CAM Birth Story #21: Mari's Births

In honor of Cesarean Awareness Month 2010, we will be filling the blogosphere with stories from real women (and their families) who know first-hand the consequences of a 32% cesarean rate. Each day we will post at least one birth story submitted by these women. Prepare to be moved (hint: grab a box of Kleenex)!

From Mari…

When I found out I was pregnant, I did what so many women do, and asked my closest female relatives and friends which doctor to go to. It was a large practice, so I thought it would be a great place to go…always someone to answer our questions, ’round the clock availability, easy scheduling, etc. We settled in with them, and did everything “by the book”. Ultrasounds in the office at fairly frequent intervals, urine tests, level 2 ultrasound, blood work, regular pelvic exams, office visits monthly, always with a different doctor.

At 24 weeks, I started experiencing intense back pain. Our OB recommended going to the hospital to be checked out for possible pre-term labor. It turned out that I had a severe kidney infection because my right ureter was completely blocked off. After a couple of hours of toying with the idea of placing a stent and manually removing the “sludge” (sorry for the graphic), the urologist decided it probably wasn’t necessary. He pout me on stronger antibiotics and went home. I sent my husband home to shower and gather some things for me. 45 minutes later, the urologist came back;  as he was driving home, he had the intense feeling that something was going terribly wrong and he felt compelled to come back and check on me. He insisted on doing the surgery based on a gut feeling. We agreed because despite hours on IV antibiotics, my fever was not coming down and the pain was intensifying. Someone from the OB office spoke with the urologist and gave their “ok” to proceed, but none bothered to come check on us, despite the fact that we were on the prenatal floor. In the recovery room, I remember being extremely cold and requesting more blankets. As foggy as I was from the anesthesia, I recall watching my temperature rising on the monitor next to me. The last thing I remember was seeing it reach 106.0F, and then seizures set in. There was a rush of activity around me, and a couple of hours later I finally came to in the ICU with my family surrounding me. The doctors assured us that I would be fine, and my family was asked to leave so I could rest. Shortly after they left, my blood pressure was bottoming out and I was losing consciousness. Another frenzy of doctors came in an inserted two central lines and an inter-arterial blood pressure regulator in my wrist. Unable to stabilize me, they put me in a drug-induced coma for 3 weeks to fight an overwhelming case of sepsis. The cause is still up for debate…did the infection enter the bloodstream during the stent placement? Or would this have happened regardless? The urologist determined that I had most likely had an asymptomatic UTI, that the obstetrician sh ould have caught on earlier visits.

We expected to deliver early considering the massive amounts of medication I was on, including Dilantin, an anti-seizure medicine used to control the seizures that continued for weeks in the aftermath of this ordeal. 11 days after my due date, I started feeling intense back pain. I started crying at the possibility that I had another kidney infection. Then my husband reminded me that “that baby needs to come out sometime…it’s probably today!”

We went to the hospital and the nurse told me I was about 5cm dilated. She encouraged me to have an epidural right away, because “no woman should be a martyr, and no metals are awarded for bravery in childbirth!” I ignorantly agreed. Big mistake. An hour later, my favorite OB from the practice came in. I was so excited because this doctor had been with me when I was ill and I felt a connection with her. She asked me if she could break my water. I didn’t see any reason not to. She also asked to sart me on Pitocin since I was not progressing as quickly as she would have liked. Again, I didn’t see any reason to not oblige. Until the baby’s heartbeat was unable to recover after contractions.

Because of the supposed cord collapses, the OB started an amniofusion to replenish my water. And it worked like a charm. A couple of hours into my hospital stay now, the OB informed me that I was only at 6cm at noon…on a Friday… She would be in to check me every hour. An intern came in to check me at about 3:30pm and told me I was at 7.5, maybe 8cm. When the OB came in minutes later, she said I was only at 6 to 6.5 and that it was probably time to start discussing a cesarean delivery. I asked to wait another hour and see if there was any progression. The OB then sat down to talk to me about the implications of waiting too long and even had the gall to tell me that if I didn’t have a cesarean soon, I would risk losing the baby.  “Of course, you wouldn’t want to be responsible for your baby’s death…” I was apprehensive, but did not want to be a difficult patient. I did not want to question the doctor’s judgement. She explained to me that if we waited any longer, the risk to the baby far outweighed the benefit of a vaginal delivery. She showed me a picture of her own daughter, and asked me if I wanted to witness my child grow up like her little girl. I ask that we wait another hour, hoping to not be scolded.  An hour later, the intern checked me and said I was at least 8, if not closer to 9cm. When the OB came in, she said I was still at 6.5. Within seconds, the nurse was prepping me for a cesarean. I am ashamed to admit this, but for a brief moment I was secretly happy that I wouldn’t have to go through the pain and trauma of a vaginal delivery.  As we rolled in to the OR, the OB remarked “let’s make this a quick one, I need to get to my daughter’s dance recital”. In the OR, just before making her cut, she informed me that she would deliver the baby, but another doctor would be coming in to close me because she had to leave. I am now certain that I was in the later stages of transition or perhaps even completely dilated, as the baby’s head was so far down they had to use the vacuum to forcefully pull him back out, and also pushed upward through the vagina on the baby’s head and dislodge him from the birth canal. Mohamed Rayane was born at 5:25pm on Friday June 9, 2006. At 6:45pm, doctor number two came in to put me back together. The doctor was training a student, and informed him that today, they would be doing “the quick and easy ones even though they don’t hold as well”.

I lost my voice from the second I walked in to that hospital. I let myself be confined to a bed, undergo procedures that I didn’t understand, and probably didn’t need. I was shaven in a room full of my family by a nurse who didn’t respect my body. I was strapped to the table, shaking unctonrollably for over an hour while shifts changed. If I saw my baby in his first few minutes of life, I don’t remember it, and when I saw him in the recovery room, I could not have cared less. I did not want to hold him, much less nurse him. I was cold, uncomfortable and alone. The epidural made me itch, and it took hours for someone to finally get me some Benadryl. When I attempted to do something right by rooming in with my baby, they pretty much threw up their hands and said good luck. I remember sitting up in the chair in the corner of the room, holding my baby, and not being able to stand up to put him back in the bassinett. I was weeping silently, in excruciating pain, just trying desperately to not drop the baby on the floor. Again, I was alone. And even now as I type this, the experience makes me feel alone.

My physical cesarean recovery was what I would classify as “normal”…I pulled open my  incision site on our first night home from the hospital, there was general discomfort, weakness and oozing. I thought that was how everyone recovered, and I tolerated the physical pain well enough. Emotionally, I was indifferent for at least 3 months. I focused on caring for my son, scrutinizing him for any possible side effects from my illness and medications. Thankfully, the only sideeffect was an initial 3 days of withdraw since the  Dilantin passes across the placenta, but not into breast milk. He is now a healthy, happy three and a half year old. But the pain doesn’t stop once the incision heals. I still struggle with an emotional bond that just doesn’t seem to be there, and this is the hardest part of my journey to cesarean recovery.

As those initial weeks turned into months, and the initial Mommy High wore off, I started feeling the emotional effects of my cesarean. I went from denial, to confusion, to resentment. There were times when I hated the baby; I could convince myself that it was all his fault. These were fleeting thoughts, but the fright they caused me lingered for days.

Thank God I got pregnant again without too much thought. I scheduled my appointment with the same OB office (hello, how dumb am I???). My initial interview with them was unsuccessful, as the nurse informed me that their insurance policy would not allow them to offer me the option of a VBAC. I left the office before ever seeing a doctor. I scheduled an appointment with a local nurse midwife, one of only two or three who were practicing in hospitals at the time. We all know how true midwifery care compares to traditional obstetric care, and I was thrilled to be given a chance to do things the way I now knew they were supposed to be done. I declined unnecessary testing, refused when the backup OB wanted me to be induced, and worked through my labor at home much better than I ever thought I could. I nursed Mohamed, kissed him goodbye, and went to the hospital still nervous that I would end up with the cesarean I feared. My initial assessment was 8cm, and about 2 hours later, I pushed a couple of times and my beautiful baby was in my arms. Jad Amine was born at 1:01am, Thanksgiving, 2008. I held him and cried and spent a few moments really understanding the mother-baby attachment that I missed out on with my older son. He nursed immediately, and I held his pulsating cord in my hand and felt the life-blood connection between us. Within an hour after the birth, my repair was complete, baby fed, and I was showered and ready for the rest of my newly-empowered life to begin.  This part of my story is so much shorter because there is nothing else to say. It was so “right” that there are no words to describe. Sure, it wasn’t perfect – the midwife on call that day Pitted me, and was generally unattentive, but because my last birth had taught me be strong for myself, I guess I didn’t really need her emotional support anyway. VBAC has a place in contemporary medicine, and is the broken woman’s way to regain faith in herself. While I don’t think a scarred woman is ever really whole again, I think that VBAC helps restore some of the pieces.

I still struggle with the emotional bonds that I have with each of my boys. And maybe some day I’ll stop worrying about it. In the mean time, I hug them and kiss them every day as I hold them close to me in our family bed. I close my eyes apologizing for how my own ignorance affected Mohamed’s birth, and wondering what the long-term effects will be on them. Do I suffer from post-partum depression? Not clasically. But there is a grieving process for Cesarean moms that only another sectioned woman can understand.

Enough said.