CAM Birth Story #45: Janea's HBA2C

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 Janea…

I’ve had a few friends and family ask about Ursula’s birth story. I feel that to set Ursula’s birth story in the proper context, I need to revisit my previous birth experiences. It may give some insight as to why we chose to do things a certain way. It’s a long read, so you may want to pull up a comfy chair. Or, if you prefer to get right to her story, just scroll down to Ursula’s Birth Story.

Rowan’s Birth Story –
My pregnancy with Rowan was fairly uneventful. It was a healthy pregnancy and I didn’t have much for morning sickness. I saw a certified nurse midwife at our local women’s clinic and had planned a typical hospital birth. I had all the typical testing and two ultrasounds. My midwife never saw any complications until I was at about 37 ½ weeks when she thought my baby was breech. An ultrasound confirmed that my baby was indeed breech. It was a Friday, and my midwife gave me two options. I could schedule an external version to try to turn the baby, or I could schedule a cesarean. I wasn’t given much information as to the risks of either procedure. I was also told that I needed to give them my decision by Monday so they could do all of the scheduling. I consulted my immediate family and extended family. No one was confident in trying to turn the baby as they thought turning it might cause harm to the baby. I thought about seeing a chiropractor to help turn the baby with a gentle procedure called the Webster technique. I ended up not having Webster’s done because I had family and friends voicing their fears over trying to turn a baby that “probably had a reason for being breech.” I felt that I had no other choice but to have my first baby by cesarean, on a scheduled date. I was never allowed to go into labor. I had never felt that I had experienced Braxton Hicks contractions. The surgery was in the morning and went relatively well and my midwife strongly advocated that my baby be brought to me as soon as I was out of the operating room. I got my baby in about an hour. Later I had come to find out that she had been crying very hard the entire time I was separated from her. The nurse brought her into my room. She was crying and chewing on her hand. My blood pressure was low and I could not sit up right away. So the nurses tried to help me nurse in a side lying position. When I was able to take food, I was given broth. I wasn’t able to keep any food down, so I was asked if wanted some drugs to help with that. I said sure, but I was not informed that it would make me fall asleep. As I was passing out, Rowan was once again screaming and I felt terrible that I could not nurse her. I just wanted her to not feel hunger so I gave permission to feed her formula, a decision I have come to regret.

After leaving the hospital, my recovery was slow and I couldn’t move around easily. This made nursing very difficult. Rowan and I also developed thrush, a type of yeast infection that affects the digestive system (and for me, my breast tissue). Rowan’s thrush was cured quickly with prescription medication. My thrush was not treated quickly and was very painful. You see there isn’t much research or information on how to treat thrush in the breast tissue. Because of the intense pain I was feeling, I weaned Rowan from the breast and fed her formula. I was very depressed about this decision. In the following months, I had a hard time bonding with Rowan. She seemed to cry all of the time and was never happy. She gained a lot of weight and her pediatrician reprimanded me, telling me that I was setting her up for obesity. I felt like I was a failure as a woman. I failed to birth my baby and failed to feed my baby…with the body I was given. This was how I felt at the time. I had family telling me that one was just as good as the other. I had friends telling me that I could have handled thing differently – fought for myself and my baby to do everything naturally. I didn’t feel like I was on the same wavelength as anyone. As time went on, I learned to adjust to frequently washing bottles, purchasing expensive formula. I eventually found joy in raising my daughter.

Harvey’s Birth Story –
My husband and I decided that we wanted to start trying for a second pregnancy when Rowan was about a year old. It took about 5 or 6 months of trying before we conceived. I didn’t want to have the same birth experience with this second pregnancy, so I started researching my options. I did not want to have another cesarean without a real medical reason. After reading data on the safety of vbac’s (vaginal birth after cesarean) I decided that I wanted a vaginal birth. I discovered that the chances of having a successful vbac went up when there were less birth interventions. This made me question using a hospital for my vbac or planning a home birth. I decided that I did not want to be in an environment that typically uses interventions that cascade, leading me closer and closer to another cesarean – a major abdominal surgery that has many risks in and of itself. My husband and I felt that if we were to stay in our own natural environment, we would feel more comfortable and confident in my body’s ability to birth a baby. We searched our nearby area and found 3 midwives that would attend a vbac in my home. After interviewing them all, we decided on one that we thought would be best for us. I had another healthy pregnancy, but at 30 weeks my midwife found the baby to be breech. We tried many non-invasive, “natural” techniques to try to turn the baby – pelvic tilts, swimming, standing on my hands in a pool, homeopathy, chiropractic visits that included Webster technique, talking to the baby, playing music down by the pubic bone, hot and cold packs, and acupuncture. None of these attempts help to turn my baby. When I was at 37 weeks, I had an OB try to turn the baby using a procedure called an external version. I was admitted to the hospital and a nurse listened to the baby’s heart rate as the OB tried to turn the baby. He pushed quite hard, but that baby would not turn. Once again I was scheduled for a cesarean. My midwife said she could no longer attend a home birth since I was breech, and my OB (although being experienced) recommended I have surgery. Harvey was born on a Friday morning. I was able to see him about a half an hour after he was born. He was much more calm than Rowan but I still had a hard time nursing him. Once again, I was not allowed to sit up – not even to 45 degrees. My blood pressure was low enough that I risked passing out if I sat up. The nurses helped to hold him by my side to attempt nursing. Eventually I was able to sit up and nurse. My recovery seemed to go faster this time around. I was released from the hospital and started life with a toddle and a newborn. At about the same 2 week point, post partum, Harvey and I developed thrush again. He was treated and cured quickly. I had to fight for a more aggressive treatment for myself. There was research showing that I needed a 10 day dosage of Diflucan, a treatment that my insurance company determined that I couldn’t have. After talking to my doctor, they allowed me to get the prescription, however they would only allow me to purchase the medication 2 pills at a time. I took the drugs and didn’t feel any improvement. I had pain with nursing which led to engorgement, which led to improper latch, which led to open sores, which led to more pain. I felt I couldn’t take it anymore. Once again I was depressed and angry that I ended up with virtually the same birth experience even though I had tried so hard to have a “better birth”. I weaned Harvey from the breast and started him on the formula. I did have a better bonding experience with him though. I think that his calm, content personality helped me to connect with him much faster. Again, I felt that I had failed and this time, I felt that other people in my support had failed me.

Ursula’s Birth Story –
Shortly after my husband and I started discussing having more children, we conceived our 3rd child. Although we had talked about it, it still caught us off guard. We were not expecting to become pregnant so quickly. I felt unprepared and worried. How was I going to take care of two small children and a newborn? That was something I would just have to figure out. There was no turning back. As we looked ahead to the pregnancy and birth of this third child, we discussed our options. This time, the three midwives I had interviewed for Harvey’s birth were not willing to attend a vba2c (vaginal birth after 2 cesareans) at my home. Most midwives in my state shared the same position. It wasn’t that they didn’t believe in my ability to give birth. But like many other care providers, they worried about their own liability. Liability/fear based care vs. evidence based care. However, I did have the good fortune of a friend referring me to a midwife about 2 hours away from me. My husband and I decided to call her and meet with her. She was open to the idea of a vba2c but wanted to get our opinion on it. She would work with us and attend the birth if we had confidence in my body. We had no reason to doubt my abilities, so we all began planning for a home birth. Only once did I visit my clinic midwife whom I originally saw with Rowan’s birth. She informed me that if I were to use my town’s hospital, they would have me schedule a repeat cesarean. It didn’t make sense to me. Why schedule a surgical birth when mom and baby are perfectly healthy….not in any distress? Unfortunately, this is the case with many hospitals in our country. Many mothers are never given the opportunity to make an informed choice as to how to birth their baby. They are mandated repeat surgical births. I did not want that for myself. I know that the risks of surgical birth far outweigh the risks involved with vbac after one or multiple cesareans for many mothers. I could go into much more detail about this, but I’d rather move onto the birth story itself.

We planned another home birth and saw our midwife periodically. For most of the pregnancy I drove the 2 hours to see her, but at the end she made a few home visits. My vitals were great all along the way and my baby stayed in a head down position (yay!) At 34 weeks, I had gathered and purchased supplies for a home birth (many of which I already had from planning Harvey’s birth). Everything was set. My due date was fast approaching. My midwife visited me at my home and I had my first internal exam – at my request. Up until now, I had been trying to locate my cervix on my own and had a terrible time finding it. When she checked me, she discovered that my cervix was not centered but off to the left side. This meant that any contractions that I might have would be less effective in opening up the cervix, possibly leading to a swollen cervix or a pinched cervix. Something we did not want to deal with in labor. She tried to nudge it to a center position and eventually did get it there. During this “nudge” I went from a half centimeter dilated to 2 cm dilated, and I was mostly effaced. She said my cervix was “stretchy”. This was good news as it meant that my cervix was doing a good job at getting ready for the baby.

My due date had now passed and I was not having much going on with contractions. The midwife wanted to see me again, but this time I would have to drive to see her. I was very okay with this as I have heard many stories of how women would start their labors and have contractions steadily and then have them fade away. Also, most first time labors last 12 or more hours. If I went into labor, I felt we could drive the 2 hours home or just stay in Green Bay. As it was, my in-laws live in Green Bay and could watch our two children. If I didn’t go into labor, my husband and I would spend our “childless” night at a hotel suite – relaxing.

So we drove to Green Bay. I had been feeling a few contractions on the way up, but didn’t think too much of them since I could talk through them. I could walk through them. Since this was my first labor, I may have been naïve, but I thought these contractions were no big deal. I had my appointment with my midwife at 7:30 pm. We planned to have me visit a chiropractor afterward. She checked my cervix again and found that it had moved back to the left side. She “nudged” it back and said that I was about 5-6 cm dilated this time. Our appointment was pretty much done and I hopped off the table….and then I had a big contraction. I had to hold the side of the table and breathe through it. I had a few more contractions and they were strong and about 3 minutes apart. We all thought that this was the real deal and quickly progressing. Midwife called the chiropractor and said that we wouldn’t make it to their office. The chiropractor would meet us at our hotel suite. I started walking and made it as far as the front lobby of her office building. Then I was nauseous. She got me a plastic bag and I threw up. We both knew that this was a sign of labor progressing further. She decided to follow us to our hotel suite and call off the chiropractor all together. My contractions were starting to get painful and I had to vocalize through them. As we drove to the hotel, every little bump on the road was terrible, stopping at intersections was terrible….only the highway was somewhat manageable. We got to the hotel and my husband went to check in. I stayed out in the car and tried to look like a normal person. Only once did I have to quietly vocalize through a contraction because of a lady passing by. My husband came back and we drove to the side door of the hotel. We had great fortune in finding that the suite I had reserved was on the first floor and right next to the exit door. Our room was on the very end corner. It was a king bed in a bedroom separate from the suite living room. It also had a two person bath.

We did pack our birth supplies for the trip. I figured that I would rather have them and not need them vs. need them and not have them. I didn’t really think that they would get used. I thought that we would get back home….that I wouldn’t even go into labor that weekend. I was wrong….but prepared.

We brought in all of our things. I immediately went to the coffee table in the living room and clung to it. I was most comfortable on my knees, hanging onto the coffee table. I was beginning to have a lot of pain in my low back with every contraction. The midwife and Andy took turns pressing on my sacrum. This helped for a little while, but eventually it became just as bothersome as the back pain itself. I don’t know how long I spent at the coffee table, but my knees began to hurt.

I tried to hold Andy and do the “labor dance” but that was not helpful at all.

So the midwife started to fill the tub and I got in. It felt good to be in the warm water and it did help some of my contractions. In a little while, I started to feel extra warm. Andy put a cold washcloth on my forehead and I sipped juice and water. When my fingers turned “pruney” I had the midwife check me. I was almost 8 cm dilated and my contractions were just a little farther apart….probably due to the comfort of the water.

I decided to take my midwife’s suggestion that I move to another position to keep contractions going and pressure on the cervix even. I knelt at the coffee table again and at one point, I sat on her birth stool. Contractions were becoming even more painful and I was having a harder time breathing through them.

I wanted to get back into the tub.

Seriously, every time I got into or out of the tub, it induced a contraction and I had to deal with it standing or straddling the tub. That was not fun. My second stint in the tub didn’t help comfort me at all. The midwife checked me again and found me to be about 9.5 cm dilated. We decided that she would attempt to break my water and see if that helped with my back pain/pressure. Also, it would hopefully help keep things moving. I felt the water break, it was warmer than the tub water and it was clear. No meconium. I stayed in the tub for a little while longer and had started to get some contractions that felt “pushy”.

This was about 1:20 am. I tried to stay in the water, but it was just not feeling good anymore and was getting rather cool. I didn’t want to heat it up again as I felt I was already warm and starting to perspire. So, Andy and my midwife helped me out of the tub. I had to “crab walk” over to the bed with the baby being so low in my pelvis. Not the most flattering sight. We had put down a thin plastic sheet and some of my flannel sheets from home. On top of that were some chux pads to help absorb any fluids that inevitably come with childbirth. Strangely enough, the position that I wanted to be in was semi-reclined on the bed, pillows behind my back and my knees up. The midwife and my husband helped hold my knees this way. This reminded me a bit of how I’ve seen moms push in a hospital setting. By that point, I didn’t care. I just wanted to be as comfortable as I could get. I was really getting sick and tired of labor at this point and just wanted this baby out of me. I give myself credit for never swearing in labor. I thought I would, but the only thing that came close was “oh hell.” Many, many times did I say, “this is terrible” and “I don’t want to do this anymore.” I even apologized to the midwife a couple times when I felt I was being loud or complaining too much.

Once in position in bed, I stayed there. When the contractions came, it was incredibly difficult to vocalize properly or breathe properly. A few times I made some panicky, high pitched sounds, but my midwife got me to re-focus on my breathing, etc. My body was doing all the pushing. It was very much like the heaving one feels when vomiting. You can’t control it really, it just takes over (at least it did for me). I started to feel my tissue stretching and I prayed that it was enough. I would have been so mad to feel all that and not be big enough for the baby to come out. It really hurt. I kept thinking, “is this the burning women talk about?” I guess I felt the burn a little bit. My midwife asked if I wanted a mirror or if I wanted to feel the baby’s head. At the time, I did not want to see or feel this baby coming out. I thought that the image of it would really freak me out. I did feel something concerning in the final pushes. I guess it was a stretching sensation near my urethra. So I placed my hand on that tissue to keep it somewhat immobilized. (Afterward, my midwife said that it was good of me to do that. If a tear did occur in that spot, it would have been hard to fix.) Finally, one of the last pushes lasted longer than any of the other pushes and the head started coming out. I think the midwife tried to hold the head to control the speed so that my tissue would have time enough to stretch and not tear. But there was no stopping this baby or my body’s overwhelming urge to push. The head popped out and in a couple seconds, the rest of the body slid out quickly with a large gush of water. There was a lot of fluid according to the midwife.

Our baby was born at 2:50 am. Baby was a great color, cried right away and was placed on my chest. After a quick check, I did not tear, but had some “skid marks”. The baby then proceeded to pee and poop on me. Awesome! 🙂 We waited for the cord to stop pulsing and the midwife put the cord clamp on. Baby was kicking a bit and that made it difficult to get the clamp positioned at first. At this time we discovered that our baby was a girl! Andy cut the cord while trying to hold our camera, lol. I don’t remember much of what was going on around me. When that baby was set down on my chest, I just stared at her and her face. I rubbed her a bit with the blanket, but she was doing great. I think I was in kind of a birth “la la land”. It was hard to process other people around me and I just watched the baby.

She calmed down and started nursing in the next 5 minutes. I stayed on the bed while the midwife changed the pads around me. In about a half hour, she asked me to give a push and I delivered the placenta. We examined it, and it looked healthy. Not too long after that, my parents had arrived. They drove about 3 hours to Green Bay and were the first of my family to meet our new little girl. They brought us three white roses (each representing our children). After I had time to rest and nurse in bed, my midwife encouraged me to use the bathroom. I was able to walk there…slowly. But everything went fine once on the toilet. I noticed a slight ringing in my ears, so I was wheeled back to the room on a hotel chair. I got back into bed and watched as my midwife took our little girl’s vitals. She weighed in at 8 lbs 4 oz. She was 20 inches long and her head was 14 ¼ inches circumference with a bit of molding in the back of the skull. We figured she had her head very well tucked as that was the part of her head that presented first.

It was around five in the morning when my midwife had all of her supplies packed and she departed. She would revisit us the next day to see how we were doing. My parents slept in the pull out couch. Andy and I….and our new baby girl slept comfortably in the king size bed. Our baby (still without name) slept and nursed well for the next four hours.

We started our day just after 9 am. Andy and my dad brought some continental breakfast back to our room. It tasted so good. I was so happy to have food in my stomach again. The last time I ate anything was the previous night’s dinner, which I didn’t get to keep down. I felt so much better as I “recovered” from childbirth. With the cesareans, I couldn’t eat food for a day. I couldn’t get out of bed to walk, no less change diapers for my baby. When I could get out of bed, it was very difficult just to stand, walk, sit, laugh, cough….forget bending over. With this birth, I could walk. I could sit. I could laugh. I could bend over. I could snap my waistband on my pants. I could change diapers and maneuver with my baby. Overall, I just felt more capable of tending to myself and my child’s needs and that means a lot to me.

We decided on the first name right away. Ursula is an old German name. It means “little bear”, derived from a diminutive form of the Latin word ursa “she-bear”. Saint Ursula was a legendary virgin princess of the 4th century who was martyred by the Huns while returning from a pilgrimage. In England the saint was popular during the Middle Ages, and the name came into general use.

After a little while, we settled on a middle name. Seren is Welsh and means “star”. We just liked the sound of the names together.

I knew that I could do it…

I could give birth even though I had scars (mental and physical) from my past childbirth experiences.

There are many people that supported me along the way that I need to give thanks.

To my family;
to the group of women online that offer continuous support;
to my real life friends;
to my friend Lauren in New York (whose own home birth after 2 cesareans brought me so much hope);
to my midwife who believed in me and my body;
to my husband who provided me with unwavering love, trust and support;
and to the almighty Father, in Whom I placed all my faith and trust with this pregnancy and in my daily life.