Retrospective Disappointment

I moved to my current location two years ago.  I’m on a quest to find the right provider, whether she be an OB, CNM, PA, or lay midwife.  I have yet to find a comfortable fit, but if and when I get pregnant again, I know I’ll find her.  I say “her” because I’m less likely to go through this process with a male provider.  Actually, I love our family practice doctor, and if he still delivered babies . . . I’d be a happy gal . . . or at least a hopeful one!

I talked to my CNM from my 2004 pregnancy and discovered that I have reason to be disappointed . . . I reminded her that she had told me I had a good pelvis for birthing.  She told me that you never know what a pelvis will or will not do until it’s put to the trial of labor.  Which at first was comforting . . . until she said that I am the example of someone who looks like they should be able to vaginally birth a child and didn’t.  Then again, I had so many things working against me that day.

I told her that an OB here in town said that my pelvis may not be adequate for natural childbirth.  It’s wide enough but not long enough (anterior-posterior).  My former CNM said that this pelvis shape (platypelloid) is rare and contraindicated for vaginal delivery.  I was so surprised to hear that from her.  I guess because my daughter never ever engaged into my pelvis (and I was fully dilated), perhaps she buys into this possibility.  I wish she didn’t buy into the whole contraindicated pelvis idea at all.  A truly contracted pelvis is extremely rare and is usually due to some sort of physical trauma.

I was disappointed by her advice to me regarding repeat c-section.  She told me it was ok to want to schedule a c-section in the future.  I guess she’s never had a c-section herself.  I doubt she’d be telling me to be ok with it otherwise.  Of course I am thankful that my daughter and I are both here and healthy.  I am thankful that my scar is minimal.  I am thankful that my c-section recovery was super easy.  But there are so many horror stories out there – I know women who have had their incisions burst open after the fact.  I know women who have atrocious-looking scars.  I know women who had excruciatingly painful recoveries.  I know too many women who have regrets – whether immediate or retrospective – regarding their cesareans.  Many women who have had cesareans don’t even feel like they ever truly birthed their babies.

Of course no OB or CNM is going to admit that actions they took may have caused the need for a cesarean section.  I believe the OB did her job – by the time she was called in, my daughter was stuck and just not coming out vaginally.  I didn’t think I’d need a doula, and I have no way of knowing whether or not after the hours of pushing that anything else could have been done.  I believe that my CNM offered me bad choices.  She knew that I didn’t want any intervention.  I shouldn’t have let her break my water.  Damnit!  I knew better.  That choice was the beginning of the trail to cesarean.  I regret that choice with every ounce of my being.

I hope my readers understand where I’m coming from.  I don’t believe cesarean to always be unnecessary.  I’m sure that by the time I had the cesarean that it was necessary.  I know some women do fine with ruptured membranes and induction and epidurals.  I knew that route wasn’t for me, but I succumbed to pressure.  I strongly believe that a woman’s body is built for childbirth, even if they’re not able to vaginally birth all of their children.  I believe that a woman must trust her instincts above everything else, because she and she alone is connected to the child within, and no doctor or midwife can possibly know more about that connection than the woman.

What NOT to say is much more important than what not to wear

Discussing a c-section with well-meaning family members and friends can be difficult.  The over-medicalization and institutionalization of pregnancy, labor, and delivery makes it hard for some people to understand why we mourn our c-sections.  (Sometimes these people are not-so-lovingly referred to as “sheeple”.  Baaaaaaaaa!)

I didn’t initially mourn.  I think my first response to the spinal was “why don’t women ALWAYS have one of these!”  (Oh, geez, no I din’t!)  My CNM looked crest-fallen.  My OB (who did a beautiful job with my c-section, by the way) laughed . . . and knew that she had won that time.  I don’t mean that my CNM was disappointed in me or that my OB was some saw-crazed freak; it just kinda “happened”.

So now I have a scar.

Oh, and NOW you’re telling me that I’m at an increased risk of uterine rupture if I choose to VBAC.  (My OB has had a VBAC go very wrong, and I know she carries that pain very deep in her heart.  It was obvious when she told me about it.)  But how had I been so oblivious to the serious risks that were presented by the medical community about VBACs?

So, here I have the VBAC/HBAC supporters saying one thing and interpreting data one way . . . and the medical community saying something very different and using the data in a very different way.  Gawd I hate that.  Can’t a fact be a fact be a fact . . . basta!  Genug!!!

But I digress . . . this purpose of this post is to inform you of the “helpful” things people say to those of us who endure (notice present tense) cesarean section:

  • At least you have a healthy baby (yes, true)
  • At least the c-section was an option for you (yes, true again, I suppose)
  • Maybe you’re just not built for natural childbirth (bullsh*t!)
  • Well at least you won’t have incontinence issues (not always true; true for me)
  • Well at least you didn’t have your vagina ripped open wide; gee vaginal birth really hurts (you’re kidding, right?)
  • Huh, so and so had a section and was really pleased (well good for her; notice, I’m not her?)
  • So are you gonna get a tummy tuck with your next one? (are you insane?!!!)
  • Huh, c-sections are quite common these days (?!?!?!?!?!?!?!?!!?!?!?!!!!^*&#@*!)

Here are a couple of tasty ones that an OB tried on me:

  • I don’t know why you wouldn’t just do a repeat.  I mean you won’t even have to go into labor.  (are you as dumb as you look?)
  • Well, ya know, we could tie your tubes while we’re in there.  They’ll just be flopping around down there anyway.  (ok, I only said I “think” I want 2 kids)

Please feel free to comment below and add your “favorites”.

Mourning the c-section

I’ve just recently joined an on-line community of people who support VBAC, HBAC, and discuss the trauma and risks of c/s. I am hoping that I can gain some courage from this listserv and get some answers!

Through this listserv I came across the website for the ICAN (International Cesarean Awareness Network) Publications Director. She posted her birth stories - the first one a traumatic-sounding c/s, and the second an empowering HBAC. Her stories give me hope, but they also stir up regret and anger as I begin my journey anew. The regret I can work through. The anger I can use as fuel.

Condemned before beginning

This gal discusses how she felt condemned before she even tried to get pregnant the first time. Her midwife was an infertility specialist of sorts and had probably seen a lot of women who suffered with infertility. She told this woman that her age 31 – the same age I was when I conceived my daughter – could contribute to conception problems. Geez!

I didn’t have that experience first time around, but two OBs here in town have condemned me. I have been enticed to fail or give up. I am new to this town so have had to search for new practitioners. I had been thinking that I would try a hospital VBAC with an OB and a doula. (My first labor was attended by a midwife, the L&D nurses at the hospital, and my husband). I believed that the first OB I saw was a supporter of VBAC, and since he had recently built a free-standing birth center, I decided to visit him. I’ve never had a male gynecologist but was willing to work with a man if I thought it would be best for me and a future baby. When he did the pelvic exam, he determined that my pelvis is ample laterally but narrow longitudinally. I’m supposing that is what is referred to in the medical field as a “contracted pelvis”, but I’m not certain.

I was having trouble with my birth control method and needed to be seen. I was on the Nuvaring, and I highly discourage its use. It can fall out without you even knowing, for one. My new OB/GYN wasn’t able to see me, but his new partner could see me. The staff spoke very kindly of this new partner. He didn’t feel the need to do an exam (“I can do one if you want“), so we just talked. Since he’s the other doctor’s back-up, I decided to ask him about his experience with VBACs. Here’s what I learned in a very short amount of time:

  • Yes, I do them (not yes I encourage them as much as possible).
  • “Why wouldn’t you just do a scheduled repeat c?”
  • “Your tubes will just be flopping around during the surgery, so we could tie them for you.” (Did I mention that I was interested in having my tubes tied? NO!)
  • When I explained a little of my unique situation he said “wow, this is just getting worse!” meaning that he had little faith that I could do a VBAC.
  • They will likely discontinue their VBAC services because the hospital is forcing them to labor-sit all VBAC candidates and that completely paralyzes their practice.

What a piece of work that guy was – so presumptuous! He treated me like I was a village idiot not a highly-educated fully-cognizant woman. I decided then and there to leave the practice. Even if the 1st OB was a dream (which I wasn’t sure), I couldn’t take the chance that this yahoo would be my L&D partner.

The Body is Wise
I am an opera singer, so I am pretty “in tune” with my body. Singing requires excellent coordination of breath and tone. I know how my abdomen, pelvis, and throat should feel in order to produce an optimal sound. However, I’ve never particularly considered the body to be wise. But the body often knows better than the mind.

Ow!
Late in my pregnancy I had quite a bit of pain. Of course it had been painful for most of the pregnancy to roll over in bed, but as my baby took up more space, new pains arose. I was often temporarily debilitated by intense pains when walking. It felt like my daughter was scraping or poking my cervix. What was she doing down there and how was she doing it? I don’t know and didn’t ask my midwife about it. But I think she had her hands up by her head during most of the pregnancy, and certainly “arms up” was a position that loved outside the womb.

Ugh!
My due date came and went. I saw my midwife who said that I was still about a week out. We went home a bit dejected but enjoyed a quiet afternoon at home without the extended family. I started getting violently ill that evening which began producing very strong contractions. I didn’t really consider that I was in labor. The contractions were manageable; the illness was NOT. I probably should have tried to contact one of the doulas I knew to see if they had any remedies for my symptoms. I didn’t want to go to the hospital . . . didn’t know how I’d get there without getting sick in the car . . . didn’t think I could walk the few steps to the car. In retrospect, I wonder if I should have stayed home and dealt with the dehydration on my own.

“That’s not amniotic fluid!”
We arrived at the hospital, and I was evidently 9cm dilated. I knew that I didn’t want any intervention, but I allowed my midwife to break my water. I think that was a big mistake. Catherine didn’t slide into position as expected. I was so weak that I didn’t try alternate birthing positions. Since I had diarrhea along with the vomiting, I felt inhibited. I didn’t want to get in a different position that might gross my midwife out. Stupid! Listen to the body! The body said, “Laboring on your left side really sucks.” The fetal monitor argued back: “Laboring sitting up stresses out the baby.” I ignored my body, and I pushed from my side to no avail.

Out!!
Everyone was tired. My contractions seemed constant (though the monitor told its own story) but were unproductive. I had such a strong urge to push, and that urge stuck with me for hours. The midwife called the OB. I really liked the OB – she’s no nonsense but cute and friendly. She has children of her own. She thought she could get the baby out naturally. After an hour she gave up. So did I.

“So how has this changed me? I am much less trusting than I ever was. I have a better understanding of my limits, and a raging hatred for those who sought to impose limits upon me when I was weak, who told me I wasn’t progressing…but what is 9 centimeters dilation, if not progress? I have a face to put to those who place their own political standing above the health and well-being of those in their care. And above all else, I have more faith in myself than I ever had before, because now I have a clear picture of what happens when you place your faith in someone else when it truly rests with you.” – Laureen

Her statement resonates on many levels. I too am much less trusting of the medical profession in general. I too ended up with a c/s for failing to progress (I assume), even though I was fully dilated. I too despise the political element of health care. Personal agenda has no place in health care. I hate the fact that being a woman often causes me to be treated as a lesser man – not only by OBs, but by mental health practitioners and even pediatricians!

I have been forever changed. I bear physical and mental scars of my history. However, the scars can serve as reminders when I am feeling weak or am being attacked for my beliefs. And perhaps my scars can save others from this same fate.