Tuesday, July 13, 2010

By Request

I have had several people ask me to write out my birth story for Ethan, so, without further ado, here it is. I have included a little background information on my other births to help you see what lead me to the choices I was making for Ethan's birth. I know some of this is controversial so if you want to comment or ask questions, I just ask that you do it in a respectful way. Happy reading!

My journey to plan for a HBA3C (home birth after 3 c-sections for those of you who aren't indoctrinated in the world of birth terminology) started 7 1/2 years ago with the birth of my first born. I had who I considered to be the best doctor in the area (I still do think that by the way-shout out to Dr. Debra Madura with Clarian Arnett-arguably one of the more progressive physicians in the area in terms of allowing women to have choice in their birthing options and supporting natural labor) and was fully immersed in the medical model of birth. I lived and breathed the What to Expect books. I mean, that's just what you are supposed to do right? RIGHT????

I did plan for a natural birth, that was a deep heart's desire of mine, but I had no idea how impossible that was to achieve in a hospital setting. I went past my due date with no signs of labor and my OB asked if I wanted to be induced. SURE! I just wanted to meet my baby!

So at five days past my due date I went in for an induction, completely clueless about what it meant to be induced. Sure I knew all about the pitocin and what they were going to do, but I was clueless about risks etc... I completely expected to have my natural birth. My mom never had any issues so why should I? I never even really considered csection as a possibility. It wasn't until I got to the hospital that I learned an induction could fail and I could be sent home. Well, I was determined that wouldn't happen to me-no way I was leaving that hospital without a baby! No one told me that being induced INCREASES YOUR ODDS AT HAVING A C-SECTION BY 50%!!!! (Yes, you read that right!)

What ensued was what I have since learned is a very typical story known as the cascade of interventions-intervention after intervention to try to move things along, never dilating past a 1-artificially broken waters, internal monitors, nubain, epidural-and after 16 hours of labor with no progress and broken waters, my daughter was born via csection.

She was perfect, I was fine, no indication for the csection except FTP (failure to progress, or as I like to refer to it, FAILURE TO BE PATIENT). She was a bigger baby, 9 lbs, 3 oz and VERY broad shouldered. Everyone said thank God you didn't have to push her out-like that was funny or something. But I was happy to have my baby and not too upset about the csection.

That is, until the next day when they got me out of bed. The pain was unbelievable. They always talk about it like it's no big deal just a little surgery, so that was my expectation. Don't be fooled. IT IS MAJOR ABDOMINAL SURGERY. They pull your insides out-your bladder and intestine and uterus-and then put you back together. Under no other circumstances would someone be awake during such an ordeal, much less told to "be grateful" and "be happy" and "get over it".

My recovery was absolutely horrid. Every time I stood up I felt as if my body was ripping in two and my insides were going to fall out. I couldn't cough, laugh, cry, sneeze, use the bathroom without excruciating pain. Not to mention, I felt like a complete and total failure but I couldn't quite figure out why. I was so excited to have my baby and loved her fiercely from the moment I saw her, BUT I started to realize even then, within days of her birth, that having a perfectly healthy baby, while vitally important, was not the ONLY important thing. Having a physically and emotionally healthy mom was just as important. Usually, once the baby comes, Mom is taken out of the equation and everyone says oh-so-helpful things like, "Be grateful you have a healthy baby." or "What are you upset about? You have a healthy baby." or even the hurtful "Get over it. Lots of women have c-sections and are fine." I had the baby blues and grieved the loss of my birth and determined to do it differently the next time.

Fast forward to pregnancy number 2 (technically number 3-we had a miscarriage in between which I now attribute to the previous csection). I was SO determined for a VBAC, but again buying into the medical model, with the exception that my doctor wouldn't induce (this can introduce a whole host of extra complications, even more so when you have had a previous csection) so I knew I had to go into labor on my own-not that I wanted to repeat that experience anyway.

However, since I never dilated with my daughter, nor had so much as a contraction without the pit, I was convinced something was wrong with my body, I would not be able to do it because I would never go into labor on my own. WRONG! I had an appointment on Friday and I was still tight and closed and my OB said, "see ya next week." I was having plenty of contractions but quite discouraged that yet again nothing was happening.

I was 38 weeks, 6 days pregnant. I was completely unprepared for labor, had no bags packed because I had convinced myself it wasn't happening. That night at 2 am my water broke in a huge gush. Like a good little patient I called immediately and after waking my daughter, getting ready and dropping her at a friend's we got to the hospital around 4 am. I had started contracting, hard and fast, 2-3 min apart. Man it hurt!

But I was so flippin' excited! I couldn't believe it, I was doing it! It was the first time I actually believed it might happen. I labored like that, contractions 2-3 min apart all through the night and until about noon the next day. I was in a lot of pain but I didn't want any interventions-no drugs, no epidural.

I had fairly supportive nurses and I was concerned about the 24 hour rule but the doc on call was so laid back-he said since I was getting antibiotics for GBS anyway, that I could labor as long as I wanted. They didn't check me, they basically just left me alone to do my thing-with one exception. I live in a town where there are three nursing schools so of course they asked if the nursing students could "study" me, since VBACs are so rare. So I agreed, but man was that annoying.

So anyway, I did everything I could to get this baby moving-walked the halls, hot showers, birthing ball. I was crying out for my mommy and right about the time she came contractions just stopped. I would have maybe one or two an hour and that was it. Things stayed that way for 24 hours. They moved me off of L&D to an empty hall because they needed the room for women who were really in labor, of course. I was never told at the time that this was perfectly normal and actually quite common. As you can imagine, I was incredibly discouraged. And hungry-I hadn't eaten for 48 hours and was utterly exhausted.

At this point I had a few nurses telling me to give up-that was frustrating, but thankfully I am very stubborn. So that night (it was Sunday evening by then) I asked for them to bring the birthing ball into my room. Rick was gone with Madison to change clothes and shower and such and I was all alone in my room. I just sat on the birthing ball and cried out to God, pleading with him to bring the contractions back. I can only think of one other time I have prayed so hard and so fervently and wanted something so badly.

Within an hour contractions were 7 minutes apart, then 5, then they finally moved me back to L&D and I labored like that through the night. I was able to relax and laugh between contractions but I really had to work through them. The hospital was really flexible and didn't require continuous fetal monitoring or anything like that so I was able to be as mobile as possible. They even let me go outside at one point-I remember it being the first warm day of the year-this was early March-and begging to go outside since I was so tired of being in there and so they let me-in a wheelchair, but I didn't care, it was fresh air.

My OB came in Monday morning, shocked to find me still there and asked if she could check me. I hadn't been checked yet so I consented and I wasn't even a 1. I couldn't believe it-it was like my world came crashing down in that moment-all my hard work was for nothing. At 12:14 Monday afternoon, 58 hours after my water broke, my son was delivered via csection for FTP...again. My body had failed me...again.

Fast forward 2 more years to baby number 3-diagnosed with GD (gestational diabetes), insulin-dependent, had the fear of God put in me that the baby was going to be huge, was measuring five weeks ahead. So, I did something I never thought I would do and had an elective repeat csection. Turns out, he was my smallest baby at 8 lbs 6 ounces and perfect in every way.

Two years later and I'm pregnant again and determined to do it differently this time. Each of my recoveries had been horrible, I had had to wait hours to even get to meet each of my babies because of complications with anesthesia and hospital protocol, I had complications at the beginning of this pregnancy which were caused by the previous csections and I longed so badly to be the first one to hold my sweet baby and to nurse him right away and not feel so disconnected from the births of my children. I wanted to join the ranks of millions of women the world over and do what I was created to do and birth my baby naturally.

I had learned a lot from the GD experience and I was determined to not have that again, even though they told me at every appt I WAS GOING to have it-I am overweight and there is a 70% recurrence rate so it was a done deal right? I was taking really good care of myself and eating right and so nervous when the time came for the GD test. All this time I had been doing more and more research, reading books like Silent Knife, and Pushed and Ina May's Guide to Childbirth and Birthing from Within. I KNEW I wanted a homebirth.

I did so much research and reading that my eyes started to go blurry. I learned so many new and startling things that I had never considered before about the modern medical-model of maternity care (a whole other post in itself which I would love to write sometime-but if anyone is interested in the research or questions whether what I was planning was really safe, feel free to ask). Mainly, I became convinced that I would never have the birth I desired in a hospital setting, no matter how wonderful and family-friendly the hospital and it's staff may be. Secondly, I was convinced by scores of compelling research and evidence that this was indeed a very safe way to birth my child.

I NEVER would have put him at risk, but it was amazing the number of people who thought I was doing just that and had no problem sharing their opinions on the matter with me-despite having known me for years and never once questioning my commitment to caring about the safety of my children or doing something without their best interest at heart. That was probably the hardest part of the whole journey. I felt incredibly lonely and judged for the decisions I was making, by people who knew me, to whom I was very close, who knew the kind of mom I was. None of that mattered. I was considering something non-mainstream, and instead of supporting me and looking at the research, snap judgements were made and I felt incredibly ostracized. It was a very hard time and very hurtful for me. I understood their concern for me, but at the same time I just needed some understanding and support.

It was at that time I connected with some women from International Cesarean Awareness Network, ICAN, and that was so helpful to be heard and to connect with women who knew exactly what I was going through and had been there themselves. I cannot overstate the importance and value of the support I received there, and how much I would recommend the site to someone in our situation.

So, I started talking to all the HBMWs (home birth midwives) in my state. I had lots of interesting conversations, but NO ONE wanted the risk of a 3-peater, especially with the threat of GD. BUT-I PASSED THE TEST!!! I could not have been more excited, I was on cloud nine and so mad at the u/s tech who told me she'd see me again "you know, because of the diabetes" like it was a given. YES! I proved them wrong!!

Then I really started to hunker down and get serious about this home birth business. I had to convince Rick that it was a good idea, which wasn't too hard to do after I started reading him the research on the risks of csections and especially repeat csections and he read Birth Partner on his own. He agreed with me that this would be the best, most beautiful, natural way to bring our son into the world.

Long story short, I finally found a MW willing to take a chance on me and she was the first person ever to tell me I could do it. I had no idea how badly I needed to hear that. I remained under the care of my OB as well, just in case I needed a transfer but I was so sure that this would be my time. I did everything right.

Of course, many of you know the rest of the story. My little guy was breech and big and despite trying every possible thing-chiropractor, acupuncture, moxibustion, pulsatilla, standing on my head-among many other positions I tried to get him to turn-he wouldn't budge. He wasn't even in a good position to deliver breech which I was willing to try-he was oblique, almost transverse, laying sideways facing my right side with his butt in my pelvis and head and feet up under my ribs.

Another long story short, all the research I did said vaginal breech birth was a viable option, IF the baby was not big. A late term u/s confirmed that he was good size (I know, I know they can be inaccurate, but my u/s tech is notoriously accurate and had been right on target for all of my kids, plus he was right around the same weight as they were at that point so I didn't think by some miracle I would all of a sudden be popping out a 7 pounder. I have big babies, that's all there is to it-and that didn't scare me one bit when I thought about delivering a baby head-down). So my MW risked me out-she conferred with another MW who was to be her back-up and they both agreed I should have a csection, as did my OB of course.

I was crushed beyond belief, but there was NO WAY I was delivering breech unassisted. The most heart-breaking moment came when my husband deflated the pool in our room-it was like I could physically feel my heart deflating as well. I had a visceral reaction to it, like it was somehow symbolic of my failure and even typing it out is bringing me to tears remembering those emotions again.

So, at 2 days past my due date, I had ANOTHER ERCS (elective repeat csection-something I had sworn to never do again).

However, this time around it was a little different-and this is where the story gets better. Because I had done all my research and had been around this block a few times, I knew exactly what I wanted out of my csection. The decision to do the csection was made on a Wednesday and the surgery was scheduled for that Friday. I went home, typed out a birth plan and took it into the hospital the next day when they had me do all of my pre-testing.

In between my 3rd and 4th babies a new hospital had opened so I had no idea what kind of response I would get. I was asking for a lot of unusual things-no narcotics in my spinal, to have my husband present for the administration of the spinal, to be able to see my baby being born, for him not to be suctioned or bathed, to wait for the cord to stop pulsating before cutting it, among many, other things. I figured they would laugh in my face but I tell you what these nurses were top notch, so sweet.

I was afraid even if they did do what I wanted they would be resentful about it and I would feel that. But they bent over backwards to give me everything I wanted. One nurse even said, in complete sincerity, "we will do everything we can to give you everything you want." Every nurse who came into my room acknowledged, without me asking, that they had read my birth plan. My OB and my anesthesiologist happened to be there while I was in for pre-testing, both read the birth plan and were fine with most of it. My anesthesiologist really tried to convince me to take the narcs (I don't do well at all with them and basically slept through my first two csections and had a long and difficult time coming out of recovery so I wasn't able to see my babies until many hours after their births). But I had done it that way with my last birth so I knew it could be done. She thought I didn't know what I was in for pain-wise and I assured her I most certainly did and I would take the pain any day over not being present and fully aware at the birth of my own child. She accepted that and even let my husband be there the whole time-he walked me into the OR and walked out with me (well I rode on the bed but you know what I mean).

They lowered the curtain so I could see my baby right away-the first time I saw my others they were already bundled up and bathed. I loved seeing him all goopy and messy-it was beautiful. The whole experience from start to finish was surreal. I never thought a csection could be beautiful but his was. I had him on my chest nursing when he was 30 minutes old. He was awake and alert. I had never seen any of my other babies like that. I was awake and alert and had I had the narcs I would have missed that completely. It was amazing! He latched on right away and nursed for 35 minutes the first time-it was awesome!!!

He was so much easier and I fully believe it was because he had no drugs in his system, nor did I. My milk came in before I left the hospital and his poop was already yellow (that's a good thing for those unfamiliar with babies) by the time we left as well-it was five days before my milk came in with each of my other kids, and in the meantime I had to listen to them cry because they were so hungry by the time it came in fully. I had none of that this time around. In fact, the nurses were coming into my room asking me to give nursing lessons to the other moms on the floor. After four kids, it is kind-of second-nature.

It was all around just an awesome, amazing experience that I never would have had had I not done my research, stood up for myself and asked for what I wanted. Finally, I felt empowered, like my voice mattered, like I wasn't just a vehicle to get the baby here but that what I felt and wanted was important. FINALLY!!!

Now my recovery this time around was the worst yet-I ended up with a spinal headache which was horrible, I seriously thought I was dying. Then I ended up with my scar opening up and an ecoli infection at the incision site, which Rick had to pack daily for a couple of weeks. It was humiliating and disgusting and just all around awful. I was completely disgusted with myself and Rick was so gentle and tender with me. I was a big baby about it all and he was absolutely perfect, my rock through it all. It was the first time in ten years of marriage that he had to quote our marriage vows back to me and reassure me he was there for the long haul, no matter how bad things got. And it was bad.

So even though the actual birth and hospital stay was awesome, I still firmly believe CSECTIONS SUCK!!! Here I am 12, almost 13 weeks later and still having pain (edited: it is now a year later, and I still experience pain). So when we get pregnant again I will try again for my HBAC. Yes, I will! The hard part for me was that my csection this time around had nothing to do with the fact that I had already had 3 csections-it was something completely out of my control. But I am still determined for the birth I want.

I was talking to Rick the other night telling him how I would have ten more kids if it weren't for having the csections. I said something about not being able to give birth normally. And he said the sweetest and most meaningful thing. He said, "It's not that you can't. It's that you haven't yet." God, I love that man!

Anyway, I know this was really long (you are used to that by now if you have read any of my other posts) and if you read all the way to the end , God bless you and thank you.

I hope that if you are a woman facing similar decisions as mine, you can be encouraged by my story to stand up for yourself and not back down and that even if you have to have a csection that it can be a better experience than you can imagine-you just have to ask for it. Not saying that all hospitals will be as great as mine was, but it never hurts to ask and keep on asking if need be. I found a lot of healing this time around. I still wonder what would have happened if I went into labor and question whether I should have waited. I am sure I always will. But I don't regret my decision. My boy is beautiful and our journey taught me so much. I will be forever grateful for that!


Jenny said...

Thanks for posting that. You are an amazing woman and even though you did end up with the csec, you now have a wealth of knowledge that I know will impact many areas of your life and the experience of standing up for what you believe in will take you far.

meghanndubea said...

Lisa, Thank you for sharing your story! I have been having feelings of disconnect with Addisyn's c-section birth. Thank you for letting me know I am not alone in those feelings. God bless you and your little ones!

The Epsteens said...

Meghann-you are DEFINITELY not alone. I cannot tell you the number of women I have spoken with who have been through a csection and feel the same way. I got a lot of support this time around at a website called ican-online.com. ICAN stands for International Ceasarean Awareness Network and is run completely by volunteers. There is scores of research, resources and information on their website as well as forums where you can talk directly with women who have been there as well. I highly recommend it. Their name also reflects their philosophy on birth, that we CAN birth our babies normally and naturally and that most csections are unnecessary, and even if they are necessary, you have choices for future births. Definitely check it out, especially if and when you decide to have another. If you ever want to talk more about it, just let me know.

The Epsteens said...

Thanks Jenny!

True Nutrition - Tim & Cheryl said...

That was so BEAUTIFUL - just like you! I'm so proud of you!!

E said...

Great story and what a wealth of info you have now! You know you will be called to share it, too.

I felt the same way with Ben's birth - more like "snapshot" memories than me actually being there.

As I watched you go thru this pregnancy, you were so dedicated to learning all you could. You knew what you want and asked for it - when a lot of women just believe what they are told. It made me look at my "medical relationships" in a whole new way.

I remember your disappointment in not being able to have the HBAC, but you had great perspective thru the whole process. And we're so glad for the gift of little Ethan. :)

The Epsteens said...

Thanks everyone-you are all so sweet!

Eileen-I am so glad if anything I experienced has helped you in anyway. That alone makes it worth it. And I can't wait to see what the future holds for you ;) You know I could talk about this stuff for hours-you just let me know when you're ready lol!!!