What Can I Say?

I am so out of the loop when it comes to anything having to do with reproduction these days.  I’m not in the loop . . . I’m not in the outskirts or the suburbs.  I’m off the grid.  However, a new comment on my ever “popular” miscarriage and hormones post made me feel compelled to post an update.

Random thoughts about life, birth, and the like . . .

  • My 1/2 acre yard and gardens are in disastrous condition, but I did plant some annuals today; that made me happy!
  • My husband is getting ready to add a second floor to our house – his company is called Aria Construction, and they do fantastic high-end work
  • My youngest is now almost 11 months – I still want to smash her into 0-3 mo. clothes…
  • The twins will be 3 in August, and they are such a joy and such a torment.  I still can’t believe they are mine!!
  • My oldest, age 7, had a stupidly horrible time in 1st grade.  Here’s hoping for rest and recovery this summer and a better experience in 2nd grade.
  • No, I’ve still not written my birth story from July 12, 2011 . . . what’s the hang-up?  Well, I still have issues with G’s birth and with a local care provider.  That’s part of it, I’m sure.

Am I recovered from my birth losses?

Yes and no . . . those losses, in a way, made these last three children possible.  However, I still feel an emptiness that will never go away.

Am I recovered from my birthing losses?

Mostly no.  Physical activity causes the adhesions to hurt.  The unevenness in my lower abdomen (fat layer – scar – fat layer) is something I see and feel every day.  Although my VBA2C was a “success,” I feel quite bitter about the last weeks (from 31 weeks to nearly 42 weeks) of my pregnancy.  From 39 weeks onward, every day was a struggle, emotionally.  The birth was stressful.  I didn’t feel a darned thing and had to be told when and how to push.  I didn’t birth my child, but at least I didn’t have to endure her being cut out of my body.

Birth advocacy . . .

I still feel quite out of sorts about childbirth in Missoula and elsewhere.  Any time I see that someone had a cesarean – primary or repeat – I want to know why.  I wish Missoulians seemed to care more about how they birth their babies.  I feel like people either go the homebirth route and mostly enjoy a rewarding birth experience or people sign up for the slaughter.  I know there are good docs and good nurses out there, but I definitely lack trust.  And people don’t know their rights or don’t care that they have rights or don’t know how to exercise their rights when it comes to their own health care.  Everyone else seems to just mind their own business.  <shrug>  I’m planning a few VBAC Resources and Support sessions this year – wish me luck!

Well, that’s where I am today.  I see that Rixa is blogging about important stuff, of course.  See her latest regarding the Human Rights in Childbirth panel.

Happy Birth Day to Me

Today is my birthday, and I have a lot planned for ugly number 39:

  • Walmart for baby proofing (see photo below) and crafting stuff
  • Finish G’s birth story since she turned 6 months old yesterday
  • Meet a friend and hike “the M” today before the weather turns (hooray, snow!)
  • Bake me a cake (no I don’t mind pampering myself on my birthday)
  • Go to one of my BF’s to celebrate avec family (it may even turn into an overnight par-tay)

    Happy Birthday to Me (aka thank you for not killing yourselves)

My good friend from Birth After Cesarean posted this yesterday on my wall:

Well, who would have thought this past year would bring so much difference for you, woman!

Seriously, this has been an epic year for me.  I happily and healthily grew another blessing.  Against all odds, really . . . I had a successful hospital VBA2C.  I held my ground and refused a cesarean.  I achieved tenure and was promoted at my University.  I performed a solo faculty recital (my recital partner backed out on me a week prior) a mere 2 months post partum!  My hubby and I drove to and from Denver for the holidays with our four young kids (which I consider a HUGE success).  My Dad flew me to Houston to check on my ailing aunt, and I was able to see my mom, brother, SIL, niece, and meet my nephew!  And we ended our childbearing years yesterday with a vasectomy.

It’s crazy to think that my childbearing years are over.  I love pregnancy.  I might even be addicted to pregnancy.  I am jealous of every pregnant woman I see.  And thankfully a part of me is at peace with being done.  But, now I have to face raising these beautiful children that my husband and I conceived.  Some days it’s really really hard to be a good parent . . . to be a minimally acceptable parent.  I never feel like I’m a spectacular parent.  But maybe now that I’m done making, baking, and birthing babies, I can focus on being a better parent?

So, what’s next?  I think I’ll eat a little something and go for my hike.  Guess I’ll have to postpone finishing my birth story until this afternoon while my birthday cake is baking.

After that I’ll continue herding my little flock of kids and herding my big flock of students and loving my husband and my home!

Birth Snapshot: Out the Vagina

No, I still haven’t finished my 4th and final daughter’s birth story.  I’ve been too busy and too distracted, and honestly not terribly motivated to share all the gory details.  This is why I’m trying to post these ‘snapshots.’  I wrote about my VBA2C for ICAN’s blog, so if you’re interested, go read that post – it shares a lot of what went ‘wrong’ with the birth.

I’ve never enjoyed one of those ‘perfect births.’  You know – the ones you do hear about in the homebirth community – the candles, the soft music, the water, the privacy.  I’m still left so unsatisfied . . . and yet thankful.

My baby did come out vaginally.  I still don’t know how that happened.  Sheer dumb luck?  God?  A little of both??  In spite of all of the interventions at the hospital, the stress, the loss of my quested homebirth, she came out vaginally.

Praise God!

Birth snapshot: Two weeks ago today…

Two weeks ago today I was utterly hopeless.  By 1pm I had lost my midwife and pissed off the only medpro that was ‘in charge’ of me.

Two weeks ago today and at this time I should have been getting prepped for a repeat cesarean.  Instead, we called the hospital that morning and called the OB’s office to cancel that surgery.  We felt the surgery was at best premature but more than likely completely unnecessary and scheduled out of medico-legal fear.  The only reason I allowed the scheduling of that surgery was because I didn’t think I’d still be pregnant at 41 weeks and 4 days and didn’t plan on needing an obstetrician anyway!

Two weeks ago today and by this time of day, my husband had called my midwife.  He thought her suggestion to just show up at the hospital on that day (with relatively no labor signs) just to appease the doctor was quite strange.  Little did we know that she no longer felt comfortable helping us at home.  Thank God my husband was able to pull that out of her.  So . . . by this time of day I was that patient who goes against medical advice (AMA) and cancels a scheduled surgery and doesn’t check back in with the OB and doesn’t show up at the hospital during business hours.  And my midwife abandoned me when I needed her and expected her the most.

Two weeks ago today and an hour from now, I took a 2.5oz dose of castor oil that did nothing but make me feel sick to my stomach.  We started getting ready to go to the hospital.  I had no idea what you put in a hospital bag . . . couldn’t remember.  I tried to rest but was restless; tried to sleep but was too wired.  Sleep was way to passive for me at the time – I had walked a big blister onto the bottom of my foot; I had bounced on the ball; I had squatted.  I researched ways to help get my baby better positioned if and when contractions resumed.  I researched post-41-week birth outcomes.  I looked and looked for any justification for a pre-42-week cesarean.  I looked and looked for evidence that stillbirth rates doubled at this point in a healthy pregnancy.

Two weeks ago today . . . by 1:02pm, I had no faith in myself.  I had no faith in my birth community.  I had no faith in my care providers.  And yet I had so much . . . an amazingly supportive husband, my in-laws who dropped their plans and raced up her from Denver to take care of us, my 3 sweet girls, and my cozy happy healthy baby in utero.  Why did it have to be such a hopeless day?

Against All Odds: Gillian, VBA2C

I have neglected to post an announcement about my daughter’s birth.  I was thinking that I would have a birth story ready to post within a few days of her birth, but clearly that is not the case.  Actually, in addition to her birth story, I will be drafting additional posts related to this crazy birth experience and a couple of guest posts for other blogs.  Stay tuned!  For now, here are some stats for your enjoyment, and a picture of my latest love bug.

Gillian, day 2

  • Gillian, born Tuesday, July 12 around 5:30 am
  • 8 lbs, 14 oz
  • 21.5 inches long
  • 15.5 inch head!
  • HARD labor commenced at 7pm on Monday, July 11, about 5 hours after a second dose of castor oil while pumping, at 41w4d gestation, the same day I cancelled the ‘required’ 41.5w cesarean (scheduled for 1:30pm on July 11)
  • About the only thing that was physiologically NORMAL about all of this is that she came out of my vagina and I was not given pitocin (well, not until stage 3)

I must give particular thanks to the women of ICAN and Birth After Cesarean for lifting me up, particularly during the last trimester of this pregnancy.  The last week of my pregnancy was sheer emotional hell, and I wouldn’t have made it through without these networks of amazing women.

Re-Birthing Catherine

Background:  I spend a lot of time mulling over the amazing information on kmom’s Plus Size Pregnancy site.  Today I was drawn to the “Emotional Homework” suggestions found under Increasing the Odds for a Safe and Successful VBA2+C.  I started tearing up and getting a lump in my throat . . . not that it takes much to touch my poor lil feelings these days.

Try ‘rebirthing’ your cesarean births - Although it is often a very emotional exercise, many women find it particularly helpful to recall every detail of their cesarean births, and then later re-script the labor and birth so that it goes the way they would have wanted it to go.  Start by recalling (either verbally or by writing it down) every sensory detail of a prior birth. [ . . . ]  Then, when you feel ready, re-script and re-experience the labor and birth the way you would LIKE it to have gone.  Change whatever needs changing, as small or as big as needs be.  Concentrate particularly on healing things with your child, having the wonderful birth and nurturing time afterwards that so many of us grieve missing.  Write out the storyline of the changed birth so you will have it and review it as needed.

My 2004 birth story (the hind-sight is 20-20 version) is here.  I will say that re-reading my surgical report and going over it with my midwife recently was quite illuminating, and that makes this re-birth process a bit easier on my left brain though my right brain is in agony right now.

Deep breath.  [Contraction]  Ppphhhhhhhhh . . . here we go.

my last belly pic 12/2004!

I went to my 40 week pre-natal appointment with my CNM a day after my guess date passed.  I was a bit disappointed that nothing was going on – very little effacement or dilation, but also wasn’t terribly surprised since I had learned that many first time moms go into their 41st week before natural labor sets in.  All of our family had been in town for Christmas, but the brothers and sisters had to head back out to jobs and school and stuff.  It was just us, our dog, and both sets of parents left in town at this point.  Still we’d both had enough family time, so after a good lunch at one of our favorite burrito places, DH and I left for home ALONE to just chillax.  I think I spent most of the afternoon on the couch sleeping through movies.  DH was gaming on-line.

Later in the day I started getting really sick.  I guess it could have been as early as 6:30pm or as late as 8:30pm, but regardless, I was a sick puppy.  My blood pressure runs a bit low, so vomiting + being on the toilet = passing out for me.  It was a fun game to see if I could finish my business before falling to the floor.  So, I was in and out of bed and the bathroom.  There wasn’t much DH could do for me, and I was so sick that I wasn’t staying remotely hydrated.  And I was contracting (though I hardly even remember that detail).

DH insisted on calling our midwife, and of course she just advised that he do his best to get me hydrated and not to worry about the contractions, because of course, there’s no way that I’d be in labor!  That made sense to me.  I certainly didn’t feel like I was in labor.  I felt sick as a dog, and I was getting sicker and sicker.  After a few more hours of this, DH called the midwife back saying that even if I wasn’t in labor, he was worried about how dehydrated I had become.  (We’re both professional singers, so we’re very conscious about hydration.)

This was after midnight.  He’s scurrying around the house trying to figure out what to put in our hospital bag, and I’m thinking that he’s nuts for trying to take me out of the house in this condition.  I remember not wanting to leave the house.  No, no, no – this is just NOT right.  And how the hell am I supposed to get to the car without passing out, pooping myself, or vomiting everywhere?  Hmmm??  And once I’m in the car, how the hell am I supposed to ride in the car without pooping or vomiting everywhere?  Hmmmmmmm???  Oddly enough (thought I get it now), I stopped getting sick.  I became more aware of the contractions, I guess, but I was more curious about why I had suddenly stopped getting sick!

We arrived at the hospital a few minutes later.  The intake gal wasn’t the slightest bit concerned about me . . . taking her sweet ass time while I’m contracting away and wondering when the next wave of sickness would take over my body.  I didn’t think I could get to L&D on my own, so once DH got back from parking the car, I think he wheeled me away to L&D.  I was kind of excited in a way!

Get to L&D.  Everyone is in slow motion.  They knew that I was on my way, but yeah yeah . . . 1st time mom thinks she’s in labor, yeah right.  They didn’t have a proper L&D room ready for me, so they put me somewhere else for my initial assessment.  It didn’t bother me any.  I was just trying to manage contractions.  So blah blah whatever questions that I couldn’t focus on but DH was mostly able to answer.  Taking their sweet ass time.  They check my cervix and holy moly SHE’S 9 CM DILATED!!!  GET HER MIDWIFE HERE STAT!!!  All hell breaks loose.  It was comical.  They readied a L&D room and transferred me.

So here we go!!!  We get set up in our room and our midwife arrives looking a bit sheepish since she insisted TWICE to my DH that I was NOT in labor.  After confirming that I was 9cm dilated, she offered to break my water to help move things along faster.  I knew that she was just trying to help since I was so sick, but DH reminded her that we were not interested in any unnecessary interventions.  He asked again about my dehydration, and they said the quickest way to remedy this was IV fluids.  It sounded like a good choice even though I was bummed to be connected to tubing that could restrict my movement.

At some point the labor nurse noticed fluid coming out of me.  I think she thought that was amniotic fluid, but no . . . ick, it was from uhhhhmmmmm, somewhere else in the vicinity.  I was a bit embarrassed that I was having diarrhea everywhere, but I knew that in order to bring this baby down, I needed to move and change positions.  For some reason, it seemed logical that I would turn my butt to the room and sort of drape myself over the back of the elevated head of the bed.  That was just a great position for me, even though I was making such a mess.  Thank God for chux pads, people!!!  Anyway, from this position, I was able to sway my hips and bounce like a maniac and still ‘rest’ my head.  Upright positions definitely felt the best and seemed the most productive.

I didn’t ever really ‘hit the wall’ like I had expected because obviously I transitioned either at home or in the car when I was still so sick.  Once I got to the hospital, I was still having diarrhea, but I stopped vomiting thankfully!!  I started feeling pushy, so my midwife examined me again and encouraged me to push.  However, she had me on my side for pushing and was having me push for counts of 10.  This was horrible.  They had to give me oxygen, and the position was excruciatingly painful.  My contractions were one on top of the other even though the stupid monitor was telling them that my contractions were ending.  I hated that damned machine.  I wasn’t making progress.  I was getting tired.  I was frustrated.  I was sick.  I was contracting and grunting and moaning and getting nowhere fast.  My midwife estimated that the baby was stuck at 0 position and not tolerating pushing particularly well.

DH & I thought back on our childbirth education series.  We knew something had to change.  So, I got back into that other strange position of draping myself over the top/back part of the bed and pushed in that position.  The counting to 10 was driving me crazy, and I yelled for everyone to stop.  I just decided to push whenever for however long and see what that did.  I felt my baby girl making her way down.  Eventually, that is.  My midwife wanted me to lie down so she could check the baby’s position, but I didn’t see how I could possibly do that, so she contorted herself and checked me and found that I was +1 or +2 . . . can’t remember.  Aha, progress!  That was all I needed to invigorate me.

Some rights reserved by Travis S.

I do remember wondering when pushing would end.  I thought I recalled reading that 1.5 hours was fairly standard, but I had been pushing for twice as long at least.  However, I was surviving (I think thanks to that bag of fluids), and the baby was now doing better with the pushing.  Hooray!  What seemed like an eternity later . . . eventually resulted in me feeling like my vagina was on fire and going to explode.  Baby was crowning!!  My midwife applied counter pressure to the perineum so I wouldn’t tear and encouraged me to ‘go easy’ with the pushing if possible.  Eventually I couldn’t resist any longer, plus I was tired of the out and in game that the baby was playing.  I pushed really hard – I think I was on all 4s at this point – and her head came out.  Relief.  It feels so much better once the head is out, I can’t even tell you.  A couple more pushes and the shoulders and body were out, and my sticky gooey baby was in my arms.

Many women feel like birthing their babies was a transformative experience.  I am one of those women.  I felt like, if I can do that, I can do anything.

 

The Bestest VBAC of All

So I got an epidural for my VBAC.  Get over it.”  What a great title!  You know exactly what kind of story you’re going to read and can even take a guess at the spectrum of responses to such a post.

I think this is an important post to read.  A VBAC doesn’t have to be a fully unmedicated waterbirth at home to be a ‘success.’  Yet, we run the risk of presenting a set of demands on VBAC mamas, and for many if not most this might be obstructive.

My sense of this woman’s story is that she got the epidural knowing what risks and benefits are involved.  If not, then yeah, maybe she got lucky.  My sense of other women’s stories who have had epidurals, is that even though in most women, the risks may outweigh the benefits . . . some women just don’t dilate or labor well without them.  Perhaps we can hindsight quarterback their birth preparation process, but I think that’s a fruitless discussion.

I agree with Andrea’s point that fighting about the best way to VBAC isn’t constructive.  Ideally, we wouldn’t even need to address the “best way to VBAC” if we had a medically-appropriate cesarean rate in this country.  And if “normal birth” (and I do mean natural) has a high degree of variability, so much so that we insist women be left to labor in peace without clock pressure, then we must be willing to accept variability in the way women pursue their VBACs.

Most of us, I would assume, who consider ourselves to be VBACtivists, are working so hard to re-educate women about patient autonomy, patient choice, informed consent, and participating in health care choices, that we start from the position that a woman who requests an intervention such as an epidural during a VBAC labor doesn’t know the risks.  And this is probably how the squabbles begin.

Further, plenty of “die hard” VBAC gals make “natural choices” that I find potentially risky.  I’m pretty specifically talking about the use of EPO for home induction and tonics such as 5w or PN6.  And some women say NO to induction but YES to augmentation.  And some women agree to AROM (having their waters broken).  Some women have their membranes stripped.  And I get it . . . because as soon as you get to 40 weeks, you’re treated as a ticking time bomb.

What will I do this time?  Only time will tell.  But you bet your butt that if I get exhausted laboring at home but think an epidural will help me regain the strength to birth this child vaginally, we’ll hop in the car and accept the the bad with the good.