Tuesday, August 11, 2009

Journey of a VBAC

I met my now husband over the internet when I was 21. I lived in Colorado and he lived IN Georgia. After going to Georgia to meet face to face, it wasn't long before I moved. Several months after moving to Greorgia, I was pregnant with my oldest daughter. I liked the idea of a midwife, so when choosing a HCP I chose one that was predominately midwife-based, but which also had doctors on-call. I had never considered the logistics of having a baby. My brother-in-laws wife had used this office when she was pregnant with their daughter, and I had gotten glowing reviews, so for me it just made sense to go with them than to shop around.

During my first visit, I was found to not be as far along as my LMP had dated me, but the baby looked good and my due date was bumped back two weeks.

The visits were ok, although I never saw a midwife more than twice, and so had no relationship with any of them. I also took the labor and delivery class offered through the hospital where I was to deliver; I remember clearly that out of the class of 30 couples, there were only two that had plans for natural childbirth and we were one of them.

I went into labor at about 5am three days before my daughter's due date. The hospital was an hour drive away, so by about 8 am we headed in that direction. My mother-in-law went with us. I got to the hospital with very bearable contractions, and was admitted into labor and delivery. The nurse came in and asked me if I wanted an epidural. I told her no, and I was informed that I "would be getting an epidural." They checked me. I was three cm dialated. The midwife in charge of my care acted like I was bothering her by being there. She was also one of the midwives I had never even met at the practice.

An hour later they came back and I was still at 3cm. They would not let me get up and walk around, but instead began talking about pitocin. I refused pitocin, so the midwife came in and basically told me that I was being hard-headed and potentially causing trouble for the baby by refusing. I refused three more times, before relenting. About every 15 minutes someone new would come in and try to coerce me into the pit.

They got the pic going and when that didn't speed things up as fast as they wanted, they broke my water. The combination did the trick, and pretty soon the contractions were coming hard and fast. I refused pain medication twice more, before relenting. I told them I would take something, but not an epidural. It was almost an hour before they nurse came in to push something through my IV. Not five minutes later, another nurse came in and gave me a pain pill. Some time later, they did manage to talk me into an epidural. I am very sensitive to pain medication and the combination of the injection and pill left me nauseous, dizzy and very sleepy. So much so in fact, that after throwing up, I slept while they put the epidural in. I have had spinals with my other births and I can tell you that I do not know, to this day, how anyone sleeps through getting a needle in their spine.

After the epidural, I do not remember much. I mostly dozed, drifting in and out of consciouness with a sense of unreality. I do remember the midwife screaming at me to wake up and push, and threatening to turn the epidural off if I did not. I feel asleep every time someone quit talking to me, and had to be not only awakened to push, but also awakened in the middle of pushing. I found out later, they were talking about doing a c-section, but my husband and mother-in-law refused, knowing how I felt about it.

I also remember at one point, being shown my daughter's crowning head with a mirror. It all became real to me at that point, and I remember pushing with all my might, as I was shouted at, trying to get my daughter born. Her cord was short, which caused some difficulty, or so I was told. It was also wrapped around her neck twice. I had so much perineal swelling from the forced pushing that I was kept in the hospital for an extra day. And due to the pain medication, both myself and my daughter spent most of our first days asleep.

I will always remember the sight of her head, and I just wish I had known then (maybe its better I didnt), that it would be the last of my children I would get to watch be born. It would not, however, be the last birth I was unconscious, or mostly unconscious for, sadly enough.

When my daughter was a few months old, we moved to Texas, where my family had migrated from Colorado. My husband, daughter and I stayed with my parents for several months. During that time, I found myself pregnant again, although I had been taking birth control pills. I was devestated. I felt as though somehow I had betrayed my daughter by getting pregnant so quickly. However, as time went by, of course I fell in love with the baby I carried. When we found out, during a routine ultrasound that the baby was a boy, we were ecstatic. The doctor we used was one of two available in the small town we lived in, and once more, I just accepted care based on someone else's recommendation.

I assumed that since my daughter had arrived before her due date, my son would beat his Dec. 7th deadline. However, come the 7th, I was more hugely pregnant than ever before, so when I walked into the doctor's office for my check-up and he offered to induce, I jumped at the chance. At this point, I had still skipped all the chapters in my prenatal books that dealt with c-section, complications etc. After all, those things were for other people, not me.

At midnight, I dutifully arrived at the hospital, palmed my sleeping pill and spent the night listening to the soothing sounds of my baby's heartbeat. The next morning, despite some resevervations and with the promise that the pitocin would be at the lowest lvl possible and would be stopped once labor started, I was given a suppository to dialate my cervix, which was still stubbornly closed and pitocin. Nothing happened; two pit increases later and I was still not in labor.

A few hours later, the doctor came by and said that due to the fact I was not going into labor, he would send me home. The baby was still high enough they could not break my water. They turned off the pit, gave me some lunch and were preparing to discharge me when I started having contractions. The contractions were not terribly strong, but they were regular and so deciding that I was in labor, they began making preparations for me to stay.

The contractions lasted until the next morning, but I never dialated or effaced and the baby never engaged, which leads me to think that I wasn't truly in labor (along with another point I will get to eventually). But at the time, all I could think was that the doctor was right and something was wrong. Once more, they were going to discharge me and let me come back in 48 hours to try induction again. That's when my mother piped up and asked them to do an US to check on the baby's size. A nurse herself, I am sure she was trying to be helpful, but this sent us down an irreversable path.

The doctor obligingly did the US and promptly decided that the baby was at least 10lbs and that the reason I was not going into labor is that he was too large. I was then given an ultimatum, have a c-section or else come back in a few days and have a c-section with the risk that the baby would die before then. Where he came up with this, I do not know to this day. So, feeling trapped and like I was doing the right thing, I agreed to the section.

My husband did not want to be with me during the section, so my mother accompanied me. They gave me the spinal, and the foley catheter, both of which to me are almost humiliating beyond endurance, as well as being painful. It took 7 sticks before the epidural went where it was supposed to go. The result was that once more I dozed off and on during the birth of my child. I woke up once, not even realizing they had started and looked up to see blood in a tube past my head. I never heard my son's first cries, I never saw his body emerge from mine.

In fact, I did not see him until several hours after the surgery. They finally brought him to me, but to be honest, I was hurting so much it was hard to hold him and hard to nurse him. I did both. The nurses left him in my room, which is what I had wanted, but everytime they came in they put him in his bassinet and moved it across the room. I could not get him out of it by myself for the first day, and I had a hard time getting anyone to help me. My husband had to go to work, and my parents were not that interested in hanging out in the hospital with me. The first couple of days were rough on my and the baby.

Finally, I was let to go home. Wheeled out of the hospital, every bump jarred my tender abdomen and I felt like a tired old woman. When I got out, my husband had forgotten to fill my pain medication, so I had to go out and do that, as well as picking up some last minute items he had forgotten. (If you are thinking my husband is a creep, I must tell you, he and I were not having an easy time of it in those days, and things have since moved to the other end of the spectrum.) My mother stopped by the day after I got home to watch the baby and my daughter, so I could take a shower. As soon as I got out, she left. That was the extent of help I had at this point.

I felt like I had something to prove, that having two babies so close together did not mean that I would not be able to keep my house spotless and my kids the same way. As a result, I never took the time to sit and snuggle my son the way I did with my daughter. This is one thing I will regret to my death, and a thing I cannot go back and change.

On Dec 25th, 2004 I woke up with my son about 5am and nursed him. He fell back asleep with us, in our bed. About 7 am the cats knocked a basket off in the bathroom. My husband got up to clean up the mess and I got up to get everyone ready to go to my parents' house for Christmas. When I went to get him up, he was dead. I know I screamed and I know my husband and my brother (who had stayed the night with us) came running, and I know I would not let them take him. I had no idea what to do, so I called my mom. After a short conversation with her, I called EMS.

I have to say, every single person who was with EMS at the time, showed up at my house. Many of them gave up Christmas morning with their own families, to try to save mine. It was too late. When they got there, the baby was still warm, and they were hopeful they could bring him back, but they never got heart tones back. They took him to the hospital, leaving me and my husband to get their on our own.

The hours in the waiting room were some of the longest and hardest I have ever known. They worked on my son for several hours, past the time of any ohope of getting him back. We insisted we get to see him before the funeral home came, and I will never forget his tiny, naked body with all the tubes and needles in it. And the sharp stab when I realized that he still had the diaper rash we had been fighting since he came home from the hospital. What a bad mother I had to be. Not only had my son died, but he had died with diaper rash.

CPS of course did an investigation, since he had died in our home. They were furious he had been in our bed. For several weeks we were not allowed to be alone with my daughter, and so spent the time of the funeral and the weeks after, with my husband's family from Georgia camped on my living room floor and my brother there to "chaperone" us.

We knew we wanted to have another baby as soon as possible, but I was still bleeding from recently giving birth. Also, no one told me how bad the breast engorgement would be. I had a hideous scar from a surgery I had not wanted, giant, leaking breasts and a postpartum body, with no baby to show for it.

Several months later, I did get pregnant again. However, when I was 7 weeks or so along, I had a miscarriage. I was so angry and so devestated. I felt like my body was in revolt against me. It had let me down in childbirth, and now it had failed to do the thing it had done so effortlessly before, and provide a hospitable environment for a baby to grow. At this point, the desire for another baby became almost all consuming. No one ever told me how quiet a house with a 2 year old in it can be, when it should also have the sounds of a growing infant.

Three months later, I was pregnant again, with my second daughter. I was terrified that something would go wrong. In my course of trying to deal with my son's death and getting pregnant again, I had encounted many women with many problems. I had seen and heard so many horror stories, it became a wonder to me that any baby is ever born healthy and alive.

The doctor who had delivered my son had moved his practice to another town, and I dutifully followed, thinking that he would be a good choice since he had delivered my son, and had also been the doctor on call that had worked so hard to try to save him in the ER. My first appointment and the doctor wasn't even there. They were still trying to set up the equipment, and the nurse who did my history, refused to write that I was pregnant, since there was no US machine and therefore no way for them to be sure that the pregnancy was viable. They never even did a pregnancy test..

I spent every trip to the bathroom searching for signs of impending miscarriage. I went for my next appointment; still no US machine, although they offered to let me pay out of pocket to go to the hospital. Then they tried to get heart tones, and could not find them with the doppler.. Finally, at the next appointment, it was shown that my pregnancy was viable.

I spent time anxiously awaiting the kicks that would signal life. At my 20 week appointment, the US showed that we were expecting another girl. The response from friends and family was enormous- they were relieved it would not be another boy. Again, I was left feeling like my body had somehow created a defective child. We were still, at this point, waiting for the autopsy report. CPS had told us they had no proof we had killed the baby, until the autopsy report came in. I was also told by our case worker that she had a nephew and she couldn't imagine how hard it would be if he died, so she knew exactly how I felt.

Shadowing my pregnancy was the thought that maybe my son had some birth defect we hadn't caught, and worry that I still had not at 22 weeks felt my baby move. Two things happened, shortly after one another, at that point. The autopsy report came back inconclusive. They had no idea why my son died, and other than telling me it was unlikely to occur again, we had no answers. CPS was forced to close their investigation, although I was told that regardless of what the autopsy showed, they believed he had died from overlay, and their report would show that. I did go to the head of CPS and file a complaint and get the records changed.

The second thing is that I had my 24 week appointment. The doctor did the exam and then casually said that "Oh by the way, your blood work came back wierd from the screening, so it's no big deal, but you need to see a high risk OB/neonatologist and have at least a high resolution ultrasound and possibly an amnio, because something may be wrong with the baby." I was shocked, and of course, a nervous wreck. It took two days for the doctor's office to call me with an appointment and it was a week before they could fit us in.

We sat through genetic counseling and were told that the test for down's syndrome had come back with indicators she may have downs. We declined an amnio, and went in for the US. What we found was a healthy baby that was 10 days younger than her due date suggested. They could not guarantee that she did not have downs, since we declined the amnio, but said she looked good. We also found that I was not feeling much movement because her placenta was anterior.

I knew for sure when my LMP was, but the ultrasound did show her dates being off. However, because they were not 14 full days off, the doctor refused to change them.

The next several months were anxiety-laced. I seldom felt consitant movement, and could not shake the feeling that this baby would be born dead. I had asked my doctor about a VBAC. He told me that the hospital would not allow it, and would fight me every step of the way. However, if that is what I really wanted, to wait until I was in labor and then come in when it was too late to do a c-section. I was not sleeping well, constantly waking up to make sure the baby was still alive. When, at 38 weeks, he offered me a repeat c-section, I took it. I wanted the baby out where I could see her. I did not think to take into consideration the 10 day time descrepancy, and the doctor never brought it up.

My daughter was born via c-section, almost 4 weeks early. She had trouble breathing, and was in the nursery for 6 hours before I saw her. She also has a deep sacral dimple which they x-rayed before I ever saw her. They would not tell me anything until the x-ray results were back in. The spinal they tried to put in, only took on 1/2 of my body. I was told they were giving me oxygen to help the medication circulate. Instead, they gave me general anesthesia. My husband was "allowed" to watch them do surgery from the foot of the bed. They told him there was no reason to sit by my head since I was out.

When my daughter was 6 days old, she developed a nasty congestion. I took her to the doctor repeatedly. I was told that I was just understandably paranoid, and that she was fine, just had some newborn stuffiness. Finally, I insisted they test her, and she came back positive for RSV. The doctor told me she was on her way out of it, and not to worry. That night, as I sat up holding my daughter, she started coughing and could not stop. She coughed continuously for several hours, occassionally turning bluish in color. I finally took her to the ER and she was sent to the Children's Hospital over an hour away. Again, I was not allowed to ride in the ambulance with my baby, but was taken to the hospital by my sister.

My husband stayed home to be with my oldest. He came the next day to stay with us, leaving my oldest with my parents. They put my baby on oxygen, and I spent the next nine days sleeping in a chair, away from my first daughter and scared to death. We waited through pertussis tests and quarantine, x-rays and blood work and finally, she was sent home when she was 16 days old, the same age my son was when he died.

I began reading, and became certain the c-section was responsible for my daughter's health problems. I was determined to avoid another one. When I became pregnant with my third daughter, I found a midwife who would let me have a homebirth after 2 c-sections. The money was tight to pay for her, but I was ecstatic. Then, after my first appointment, she called me to tell me that Texas had passed a law prohibiting her from attending my birth. I was wrecked again. I also found out later that was a blatant lie. Had I known, I could have gone to another midwife, but I had no reason to think anyone would tell me differently than she had.

My previous doctor was back in town and I saw him for a couple of visits, then began looking for someone who would help me have a VBA2C. I found a doctor in New Mexico, who was not excited about it, and insisted I get an epidural "just in case" but who would do it none the less.

My daughter's due date came, and I had a doctor's appointment. I was showing no signs of going into labor. The baby was still high and floating. My doctor said normally she would let me go one more week, but she had been called out of the country on a family emergency, and the doctor who was taking over for her would not allow me to have a VBAC. I was told he would section me regardless. The choice was presented to me as- 1. have a section with a doctor I trusted before she left town 2.. have a section when she got back in 1 week or 3. have a section when I went into labor with a doctor I did not know. After an hour of crying and talking to my husband I went with option 1.

The c-section was by far my best, although the baby was once more kept in the nursery for 5 hours for observation and breathing troubles. I was given a spinal, and once more my husband had to wake me up every couple of minutes. I did get to see her after she was born for a few seconds, but I do not remember it very clearly. And once more, when she was less than 2 weeks old, she was hospitalized for RSV.

My home is smoke-free and free of other risk factors for RSV. The only common denominator was the C-sections.

My 4th daughter, I did not want another C-section. I planned a UBAC. The following is the birth story that I posted to my web group,

As you all know, I had planned a UBA3C, and it is to my sincere disappointment in myself and grief for the birth I had planned that I did not get it. In the past, I have had fairly traumatic birth experiences, including one vaginal birth that was super-intervened into and three unnecessary c-sections. This birth left them all in the dust as far as bad birth experiences went.

On monday, after weeks of contractions, and days of strong contractions, my contractions settled into a pattern of a contraction that took much of my focus about every 7 minutes. I laid down and tried to sleep, but was awakened off and on throughout the night. Still not really believing that I was actually in labor, at 5am, I was unable to go back to sleep, as the contractions were coming about 3 minutes apart and took all my focus. At this point, I had still not had any bloody show, lost my mucus plug or broken my water. The baby was still moving well. I labored alone for 2 hours or so in the tub. About 7 my husband came into the bathroom and helped me focus on breathing. By this point, my contractions were less than 2 minutes apart.

No position change helped much, and the contractions continued to get closer together and stronger. At this point, let me say that had someone been here besides my husband who was great, the outcome may have been different, but the only labor I had ever experienced was pit-augmented and arom augmented. Everything I had read over and over in the last few weeks basically said I couldnt be too far into labor without the show even though my contractions were so strong and close together. However, I half expected to give birth with every contraction that is how strong they were. (Please forgive me this email, I am crying as I write it, and trying to explain things to myself as much as anyone). I know that I had not slept in 4 days due to contractions and I was falling asleep in the small rest between contractions, only to be awakened as they began to peak. The contractions I stayed awake between were the easiest because I could prepare myself, but as the morning wore on, I found myself falling asleep more and more frequently.

By 11:30 am I had been having contractions that were less than 1 minute apart for several hours. My husband was not prepared for them, and to be honest, neither was I. I went from no real labor pattern to hard-core labor in no time, with very little preparation. Again, had someone been here it might have made all the difference, but the two people who were supposed to come both ended up having family situations that prevented them from making the drive.

Still having no signs of eminent birth, other than the contractions, I was getting worried. I had had three days of contractions that were not too bad, three days of contractions that were stronger and was desperately afraid that I would continue in the labor pattern i was in for longer than the baby and I could take. There is no way to say it that makes it better: I did what I had sworn I would NEVER do, and went to the hospital...

When I got there, they sent my husband to admitting and took my to labor and delivery. They began doing the prep for me to give birth and when they checked my cervix i was at 6cm. About this time, it all came unraveled. They called the doctor who had done my early prenatal care, and he informed them that I would have to have another c-section because he would not deliver me vaginally. I fought and argued with them and was told that they would be doing a c-section and that it would be a race to get me on the operating table before I was ready to push. My husband was still not there, and my contractions were getting if anything stronger. During them, I was pushed to sign consent forms, given an IV, had my blood drawn and was constantly being bitched at because I should have known a vbac was not a safe option for me (their words) and how could I have waited to come in until the baby was three weeks past due, i was so irresponsible (their words again).

I fought and cried and begged and was wheeled off to surgery without my husband. I found out later, that when the doctor was called and told I was in the hospital in labor, he was screaming obscenities and throwing charts, mad that I "had put everyone in that position". They checked me before I went to the OR and i was 8-9 cm.

They tried to get the spinal in 8 times, through the contractions, the whole time complaining that I was not holding still, even though the contractions were about 40 seconds apart. Finally, with me pleading for them to do something, anything, they made me lay down, gave me the foley, lectured me about how unsafe general anesthesia was for the baby, and put me under. As I lay there, waiting for them to turn on the gas, I just wanted to be dead.

Let me add here, that the OB "checked" me before putting me under and told them it was fine I was only 5 cm and the baby's head was high. How is this even possible except as a way to cover his own ass?

I woke up in recovery, already hurting from the operation, since I had no pain medication outside of general anesthesia. I was told that I would need to let them know as soon as I began to hurt to stay on top of the pain, and that they would let my nurse know and she would get me something when I got to my room. They wheeled me into my room, and transferred me to my bed. My husband and girls were there, and although it had been over an hour since the baby was delivered, they would not tell him how much she weighed or how big she was, and he had not gotten to see her.

After 30 minutes I called the nurse's station. I was told they would bring me medication. 30 minutes later I called again, same response. I was really hurting by this point. The CNAs came in to change the pad underneath me. They asked if I could feel my legs, as I lay there with tears running down from my face from being shifted for the chux change. I told them I had been waiting for pain medication, and they called the nurse's station. An hour later, the nurse brought me something for my IV. She pushed it through, laughed off it taking so long, she was very busy and left.

Almost immediatly my arm began to burn. I have had enough IVs to know that it happens, but the burning became more intense, and when I looked at my arm it was swollen hugely above and below the tape and my entire arm felt like it was on fire. I called the nurse's station and they came down to check it. Come to find out, when she pushed the medication through she blew my vein and pumped all the fluid into my arm instead of a vein. She said "I guess I should have checked the IV huh?"

They put the IV in the other arm and said not to worry the swelling would go down in a couple of days it really wasnt that bad. My husband went to the nursery two more times and I called the nurse's station countless times to find out why I had still not seen my baby. They still refused to give us any information on her. 4 hours later, I finally got to see my daughter for the first time.

I was told that they were very unhappy that she was past-due (her skin was peeling and her nails long) and that they had trouble getting her body temperature regulated because she was so late. I was not aware this was even in the realm of reality (so please correct me if I am wrong) and that due to the fact that she had merconium staining they had bathed her several times. My giant past due baby was 7lbs 6oz and 21 inches long. She is tall and very slender. I cannot imagine what she would have looked like had I gone in at 38 weeks (as this doctor prefers) and let her be taken 5 weeks before she was ready. I suspect she would have had a long stay in the NICU. Anyway, after enduring yet another lecture about the dangers I had put her through, they finally left us with the baby.

I will wrap this up quickly, as I know it is long, and not what I am sure many of you want to be reading. Over the next two days: Due to the veins in my left arm being blown and the IV in my right they had a hard time taking blood every two hours, which is what they insisted on. I have needle tracks in my hand, my wrist and up and down my left arm, not to mention the swelling from the initial IV and bruising from the blood draw while I was in labor (once from each arm). I was never offered pain medication, and instead had to call for it and wait, sometimes as long as 3 hours. The nurse told me there were several times she never found out I had called for pain medication until I called down and had her come fix my IV.

Although my foley catheter and IV were supposed to be out after 24 hours, it was almost 32 before the catheter was out and 37 before the IV were out. When I complained I was told that it was basically my own fault, and that they were busy and would get to it when they could.

The last night I was there, I was given a pain pill that 7 hours later still had my dizzy and so drugged out I could barely keep my eyes open and no one would tell me what it was, just that it was something for pain.

I have almost no feeling in most of my belly externally. I have been crying almost non-stop since the delivery (HA you cant even call it that). My husband does not understand, and to be honest I feel numb and hollowed out. Having had three sections I never really understood how people could endure them and look at their baby and feel nothing, but for me it was almost 2 days before I could even take joy in her. The rest of the time, I was going through the motions in hopes it would come. I dont know what to do at this point.

Having dropped my prenatal care and doing my own and planning for this UBAC had seriously empowered me so much and I feel like a complete failure... I feel like I gave in too easily, although part of me knows that isnt true, and I feel betrayed. Yet part of me feels like maybe I got what I deserved. I don't even know if this makes sense, but I wanted to be able to tell someone who might understand, and I thought if anyone would it would be you guys. I can tell you that I will never set foot in another doctors office or hospital if I am still able move on my own.

Michele Henson
http://creative-mommy.blogspot.com/

5 comments:

Kayce Pearson said...

As I read this, tears are streaming down my face.

I can't believe they would treat you this way. I know it happens everyday, but every time I hear a story of it, it brings back the hate and anger from my cesarean.

I am so sorry that this has happened to you. You should not have been treated this way over and over again.

I know you can do a UBAC. I know you have the strength and courage to do it.

You are not a failure for having another cesarean. You just live in a system that does all they can to make pregnant women feel like they don't know what they are doing and try to section as many of them as they can.

I know you can do it next time! It's your baby and your life, you can do it.

Lisa said...

I am so sorry for what you've had to go through. Did either you or your husband sign consent for the cesarean? It just sickens me that they completely violated your right to choose how to birth.

You didn't fail, you were failed by a system that abuses women & babies for profit.

Michele said...

thank you for your kind words. i am working on healing past the last c-section. it will be a journey i think, but if i can help others along the way then some good can come out of what i believe was evil done against me

Defrazzled said...

Hi, I am amazed at how horrible your experiences were! I just had my third cesarean and the last one was the best! I was up and walking really fast and had a great bonding experience w my baby in the hospital. I was healed enough to resume all of my normal activities and pain free just two weeks after! I know not all women have such a positive experience but it is possible!

Cesarean Epidemic said...

I am not the writer of this post, just the blog admin, but I have had 2 cesareans, one not by choice and they were both horrible experiences. I cannot understand why anyone would opt for a cesarean or how they can make them a "great" experience.