The Beginning of the End of the Beginning

I am sad (and relieved) to announce that ICAN of Greater Missoula is officially closed.  I really don’t understand why it wasn’t sustainable in this community.  Here are a couple of thoughts . . .

1.  The homebirthers and homebirth midwives are doing their part for sure, but unless you know someone personally who has birthed at home or who has used a midwife or is a midwife, you just won’t know much about how that works here in the greater Missoula area.

2.  The traditional birth culture prescribed by the medical community does not want to change.  Sure they built a “birth center” at the hospital, but all that really means is that women now have private bathrooms, tubs (I wonder if women are even allowed to use them?), and nicer accommodations.  I don’t think anything has fundamentally changed to make birthing healthier for women and babies at our hospital.  If I’m wrong, I’m happy to update this post at any time.  Our docs participate in a town-wide on call group.  What this means is that if you don’t birth your baby during office hours or during your doctor’s on call duty, you’re not likely to have your doctor help you birth your baby.  There are a few doctors that this does not apply to, and the key is to be with one of them.  Our medical community “killed” the birth center established by Dr. Montgomery, but kudos to Jeanne Hebl, CNM for establishing a successful homey birth center after Dr. Montgomery’s untimely death.  By November 15, 2011 Hebl’s birth center had assisted with 100 births.

3.  Women (families) in this town don’t know that they are “allowed” to have an opinion about birth much less how to have the birth experience that best suits their needs and wishes.  This is where I feel like I failed.  For example, when I was planning my HBA2C I ran into an acquaintance whose wife was getting ready for her 3rd cesarean.  They were told they weren’t allowed to do a VBA2C in Missoula.  I didn’t birth my baby at home, much to my surprise and chagrin, but I did have a most unlikely and uncommon VBA2C at the local hospital with a very good OB who did his best to scare the shit out of me during my appointments.  However, when push came to shove (literally) – HE WAS THERE.

Support for women and families in this community will always be there.  I hope families continue to seek out the best birth experiences that fit their needs and their dreams.  I will continue to offer support when and where I can.  And VBAC/CBAC support in Missoula does have a Facebook presence.  Click here to reach our page.

Here’s a recent picture of my amazing VBA2C baby:

My precious VBA2C baby at age 23 months

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!

Empowered Birth Week

I’ve been so overwhelmed with the start of a new academic year, raising four young daughters, and trying to reserve some time for fun . . . that I have neglected other important aspects of who I am.  I am this blog!  And I am an empowered birther!  Are you?

Even if you had pain meds . . . or an induction . . . or a cesarean . . . you might have had an empowered birth.  Who decides what constitutes an empowered birth.  YOU DO, and don’t you forget it.  It’s not for medicalists or luddites to determine though many are happy to throw in an oar.  You have to be ok with your birth experiences, and if you’re not, I encourage you to figure out why and try to resolve that.

Did I have an empowering birth experience?  I suppose the answer depends on the moment you ask me about it.  Sometimes I think that if I had gone a different direction in terms of care providers that I’d have had a birth experience perhaps more resemblant of the one I so deeply desired.  Sometimes I think that my pain-in-the-ass, scare-tactic OB was an angel.  He was the best birth coach ever, as far as I’m concerned, especially considering that I had NO idea where my ass was nor how to push from that imaginary ass.

And it’s ok to struggle with being ‘ok’ with your birth experiences whether they are au natural or full-service medicalized.  It’s ok to question (or not) the validity of your birth choices (or the choices made on your behalf).  Wherever you are on the spectrum, I encourage you to think of yourself as an empowered woman.  You have the power to be fully present and accepting and/or participant in your health care decisions.  For me, being fully present and a participant are at the heart of being an empowered ‘patient.’

Birth Snapshot: The Epidural

Labortrials got an epidural?!  Oh me oh my.  Yes, friends, I consented (begged for, even) to the bleepin’ epidural.  How did this happen, and how do I feel about it now?  Well . . .

I arrived at the hospital worried that something was wrong.  The labor contractions came fast and painful, and I knew that less than 24 hours previously I was not dilated but a smidge.  I also felt as strange ‘pop’ down there and knew it wasn’t my water, so that in conjunction with the scary contractions (tetanic, perhaps) sent me packing to the hospital quickly.

The OB arrived, checked me, and found me to be 2cm dilated, but the baby was high.  According to the monitor, the baby was not handling the contractions well.  (She was having late decelerations.)  The OB restricted me to laboring on my side; the labor nurse told me I had to relax my body in order to dilate.  The contractions really were more than I could handle with the position restriction.  The OB checked me a few hours later, and I was still stuck at 2cm.  I knew that as soon as I could get an epidural that I needed to have it put in.  There was no way I was going to withstand the contractions, restrict my movement, and relax enough to dilate without pain management.

Interesting that this evening on my twitter feed, I saw @RobinPregnancy’s tweet about epidurals:

Did you ever have an #epidural that didn’t work quite as well as you’d hoped? http://ow.ly/6ejKI #pregnancy #About

I had an intrathecal with an epidural placed.  The idea was that the intrathecal could possibly get me through the next several centimeters of dilation more quickly and would wear off.  If and when I wanted the epidural, it would be ready and waiting for me.  The intrathecal improved my quality of life dramatically, and indeed I did progress quickly from 4cm to 8cm dilation.  Then I got stuck at 8cm and for a few hours, so I wanted the epidural.

However, the epidural was slow to work, and when it did, it didn’t provide enough relief.  My labor was not progressing very well, so I was concerned that if the epidural didn’t work and I needed a cesarean, that I’d feel the surgery.  I was terrified, actually.  This caused me to over-react.  The anesthesiologist gave me a bolus of something (yes, it’s horrible that I can’t recall this information), and when that didn’t seem to give me enough pain coverage, I received another bolus of something (nope, can’t remember what that was either).

So, when it came time to push, and thank God I got to that point, I couldn’t feel a darned thing.  I could sense when a contraction was beginning, but that was about it.  I had some sensation in my toes.  I had no idea where my vagina was or how to push.  That was terrible.  My OB was a tremendous labor coach, so he talked me through every contraction . . . every push.

Ideal?  I suppose that depends on how you look at it.  The purist in me says “technically, you had a vaginal birth, but you missed the whole darned thing.”  The practical-ist in me says “honey, if you hadn’t gotten that epidural, who knows if you’d have dilated quick enough for the OB, or if the epidural is what helped calm the baby’s response to the labor contractions (stressed mom can lead to stressed baby), or if you would have outlasted the pain.”  No one made me get an epidural.  I told them on entry that I wasn’t interested, and they left me alone.  I asked for the epidural – it was my request; my choice.

People can be sooooooo judgmental about the use (or refusal) of epidurals.  Read this woman’s story over at Unnecessarean.  Don’t miss the comments which are QUITE polarized.  Given what I’ve been through, you may laugh at my comments.  Would I recommend an epidural to my closest friends and family members?  Yes, with caveats.  Would I recommend my closest friends and family members NOT accept an epidural?  Yes, with caveats.  Would I recommend epidurals for VBACs?  Yes, with caveats.  Is the epidural the beginning of the end in terms of natural childbirth?  Yes and no.  Does the epidural cause a cascade of interventions?  Yes and no.

Yes.

and

No.

Yes, it’s not that simple . . .

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!