The Hopeless Wanderer
I almost wrote a "retraction piece"a few months ago. I giggle typing that, like my writing is some important article in The Times. I wrote my vbac blog post, Intellect and Eve, feeling very strong and empowered. Then something happened. My op report came in on my previous sections and in the large print it said "primary classical" in the small print, it dictated almost every move the delivering doctor made, which was basically this... "low transverse cut was made with a knife, then a low vertical cut was made which was extended superiorly with the bandage scissors." WTF. He basically cut across my uterus (normal) then when he couldn't get Warren out (which I've been told multiple times now by multiple birth professionals, is idiotic) He cut upward from the middle of the horizontal line. When that still didn't work, he extended the cut... how much is in question, but he labeled it "classical" and that's where my hopes and dreams seemed to die.
My doctor (one of two in the most VBAC friendly practice in my area) said, "so we won't be talking about vbac's anymore". Then she went back to looking at her stupid lap-top and was talking to me about other things which I barely heard until she said this, "I'd like to deliver at 36 weeks." Alarms went off in my head. Uh, no. I had already been through this... I had fought and clawed for 38 weeks with my third (post special scar baby) and no one was ripping this kid out of my womb at 36 weeks. I said, "Dr. G-C, 36 weeks really makes me uncomfortable. That is just way too early for me. Even my baby sectioned at 38 weeks ended up in the NICU for a week because he wasn't ready." She suddenly looked up from her lap-top as if remembering that there was an actual person there and said, "Well, we will play it by ear and see if we can get you to 38."
I went to my car, called my husband and cried again. Then I told myself to get rid of Eve and use some intellect. I kept telling myself that all week. But something weird was happening. My intellect kept telling me to listen to Eve. By the end of one week I had decided that I wasn't going to schedule a section. I would wait for labor, labor at home as long as possible and then go in and either have a section (if that's what I felt was needed) or have my husband block the door and VBAC this kid. I almost wanted the hospital to get rowdy, call the police, call social services... I wanted to fight them all. Fight them for every women like me and take all their big insurance checks.
I told my husband what I was thinking. "Ok." he said, "But, I thought you wanted to do some research on your scar before making this decision. You know... get your old scar ultra-sound, talk to the perinatoligist that told you that your scar was strong and thick, see if he knows if it really is a classical."
"You know what?," I answered, "I don't even think I care what kind of scar I have or how long it is."
"Oh, I didn't know you felt that way about it."
"I didn't either."
Then, I thought I lost him. I thought my partner in crime had jumped on his horse and high-tailed it out of there.
But when he came home that night (or the next, or the one after that... he works so much I don't know when I see him). He was still on board. He is such a all-star. He still got it, got me, got the importance of all of this.
The next thing I did was tell a few (a very, very few) number of friends my plans. One of them, told me about her homebirth midwife, Laurice, and that I should meet with her. And we did. Outside her office David and I once again got into a domestic disturbance over my terrible parallel parking but inside he was again my champion. I remember listening to him speak to the midwife thinking, "Didn't we almost have the police called on us over my parking spot?". But regardless I just didn't click with Laurice and when it came down to it, she just didn't seem supportive of a homebirth with me. Instead she kept steering me towards an OB she works with, Dr. K, and kept telling me that my C-section would go best with him. In my head, I wanted to scream, "I'm not looking for a good C-section surgeon! All of these clowns are proficient with a knife! I am looking for someone who is not scared of BIRTH!" And so we left, with the name of a new OB and not much else.
I did go meet with Dr. K, and he (as I suspected) was not vbac supportive for me, but I wasn't vbac supportive for him either. He was completely weird and I wouldn't trust him with a vaginal swab. But, the guy did say he was comfortable waiting until labor to do the C-section, which is all I really needed from a doctor at that point anyway. Since I was going to labor at home as long as possible and try to show up at the hospital so far along that either 1) they would just let me proceed with a vbac or 2) I would have to fight but it wouldn't be as long of a fight. A doctor who would wait until labor provided me with the opportunity to try this as opposed to the ones who would schedule waaaaaay before labor had a chance to begin.
I shared my plans on a FB support group that I belong to. It's called "special scars - special women". It's basically a group of C-section moms who have weird scars on their uteruses which gives insurance companies and hospitals and excuse to phase them out of the medical model for vbac'ing. There something life-changing happened. I was starting to ask the group about "unassisted birth". You see, if I was going to labor at home, what if I did so well the baby just came out? But before I could completely fall down that vortex, Sarah, a member from Indiana, contacted me and told me that she knew of a highly experienced homebirth midwife that had done vbac's on all kind of scars. She was not located in my city, however, but I was still interested. Sarah gave me her name and number and I was excited to call her and scared at the same time. Hearing "no" so often was not a fun thing.
But I called. The next morning around 10 am, with shaky hands and a shaky voice, I called the number. The phone rang... "Hello, this is Anne!" a voice said. I was a little shocked to be immediately in contact and it derailed my thought process a bit. "Uhh hh, Hi! My name is Leah..." I began. I felt like I was sending out a signal, like - "Help me Obi One Kanobi, your my only hope!." Then the words started to come. I told her that I was looking for someone to help me birth and I had three things against me. #1 I was already 32 weeks pregnant, due August 1st, and she may not be able to fit me into her calendar. Her answer - Let me check my schedule... Ok, we are busy but we can make it work. #2 I am in a different city and I don't know if it is too far away? Her answer - We have some options that you could stay in to birth #3 Ok, This is the tricky one that has thrown me out of every place possible... I have had one vaginal birth and 2 C-sections. One of the sections is a t-scar with a possible classical extension. Would you be willing to work with that? I just need someone who can see that I can do this and help me do it. Her answer, and one of the most important answers of my life - There is a lot of fear surrounding vbac's, but when I started delivering babies, classical section vbac's were all I saw. I have a lot of experience and we fully believe in the body's ability to heal...
Then she started to tell me more about herself and I suddenly felt like she was reassuring me instead of me trying to reassure every other doctor or midwife I had met. On the phone she exuded confidence without sounding rash or cocky. She told me that she new her limitations and that we would know if something wasn't going right. My biggest impression from her on the phone... no fear.
She made a consultation appointment for me the following week. We hung up, some tears of relief rolled down my cheeks, and I called my husband. He was busy at work but excited for us. I told him my appointment was next Wednesday at 3, and would he be able to come? He said absolutely and I knew we were finally on our way somewhere.
June 5, 2013 - Meeting The Midwife
Wednesday, we packed the kids in the car, except for James because he had final exams, and started the trip to Anne. It took us about 1.5 hours with some traffic. Not too bad. We pulled into the parking lot at Anne's office and to my kid's delight, an Amish horse and buggy pulled right in. We all got out of the car and walked up the path. I noticed the Amish and Mennonite husbands sitting outside or sleeping in cars, so I told my husband to wait outside with the kids while I checked in. I went inside and there were 2 or 3 Amish women already waiting. I checked in with the women at the desk. She said that they were running behind so I went back outside and told my husband to keep playing with the kids and I'd call him in when Anne was ready for us.
Back inside and looking around the waiting room, I was fascinated by the posters about natural herbs and cloth diapers. There was antique wooden furniture and pictures of happy little Amish kids. There was also a collection of antique medical equipment. As I looked around, I locked eyes with an Amish women about my age. She was pretty and plain, and as she smiled a shy but warm smile at me, her peaches and cream complexion was completely broken by a set of horrible teeth. But there we were smiling at each other, crossing the boundaries of community and culture, looking into each other's eyes and being present with each other. We were both there for some undeniable commonalities: our births, our babies, and our womanhood.
The woman behind the desk, and the other women working there were not plain people. They did, for the most part, have an earthiness about them that I found fun. Then Anne came out and I almost fell off my chair. The women looked like an attorney... stylish clothing, smart glasses. She's going to have a damn lap-top, I thought. I called my husband and kids in and we went back to an "exam room" that was more like a living room with a random exam table against one wall. There were really cool wooden toys that my kids immediately took to, and in the world of angry birds and Nintendo DS, this amazed me. My husband, Anne, and another midwife, Greta all took chairs while I sat center stage on the table.
They sat expectantly, allowing me to speak first. I told them my birth history, I told them the ease of James's vaginal birth and also the realized disappointment of it. That the doctor was irritated with a teenage girl giving birth, that they just railroaded me into meds, and at the end had no patience or input for my pain or inexperience during pushing and cut a nasty episiotomy to get him out faster. Then came Warren and David's births, the cesarean sections. The breech they wouldn't let me birth and cut a T scar when he was so descended he got stuck in the section. Then the rcs I had when I thought I had no option. The nicu stays, the sick newborns struggling to nurse, my own sadness and anger over it all. The midwives listened and understood, and when I said I could do it they believed me and easily took me on as a patient.
We left Anne's office and before we even got to the car the tears were coming agian. David pulled me into his arms and said, "I know, I know, she was awesome."
June - August 2013 - The Waiting
I had prenatal appointments with Anne every two weeks at this point. I loved driving down to see her and the other midwives and assistants. It was such a comforting, calm place and I would leave feeling more and more normal and confident every time. Anne would often ask me, "How are you feeling about your vbac?" I told her honestly, "I feel... comfortable." I wasn't overly confident but I didn't have much fear, I honestly just felt comfortable, like everything fit. Anne said that that was a perfect feeling.
At the end of June, we went to the beach for a week and Anne gave me a bunch of books to read from her library. I loved them. I sat on the beach in the early mornings reading about greek Chronos and Kairos, staring at the open ocean and feeling the timelessness of my baby in my womb.
|on the beach...|
The weeks went on and I kept busy with regular appointments with Anne and weekly appointments with a prenatal chiropractor. I also kept busy with my kids... swimming, parks, movies, whatever I could do. I had been seeing a close "shadow care" OB for emergency convenience and dropped him at 38 weeks feeling he was just an annoyance.
40 weeks came and went, and I started to get the annoying post-date comments and questions. David got a txt from his sister (childless of course) asking what was up with me and informing him that inductions are supposed to happen at 41 weeks. Oi Vey! If you are going to spout off where you don't belong at least have the correct info. I mean even Kate Middleton had just gone a week late in her very famous pregnancy. I saw Anne for a regular appointment at 40 weeks 3 days. I told her about all the stupid comments and questions. She casually and happily said, "You go as long as it takes!" I smiled at her.
August 12th - The Birthday
At 1 am, at 41 weeks and 1 day, I woke up with a contraction. David was next to me in bed watching TV and after the second contraction, I let him know that it might be time. We timed contractions for an hour and they were 10 min apart and about 50 seconds long. I called Anne around 2 am, and she told us to start heading down. I took a quick shower while David packed the car, then we woke up James and told him we were leaving. We gave him instructions to call his grandparents in the morning to come get him and his brothers. Then we headed out.
We passed the hospital that I would have delivered at only 3 blocks from our house. David joked sarcastically, "There's the hospital! We could just pull in. It would be a lot easier!" I laughed, "It might be closer, but it's definately not easier!". We grinned at each other and the big bright hospital faded in the distance.
On the way down we stopped at Walmart for snacks and drinks so we arrived at our place around 5 am. There we were met by Tessa, one of the midwife apprentices, she showed us to our room and helped me unpack. She listened to the baby and checked my cervix. Baby sounded happy but my cervix was too high to even feel! Tessa emphasized to me that I was very soft and that was good.
Tessa told us to try and get some sleep, so David and I climbed into bed. I couldn't sleep well through the contractions so I got up and sat on the sofa. Tessa sat with me and kept me company while David caught some zzzzz's. As time past she noticed that my contractions were getting tougher for me and spaced closer together, so she started to rub my back during them. Around 10 am she checked me again and told me again that I was very soft, but didn't offer a dilation number. I knew that must mean I wasn't very dilated but they only wanted to offer me positive information unless I asked for more, which I didn't. I wasn't at a hospital, so I wasn't worried about being on anyone's timeline. As long as the baby and I were doing well, I knew they would allow my body to do what it needed.
Around the same time as my 2nd cervical check, David woke up and took over rubbing my back during contractions which were becoming increasingly more painful and closer together. I tried a couple of positions to labor in which definitely helped keep my mind sane. At one point I was laboring laying down on my left side because I was tired from little sleep. Tessa checked his heart rate (which she was doing every 30 min at this point) and said it sounded a little slow and that he probably didn't like the position I was in. So she got me up and sitting on a birthing ball. His heart beat immediately went back up. "Amazing", I thought. What if I was in a hospital, lying there with an epidural and his heart beat dropped? No one would causally say, "Oh, jeeze, he's not digging this laying down stuff you're doing. Let's get up and get on a ball." They can't get you up on a damn ball or really up at all! What would they be left to do but start talking about sections!
At noon I told David to go out and get some lunch. He was reluctant but I told him better now than later. He left and by that time Greta (Anne's 2nd in command) was there. She had brought in another mother in labor. That mom was put in a room somewhere upstairs but they told me that she was Amish, having her first baby, and the baby was breech. I thought about this mystery woman many times during my labor, like a kindred soul. After all, my first section, and special scar section, was a breech baby.
Of course, as soon as David left, my labor felt even worse... then around 1 pm Greta checked me. Again I wasn't offered a number but only given encouraging facts. She suggested I get into the birthing tub to help with my labor as it may give me a chance to rest. I said sure and Tessa filled up the tub. As I was undressing I heard Greta tell Tessa that I was dilated 1/2 cm. Got that? After 12 solid hours of labor I was only 1/2 cm. But, for some reason I didn't care, I just got in the tub. I ended up hating the birthing tub. This was so weird because for years I have been jealous of women who have been able to use them. Plus I was a swimmer! This should have totally been my thing. But it wasn't... I was uncomfortable and for some reason my labor pains felt worse. David was back and he tried to help me thru it in the tub, but it was awkward. Suddenly I was moaning with the pain. Up until that point I had been a quiet laborer... just breathing away thru my contractions. Now I was moaning and groaning. Then I started to throw-up. David, with his lightning fast reflexes grabbed a trash can and held it for me. I puked, and the midwives said I should be checked again. I wasn't excited to be checked. I knew that throwing up was a sign of transition, but I was only a 1/2 cm last time and I didn't think there was anyway I could be transitioning.
Now it was 2pm and when Greta pulled her fingers out of me she said, "You are 5-6 cm". My spirits totally lifted. Literally 40 min after I had heard that I was 1/2 cm, I was 5-6! I was getting somewhere! And that somewhere started to come fast. Suddenly over the next hour my labor was out of control, and at one point blood leaked down my leg sending my husband into a panic. He yelled for Tessa. She came and calmly told us it was just "bloody show" and that because I was a vbac we should expect to see a bit more blood that usual. Again, in some small sane part of my brain, I remembered women who had attempted vbac's in hospitals and had ended up with repeat sections because nurses and doctors has scared them saying that there was "too much blood coming out of them." I was so glad I was where I was.
The contractions were coming fast and crazy hard. I preferred sitting on the birth ball and around 3:15, during a contraction my body pushed a little and it felt a little good. I told David, "Tell Tessa I'm feeling 'pushy'". He went and got her. She asked, "Are you feeling like you want to push?" I said, "I did push a little during that last one and I think that's what I want to do now." I can't say that I felt a strong urge to push, like you hear about... it was more like that my body just started showing me that that was what was supposed to happen.
Tessa asked me an amazing question. "How did you picture yourself giving birth?" I knew the answer like I knew my name. I had dreamed it, envisioned it, even drawn it. The answer had been with me a long time. It was in the dead stare I gave doctors, it was in my anger that I lashed like a whip at unsupportive people, it stared at me in the bright lights of the OR rooms, it surrounded me in the nicu, it lived in the happy heart of my young self, and it came with me when I was born. The answer had been waiting a long time.
I answered, "Squatting with my husband supporting me" "Ok, let's get you going with that." She said. Now, somewhere during the last hour, Ally, another apprentice midwife had arrived. Tessa turned to Ally and said, "Call Anne and tell her she's ready". Ally made the call and then assisted Tessa with positioning David and I for pushing. I asked Tessa, "What do I do? Do I push now?" She said, "If that's what you feel like you should do." "Ok, I said."
During my first push, Tessa felt my cervix and said "You are at 10 and baby is right there." I barely cared what they were saying at this point. I felt like my body was on auto-pilot and was just following along. I kept pushing with the contractions and moaning. The midwives kept trying to redirect my moaning to low sounds and I tried the best I could with that. I honestly didn't feel like I was pushing very much, but they kept telling me how awesome I was doing, and that baby was moving down. I remember pushing with James (my oldest child) and how hard I worked, but I was in a hospital, pushing on my back with an epidural. I think squatting and being so aware of my body and the pain made all the difference.
David was awesome during this. At first I was holding onto his waist and my knees were digging into his calves as I pushed. He joked, "We don't need a hospital to birth but we might end up there later after she breaks my legs!" Anne saved David by walking into the room with her "birthing stool". It looks like a little foot stool with a padded toilette seat shaped sitting thing on top. I got down on it and it was immediately relieving to most of my body and I could push in a squatting position without loosing my legs. David was behind me with a pillow that I could lean back into and he rubbed my arms and back as needed.
I kept pushing with the contractions and I was getting better at it. I could feel my moaning connect to the push and the efficiency of it all. My water still hadn't broke and Tessa told my that my sack was really tough but then suddenly during a push I felt it break and the fluid came out. It was a little green, but I was expecting that with a 41 + weeker. Tessa asked Ally to get a mirror and I knew that was a good sign. After the next pushing session they put the mirror under me and angled it up. "Look at your babies head" Tessa said. David and I looked and there it was... a dark head of hair. That was it, that's all I needed. The next contraction started and I connected my moan with my push and suddenly I felt him slide out. Everything next was a whirlwind. Tessa caught him and Ally and Anne were telling me "He's here! He's here! Look at your baby! You did it!" They put him right into my arms and I was crying with joy and amazement. David cried along with me. I kept telling Brody (my new baby boy) how beautiful he was and telling everyone else, "I can't believe I did it!" The midwives kept saying things like, "You did amazing! You trusted your body and your body knew what to do." I did, didn't I? I thought.
Brody born at 3:37 pm and over 5 weeks past his would-be csection date immediately started sucking at the skin on my breast so I redirected him to my nipple and there, with his cord still attached and connected to his placenta, he latched on an nursed. It was surreal. I was still in shock that was sitting there, still on the birthing stool, baby in arms still connected to my body, no IV's in my arm, no drugs in body, no wounds to be stitched up. The midwives looked so happy for me and yet so calm at the same time. It was like I was at the end of what they knew I could do all along and were happy to see me realize it.
I had been on the birthing stool for a while at that point and the midwives wanted to get me off and in bed. The had been working with me trying to pass the placenta but I was having a hard time finding the energy. The cord had stopped pulsing so they clamped it and had David cut it. I gave the baby to him while the midwives helped me up and into bed. There Anne and Tessa sat and worked with me on the placenta while Ally did Brody's newborn exam on the bed right next to me. His first apgar score was a 9, literally the healthiest newborn I had ever birthed and his newborn exam showed him to be in perfect condition. Then they put him on the scale and did his measurements. He weighed in at 8 lbs, 10 ounces, 21 inches long and head circumference was 14.25 inches. Again another amazement! My vba2c baby was my biggest baby in every way and I didn't even tear my perineum pushing him out!
They gave the baby back to me and left us to bond. So, we nursed and had skin to skin and happily chatted with the very proud new Dad. I was so nice not to have nurses running in and out. No one was trying to take my baby to a nursery or for baths or whatever unnecessary nonsense. My new little Brody and I just laid in bed, both naked and sweaty and a little dirty and just smelled each other, listened to each other, and became secure that our bond would continue outside the womb.
|Skin to skin...|
The B&B we stayed in was great. The owners daughter had worked for Anne and came back when it was time to birth her first child. Betty, the owner, swears her daughter would have had a section in the hospital because her daughter's long labor would have been labeled as "failure to progress". I feel like everywhere I turn I run into someone who is eager to tell me that they had been victimized by or saved from a bad hospital birth experience. I know I am sadly not alone and that the overwhelming support I get comes from places of enlightenment instead of the fear and ignorance I get from detractors. My husband sent out a birth announcement email to people that night in the B&B and along with some "Congrats!", got responses like, "You are lucky." (as in you are lucky to be alive) and "Glad the baby is ok." (have you ever said that to someone who just had a good birth and a healthy baby?) and some usual dramatic nonsense involving dead grandmothers that often get's thrown around. I don't know what disappoints dead grandmothers more - natural vaginal birth or grandkids throwing their name in people's faces every time there's an issue.
Besides the midwives and attendants, there are a lot of people to thank on this journey. Some, I've known for years and some I have just met in this pregnancy. Some people I was in regular contact with and others were a kind, informative soul in passing. You all know who you are and I thank you deeply and with much love. I would like to give a special shout out to my parents for their support and understanding of my birth choices even if they were a little worried and for always being willing to watch my kids during appointments 1.5 hrs away with Anne and for keeping them while I delivered. I also want to thank the "Special Scars - Special Women" organization and the women in the support group. I honestly would not have done this without all of their collective knowledge and support. I thank my kids for just being themselves and my oldest, James, for trusting his parents and helping with the little ones.
But mostly, I would like to thank my husband, David. He was my rock, my research assistant, my mouth piece when I didn't know the words, my protector, my birth partner, and my biggest supporter. You are a man that is one in a million and I am happy and proud to call you mine.
I wish the world happy and safe birthing, after all - "Childbirth should be your greatest achievement not your greatest fear." (Jane Weideman)