Tag Archives: birth method

Caroline’s birth story – pt 2

Read part 1 here.

Before I get to the real nitty gritty of the delivery, I have realized I can’t describe Caroline’s birth story without acknowledging my state of mind of going into it, because I have realized that it is inherently part of the story. Although it had every medical intervention possible short of a C-section, Sam’s birth went well. Due to an undiagnosed case of von willebrands (plus I suspect, some bad luck), the post-birth part did not go well. Aside from brief outbursts of emotion, this was something I realize now that I chose not to fully process.

In part, I think it is hard to process something that you are unconscious, or heavily medicated, for. In larger part, it is frankly easier, if more cowardly, to go into something that nearly killed you last time pretending that it didn’t nearly kill you last time. The first sign that I might in some sort of denial may be that I refused to believe I had von willebrands for a while. OK, I still don’t really believe it, but I do accept my smart hematologist’s edict that we have to treat me as if I have it, given my “history”. But as mild von willebrands essentially needs no treatment in day to day life, that issue didn’t rear its head too often.

Another sign might have been that if someone brought up how close the call had come, I was genuinely shocked and surprised, and little awkward. I remember my friend Taylor saying on Sam’s birthday “Hey – it’s the anniversary of you surviving!” and I just kind of stared open mouthed like a guppy at feeding time, and then scowled and changed the subject. And when I transferred to my new OB (Dr. Dryden) the nurses muttered to each other “Dryden saved her” – and I just scowled again and labelled them as “over dramatic”. But again, this was not something that often came up – people don’t generally like to bring up nasty medical experiences (at least, not if they want to keep their friends…).

Things started to change when (1) expert people telling me how serious the situation really had been; and (2) having to prepare to give birth again. When I saw my OB at my first trimester appointment she brought up my chart and started stutter as she read the history saying “I can see you had a massive transfusion“. I did. Massive transfusions are not good (well.. they are good, it’s just the situations requiring them is not good), and when I initially told people about my birth experience I would say “As I went to OR I just remember the words ‘massive transfusion protocol'”. But then I decided that I probably dreamed that, or made it up for dramatic effect. So I was kind of shocked to hear the surgeon in charge of the birth state it. And see it there in my notes for all to see.

During that visit, my OB said to me “You’re lucky to be able to have another child!” and I said “well… it’s due to YOU” and she looked confused and I reminded her “You were the one who delivered my son… you saved me and my uterus by using a new procedure… you sewed the balloon into my cervix which hadn’t been done before.. right?” and the light dawned, and her eyes went wide with recognition and then a kind of fear and I’ll never forget her saying “Oh my God… it’s you… you’re you… You came back!” [aside: of course I came back – she was the most awesome surgeon ever! And my kiddo is the greatest kiddo ever]. I nodded and my OB – my extremely experienced OB who seems to specialize in high risk cases – said “I will never forget your birth”. Seeing how seriously she took the situation was not something my “it was no big deal” mindset was ready for. I looked her straight in the eyes and said “It’s fine… you did great last time with no warning, I have no worries about this time with plenty of warning… I trust you completely”. Then I pretty much packed up my things and left. Which was nice for my OB, but essentially what I was saying was “I don’t want to think about this, or deal with it, so I am shutting the whole conversation down”.

The I vowed not to think about birth until I hit the second trimester and the highest risk of miscarriage passed. And then, at that point, I would start to think things like “do I want an epidural?” and never really get very far with my answers. And suddenly I was 35 weeks and it was my beautiful baby shower and I was telling people that ‘yes, I was totally ready for everything” but when they got to specifics ‘no, I had not bought diapers yet…’ and ‘no I had not packed my hospital bags..’ and ‘no, I had not sorted the nursery’ and ‘no, no, no’. And that triggered something in me… some deep seated awareness that holy crap, I was actually going to have to do this again. And suddenly the darkest recesses of my mind took over and would pipe up at inopportune times. Like when I was reading Sam a book, something deep in my mind would say “I hope that if you die someone will tell Sam that his Mum used to read him books and do all he silly voices with him..”. I would squash the thought but later on the voice would say “If you die, hopefully people will tell your children ‘she loved you so much, she risked everything to bring you into this world'”. It wa startling to me how strong these thoughts were.

The next day I was in Starbucks and I had to walk past my hospital and while standing in line waiting for ‘the usual’ [tall decaff PSL, no whip, just one pump of syrup] I began to shake and cry and it is very awkward when heavily pregnant women start silently bawling in public because no one thinks they can ignore them and everyone thinks it is about the baby and tries to help . And when strangers asked if I was OK, it’s not like I could regale them with the whole birth history that I was trying to deny….

It’s funny, looking back, I don’t think I truly accepted what happened after Sam’s birth until after Caroline’s birth. I was taken up to a postpartum recovery room, and the nurse in the room said “Have you given birth here before?” and I said “Yes! Almost three years to the day I delivered my son here” and she said “OK, I am going to be honest… I knew that… I remember you… No one will ever forget your birth” and I thought “Geez… even nurses not involved in the situation are freaked out about this”. And my OB came by to visit me, and everything was perfect (and as you’ll find out in part 3 she has been utterly amazing in the birth) and I was holding my sweet Caroline and fully recovered within about an hour and my OB could finally say “I’ll just never forget your first birth… it’s just emblazoned in my memory and I can’t shift it”. And I thought ‘crap.. it really was that bad’.

So I didn’t finalize the process before Caroline came along, but I did begin to accept that I was utterly freaked out about giving birth again – not necessarily because I thought the same thing would happen, but because I realized that anything could happen. So I began to accept that I was scared, and angry. I was angry at my body for letting me down. My strong, half marathon and tough mudder running body builders body. And I was angry at the ‘natural birth’ community. I was angry at their message that ‘women were made to do this and should just trust their bodies’ (because where would that have got me? Let’s say it: dead is where) and even more angry at my treatment after birth. Basically, from all the natural birth communities I engaged with while pregnant, suddenly not one of them wanted to share my birth story, which left me feeling excluded and shunned. And then angry that by purposefully denying these stories, some parts of the natural birth community are lying to their followers: they simply discount the very real, and very rare, dangers rather than acknowledge them and allow women and their partners to make informed choices.

It was a tough few weeks and probably contributed to a lot of the depression I suffered with at the end of Caroline’s pregnancy (not something I have admitted before). I was scared and felt trapped – trapped into having to do something I was scared of. But, the reason that this is so part of Caroline’s birth is that I eschewed all thinking about actual birth before going into labor (in fact, possibly while in labor, which is why I didn’t accept I was until I was fully in transition. Although sleeping through labor definitely has some up sides…). Consequently, I didn’t have any kind of plan for what I would do in labor. At all. I just ticked the ‘no epidural’ box on my hospital pre-addmission forms and that was it.

So, I went into the delivery room really quite unprepared…

I’m glad I have written this down now. I am still 28% hippie and believe in things like the damages of repressed emotions, so I am glad to have written it down and am now able to really move onwards an upwards.

 

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How to be supportive of women’s birthing choices

*Note: throughout I got tired of writing ‘women and their partners and families’, so I just wrote ‘women’. But I do believe wholeheartedly that birth decisions affect the whole family, and so should be a somewhat group decision.

Ah, the Mummy wars. Just as we might be close to reaching some kind of rapprochement over one issue (breastfeeding), we really hammer into a new one: birth. For the unenlightened, a war is indeed brewing. On one extreme, you have the group who think that any intervention is ‘birth rape’ (not kidding…). On the other side, perhaps as a backlash, you have the women claiming that allowing any kind of pain in childbirth is anti-feminist, and women who don’t give birth in a hospital are baby killers. It’s just another incarnation of the nipple waving breastfeeding sluts vs. the poisoning lazy formula feeders debate.

It would be nice if we could just ignore this. Let the extremists be extreme, and live in a happy middle road. But the knock on effect is that women are becoming miserable – people feel judged and found wanting, guilty, denied a right, some even feel violated for a medical professional doing their best. While I support attempts to improve medical care, and thus women’s birthing experiences, this does not seem the right way to go about it. I understand that is hard when people think they are fighting risk to babies, or denial of rights to women – both highly passionate issues – but it seems to me that the path we are going down is not working. Families and caregivers need to unite in support of one and another to enable informed choices and happiness with those. That’s not the same as inaction, nor will it lead to stagnation. I believe that within this modus operandi, there is still room for encouraging change and I also believe it is the way to help women and their partners make better choice.

Here is how I try to be supportive of all birthing choices:

(1) Everyone: Be realistic and scientific.

Don’t lie. Home birthers: admit that the risks to mother and child are higher (but very small) and note openly that scientific evidence shows that epidurals at the right time do not increase C-section rates. Hospital birthers: be open: yes, a C-section is more likely, even when other factors are controlled for. Yes, pitocin increases the likelihood one will want an epidural, and not due to this, also increases the likelihood of a C-section. Be honest: you are more in the doctor’s hands, and you may be pressured to make an alternative choice. Home birthers: women in hospital may also not be pressured to make choices against their will and may work with professionals who are incredibly dedicated to following their birth wishes.

I have seen both done. At my Bradley classes (a natural birth class), our instructor was having a home birth. In the discussion about risks and benefits she noted that the risk were higher, but in absolute terms extremely minimal. She told us to go away, read, and make our own decisions. When my OB told me I needed an induction and I was resistant, she honestly talked through the increase in C-section occurrence. She told me to go away, think and read, and make my own decision.

Only by talking through openly and honestly about the facts and figures can women* make informed choices, and research ways to mitigate unwanted outcomes. When my OB was open about the increase in C-section risk with pitocin, I was able to research how to deal with this, and constructed a careful plan which took 2 days to effect, but resulted in a vaginal birth.

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(2) Anti-home birthers: Accept that you cannot save all of the babies, all of the time.

It can be a very emotive subject, and anti-home birthers usually cite the well-documented and reliable statistics of increased mortality with home birth. It is a tiny increase, but the pleading ‘won’t you please think of the children’, often accompanied by a picture of a stillbirth, can be very compelling. But here is the thing: home birth is not the last bastion of child (or maternal) risk. Children are starving to death, being shot to death in war, being shot to death because of lax safety, dying of vaccine preventable diseases, dying of non preventable diseases, dying because the basic standard of medical care is not uniformly distributed across economic strata in the US. That’s not to say that we should be cavalier about infant mortality, but some perspective helps. If you are not pouring equal amount of vocal outrage into all causes of child suffering (especially given how many more children die from these other causes, than from home birth), I would ask you to reconsider your reasons for championing an anti-home stance.

(3) Home birthers: to use your own words: anyone could do it.

If forced to, then I am pretty sure (but have not checked the empirical evidence) that anyone could deal with the pain of childbirth. Some people choose to have an epidural (or other pain relief) and there is nothing ‘weak’ about it. It’s just a choice, like the one to go to Kroger vs. Fiesta (or Tesco vs. Sainsburys for my dear UK readers), and should not have a value judgement attached to it.

(4) Anti-home birthers: We all take risks with our child.

Accept it, we all take unnecessary risks with our child. To anyone taking a ‘holier than thou’ approach to their child rearing I could point out preventable risks you take. Take your child in a car? Increased risk!! Why not stay at home or within walking distance until the child is 16 ?  You might say: that’s not practical, the benefit outweighs the unrealistic cost.

Sure – to *you*. There are people, I am sure, who follow this (small number though they are).  Ultimately: you don’t know the cost to someone of going into hospital. You don’t know their fears and needs, and how strong they are. You cannot judge for someone else whether the costs outweigh the benefits, because you don’t know them.

(4) Home birthers: We all take risks with our child.

You may tout increased bonding for a drug free childbirth, or a cite the evidence that some aspects of pain relief get to the baby and affect their immediate post-birth presentation. But again, you will do something that is sub optimal for your child’s development (although defining that is tricky), sometimes out of ignorance (and so some education is OK), but sometimes because to you and your family judge the benefit to be greater than the cost, as above. And that’s OK.

I could go on, but it has been (for me) a long post. I will always choose a hospital birth. I will always research and learn, but I will always reach an agreement with my trained medical professional. If I can’t do that, I will seek out a medical professional with whom I can, because this provider is obviously not right for me. For my birth, I agreed to an unwanted induction, but I worked out a fairly long and complicated plan for doing everything I could to ensure a vaginal birth. Indeed, this was necessary, if I had not worked with my OB on devising a 2-day induction, I would have been one of the ‘C-sections after a day on pit’ statistics.

That being said, if I had had a C-section, I hope I would have worked with my provider and still have thought it a wonderful experience. Many aspects of my birth sucked (or at least the aftermath), but I am delighted with the whole experience. Shit happens. But I got this thing out of it:

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My plea: chill, relax, channel your energy / outrage somewhere else [send refugees donations, volunteer at your local hospital, whatever], remember that you are not a bat, and don’t know what it is like to be a bat. Gain some perspective: birth is important, but it is just one aspect of a whole lifetime of wonderful experiences.

Peace. Love. Babies.