Showing posts with label Audrey's birth part 1. Show all posts
Showing posts with label Audrey's birth part 1. Show all posts
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.
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