Tuesday, November 01, 2011

My thoughts on my births

Meeting Walter for the first time in the OR
I've probably told some of this in previous posts, but I've been thinking about this a lot lately and felt like it would be cathartic to write it out.

I have had a couple of people ask why I would want to try VBA2C (vaginal birth after 2 cesarean).  When I had Dean, I was sure that it was a life and death situation by the way the doctor was acting. After my 18 hours of labor and c-section with him, all the drugs in my system left me convulsing and I could barely open my eyes (let alone nurse or hold him) when Matt brought him after he'd been cleaned. I remember hearing myself say in a very drug induced way, "Thank you for saving my baby!" as they were sewing me back up.  My actual doctor was the one who did the c-section (though she wasn't there at all for my 18 hours of labor), but she did a great job and I healed up pretty well. Because I felt like it was so "emergency" I never really felt angry about having to have a c-section (though I did feel very angry about the nurse refusing to help me get him latched that night because she had "5 hours of charting she was behind on" etc. So Matt just ended up holding him, we sent him back to the nursery for the whole night, and I slept off all the drugs that were in my system). It's just what happened. I don't feel like I had many problems recovering from Dean's birth emotionally. As I look back on it, it probably wasn't quite as dire of a situation nor was his cone head or molding abnormal.  It's hard to say, though, since we were so naive of the actual birthing process, interventions and the like.  Oh, and as an aside, I just heard from a reputable source (though I haven't had official confirmation) that the c-section rate in my area is 50%!! That is outrageously high in my opinion. Makes me think that the doctors here jump to c-section unnecessarily and quickly!

When I was pregnant with Walter, I did have a desire to try for a vaginal birth. My OB would have allowed me a trial of labor at Centennial Hospital which was further away from us (and my doctor's practice) than MCM. She was a pretty laid back doctor, so I didn't really feel like she was truly discouraging me from having a VBAC, but she also didn't inform me much of anything or encourage me either. I was never given a clear reason as to why I had a c-section with Dean. She stressed that they could not induce me and who knows how long I'd go or how big my baby would be.  She also mentioned she would have had to cancel all her appointments when I went into labor since the hospital was further from her practice and I was higher risk.  Matt didn't feel all that comfortable with a VBAC.  He couldn't really see another outcome than another c-section, so why not just take the emergency out of the equation.  In the end I went with a scheduled c-section.  I kind of felt like my body was "broken". I wasn't sure if I was "big enough" to birth a normal baby.

Walt's birth was so much more surreal than Dean's. I knew what day I'd have him. I knew what time of day. I didn't have one contraction nor one Braxton Hicks contraction even. I was happy to have my baby after surgery, but I honestly don't think I felt like I'd "earned" him. After having Dean I was a leaky lactating mess every time he cried or even when I thought about him. It was not so with Walt. I was, however, leaky when I heard Dean cry even after I had Walt home. I gave away all my nursing pads after about 4 months and then at about 5 or 6 months I finally felt connected enough to the little guy and started gushing like I'd just started nursing him!  My emotional state after I had Walt was precarious. I was a wreck.  I felt like a crazy person most of the time. Walt was so good so I felt guilty about being such a mess, but Dean was just hitting his 2's and I was not handling that well. I felt very, very disconnected from my family of origin and didn't feel like I had enough close friends to lean on or call on anyone.  It didn't help that the few people I did try and reach out to were not that responsive or were actually quite aloof. I remember talking to my mom at one point saying I just wanted to come spend a month in Snowflake so I could get my head back on right.  Luckily we were able to go to CA for Christmas that year for 3 weeks. I had help. I was able to go on some dates with Matt. I felt like I was able to finally "heal" emotionally and put my crazies away for good.  That was about 6 months after Walt was born.

When I started running again in March of 2010, I started voicing my desire of having a vba2c as I jogged with my running partner. I knew I was a ways off from even wanting to be pregnant, and I didn't know if it was even possible, but I knew I didn't want to have to go through another postpartum experience like I'd just been through. I talked about it a lot. I kept going to see my OB, though for most of my check ups I ended up with the nurse rather than my OB.  At my 1 year check up I remember asking the nurse practitioner if a vba2c was even possible, and she said they didn't do it and didn't know anyone who did. I even wrote my doctor and asked if it was possible and she said no, and that she didn't know of any doctor who would do a vaginal birth after multiple cesareans. That sounded like bull to me.

I had a friend who had been a midwife before moving to TX. Talking with her about my birth experience with Dean was the first time I questioned the veracity of the "emergency" of my c-section, and she told me some things they could have tried rather than going straight to a c-section. I started thinking in the direction of midwife and birthing center though I'd never really considered it before. After I learned I was pregnant with baby #3, I emailed her and asked if she knew of anyone who would do a vba2c since my doctor swore she didn't.  She pointed me to the ICAN group of North Texas (International Cesarean Awareness Network).  I also had a lead on a midwife about 1/2 hour north of me from a friend who'd had 5 home births with midwives, the last being with this particular midwife in Sherman. The ICAN is how I got in contact with Dr. Cummings, the OB I chose to go with, and the midwives in Sherman that I considered, but Matt felt was too risky.  Both said they'd allow me a trial of labor.

I just sent my papers and deposit into the woman that I've hired to be my doula because, honestly, I know I need someone else in there if I'm going to accomplish what I want to. No matter how many classes I take or books I read, I really want someone there to keep it real, simple, calm, and keep me informed.  

Kathy, my doula, asked if I had planned a natural birth the first time around and if I was hoping to go med free this time or if I just wanted to vbac. I didn't really have a plan with Dean. I didn't know what to expect enough to write out a real birth plan. I had mixed emotions on the meds. I had friends and siblings who had done it both ways and loved the ease of the epidural. I also had friends and family who were very adamant about having a natural birth. I went 9 hours from my water breaking until I got an epidural with Dean, and that was when Matt stepped out for breakfast and I didn't want to go on by myself with contractions. My goal was to try to go without, but if I wanted them, then I wasn't opposed to them.  This time, my original goal was to just vbac successfully, labor at home as long as possible, and see how it went in the way of meds. So not all that different from the first time around.

However, the more reading and research I do, and the more birth stories I read, I'm convinced I would like to have a natural birth. And with a doula by my side (Matt kind of doesn't get why you wouldn't go straight to an epidural), I really think I can do it.  I don't do things just because they're easy, and I don't NOT do things because they're challenging. I didn't run a half marathon because it was easy.  I don't make my own bread or cook most of my food from scratch because it's easier than buying it.  I feel like I run on the "natural" end of the spectrum in almost all other aspects of my life. I really, really want to experience birth in it's true, primal form. Regardless of the outcome this time, be it vaginal or c-section, I don't think it will be like either of the other 2 births. I will not be bullied or tricked or scared into a c-section. If there is truly a medical concern I will listen and weigh the options rather than blindly follow the hospital staff.

I just finished watching The Business of Being Born and am in the middle of reading Your Best Birth, both by Ricki Lake. I wish I'd seen it before I had Dean. I probably would have seriously considered birthing in a birthing center (Matt's soooo not into the home birth though I have nothing against it) with certified nurse midwives.  I'm nearly convinced that my particular "emergency" c-section was most likely not a true emergency.  Maybe, but I've come a long way from thinking that I or my baby would have died during labor had I not had a c-section (my exact sentiments right after I gave birth to Dean).  There's a great birthing center in Allen that I would have gone to this time around, but their director doesn't allow VBAC patients (let alone VBA2C) since we're considered high risk.  I do realize now that my doctor is really an exception to the rule on doctors, and there really aren't many who will take on VBAmultipleC patients because of possible litigious reasons (NOT because of the possibility of the uterus rupturing).  There's only 1 other OB/GYN I know of in the area who will take new patients in my situation that I know of.  In some states (AZ being one) it's actually illegal to even have a trial of labor after 1 c-section. So, I'm glad I get to at least try.


mad white woman said...

I know you didn't ask, but here are my thoughts on your thoughts. :) I think it's awesome that you are going for a VBA2C. I don't think I know many (any?) women that would do that. At the same time, I think women also don't have enough confidence in their bodies. They are amazing! I think we are capable of so much more than we sometimes admit and more than the doctors admit.

My doc here tries to avoid c-sections whenever possible and that's one reason I really like him. I feel like we're on the same page in that aspect. 50% does seem super high.

What does a trial of labor mean? I have a friend right now that is pregnant, hoping for a VBAC and her doctor said she has to go into labor on her own, as they won't induce on a VBAC.

And finally, the epidural debate. I had one with Clara and loved it. I didn't have one with Hazel and it was awesome. I loved that too. You are preparing so well, are healthy and in tune with your body and I'm sure you will make the best decision for your situation.

Celia Marie (W.) B. said...

Just to let you know Anna, I always really appreciate your comments. As for a trial of labor, that just means that they'll let you try and have a vaginal birth before going straight to a c-section. Some hospitals/doctors don't allow it at all. Most doctors won't induce with pitocin or other synthetic drugs for VBAC (there was a horrible stint in the 90s where doctors were using cytotec-an ulcer drug not intended for pregnant women-to induce labor and it was causing a high uterus rupture rate), but mine will do a pitocin induction if I get to 42 weeks and stripping membranes (and other natural methods of inducing labor) isn't enough.

Laura said...

I have a friend here who had two c-sections and, it seems, shared some of your same thoughts about the processes. She just had her third about a year ago and was able to have him at home, with a midwife, completely naturally. I think it's great that you are able to try vba2c and hope that all goes well!

Erin said...

I'm a HUGE proponent of natural labor. I did lots of research before Clara and I'm totally convinced that the epidural is just bad news. I didn't have a doula but I did have a very supportive nurse and doctors who were happy to let me labor and deliver my way. I'm really proud of you for wanting to do the VBA2C and natural labor.

I have a friend that just had twins VBAC naturally. You really should check out her story here: http://chrisanddawnell.blogspot.com/2011/07/vbac-attack.html

I know they aren't the norm but, I've had friends have really scary emergencies with home and birth center births. So I'm glad you're going the hospital route.

I'm sending you lots of best wishes. I'm sure you'll do great! After I delivered naturally I was so incredibly happy that I had had the labor that I wanted. I hope you have the same!

A.J. Dub. said...

I think you are an amazing woman! We will keep you and the baby in our prayers for a wonderful and safe delivery.

Celia Marie (W.) B. said...

You know, my grandma had 6 vbac births after her first was c-section with a vertical cut! They'd have never let her even try today. My MIL also delivered her 3rd as a VBA2C. She wanted her second to be a vbac, but the hospital/doctor didn't let her try.

MDawg said...

Good luck, Celia! I am sure you will be happy with this birth because you are more willing to stick up for what you want. I've come to realize that there ARE options to labor and delivery and that we should be in charge of our bodies. I've felt pressure from doctors and nurses before, but I do believe we know our bodies and what they can do. Best wishes!

Felicia said...

This is a subject I became passionate about after looking into birth options with my second, so excuse my rantings.
I agree with Mad White Woman that I don't think women have enough confidence in their bodies or themselves to have a baby without seeking medical help, be it an epidural or a c-section or anything else. There's nothing inherently wrong with medical intervention, but I think we are stronger than we give ourselves credit for and many times those interventions are unnecessary.
A word on husband support: Brandon was reluctantly supportive when I decided to go naturally with #2. He was supportive of whatever decision I wanted to make, but was skeptical of why I didn't just go for the epidural, etc. that I had had with #1. (It worked out ok the first time, right?) It wasn't until we attended a natural-focused birth class, taught by a doula, that he really became fully and completely supportive. Also, after the class he felt confident that he could be that support person I needed during labor and I know that there's no way I could have done it without him. So I guess my suggestion would be to look into ways that would get Matt more involved or informed about the birth process.
Finally (and, again, sorry for the rantings), I was induced with #1, but read this article (http://www.passionatehomemaking.com/2011/03/evening-primrose-oil-a-mamas-favorite-remedy.html) before I got pregnant with #2 and decided to try taking supplements to prevent being induced again. I ended up going into labor on my own 2 days after my due date. Obviously I don't know why I went into labor when I did, but I would gladly do try it again the next time I'm pregnant.

Celia Marie (W.) B. said...

Thanks ladies. Felicia, I totally agree about the birthing class. He really doesn't want to do a group class, and my doula is a Bradley instructor and has agreed to do 2 home classes with just us. I'm hoping it will be beneficial for us and that it will help him understand his role as a supporter. I remember after having had an epidural with Dean we were both kind of like, "why did you take a day off of work for this?" I don't want it to be like that, and with Kathy's help I don't think it will be.

leethie said...

I also used evening primrose oil my last pregnancy. I asked a midwife about it my last visit and she recommended red raspberry leaf tea even more (which I also took last time, too). It strengthens the uterine muscles and can be taken throughout pregnancy in small amounts. Its good for recovery as well.
I worked through a lot of feelings of regret in preparation for my 3rd birth, too, and I had a great experience. Hope yours is fulfilling as well, no matter the outcome!

Celia Marie (W.) B. said...

The only problem I've seen with the evening primrose oil is that it acts as a blood thinner also, so if you're going to have a surgery (which I hope I won't, but being a vba2c, I shouldn't completely rule it out), you shouldn't take it. I'll look into the raspberry leaf tea too.

Amy said...

It's not illegal to have a trial of labor after a c-section in AZ...at least my dr. was willing to let me try a vbac after my first. But my 2nd ended up being breech too. My dr. was even considering letting me do a vba2c, but it didn't work out.

Celia Marie (W.) B. said...

It might just be at certain hospitals then since I had friends tell me that they weren't able to try to vbac even after 1 c-section. Maybe just the white mountains? Glad you were able to try.