring!”
After a few more tugs Kate, my nurse, said “I see the baby…do you want to know if she has hair?” “Sure” I said, and she answered “She’s got a lot of dark hair!” More tugging and pushing, and then Dr. Daube asked for the vacuum extractor. I thought, “Oh, this kid has a huge head like Nathan!” (Nathan had to have forceps to get him out). So he sucked her head out with the vacuum and we heard her cry. What a beautiful sound! Jason and I both looked at each other in excitement and I got my breath caught in my throat as I cried at that beautiful sound of a baby being born.
The cry was definitely wet sounding and quite gurgly. Dr. Daube took her around the curtain for a second while she was still all wet so I could see her right after she was born. I thought that was really nice. So I got a quick glimpse of her freshly born body. Then they brought her over to where the baby nurse and neonatologist were waiting by the warmer, as is standard. I kept hearing the neonatologist say “Lots of fluid, lots of mucus,” and I could tell things were not totally great. There was no panic or anything, but it just wasn’t quite right. They wrapped her up and brought her over to me and held her up by my head. I got to feel her precious head by mine. That is the most wonderful feeling, to have fresh baby cuddled into your face. We snapped a few pictures rather quickly. Audrey did have such dark hair, which surprised us a lot! She didn’t look like the boys did. She was just her own little person.
I only “held” her for about ten seconds because she had mucus pouring out of her nose and looked pretty dark, not all pink like she should have. So I said “give her back to them” and we all could tell that she was struggling. Again she went over to the warmer and the Neonatologist was suctioning more fluids from her nose and mouth. Well, that’s what I assume because I couldn’t see anything and was completely helpless with my belly cut open and my insides all exposed.
The neonatologist said she wanted to take Audrey to the NICU for evaluation. I told Jason “don’t let them take her away” so he started to walk over to them (because we felt the boys were taken away unnecessarily, and didn’t want her taken away). But I could tell this was different, and I knew that here they really only took them away if there was a problem, so I said “No, Jason” and we knew that she needed more care.
So there I was, lying on the operating table without a baby once again. Except this time I knew it was serious. But I was still hoping it wasn’t a big deal and I would just have the frustration of not being with her right away while she was evaluated a little more in the NICU. The details are a bit of a blur because I started feeling very bad physically. During the c-section I said I could feel some of what was going on, so the anesthesiologist gave me something for the pain. I’m not sure what it was, but I sure felt awful. During the actual surgery I felt better than I did with my first c-section, but I’d say the overall surgery and recovery was worse. They finished sewing me up and wheeled me to the recovery room. I was terribly dizzy and couldn’t even see straight. The room was tilting up and down very rapidly. I was also extremely sweaty. Kate was taking great care of me though. She was also checking on Audrey, which I was so thankful for. I was crying already at this point, but when she came and told me that they were actually admitting her as a patient in the NICU, I really started bawling. It was the worst feeling in the world! At that point I absolutely knew I had made a mistake in allowing them to do the c-section. All I felt was that I wanted her back in me, I wanted to start over.
Kate said a prayer with us and then later Jason said a prayer when my mom joined us. She was crying too. Kate was even crying. Jason wasn’t, he was very strong. I do believe our faith and prayers helped. Even though I had made a mistake and perhaps ignored the happiness/peace/comfort from the spirit that I should wait longer before having the c-section, the Lord was merciful on me.
For this surgery I was given a spinal instead of an epidural, and then right before they removed the spinal the anesthesiologist gave me “dura-morph” which gives pain control for about 24 hours, but because the spinal was removed I was able to move pretty well. The spinal and the dura-morph combo were definitely better than the epidural, which I had with the boys. But I’m not sure if it was the dura-morph or the medication he gave me in the operating room that made me feel woozy and sweaty. I couldn’t move much or I would feel dizzy.
However, I was soon doing well enough to move from recovery to post partum. On the way to my post partum room Kate wheeled me into the NICU so I could see Audrey. I was still lying flat on my back and being wheeled in my big bed, but I couldn’t pass up the chance to see her. As soon as I saw her I asked if I could hold her, even though she did have some tubes attached to her. The nurse said yes and got things ready for me to hold her. I put the head of my bed up and held her for about one minute. I was feeling very nauseous and the nurse was taking pictures. At the moment I was thinking “I wish I didn’t have to smile, I feel so awful” but later I’m glad she did because there would be no chance for pictures later. I was overcome with nausea and said I was going to throw up. They took Audrey from me and I left the NICU and entered the public hallway throwing up into a plastic bag that Kate grabbed at the last minute. She got a cool cloth for my forehead and it passed quickly. Still, it was so awful and humiliating to be feeling so terrible in front of everyone, but more awful was feeling so ill that I couldn’t even hold my daughter, let alone take care of her.
(Feb 25th, 2009)
Wow a lot of time has passed since I last wrote, but I want to try to finish the story of Audrey’s birth before I forget more details.
I left the NICU throwing up and was moved to my own room and put in the care of a very kind nurse. They assessed me and took over care. I continued to feel very awful. After the episode of throwing up, I couldn’t so much as lift my head or turn it side to side without feeling nauseas and having the room spin.
So much time has passed that I have forgotten a lot of the details, but basically there was a lot of waiting and worrying and crying on my part. I had so much regret about the c-section. It wasn’t fair! I wanted this birth! I knew the risks of the c-section. So many women don’t care about the type of birth or don’t know any of the risks and everything turns out fine. But I knew the risks, I longed for a vaginal birth, and yet here I was with another c-section and even worse, a baby in danger.
I felt very upset. I was crying a lot and feeling guilty. I just wanted to start everything over. I knew she was having these problems as a result of the c-section. Jason was trying to comfort me but I didn’t feel I could be comforted, especially as we were hearing worse news about Audrey.
Kate, who had already handed over my care and was taking care of other patients, was checking on Audrey as often as she could and giving me updates. If it weren’t for her, we would have had absolutely no communication on Audrey’s condition. First she came in and told us that Audrey was at the maximum amount of oxygen by nasal cannula and by hood oxygen. They were trying to get an umbilical line in. She had an IV, then tore it out, then got another one put in. It broke my heart, and still my breaks my heat, to think that she was poked and alone and probably scared. The warm comfort of her mother’s body was gone. Instead she had strange feelings, voices, and sights surrounding her.
Later Kate told us that the doctors in the NICU were busy taking care of some very sick babies, including ours. Audrey was showing signs of pulmonary hypertension, so they put her on a dopamine drip to raise her blood pressure. This would counteract the pulmonary hypertension so she would hopefully get some blood flow to her lungs. They were even talking about transferring her to another hospital (even though this was a level 3 NICU—the highest available) because she might need to go on an ECMO machine. The ECMO machine is an extremely high intervention that sounded so terrifying. Then she told us a little while later that Jason should probably give her a blessing, that we should contact our bishop. It sounded like she was hinting on the fact that Audrey might not survive. My heart continued to plummet into abyss. I am not sure I felt that depth of sorrow, regret, and pain before. I know now that the condition Audrey was having, pulmonary hypertension—PPHN—is indeed very scary and life threatening. It has about a 50% mortality rate. My cousin is a NICU nurse and she says PPHN is one of the most terrifying things they see. I’ve also learned that PPHN is five times more likely to occur in an elective cesarean. When I read that statistic a few months ago it hit me and confirmed what my heart knew: this was all because of the cesarean.
Even the nurses’ aids knew it. Most of them were immigrants with accents-- humble people. A few of the nurses would say it as well. When I would explain why my baby was in the NICU for aspirating fluids and complications arising from it, they would say “Oh yes, in a c-section they don’t get squeezed through the birth canal to clear their fluids”. I knew that of course, but I didn’t get annoyed by them saying it. In fact, I am glad they acknowledged that fact. Even though it was very painful for me because I felt at fault for having the c-section, it was the truth. However, my midwife and my doctor never acknowledged it, nor apologized for the c-section. They expressed concern and were kind, but said “sometimes those things just happen”. Dr Daube even said half jokingly that it was because I am a nurse. There seems to be a view that nurses have bad things happen to them. I remember hearing this during nursing school as well. I’m not sure if there is any truth to it. I do know that bad things can happen in c-sections, and I try to tell as many people as I can that c-sections are not as safe as vaginal births. Although in some cases they are life saving for mother and baby, overall a vaginal birth is safer for the mother and the baby. Many people do not know this. They think that if a c-section is lifesaving at times, it must be safer for all births.
After Kate gave us the scare that Audrey might not even live, we worked on getting someone over to help give a blessing. Our friend and former home teacher John Sapp met Jason at the hospital around 5:30 and they anointed her and gave her a blessing. I was so comforted by that.
Also, here is a picture of Audrey in the NICU. I know it's not a pretty picture, but sometimes I wish I could show it to people because this picture to me represents the effects of an unnecessary c-section.
Audrey’s Birth
(Written Sept 8, 2008)
(Written Sept 8, 2008)
I think perhaps if everything would have gone perfectly with the c-section I wouldn’t be having such a hard time with my failed VBAC. But who knows, because I never wanted the repeat c-section anyway. So here is what happened with her birth.
I lay there on the operating table, absolutely helpless and contributing nothing to the birth process. I could tell they had begun the operation, not because they told me or I felt anything, but I could smell the burning flesh as they were cutting me open and cauterizing the blood vessels that were bleeding. It’s a disgusting smell. I mentioned that and so the anesthesiologist told me he could put some oxygen tubes around my nose so I wouldn’t smell it. I said that would be preferable. I felt some tugging after a while. I asked how things looked down there and Beth, my midwife said, “They look good. You hardly have any scarring!”
After a few more tugs Kate, my nurse, said “I see the baby…do you want to know if she has hair?” “Sure” I said, and she answered “She’s got a lot of dark hair!” More tugging and pushing, and then Dr. Daube asked for the vacuum extractor. I thought, “Oh, this kid has a huge head like Nathan!” (Nathan had to have forceps to get him out). So he sucked her head out with the vacuum and we heard her cry. What a beautiful sound! Jason and I both looked at each other in excitement and I got my breath caught in my throat as I cried at that beautiful sound of a baby being born.
The cry was definitely wet sounding and quite gurgly. Dr. Daube took her around the curtain for a second while she was still all wet so I could see her right after she was born. I thought that was really nice. So I got a quick glimpse of her freshly born body. Then they brought her over to where the baby nurse and neonatologist were waiting by the warmer, as is standard. I kept hearing the neonatologist say “Lots of fluid, lots of mucus,” and I could tell things were not totally great. There was no panic or anything, but it just wasn’t quite right. They wrapped her up and brought her over to me and held her up by my head. I got to feel her precious head by mine. That is the most wonderful feeling, to have fresh baby cuddled into your face. We snapped a few pictures rather quickly. Audrey did have such dark hair, which surprised us a lot! She didn’t look like the boys did. She was just her own little person.
I only “held” her for about ten seconds because she had mucus pouring out of her nose and looked pretty dark, not all pink like she should have. So I said “give her back to them” and we all could tell that she was struggling. Again she went over to the warmer and the Neonatologist was suctioning more fluids from her nose and mouth. Well, that’s what I assume because I couldn’t see anything and was completely helpless with my belly cut open and my insides all exposed.
The neonatologist said she wanted to take Audrey to the NICU for evaluation. I told Jason “don’t let them take her away” so he started to walk over to them (because we felt the boys were taken away unnecessarily, and didn’t want her taken away). But I could tell this was different, and I knew that here they really only took them away if there was a problem, so I said “No, Jason” and we knew that she needed more care.
So there I was, lying on the operating table without a baby once again. Except this time I knew it was serious. But I was still hoping it wasn’t a big deal and I would just have the frustration of not being with her right away while she was evaluated a little more in the NICU. The details are a bit of a blur because I started feeling very bad physically. During the c-section I said I could feel some of what was going on, so the anesthesiologist gave me something for the pain. I’m not sure what it was, but I sure felt awful. During the actual surgery I felt better than I did with my first c-section, but I’d say the overall surgery and recovery was worse. They finished sewing me up and wheeled me to the recovery room. I was terribly dizzy and couldn’t even see straight. The room was tilting up and down very rapidly. I was also extremely sweaty. Kate was taking great care of me though. She was also checking on Audrey, which I was so thankful for. I was crying already at this point, but when she came and told me that they were actually admitting her as a patient in the NICU, I really started bawling. It was the worst feeling in the world! At that point I absolutely knew I had made a mistake in allowing them to do the c-section. All I felt was that I wanted her back in me, I wanted to start over.
Kate said a prayer with us and then later Jason said a prayer when my mom joined us. She was crying too. Kate was even crying. Jason wasn’t, he was very strong. I do believe our faith and prayers helped. Even though I had made a mistake and perhaps ignored the happiness/peace/comfort from the spirit that I should wait longer before having the c-section, the Lord was merciful on me.
For this surgery I was given a spinal instead of an epidural, and then right before they removed the spinal the anesthesiologist gave me “dura-morph” which gives pain control for about 24 hours, but because the spinal was removed I was able to move pretty well. The spinal and the dura-morph combo were definitely better than the epidural, which I had with the boys. But I’m not sure if it was the dura-morph or the medication he gave me in the operating room that made me feel woozy and sweaty. I couldn’t move much or I would feel dizzy.
However, I was soon doing well enough to move from recovery to post partum. On the way to my post partum room Kate wheeled me into the NICU so I could see Audrey. I was still lying flat on my back and being wheeled in my big bed, but I couldn’t pass up the chance to see her. As soon as I saw her I asked if I could hold her, even though she did have some tubes attached to her. The nurse said yes and got things ready for me to hold her. I put the head of my bed up and held her for about one minute. I was feeling very nauseous and the nurse was taking pictures. At the moment I was thinking “I wish I didn’t have to smile, I feel so awful” but later I’m glad she did because there would be no chance for pictures later. I was overcome with nausea and said I was going to throw up. They took Audrey from me and I left the NICU and entered the public hallway throwing up into a plastic bag that Kate grabbed at the last minute. She got a cool cloth for my forehead and it passed quickly. Still, it was so awful and humiliating to be feeling so terrible in front of everyone, but more awful was feeling so ill that I couldn’t even hold my daughter, let alone take care of her.
(Feb 25th, 2009)
Wow a lot of time has passed since I last wrote, but I want to try to finish the story of Audrey’s birth before I forget more details.
I left the NICU throwing up and was moved to my own room and put in the care of a very kind nurse. They assessed me and took over care. I continued to feel very awful. After the episode of throwing up, I couldn’t so much as lift my head or turn it side to side without feeling nauseas and having the room spin.
So much time has passed that I have forgotten a lot of the details, but basically there was a lot of waiting and worrying and crying on my part. I had so much regret about the c-section. It wasn’t fair! I wanted this birth! I knew the risks of the c-section. So many women don’t care about the type of birth or don’t know any of the risks and everything turns out fine. But I knew the risks, I longed for a vaginal birth, and yet here I was with another c-section and even worse, a baby in danger.
I felt very upset. I was crying a lot and feeling guilty. I just wanted to start everything over. I knew she was having these problems as a result of the c-section. Jason was trying to comfort me but I didn’t feel I could be comforted, especially as we were hearing worse news about Audrey.
Kate, who had already handed over my care and was taking care of other patients, was checking on Audrey as often as she could and giving me updates. If it weren’t for her, we would have had absolutely no communication on Audrey’s condition. First she came in and told us that Audrey was at the maximum amount of oxygen by nasal cannula and by hood oxygen. They were trying to get an umbilical line in. She had an IV, then tore it out, then got another one put in. It broke my heart, and still my breaks my heat, to think that she was poked and alone and probably scared. The warm comfort of her mother’s body was gone. Instead she had strange feelings, voices, and sights surrounding her.
Later Kate told us that the doctors in the NICU were busy taking care of some very sick babies, including ours. Audrey was showing signs of pulmonary hypertension, so they put her on a dopamine drip to raise her blood pressure. This would counteract the pulmonary hypertension so she would hopefully get some blood flow to her lungs. They were even talking about transferring her to another hospital (even though this was a level 3 NICU—the highest available) because she might need to go on an ECMO machine. The ECMO machine is an extremely high intervention that sounded so terrifying. Then she told us a little while later that Jason should probably give her a blessing, that we should contact our bishop. It sounded like she was hinting on the fact that Audrey might not survive. My heart continued to plummet into abyss. I am not sure I felt that depth of sorrow, regret, and pain before. I know now that the condition Audrey was having, pulmonary hypertension—PPHN—is indeed very scary and life threatening. It has about a 50% mortality rate. My cousin is a NICU nurse and she says PPHN is one of the most terrifying things they see. I’ve also learned that PPHN is five times more likely to occur in an elective cesarean. When I read that statistic a few months ago it hit me and confirmed what my heart knew: this was all because of the cesarean.
Even the nurses’ aids knew it. Most of them were immigrants with accents-- humble people. A few of the nurses would say it as well. When I would explain why my baby was in the NICU for aspirating fluids and complications arising from it, they would say “Oh yes, in a c-section they don’t get squeezed through the birth canal to clear their fluids”. I knew that of course, but I didn’t get annoyed by them saying it. In fact, I am glad they acknowledged that fact. Even though it was very painful for me because I felt at fault for having the c-section, it was the truth. However, my midwife and my doctor never acknowledged it, nor apologized for the c-section. They expressed concern and were kind, but said “sometimes those things just happen”. Dr Daube even said half jokingly that it was because I am a nurse. There seems to be a view that nurses have bad things happen to them. I remember hearing this during nursing school as well. I’m not sure if there is any truth to it. I do know that bad things can happen in c-sections, and I try to tell as many people as I can that c-sections are not as safe as vaginal births. Although in some cases they are life saving for mother and baby, overall a vaginal birth is safer for the mother and the baby. Many people do not know this. They think that if a c-section is lifesaving at times, it must be safer for all births.
After Kate gave us the scare that Audrey might not even live, we worked on getting someone over to help give a blessing. Our friend and former home teacher John Sapp met Jason at the hospital around 5:30 and they anointed her and gave her a blessing. I was so comforted by that.
When Jason returned I asked him what he said in the blessing, and he said he blessed her that her life would be preserved. I was very relieved. Oh, first back up a few hours. We weren’t sure exactly what we were going to name her because we wanted to spend time with her before we finalized a name. However, when Kate was letting us know how serious things were and suggesting she might even die, we knew we had to name her and make her life here on earth more grounded with a name. I hadn’t been able to see Audrey since my minute holding her in the NICU, but that was the name I favored and Jason agreed to it. So we simply said “Okay then, she will be Audrey Mae”. It felt so much better for her to have a name! And that is the name Jason used when he provided a blessing of healing to her.
Finally, at the end of the day around 6 or 7 pm the neonatologist that was at her birth came in our room and spoke with us. She told us about the fluid in her lungs that was making it difficult to breathe. She told us that she was having pulmonary hypertension but that it was being controlled finally by the dopamine and she was somewhat stabilizing. She also (or maybe it was Kate) explained how her heart was still working partly in fetal mode because of her respiratory distress. The cardiologist had seen her and done an echocardiogram. Her anatomy was fine; she just still was in fetal mode. It was nice to at least have some communication from her caretakers. Kate went above and beyond her duty in keeping us informed, and if it weren’t for her we wouldn’t have any idea what was going on. Jason was able to visit her a few times but they were busy doing things with her and also he wanted to stay and support me.
I was gradually feeling better throughout the day. Of course I was still exhausted and beat but was gaining strength and the nausea and dizziness were going away. I was still terribly sweaty though! My first post partum nurse ended her shift with me by saying a prayer. That was very touching. I didn’t like my next nurse so much. I had started pumping in the evening and she didn’t get my milk to refrigeration like she said she would for three or four hours. I know colostrum is fine to sit at room temperature, but I still wanted it refrigerated right away. Also I asked about seeing Audrey but she wasn’t very helpful with that.
At 11 pm I had a new nurse come one. She was my favorite nurse during the stay. I was crying still, or again, (who really knows as there were so many tears that first day) and she actually took a moment to listen and gave real sympathy. I wanted to see Audrey but the NICU apparently had four new admits and was closed to visitors. But she told me “I promise you I will get you to your baby tonight, as soon as the NICU will let us.” That was the most reassuring and compassionate thing I heard the whole time at the hospital. She also had a very friendly aid working with her and they spent several minutes getting me cleaned up and comfortable, and encouraged me to rest.
My rest was very fitful. I woke what seemed like every minute. Every time I heard any noise I would wake up. And in a hospital, that is quite often. I remember hearing an announcement for the NICU to have all available personnel come, or maybe it was even for a code, and I was sure it was Audrey. My heart was racing. A second later someone opened the door and I said, probably sounding quite delirious, “What is happening with my baby?!” It turned out it was just someone coming to take my blood pressure.
Finally around 3 AM my nurse and the aid came in and told me I could come see Audrey. I didn’t care one whit that I was exhausted and it was the middle of the night. In a hospital time doesn’t really matter. It is a twenty four hour world. Jason was sleeping in the hospital bed and I believe he slept through most of the night. They helped me into a wheelchair and wheeled me down to the NICU.
It was very surreal to see Audrey lying asleep in her plastic bassinet. She had oxygen tubes in her nose, an IV in her arm, and an umbilical line. She still looked beautiful, but I felt so sad for her lying there alone. And I felt so sad for me sitting in the wheel chair next to her. I was unable to hold her because of her lines. They really didn’t want to risk the venous line being pulled out. Also, the doctor that evening had said he didn’t want Audrey touched, or talked to, or stimulated in anyway, not even for a diaper change. He felt she just needed to rest quietly while her body worked on absorbing the fluid in her lungs so she could start functioning like a normal newborn. I felt this was a good plan, though it was hard not to touch her or hold her. I felt she was more the property of the NICU that my baby. Some c-section moms report feeling that they have trouble bonding with their child or even feel disconnected with it. I do not think I felt this way.
Well, maybe a little bit. But I loved her fiercely. I mourned that I didn’t get to have her in my arms at the moment of her birth and every moment after. I was very sad I wasn’t able to nurse her. I knew though that this was the medical care she needed.
I only stayed a few minutes as I was still quite weak from my surgery. When I returned to my bed I felt such relief and even joy at being able to see her that I was finally able to rest for a few hours.
The next morning the dizziness and nausea were gone. The pain medication was wearing off however, so that burning incision was a hindrance. However, I was up again and visited her in the NICU that morning. I spoke with the cardiologist and a neonatologist. The cardiologist was a very sweet man. He gave me my first real good news since she was taken to the NICU. She had another echocardiogram that morning and he said that she was getting better and would be okay. She was going to get through this. There were no congenital defects and there was just a small hole that would continue to close. I was so happy to hear some good news! I knew then that the crisis had passed. The neonatologist told me “Things were pretty hairy yesterday, but they are okay now”. The nurse the night before had told me she was in stable but critical condition. They didn’t label her condition that morning, but I felt it was probably just stable.
The NICU nurse that day was very kind. I was able to touch Audrey a little bit and talk to her. She was receiving nutrition through her IV line and was still nothing by mouth. However she was getting hungry and rooting all over the place. I felt so bad. I really wanted to have her be healthy so I could feed her. They gave her a binky, and I was worried that would interfere with breastfeeding. Now that I knew she was going to survive, I was ready to move on and have her in my arms. But they were very cautious in the NICU. She was still on oxygen, though it was being weaned. She still had her IV and venous lines in.
I asked the nurse when she had last had her diaper changed, and she said it wasn’t too long ago. I actually just wanted to see her naked. Even though they told me she was a girl, I wanted to see with my own eyes. The nurse took off her diaper and I got to look at her. She was a girl indeed. She was pretty chubby as well. She weighed 8 lbs 9 oz, and her face was a bit swollen, so she looked even fuller. She had such bright brown eyes with a very intense gaze when she was awake. I tried to spend as much time as I could with her but I also needed my rest, so I was in my room a lot that day.
The next day they determined that she could start feeding. Even though I said I wanted to breastfeed, they said she had to take a bottle first, and then she could breastfeed. I thought that was really stupid but didn’t feel like I was in much of a position to argue. The neonatologist on that day looked at her weight and prescribed a certain amount of milk that she was supposed to take. I wasn’t there when they gave Audrey her first feeding. No one even told me she was going to start. This bothered me, but at least she was getting my colostrum that I was working so hard at pumping.
The pumping wasn’t fun but at least I was getting out good amounts. The aids and nurses would always be impressed when I gave them the little plastic containers that I had pumped. One aid even said “Don’t let the other moms see that—they’ll be jealous!” That was silly but it made me feel good.
I was in the NICU when the nurse was giving Audrey her second feeding. I think it was maybe 2 ounces. The nurses said she had spit up some of her last feeding and would probably throw up this because it was too much. And she said that the next feeding was supposed to be even more! That’s what the doctor ordered, so that’s what she would get. She had a feeding tube going through her nose, and whatever she didn’t eat by bottle she would get force fed through the tube. It was frustrating but I didn’t really know if I had any control over it, so I tried not to get too upset by it. I found out they did give some formula during one of her feedings (again without asking me) but most of her feedings were my milk. She was keeping her sats up pretty well when she ate, but it was still a bit of a challenge to learn to eat and breathe from the bottle that was pouring out milk. I think it would have been better had she just been able to nurse.
Nathan and James visited me in the hospital that day, Sunday. I was so happy to see them. They
were shy at first about seeing me but then they cuddled up to me. Nathan wanted to meet Audrey but James didn’t. I took Nathan into the NICU to see his sister and it was the sweetest moment. He wasn’t at all scared but was so sweet and proud. That was the highlight of that day.
Physically I was up and walking by then, though quite slowly. Of course I was in pain but was regaining strength. I was also worried about constipation because I could tell I had a big hemorrhoid. That really was frustrating since I wasn’t expecting that with a c-section! It was quite a discomfort to me in my recovery. I was feeling happy and proud as a new mother, but I also had bouts of sadness and guilt. I remember crying into my pillow very hard when I was alone in the room saying “My baby! I just want my baby in my arms!” Another time I was holding a little baby doll that was for Audrey and I was just bawling. I was alone in my room at these times. I often had company of family, friends, or Jason, but it was nice to have a few minutes to myself to just cry.
Sunday evening I was told I could hold Audrey. She was now eating well enough that if her venous line accidentally came out it wouldn’t be a big deal. I was visiting Audrey in the NICU around 6:45 and was expecting a friend to visit around 7. My nurse asked if I wanted to hold Audrey and I couldn’t say no. She spent several minutes getting her lines and tubes situated, and then I sat in the chair and held her. It was so wonderful!! The only problem was it was soon 7 o’clock and I started worrying that my visitor would come and find my room empty. It was a stupid worry and I wish I would have just taken all the time I wanted to hold Audrey. But at about five after seven I told my nurse I had to go. I think she was kind of surprised (and maybe a little annoyed) that I was leaving after my first opportunity to hold her. I felt bad, especially when my visitor didn’t come until nearly 8! Oh well, I would have lots of time to hold her soon.
The next day was Monday and the hospital was back to its full staff. Audrey was fully off of her oxygen by then I think. She might have even had her other lines pulled. I can’t remember exactly. I knew she was better though and I was ready to take care of her. But the NICU wanted to make sure that the babies were totally ready to go home, so Audrey had to be off oxygen and be eating well for about a day. I was given the okay to nurse her so I had lactation come help me the first time I tried. Audrey latched on perfectly right away! I was so relieved! After two and a half days of nothing by mouth, then a day with a pacifier, then a day of being bottle fed, she still knew what to do. The lactation consultant was so happy and encouraging. She said I didn’t even need her, that I could teach all these other babies how to latch on.
The next time she didn’t latch on as well, and her sat monitors showed her desatting a bit. It’s a bit hard to nurse with beeping monitors, but I tried to be compliant and let them give her a bottle again. Then they would continue to stuff her full by NG tube. That afternoon I was trying to feed her but how could she eat if she wasn’t hungry?
I was in the NICU with my mom that afternoon and complaining about the feeding policy. I spoke with the nurse and she said that she was just doing her orders. I asked to speak with the doctor, so she went to find him. Incredulously, she came back and told me that he didn’t want to speak with me! I couldn’t believe it! His excuse was that he wasn’t her primary doctor. However, Audrey had had a different doctor every day, so no one was speaking me. No doctor had spoken to me in my room since the first day, and the next morning I caught a few doctors in the NICU that would speak to me, but that was the last of the communication. My mom was getting pretty worked up but I knew throwing a fit wouldn’t help.
So I just explained to the nurse that no doctor had spoken to me, and I would really like to speak to the doctor. She said she would talk to her supervisor. I guess the supervisor spoke to the doctor and a few minutes later he came over and was all nice. I was nice back and even played a little bit of “tell me about my baby oh wise doctor” to suck up. He said she was doing well and was completely weaned off her oxygen, but that they wanted to see her do “normal baby things—eat and poop—for 24 hours.” I explained that I wanted to nurse her and she was latching on well, but that she had no desire to eat because she was being stuffed by bottle. He told me that I could nurse her and changed the order to nursing on demand! That was my one triumph of Audrey’s birth. I had failed at bringing her safely into the world, but now I stood up to the doctor and was able to feed her the way that was best. The orders changed to breastfeeding on demand as long as she took a good feeding, and if it didn’t seem adequate they would follow with a bottle.
The next feeding or two she didn’t do quite as well, and was given a bottle afterwards because I only fed her for a few minutes. Truthfully I knew that this was fine but I played along and let them feed her with a bottle. That evening Audrey had a very breastfeeding friendly nurse taking care of her, and I breastfed exclusively from then on. I feel like that night was the night Audrey really learned to nurse well. The nurse observed me nursing and noted that Audrey was getting good feedings. She called me every couple of hours on my room phone when Audrey was acting hungry again. My milk was coming in and I was starting to get engorged, and my nipples were sore, but it was absolutely nothing like with the boys’ birth. I felt confident that I could nurse Audrey and take her home! She was off everything, and now we just had to prove to the doctors that we could take care of her.
This was pretty amazing because during her first day in the NICU both Kate and the neonatologist were saying she would probably be in the NICU 7-10 days. Instead, on Tuesday, June 24th on her 5th day of life she and I went home together. What a blessing! I was feeling so happy and relieved that everything turned out okay in the end. I got a little annoyed that morning when the nurse told me I couldn’t look at Audrey’s chart, but other than that it really was such a joyous day. I had descended into the pit of sorrow on Audrey’s birth day when I worried for my baby’s life, but now I was riding the waves of joy and gratitude because I was able to bring her home.
It was so special to get her out of her ugly hospital clothes and put her cute take home outfit on. I was discharged a few hours before her and then received all of her discharge instructions. It was early evening when Jason, Audrey and I all left the hospital on a beautiful summer day. I hadn’t been outside in five days and it seemed surreal almost. Jason was very happy as well, since he had actually gotten a bad sore throat and therefore stopped holding Audrey while in the hospital for fear of making her sick. But once we were out of the hospital, it seemed okay to hold her.
Audrey looked so tiny in her car seat and quietly rode home. We got to our clean home, thanks to my mom and brought our sweet Audrey into our home. It was such a wonderful feeling. We were so happy and grateful. Our hearts were full of thanks to Heavenly father for sparing her life. About an hour or so later my mom brought the boys over from the Henriksons. That was so special too! They were so sweet to her and we had a lot of fun introducing them. We have some wonderful pictures of those first few hours. My friend Leah brought dinner and mom had bought a darling little “birthday cake” to celebrate Audrey’s coming home. What a miracle it was!
There are many details I have left out about other visitors and even Jason. Jason was a rock to me the entire time. I wish he would have been more supportive of a vaginal birth, but he was absolutely supportive of me throughout the painful recovery and the even more painful emotions. He did cry a few times through the ordeal, but mostly was encouraging and faithful. And so sweet. He got a terrible headache one day and a bad sore throat another day as I mentioned. It wasn’t a picnic for him either! The hospital was about 40 minutes from our home, and he made several trips back and forth to care for the boys. He stayed with me a night or two, but not the entire time.
We were very happy to have Audrey in our home and in our lives, but I would still feel very sad because I didn’t get to birth her and because of all the trauma that happened. Those first few weeks and even months I cried many, many times. I also had a lot of bad dreams. I don’t feel I had depression, but perhaps a bit of post traumatic stress.
I started reading everything I could get my hands on in terms of books and internet sources. In time, my sadness turned to anger because of the general lack of faith in women’s bodies to give birth and the medicalization of birth. Now, 8 months later, I have a trace of sadness in me, still some anger, but mostly now just much more awareness of all that happened and why. The VBAC climate really is negative now. I feel that I want to try again to have a vaginal birth. At times I feel determined and hopeful, at other times doubtful and scared.
Finally, at the end of the day around 6 or 7 pm the neonatologist that was at her birth came in our room and spoke with us. She told us about the fluid in her lungs that was making it difficult to breathe. She told us that she was having pulmonary hypertension but that it was being controlled finally by the dopamine and she was somewhat stabilizing. She also (or maybe it was Kate) explained how her heart was still working partly in fetal mode because of her respiratory distress. The cardiologist had seen her and done an echocardiogram. Her anatomy was fine; she just still was in fetal mode. It was nice to at least have some communication from her caretakers. Kate went above and beyond her duty in keeping us informed, and if it weren’t for her we wouldn’t have any idea what was going on. Jason was able to visit her a few times but they were busy doing things with her and also he wanted to stay and support me.
I was gradually feeling better throughout the day. Of course I was still exhausted and beat but was gaining strength and the nausea and dizziness were going away. I was still terribly sweaty though! My first post partum nurse ended her shift with me by saying a prayer. That was very touching. I didn’t like my next nurse so much. I had started pumping in the evening and she didn’t get my milk to refrigeration like she said she would for three or four hours. I know colostrum is fine to sit at room temperature, but I still wanted it refrigerated right away. Also I asked about seeing Audrey but she wasn’t very helpful with that.
At 11 pm I had a new nurse come one. She was my favorite nurse during the stay. I was crying still, or again, (who really knows as there were so many tears that first day) and she actually took a moment to listen and gave real sympathy. I wanted to see Audrey but the NICU apparently had four new admits and was closed to visitors. But she told me “I promise you I will get you to your baby tonight, as soon as the NICU will let us.” That was the most reassuring and compassionate thing I heard the whole time at the hospital. She also had a very friendly aid working with her and they spent several minutes getting me cleaned up and comfortable, and encouraged me to rest.
My rest was very fitful. I woke what seemed like every minute. Every time I heard any noise I would wake up. And in a hospital, that is quite often. I remember hearing an announcement for the NICU to have all available personnel come, or maybe it was even for a code, and I was sure it was Audrey. My heart was racing. A second later someone opened the door and I said, probably sounding quite delirious, “What is happening with my baby?!” It turned out it was just someone coming to take my blood pressure.
Finally around 3 AM my nurse and the aid came in and told me I could come see Audrey. I didn’t care one whit that I was exhausted and it was the middle of the night. In a hospital time doesn’t really matter. It is a twenty four hour world. Jason was sleeping in the hospital bed and I believe he slept through most of the night. They helped me into a wheelchair and wheeled me down to the NICU.
It was very surreal to see Audrey lying asleep in her plastic bassinet. She had oxygen tubes in her nose, an IV in her arm, and an umbilical line. She still looked beautiful, but I felt so sad for her lying there alone. And I felt so sad for me sitting in the wheel chair next to her. I was unable to hold her because of her lines. They really didn’t want to risk the venous line being pulled out. Also, the doctor that evening had said he didn’t want Audrey touched, or talked to, or stimulated in anyway, not even for a diaper change. He felt she just needed to rest quietly while her body worked on absorbing the fluid in her lungs so she could start functioning like a normal newborn. I felt this was a good plan, though it was hard not to touch her or hold her. I felt she was more the property of the NICU that my baby. Some c-section moms report feeling that they have trouble bonding with their child or even feel disconnected with it. I do not think I felt this way.
Well, maybe a little bit. But I loved her fiercely. I mourned that I didn’t get to have her in my arms at the moment of her birth and every moment after. I was very sad I wasn’t able to nurse her. I knew though that this was the medical care she needed.
I only stayed a few minutes as I was still quite weak from my surgery. When I returned to my bed I felt such relief and even joy at being able to see her that I was finally able to rest for a few hours.
The next morning the dizziness and nausea were gone. The pain medication was wearing off however, so that burning incision was a hindrance. However, I was up again and visited her in the NICU that morning. I spoke with the cardiologist and a neonatologist. The cardiologist was a very sweet man. He gave me my first real good news since she was taken to the NICU. She had another echocardiogram that morning and he said that she was getting better and would be okay. She was going to get through this. There were no congenital defects and there was just a small hole that would continue to close. I was so happy to hear some good news! I knew then that the crisis had passed. The neonatologist told me “Things were pretty hairy yesterday, but they are okay now”. The nurse the night before had told me she was in stable but critical condition. They didn’t label her condition that morning, but I felt it was probably just stable.
The NICU nurse that day was very kind. I was able to touch Audrey a little bit and talk to her. She was receiving nutrition through her IV line and was still nothing by mouth. However she was getting hungry and rooting all over the place. I felt so bad. I really wanted to have her be healthy so I could feed her. They gave her a binky, and I was worried that would interfere with breastfeeding. Now that I knew she was going to survive, I was ready to move on and have her in my arms. But they were very cautious in the NICU. She was still on oxygen, though it was being weaned. She still had her IV and venous lines in.
I asked the nurse when she had last had her diaper changed, and she said it wasn’t too long ago. I actually just wanted to see her naked. Even though they told me she was a girl, I wanted to see with my own eyes. The nurse took off her diaper and I got to look at her. She was a girl indeed. She was pretty chubby as well. She weighed 8 lbs 9 oz, and her face was a bit swollen, so she looked even fuller. She had such bright brown eyes with a very intense gaze when she was awake. I tried to spend as much time as I could with her but I also needed my rest, so I was in my room a lot that day.
The next day they determined that she could start feeding. Even though I said I wanted to breastfeed, they said she had to take a bottle first, and then she could breastfeed. I thought that was really stupid but didn’t feel like I was in much of a position to argue. The neonatologist on that day looked at her weight and prescribed a certain amount of milk that she was supposed to take. I wasn’t there when they gave Audrey her first feeding. No one even told me she was going to start. This bothered me, but at least she was getting my colostrum that I was working so hard at pumping.
The pumping wasn’t fun but at least I was getting out good amounts. The aids and nurses would always be impressed when I gave them the little plastic containers that I had pumped. One aid even said “Don’t let the other moms see that—they’ll be jealous!” That was silly but it made me feel good.
I was in the NICU when the nurse was giving Audrey her second feeding. I think it was maybe 2 ounces. The nurses said she had spit up some of her last feeding and would probably throw up this because it was too much. And she said that the next feeding was supposed to be even more! That’s what the doctor ordered, so that’s what she would get. She had a feeding tube going through her nose, and whatever she didn’t eat by bottle she would get force fed through the tube. It was frustrating but I didn’t really know if I had any control over it, so I tried not to get too upset by it. I found out they did give some formula during one of her feedings (again without asking me) but most of her feedings were my milk. She was keeping her sats up pretty well when she ate, but it was still a bit of a challenge to learn to eat and breathe from the bottle that was pouring out milk. I think it would have been better had she just been able to nurse.
Nathan and James visited me in the hospital that day, Sunday. I was so happy to see them. They
were shy at first about seeing me but then they cuddled up to me. Nathan wanted to meet Audrey but James didn’t. I took Nathan into the NICU to see his sister and it was the sweetest moment. He wasn’t at all scared but was so sweet and proud. That was the highlight of that day.
Physically I was up and walking by then, though quite slowly. Of course I was in pain but was regaining strength. I was also worried about constipation because I could tell I had a big hemorrhoid. That really was frustrating since I wasn’t expecting that with a c-section! It was quite a discomfort to me in my recovery. I was feeling happy and proud as a new mother, but I also had bouts of sadness and guilt. I remember crying into my pillow very hard when I was alone in the room saying “My baby! I just want my baby in my arms!” Another time I was holding a little baby doll that was for Audrey and I was just bawling. I was alone in my room at these times. I often had company of family, friends, or Jason, but it was nice to have a few minutes to myself to just cry.
Sunday evening I was told I could hold Audrey. She was now eating well enough that if her venous line accidentally came out it wouldn’t be a big deal. I was visiting Audrey in the NICU around 6:45 and was expecting a friend to visit around 7. My nurse asked if I wanted to hold Audrey and I couldn’t say no. She spent several minutes getting her lines and tubes situated, and then I sat in the chair and held her. It was so wonderful!! The only problem was it was soon 7 o’clock and I started worrying that my visitor would come and find my room empty. It was a stupid worry and I wish I would have just taken all the time I wanted to hold Audrey. But at about five after seven I told my nurse I had to go. I think she was kind of surprised (and maybe a little annoyed) that I was leaving after my first opportunity to hold her. I felt bad, especially when my visitor didn’t come until nearly 8! Oh well, I would have lots of time to hold her soon.
The next day was Monday and the hospital was back to its full staff. Audrey was fully off of her oxygen by then I think. She might have even had her other lines pulled. I can’t remember exactly. I knew she was better though and I was ready to take care of her. But the NICU wanted to make sure that the babies were totally ready to go home, so Audrey had to be off oxygen and be eating well for about a day. I was given the okay to nurse her so I had lactation come help me the first time I tried. Audrey latched on perfectly right away! I was so relieved! After two and a half days of nothing by mouth, then a day with a pacifier, then a day of being bottle fed, she still knew what to do. The lactation consultant was so happy and encouraging. She said I didn’t even need her, that I could teach all these other babies how to latch on.
The next time she didn’t latch on as well, and her sat monitors showed her desatting a bit. It’s a bit hard to nurse with beeping monitors, but I tried to be compliant and let them give her a bottle again. Then they would continue to stuff her full by NG tube. That afternoon I was trying to feed her but how could she eat if she wasn’t hungry?
I was in the NICU with my mom that afternoon and complaining about the feeding policy. I spoke with the nurse and she said that she was just doing her orders. I asked to speak with the doctor, so she went to find him. Incredulously, she came back and told me that he didn’t want to speak with me! I couldn’t believe it! His excuse was that he wasn’t her primary doctor. However, Audrey had had a different doctor every day, so no one was speaking me. No doctor had spoken to me in my room since the first day, and the next morning I caught a few doctors in the NICU that would speak to me, but that was the last of the communication. My mom was getting pretty worked up but I knew throwing a fit wouldn’t help.
So I just explained to the nurse that no doctor had spoken to me, and I would really like to speak to the doctor. She said she would talk to her supervisor. I guess the supervisor spoke to the doctor and a few minutes later he came over and was all nice. I was nice back and even played a little bit of “tell me about my baby oh wise doctor” to suck up. He said she was doing well and was completely weaned off her oxygen, but that they wanted to see her do “normal baby things—eat and poop—for 24 hours.” I explained that I wanted to nurse her and she was latching on well, but that she had no desire to eat because she was being stuffed by bottle. He told me that I could nurse her and changed the order to nursing on demand! That was my one triumph of Audrey’s birth. I had failed at bringing her safely into the world, but now I stood up to the doctor and was able to feed her the way that was best. The orders changed to breastfeeding on demand as long as she took a good feeding, and if it didn’t seem adequate they would follow with a bottle.
The next feeding or two she didn’t do quite as well, and was given a bottle afterwards because I only fed her for a few minutes. Truthfully I knew that this was fine but I played along and let them feed her with a bottle. That evening Audrey had a very breastfeeding friendly nurse taking care of her, and I breastfed exclusively from then on. I feel like that night was the night Audrey really learned to nurse well. The nurse observed me nursing and noted that Audrey was getting good feedings. She called me every couple of hours on my room phone when Audrey was acting hungry again. My milk was coming in and I was starting to get engorged, and my nipples were sore, but it was absolutely nothing like with the boys’ birth. I felt confident that I could nurse Audrey and take her home! She was off everything, and now we just had to prove to the doctors that we could take care of her.
This was pretty amazing because during her first day in the NICU both Kate and the neonatologist were saying she would probably be in the NICU 7-10 days. Instead, on Tuesday, June 24th on her 5th day of life she and I went home together. What a blessing! I was feeling so happy and relieved that everything turned out okay in the end. I got a little annoyed that morning when the nurse told me I couldn’t look at Audrey’s chart, but other than that it really was such a joyous day. I had descended into the pit of sorrow on Audrey’s birth day when I worried for my baby’s life, but now I was riding the waves of joy and gratitude because I was able to bring her home.
It was so special to get her out of her ugly hospital clothes and put her cute take home outfit on. I was discharged a few hours before her and then received all of her discharge instructions. It was early evening when Jason, Audrey and I all left the hospital on a beautiful summer day. I hadn’t been outside in five days and it seemed surreal almost. Jason was very happy as well, since he had actually gotten a bad sore throat and therefore stopped holding Audrey while in the hospital for fear of making her sick. But once we were out of the hospital, it seemed okay to hold her.
Audrey looked so tiny in her car seat and quietly rode home. We got to our clean home, thanks to my mom and brought our sweet Audrey into our home. It was such a wonderful feeling. We were so happy and grateful. Our hearts were full of thanks to Heavenly father for sparing her life. About an hour or so later my mom brought the boys over from the Henriksons. That was so special too! They were so sweet to her and we had a lot of fun introducing them. We have some wonderful pictures of those first few hours. My friend Leah brought dinner and mom had bought a darling little “birthday cake” to celebrate Audrey’s coming home. What a miracle it was!
There are many details I have left out about other visitors and even Jason. Jason was a rock to me the entire time. I wish he would have been more supportive of a vaginal birth, but he was absolutely supportive of me throughout the painful recovery and the even more painful emotions. He did cry a few times through the ordeal, but mostly was encouraging and faithful. And so sweet. He got a terrible headache one day and a bad sore throat another day as I mentioned. It wasn’t a picnic for him either! The hospital was about 40 minutes from our home, and he made several trips back and forth to care for the boys. He stayed with me a night or two, but not the entire time.
We were very happy to have Audrey in our home and in our lives, but I would still feel very sad because I didn’t get to birth her and because of all the trauma that happened. Those first few weeks and even months I cried many, many times. I also had a lot of bad dreams. I don’t feel I had depression, but perhaps a bit of post traumatic stress.
I started reading everything I could get my hands on in terms of books and internet sources. In time, my sadness turned to anger because of the general lack of faith in women’s bodies to give birth and the medicalization of birth. Now, 8 months later, I have a trace of sadness in me, still some anger, but mostly now just much more awareness of all that happened and why. The VBAC climate really is negative now. I feel that I want to try again to have a vaginal birth. At times I feel determined and hopeful, at other times doubtful and scared.
Empowering birth stories
One of the blogs I like to read, stand and deliver, asked for people to share their empowering birth stories. Click the comments of this post to have a whole slew of awesome birth stories. If you've had a great birth you may not be obsessed with reading about other people's births like I am, but it is so encouraging to me!
Tuesday, May 12, 2009
c-section rates for local hospitals
I found an online government page where I could look up the c-section rates of hospitals in Illinois. Unfortunately, the hospitals are not enforced to keep track of this, so I wasn't able to find out all the hospitals. Here's some c-section rates from 2007:
Edward Hospital, Naperville : 35% c-section rate
Rush Copley, Aurora: 31% c-section rate
Del Nor, Geneva: 36%
West Suburban, Oak park: 20%
Hindsdale Hosptial (where Audrey was born): 26%
I wasn't able to confirm this on the listing because this hospital didn't put in their results, but I have been told that Central DuPage Hospital has a 39-40% c-section rate! (That's where I was born 29 years ago).
I think it is very important that we know what the c-section rates are of both our hospitals and the practices we see. Because I see it this way: If a doctor has a 40% c-section rate, you have about a 40% chance of having a c-section. Repeat cesareans throw the numbers higher, so probably a better indication would be a doctor's primary c-section rate rather than his overall, but still, a 40% c-section rate gives a good idea of how a doctor practices.
In summary, high cesarean rates have more to do with doctor's preferences and practices than a woman's inability to give birth.
I encourage you to find out your midwife/doctor's c-section rate and the c-section rate of the hospital you are delivering at.
Edward Hospital, Naperville : 35% c-section rate
Rush Copley, Aurora: 31% c-section rate
Del Nor, Geneva: 36%
West Suburban, Oak park: 20%
Hindsdale Hosptial (where Audrey was born): 26%
I wasn't able to confirm this on the listing because this hospital didn't put in their results, but I have been told that Central DuPage Hospital has a 39-40% c-section rate! (That's where I was born 29 years ago).
I think it is very important that we know what the c-section rates are of both our hospitals and the practices we see. Because I see it this way: If a doctor has a 40% c-section rate, you have about a 40% chance of having a c-section. Repeat cesareans throw the numbers higher, so probably a better indication would be a doctor's primary c-section rate rather than his overall, but still, a 40% c-section rate gives a good idea of how a doctor practices.
In summary, high cesarean rates have more to do with doctor's preferences and practices than a woman's inability to give birth.
I encourage you to find out your midwife/doctor's c-section rate and the c-section rate of the hospital you are delivering at.
Thursday, May 7, 2009
educated birth
Here's an encouraging little video about educating yourself in birth. I think we need to educate ourselves more. I thought I knew a lot, but now I wish I would have known more.
I was talking to a nanny at the park yesterday, and she told me "Oh I love kids but I'm so scared to have them!" "Why?" I asked. "Oh I'm so scared of the pregnancy and the labor and birth!"
It makes me a little sad, this lack of faith in a woman's ability to give birth. Most of the time, women can. Certainly a third of us don't need to be sectioned, and yet here we are with a 31% c-section rate.
I was talking to a nanny at the park yesterday, and she told me "Oh I love kids but I'm so scared to have them!" "Why?" I asked. "Oh I'm so scared of the pregnancy and the labor and birth!"
It makes me a little sad, this lack of faith in a woman's ability to give birth. Most of the time, women can. Certainly a third of us don't need to be sectioned, and yet here we are with a 31% c-section rate.
Tuesday, May 5, 2009
Very intense birth story
Do you love birth stories? I sure do. I can't get enough of them, especially natural birth stories. I read this birth story just now and Wow! I loved it. It is a story of a HBAC breech birth! It's ironic that breech births are automatic c-sections in the hospital, and so therefore women who do not want that have to birth at home, with or without a skilled attendent. Doctors simply don't know how to deliver breech babies anymore, or are unwilling to learn. They are trained in doing surgery, not in supporting a birth.
This myth that breech babies cannot be born vaginally is very ingrained into our minds these days. I myself had my first c-section because my twins were both breech. That might have been the best option for me anyway, but I honestly didn't realize breech babies could be born safely by a vaginal delivery until I did some reading and spoke with people. I know a woman had had a double footling breech 30 years ago in the same hospital Audrey was born. I love her story. I think it's sad though that a woman going to that hospital today would not be given that option. Where are our options going?
Another area where options are diminishing is in VBAC. There are so few providers in the Chicago area that offer VBAC, and even less that truly support it. There are two doctors in the entire Chicago metro area (population in the millions) that will offer a VBA2C. One is in the city of Chicago and one is in Hoffman Estates, neither which are close to me. However, I am grateful there is at least that. Some states have next to no VBAC options at all. And nation wide, a breech baby means a c-section, usually at 39 weeks.
So anyway, I think it's sad that women's choices are so limited in terms of birthing options today. Often the only place a woman can have an opportunity to give birth, instead of being told she needs automatic cesarean surgery, is her home. And almost all the time, those births are safe and satisfying.
This myth that breech babies cannot be born vaginally is very ingrained into our minds these days. I myself had my first c-section because my twins were both breech. That might have been the best option for me anyway, but I honestly didn't realize breech babies could be born safely by a vaginal delivery until I did some reading and spoke with people. I know a woman had had a double footling breech 30 years ago in the same hospital Audrey was born. I love her story. I think it's sad though that a woman going to that hospital today would not be given that option. Where are our options going?
Another area where options are diminishing is in VBAC. There are so few providers in the Chicago area that offer VBAC, and even less that truly support it. There are two doctors in the entire Chicago metro area (population in the millions) that will offer a VBA2C. One is in the city of Chicago and one is in Hoffman Estates, neither which are close to me. However, I am grateful there is at least that. Some states have next to no VBAC options at all. And nation wide, a breech baby means a c-section, usually at 39 weeks.
So anyway, I think it's sad that women's choices are so limited in terms of birthing options today. Often the only place a woman can have an opportunity to give birth, instead of being told she needs automatic cesarean surgery, is her home. And almost all the time, those births are safe and satisfying.
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