My birth story….
Let me start off by saying that this is just my opinions, feelings and thoughts. I know that there are times when medical interventions are needed and save lives. I am so grateful to be in a country where that is available when needed. However, I feel like interventions have become more like standard practices that aren’t without consequences to the mother and baby.
Everything started about 4 years ago with the birth of Jaden…. ( let me just add that I by no means want to leave Maddy out of it. Her birth was pretty typical according to the “norm” of deliveries. I had an epidural that was so strong I slept through the transition phase and could not push right because I could not feel anything. I had pitocin, even though I was in labor and moving along quickly so that I could have the baby before the doctor left for the evening. Although I could go on and on about the many reasons why I decided to go natural after THAT experience, I will leave that for another day.)
With Jaden’s birth my intention was to go natural with no pitocin and no pain meds!
So on February 15th, 2007 I started having contractions in the middle of the night and thinking I was a lot further along then I was, I called a friend who was going to help me through natural labor for the first time and headed to the hospital… (in hindsight I should have stayed home for a while)
So if I remember correct it was somewhere around 3:00 a.m. When I got to the hospital I started walking and continued to do that for several hours… I was progressing, but at a very slow pace. So I continued to walk some more. The option that kept being given to me was to break my water, since I did not know enough about that I said no at first. (In hindsight, I should have been sent home, but I guess they don’t do that any more.) After a few more hours I said “yes” to breaking my water. “What could it hurt?” I thought. I had been told that it would speed up my progress….. and I continued to walk… Getting closer to dinner time and the end of the work day my doctor came back to check on me… so with that she stated that she was going to give me an hour to progress two centimeters or I was going to be given pitocin and an epidural. This was a major blow to me because I really wanted to go natural; it was such a big passion of mine and it felt like a major failure right off the bat. After the hour had passed I was checked again!!!!!!!!!!! And this time the nurse said that I had progressed a little (not enough I guess) and so the doctor came in and checked me right after that, so twice in a row. The dr. said that I had not progressed at all and, in fact, I was swollen. Also, she said that Jaden was going to be too large to deliver, that he must be stuck, and I was now being prepped for a C-section. All I could feel at that point was just total devastation and a lot of confusion. The doctor and nurse argued a bit back and forth about my progress or lack thereof….While I was trying to get my mind around having pit and an epidural then going from not having any options anymore to a C-section was insane! My contractions were really starting to pick up during this time as well. While they were prepping me they had to give me something to stop my contractions because they were one on top of another. I would guarantee that if I had been given another hour I would have delivered no problem. Let me add here that I had no idea of what my rights were and how much control I had over the situation. Let’s just say that I quickly educated myself on my rights and choices (informed consent) when I got pregnant again.
I had not done any research on C-sections so it was all new territory for me. When I got in the operating room they gave me my spinal and then they strapped my arms down on the table. That was really hard for me and really struck a lot of fear in me. After Jaden was out and they were stitching me up (he had breathing problems presumably from all the meds just like Maddy and unlike the twins since I had none) I started panicking and screaming. I started saying that I needed to move my legs and couldn’t. My mind seemed to be telling me that I had to move my legs but obviously I could not because of the spinal. It was like my mind was going crazy and kept trying to move my legs but just couldn’t get a release of feeling like things were OK. It got so unbearable that I started shaking and screaming and saying that I was going to die. It felt so overwhelming and I could not stop it…. At that point my doctor told the anesthesiologist to put me to sleep… so that was it. I lost my time to bond and hold Jaden not to mention nursing. Patrick also felt the same way and struggled for a long time seeing me go through that and dealing with feelings of resentment toward Jaden. I am sure the whole thing sounds pretty silly and hard to understand from our perspective, but that was the real feelings and struggles that we were going through at that time. I won’t get into the recovery part very much but, for me, it was awful and very hard. I could not pick Jaden up or put him down. Not to mention having a two year old at home to take care of. It was the worst ever!!!!!!!
When I went back to my six-week check up, I asked my doctor about my next delivery and what my options were. I was told that I had no options and that I would need a repeat C-section. I knew this was wrong since I had already done my research on VBACs.
One of my biggest struggles through all this was the thought of having more children, which was something I really wanted. It took away my confidence and this is something I would have to struggle with during my next delivery. I was terrified at the thought of having to do that again which was before I knew that I did have options (VBAC) I had always wanted 4 kiddos and the thought of someone else’s (a doctor’s) choice taking that away from me was so hard. When a doctor chooses a C-section for their patient they get to go home that night and the women gets to lie there and deal with the pain. It is very impersonal to most of them, in my opinion, who seem to be practicing more out of fear of being sued than making the right decision for the mother/child.
Well fast forward about 2 years to when I found out I was pregnant for the third time. I was excited and on a serious mission to find a doctor who would do a VBAC, along with educating myself as much as I could on the subject and once again natural childbirth. I read some amazing books on the subject 1. Ina Mays :Guide to childbirth and The Bradley Method by Susan McCutcheon.
Another struggle I have is how women are putting so much trust into their dr. that they do little to no research on childbirth and don’t seek to have an active part in what is going on and the effects the birth choices have on the baby and themselves. Here are a few stats on VBACs and repeat c-sections (taken from the National Institute of Health…sheet produced by a local doula for a birth network meeting)
· Overall Vaginal Birth Rate for those attempting VBAC- 74%
· Risks of VBAC
o Uterine Rupture with VBAC at Term without induction- 0.8%
o Uterine Rupture at Term with induction- 1.5%
o When a rupture occurs-
§ No maternal deaths have been reported
§ 14-33% chance of hysterectomy
§ 94% of babies survive
o overall risk of perinatal death 0.13%
· Risks of Repeat Cesarean
o Maternal death rate 0.013% (vs. .004% with VBAC)
o Hysterectomy rate 0.28% (vs. .15% with VBAC)
o Increased risks of placental problems (placenta accreta, placenta previa) in future pregnancies- risk increases with each cesarean
o Increased risk of breathing problems in baby ( this is some of what I was talking about earlier with the advantages a baby receives going through the birth cannal)
Indiana VBAC rate- 9.3% of women with a prior cesarean have a VBAC, 90.7% have a repeat cesarean http://www.marchofdimes.com/peristats/tlanding.aspx?dv=lt®=18&top=8&lev=0&slev=4
Locally, we have a 38% cesarean rate. Indiana Cesarean Rates by hospital- http://www.theunnecesarean.com/blog/2010/9/19/indiana-cesarean-rates-by-hospital-2008.html
I was also fortunate enough to have a doula (Deborah Deig) for this birth. She had a ton of information and was a great asset to me during this time! I have added her part of the story below at the end. She did an amazing job and I felt secure knowing that she was there and had the knowledge that I did not have if certain situations presented themselves.
I refused the initial ultrasound with the pregnancy because I felt like doing natural family planning was pretty accurate on the estimated due date. I figured that I would have the ultrasound around the time when I could figure out the sex of the baby and that was all I needed at that point. I didn’t feel the due date really mattered because I still had 9 months to go anyways. I still think this was the best decision I could have made. If I would have known they were twins, I would have been stressed and not knowing really was the best thing for me personally. Plus it kept me out of the specialist office for a while which was nice….
During the next few months, Patrick had been saying that he thought it might be twins and I told him he was nuts. I really think that is why the news of the twins did not come as that much of a surprise to us. Actually the news made me feel a little better because I had felt like something was really different with this pregnancy and it was making me feel very strange. So needless to say it cleared up a lot of questions in my mind. So with that info I then wondered what the doctor was going to say about the VBAC. To my surprise he was fine with it, he wanted at least “baby A” to turn head down so that was our prayer. I was asking for something specifically by prayer, a VBAC, a full term pregnancy and no bed rest or contraction meds . Even though I was told that those prayer requests were medically improbable, I knew that with God all things are possible. I knew that he created my body to do what it does and I know it was His design.
I was advised to start seeing the specialist around week 30 for weekly non-stress tests and ultrasounds. I have done non-stress tests with maddy and jaden so I knew quite a bit about them. The ultrasounds were to mainly test for twin to twin transfusion. I had my reservations about going every week when we did not have an indication of something being wrong. That much intervention seemed a bit much to me just for routine. The first week we had a great report and I decided to go 2 weeks before another one. Went back again and had the same great report and no sign of stress or twin to twin. I only went one more time and that last time I decided I would never step foot in that office again. I was about 38 weeks by that point and was confronted by the specialist in a very hostile way. The first thing that was said was, “why are you holding on to this pregnancy? If you were my patient I would have taken you by C-section at 31 weeks.” I was completely blown away. The anger and confusion inside of me was boiling up to the surface. What type of questioning is that “holding on to my pregnancy” and “took me at 31 weeks”? Are you kidding?!? The specialist went on to try and scare me with more terms like “your babies will be born stillborn because of your choices” etc…..
At week 39 on a Monday morning I felt like my contractions were pretty strong and close together and thought I could possible be in labor so I went into the hospital. When they checked me I was only at a 5 and I was wanting to be about a 6 or 7 before I went to the hospital. I was pretty miserable though so I decided to stay and walk for a while (more like all day ) and see how it goes. As the day went on there was no progress and my contractions started to slow down and got further and further apart. I was very discouraged and frustrated. Dr. Reid came in the evening around 8 or so and after talking it through we decided to go home and get some food and rest then see what happens. The option to brake my water was all that was available and since I had done my homework I knew that if you weren’t at least at a 7 breaking the water has seemed to have more consequences than benefits. Not to mention that I did not want the 24 hour time clock to start, once again for a vaginal birth the least amount of intervention was necessary to reduce the risk of needing a repeat c-section.
I can’t remember the exact details at this point but I let the dr check me twice from week 35 to week 40. I was at a 5 for a little over a week and a 7 for almost a week. The night I went into labor it still took me 7 hours to get from an 8 to a 10 centimeter dilated. I struggled with the pain and lack of confidence in myself but made it through. At some points I wasn’t so sure I was going to make it but I did it!!!! Towards the end, I actually asked for a c-section I was half out of my mind, and my dr. went to get the anesthesiologist for pain meds. I was so close and my nurses told her to go away and that I could do it. That was exactly what I needed and I got a renewed strength and had them about 45 minutes later. I had the boys a little after midnight and started nursing right away. They did not take the babies to clean them up or do anything else like that for almost an hour which was part of my birth plan. I had to nurse the boys one at a time but that was ok with me! I nursed exclusively for 14 months and wouldn’t have changed a thing. Here is my birth plan: (to my surprise my St. Mary’s nurses had it memorized.
| Birth plan title: Patrick and Kimberly Hodges |
|
| Your full name: | |
| Name of your caregiver: | |
| Name of Hospital/Birth Center: | |
| Due date: | |
| Coach/main support (i.e. my husband, my coach, James, my mother): | |
| How do you want the plan to refer to your baby? (our baby, my daughter, the babies) |
Date:
Greeting:
Introduction: (please feel free to modify/delete any of this text)
Labor
Please perform no routine prepatory tasks (shaving, enema, etc.), unless requested.
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary. ( I will make this decision at that time I am admitted)
I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions.
I would like to play my own music. VIA Head phones player
Please limit the number of vaginal exams (If I am not far enough along, I reserve the right to leave and come back later) .
I wish to labor freely in the shower.
As long as the baby is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler, even if the membranes have ruptured.
I strongly prefer not to have an internal fetal monitor used or any pitocin given during the birth of baby B and after as well.
Please do not permit observers such as interns, students or unnecessary staff into the room without my permission.
Labor Induction/Augmentation
I would like to avoid induction
I would like to try alternative means of labor augmentation, like walking or nipple stimulation.
If induction is necessary, I would like to attempt it with prostaglandin gel or another means before pitocin is administered.
If induction is attempted, but fails, I would like to come back at another time rather than pursue further intervention (assuming my membranes are intact and that waiting presents no danger to the baby or myself).
Please do not rupture my membranes artificially
Anesthesia/Pain Medication
Please do not offer anesthesia/analgesia.
Cesarean Section Delivery
I feel very strongly that I would like to avoid a cesarean delivery
If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like (coach) to be present during the surgery.
please do not strap my arms to the table during the procedure.
I would like to be the first to hold the baby after the delivery.
I would like to breastfeed the baby immediately after the birth.
I would like our plans outlined here for after the birth to be followed as closely as possible.
Perinal Care
I would rather tear than have an episiotomy.
Please administer local anesthesia when repairing any episiotomy or tear(s).
Please suture tears only if necessary.
Delivery
Even if I am fully dilated, and assuming the baby is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.
I do not want to use stirrups while pushing.
I would like the freedom to push and deliver in any position I like.
I would appreciate help from (coach) and staff supporting my legs as I push.
After birth
Please place the baby on my stomach/chest immediately after delivery.
I will breastfeed the baby immediately.
Please allow the umbilical cord to stop pulsating before it is cut (if possible).
Newborn Care
I would like to hold the baby skin-to-skin during the first hours to help regulate baby's body temperature, instead of any medical intervention.
I would like to hold the baby through delivery of the placenta and any repair procedures.
Please evaluate and bathe the baby at my bedside.
If possible, please evaluate the baby on my abdomen.
If the baby must go to the nursery for evaluation or medical treatment, (coach), or someone I designate, will accompany the baby at all times.
If available, I would strongly prefer erythromycin eye treatment or other antibiotic eye drops instead of silver nitrate.
I would prefer to have Vitamin K administered orally.
I would like to defer the PKU screening.
I would like to defer the following vaccinations: ALL
Postpartum (Click here for postpartum features)
If available, I would prefer a private room.
I would like the baby in the nursery at night, but brought to me for breastfeeding on demand.
I would like my other children to have free visitation access.
If the baby and I are healthy, I would like to reserve the right to be released from the hospital as soon as possible following the birth.
I would like permission for access to my chart and the baby's chart.
Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.
Please do not give the baby supplements (including formula, glucose, or plain water or pacifiers) without my consent.
I prefer not to meet with the staff lactation consultant (unless requested by myself) , please do not bill for these services.
I am planning for the baby to be circumcised before we check out of the (Note:Do not waive Vitamin K shot in this event)
Here is the story of my birth from my doula!!!!!
Kimberly had a glorious birth when birthing the twins. She went from being quite miserable with the challenge of carrying two babies simultaneously while several professionals were nay saying her birth plans, to triumphant after having the birth she wanted and knew her body was capable of.
I was the birth doula. I met with Kimberly and Patrick a few times prior to labor for birth education (although Kimberly was already exceptionally well read/learned), and to go over comfort measures. Kimberly let me know that she was determined to avoid the recommended cesarean, and that she wanted a non-medicated birth.
Kimberly had a couple of false labor alarms, but things got underway near the due day. It was a slow but steady labor. She responded to the cues the contractions and pressures dictated, and the message for Kimberly was to walk incessantly, and to bend around from time to time. She walked while having contractions and between them. Kimberly draped herself on some of us for a few of the contractions and did some swaying, but then off she went walking again.
During her labor I made the conscious decision to simply walk with Kimberly and encourage her. I was ever mindful of the higher risk that was being dealt with (VBAC and the possibly of an umbilical cord issue along with two babies), so I felt it essential that her instincts should dictate her movements. Lying down was uncomfortable for Kimberly as was sitting, even on a soft large ball. I was fully expecting her to want to lie down at some point, but she never did. Nobody stopped her from walking except for the periodic baby/mom health checks, an amniotomy, and then when she was ready to push.
Emotionally Kimberly remained committed to a vaginal birth. Patrick supported her in every way and at all times. Prior to labor Kimberly had informed me that she was uncomfortable with people getting close to her head and shoulder area, so I respected and avoided that. I observed that she was comfortable with the attending nurse being close to her, so I went with that and was glad that need was met between Patrick, the nurse, and her own inner strength.
Late in labor and after sitting on the commode through several contractions with some pushing, a couple of the many nurses now present encouraged Kimberly to get on the bed and put her legs up in the stirrups, so she complied. The baby wasn’t crowning at this point, not even during contractions, but did about 15 minutes later. The personal draped her, set up lighting and a chair, and the instruments.
Kimberly pushed with the urges. Josiah slipped out without a hitch as did Malachi several minutes later. Malachi was born with his cord wrapped around his hips, crisscrossed around his chest, plus wrapped almost twice around his neck. It was quite unusual and a bit startling. Although he arrived wrapped like the present he was, his color was good and he was grimacing thereby letting us know he was fine. He did need his cord clamped and cut early, and he needed some unwinding. That was promptly done.
After the births there was the usual busyness of tending the baby(s) and putting the room back together. A lactation nurse began working with Kimberly and one of the boys, and Patrick was holding the other baby. The crowd of personal left and I also slipped out so that the family could have some quiet private time to bond in those precious first hours.
It was great that Kimberly found an obstetrician who respected her as an intelligent adult, supported her educated decisions, and intervened generally when it was needed. Agreeing to accommodate Kimberly’s choices may have involved resisting peer pressure, so I appreciated his decision.
I was exceedingly impressed with Kimberly’s determination and strength during the pregnancy and birth. She protected her babies and herself by refusing the risky drugs, numerous interventions, and major surgery. She followed her instincts throughout the labor. Because of all of this the births went off flawlessly. Kimberly and her babies were all three in the best possible health because of the wise choices she insisted upon. Bravo Kimberly!
I have noticed a lot of differences health wise between my three vaginal kids to my c-section. I have read some pretty strong evidence that discusses the positive effects on the baby going through the birth canal…. But I will save that for a later date!!!!!! That should give moms something to look into and think about when they are making their own birth choices.
Thanks for taking the time to read my story!
