Set Up.

Okay, so maybe I was jumping the gun a little, but I was curious.  First, let me say that I am NOT pregnant at this time. 

I booked an appointment with New Dawn, the main midwifery in town, just to see what our options were in the case that we were to get pregnant again.  (We aren't trying, but we also aren't preventing.  Nursing is a form of birth control in itself, called the lactational amnorrheic method if you are interested in more info.) 

The appointment was yesterday, and I was really looking forward to chatting with someone in the field about my birth experience and my future possibilities.  The midwife I met, Alicia, (I think I am remembering her name correctly), was really nice.  She was compassionate as I related my story to her, and understanding when a couple of tears made their way down my cheeks. 

She informed me of some shocking statistics, such as, when a woman is induced for her first labor, her chances of emergency C-section are 60%.  60%?!  She also told me that Mission Hospital’s rate is more like 80%.  WHAT??!  (Also, the national average of C-section births, as I have mentioned before, as about 33%; Mission’s is more like 40%.*)  

Can you imagine how angered I was by this??  I felt absolutely set up.  Surely my OB knows these rates.  I feel almost deceived.  Like a lie of omission.  I was very, very clear on my wishes for a natural birth and as little intervention as possible.  I feel like, knowing these outrageous numbers, she should have informed me of them. 

My hearing that I’d need an emergency delivery after 23 long hours of labor wouldn’t have come as such a shock.  Who knows, I may have opted not to be induced at all.  I can’t tell you what I would have done, but I can tell you that I am super upset.  Should I confront her?  I almost feel like switching doctors.  The thing is, though, that I really like her and I don’t think she intentionally deceived me.  I just feel like this is the kind of information every pregnant mother should know. 

Also, I believe I had said in a previous blog that the delivering OB had told me that my pelvis was too narrow and I wasn’t a candidate for VBAC for our next child…  The midwife looked at me in a way that told me she couldn’t believe what she had just heard.  She said that unless there is an extreme case, like disease or a pelvis that has been broken and wired shut, any woman’s pelvis will open and relax enough to vaginally deliver her baby. 

She also told me that it is best to wait at least 6 months, preferably a year, to try to conceive after having a C-section.  There may be placental attachment issues if enough time has not been given to the incision to heal, and the chances of uterine rupture go way up as well.  She said that their policy is that if a woman becomes pregnant before enough time has elapsed, the baby will automatically be delivered via Cesarean Section, that they don’t risk the “trial of labor”, as a VBAC is referred to in the medical field. 

Huh.  That gives me a lot to think about.  I hope it gives you something to chew on, too.  My next question is: what do we do to inform expectant mothers of this appalling information?  How can we become advocates for those that wish to deliver naturally?  I’m really fired up about this and want to reach out to others.  Any ideas? 

*A bit of good news, though: Mission’s VBAC success rate is somewhere between 60-80%, and New Dawn’s is around 90%.

Thoughts on Cesarean Section

So the question I want to pose is: why are there so many Cesarean Sections performed in the US now?  The rate for C-sections in the US is now at 33%!  One in three!  According to The Womanly Art of Breastfeeding, the World Health Organization sees 10-15% an acceptable rate.  So why?

Well, I am beginning to come to the conclusion that doctors are afraid of malpractice suits.  They see all the possible risks and things that could go wrong, instead of relying on the woman’s body (that knows what to do and has since Eve had her first baby).   Now, I understand that things have gone wrong in the past and can happen at any time, with any woman and with any baby.  But these things do not happen every day, nor with every woman or baby.  So why does it seem like all pregnant women who choose to use an OB instead of a midwife are treated like this?  Not every delivery is going to be life-threatening or cause serious debilitation.   

I had originally wanted to utilize the services of a midwife to deliver Lydia, but I got really comfortable with my doctor, who is a Christian, and who I felt would do everything in her power to keep me from having any form of intervention, let alone a C-section.  (Not that I blame my doctor, I blame myself really, for allowing myself to get anxious about getting the baby out of me.)   At 36 weeks I was measuring like I should have been.  Then at 37 weeks, I was measuring like I was at 35 weeks.  Worried, the doctor scheduled an ultrasound for 39 weeks and determined at that time that my placenta was on the decline.  She decided that she was not comfortable letting me carry too much past 40 weeks, if I did, and so we scheduled an induction for 40 weeks and 5 days, just in case.  And of course, you know the rest if you’ve read my previous entries. 

What would someone have done before the time when they had ultrasound?  Would they have induced me back in Bible times or even a hundred years ago?  I think not.  I know that medicine has come a long way since then, but, as my husband says, “they call it the PRACTICE of medicine for a reason”. 

So I am going to try for a VBAC (Vaginal Birth After Cesarean) for my next baby.  I am going to consult with a couple of the midwiferies in town and discuss my options.  (On a side note, the lady that was my parent’s Lamaze coach and also the person who delivered me at the time of my birth, Beth Korb, is in practice at MAHEC, a branch of our hospital here!  I’m going to try to meet her.)  I hold nothing against my doctor, but I believe it was said best by Ricki Lake and Abby Epstein in their documentary “The Business of Being Born”, that obstetricians are surgeons.  They have no business delivering babies.   (By the way, I recommend that any of you ladies thinking of having a baby watch this movie.  It is highly informative and will get you thinking.  Plus, you get to see some babies make their way into this world!)

I have been researching some about VBAC, and WebMD actually recommends that women at least try to have their baby vaginally after having had a C-section, because even a little bit of labor is good for the mother and the baby.  They call it a “trial of labor”, and up to 60% of women have successful VBACs.  Of course there are certain risk factors that make your chances of success go up or down, but that's true with any major medical or bodily occurance.

Something else that I am curious about is that the delivering doctor, who was not my OB, (I had been in labor so long that my doc's 24-hour on-call shift had ended) told me that my pelvis is too narrow and that VBAC would not be a good idea.  Where did this come from all of a sudden?  She was not the doc who examined me weekly and don’t you think that my doctor would have noticed something like a too-narrow pelvis before we started trying to deliver vaginally?  I have my annual on Monday, and I plan on discussing this at length with my doctor. 

Another thing that disappoints me about having the C-section with Lydia is that now I am no longer a candidate for home birth.  This is something that interests me b/c it seems so natural.  Where were babies born before there were hospitals?  Home.  Some people may think that home deliveries are insane, but successful ones happen every day.  It just seems the perfect place to start life out, don’t you think?  At home, where mama is comfortable and surrounded by familiarity.  At home, where you have everything you may need for your newborn.  At home, where you (hopefully) aren't surrounded by bright lights and unfamiliar faces barging in on you at all hours.

Though I am saddened by all this, I won’t let it get the best of me.  I am still capable of bringing babies into this world, and I do plan to.  The Lord has been very good to me and James, and we have been truly blessed with our wonderful daughter.  We are looking forward to the day when we get to bring her siblings into the world, no matter how they come.    

Us with Lydia, who is 3 days old in this photo.

Cesarean Section and Nursing (for me)

Did you know that women who have a C-Section have a more difficult time bonding with their babies?  I can honestly and without shame say that I experienced this.  I felt a strange disconnect from Lydia for quite some time.  I knew I had gone to the hospital and I knew she was my daughter and that I loved her, but I wasn't just crazy about her the way that my friends were with their babies. 

This is because when you deliver vaginally, immediately after the baby comes out your body begins producing Oxytocin, also referred to commonly as the "love hormone", or the "bonding hormone", which causes several things to happen.  Your uterus begins to contract so as to stop bleeding, for one, and for another, is gives you a rush of affection for the tiny creature that should be lying by now on your stomach or chest.  When a Cesarian is performed, your body doesn't generate its own Oxytocin, but rather it must be administered intravenously in its synthetic form, Pitocin.  I'm sorry, doctors and pharmaceutical companies, but what you make just can't compare to what my body can make! 

Having a C-section also causes challenges with breastfeeding to present themselves.  First and foremost, you are recovering for a major surgery.  Second, having a newborn is just plain overwhelming, no matter how many nurses or family members you've got to lend a hand.  Third, the mechanics of nursing with an incision on your abdomen are rather complicated.  They tell you and try to show you all these positions to nurse and different tips and tricks, but nursing in itself is painful starting out and then your baby wiggles and your incision is throbbing. 

There were only two things that got me through the first 6 or so weeks of nursing: prayer and sheer determination.  I would cry and cry both when I was nursing Lydia and after, and when it came time to do it again, I'd cry b/c I didn't want to go through the pain of feeding her, and then of course I felt guilty b/c I didn't want to feed my child, which made me cry even more!!  What a vicious cycle.

So the nursing hurt.  A lot.  I decided to give by brand new (and totally awesome, might I add) Medela breast pump a whirl and see if it hurt more, less, or the same.  It wasn't as bad as nursing, so I thought I'd pump and just bottle feed her.  That worked really well, except I had to lug around bottles and a thermal bag with ice packs in it all the time.  Plus, there's the inconvenience of having to pump all the time and then when you don't, you get engorged and that sucks, too. 

Let me get off track a little for a second here.  I have a friend, Jen (whom I have nicknamed "The Jenefactor"-- like benefactor) who has been so amazing.  She was very helpful and informative through my pregnancy and also gave me a ton of her daughter Shelby's clothes (Shelby is 8 months older than Lydia).  One of the ladies that works in Jen's office (Jen is a chiropractor) had a family emergency and was going to be out of the office for a while.  I told Jen I'd gladly fill in, and so I did.  Jen is a wellspring of information, constantly giving me advice, references, tips on products, and lots of other useful tidbits.  Anyhow, while I was working in her office, I borrowed a book of hers by La Leche League called The Womanly Art of Breastfeeding. 

This book is AMAZING.  It has everything a woman needs to know about breastfeeding, from pregnancy to weaning.  Anyhow, I read in this book that with breastfeeding, that it's not just important that your baby gets the breastmilk, but also the mechanics of how the baby gets the breastmilk.  When nursing from the breast, a baby's jaw is massaged differently than when fed from a bottle.  The palate is spread differently, and babies that are nursed for at least a year are far less likely to need braces later in life.  Also, the coolest thing I learned is that when a baby nurses, any germs that they may have picked up along the way get "communicated" to the nipple, and the mother's nipple then generates antibodies for those germs that get picked up the next time the baby nurses!  How cool is that??

Anyhow, to get back on track, it is because of this information that I decided to strictly nurse Lydia, not just give her breastmilk from the bottle.  This has caused us to become so much closer...  I have gone from not liking nursing AT ALL to thinking it was okay (when I was pumping and bottle feeding), to now, where I love it and can't imagine my life without it.  It makes my daughter happy and helps me to feel bonded with her.  I feel more now like she is MY baby, not just A baby. 

I don't know if my C-section caused me to have such difficulties nursing or not, but I can't imagine that it made it anny easier.  I can't change the past, but I can move forward with more knowledge, wisdom, and comfort knowing how I want to want to approach the delivery of future babies.

Me and Lydia right after nursing.  She was 2 weeks old here.  :)

My Birth Experience

So now that the initial shock of becoming a mother has worn off, I have some reflections. 


Giving birth is quite an experience!  At 39 weeks, my OB determined that my placenta was on the decline and she didn't feel comfortable letting me carry Lydia too much past 40 weeks.  We set an induction date for Tuesday, May24th (I was 40 weeks and 5 days). 

This didn't really fit in with my plan of having as natural a birth as possible, but the doc was sure that this was the way, so...  We checked in to the hospital and got settled, then they began pumping me full of Pitocin.  Yuck.  Contractions began after a while but the staff wasn't satisfied with my progress, so they decided to break my water in hopes that it might bring on stronger contractions.  That was EXCRUCIATING and exhausting, even though it only took a few seconds.  Things began to increase in intensity, but after several hours, they checked to see if I was any more dilated.  I was not.  I began to get very discouraged...  They kept increasing the Pitocin at regular intervals which made my contractions sooo strong, but I did not want any epidural, so I dealt with it. 

After I had been in labor all day and in to the late night, we got a nurse who I really clicked with.  Her name is Lauren.  She was so compassionate and caring, she was definitely in the right profession.  When we had initially checked in, we had requested one of the garden tub rooms so I could labor in the water, but they were all occupied.  At about midnight, Lauren told us a garden tub room had been vacated and that she was filling the bath for me.  We relocated and I got in.  The tub was AMAZING.  I would recommend laboring in a bath to any expectant mother.  The warm water is so soothing to the joints and it makes you feel light and bouyant, which is nice after carrying a baby so long and feeling like you weigh 9,000 pounds. 

I got out of the tub after a couple hours, and then I labored for quite a while on the birthing ball, which was also nice b/c it allows your pelvis to spread but takes the pressure off the bones at the same time.  Some time around midnight or so, the baby turned over.  She was head down, but facing my front now instead of my back, which they call "sunny-side up", and which put me into back labor.  Back labor was the worst part of my labor for both me and James.  My contractions were a minute apart by now and very strong, and poor James was alternating between pushing on my back as hard as he could to ease my pain and sleeping with his head on my bed when they were not happening. 

I had dilated to about 6 cm and then my body started pushing on its own.  The pushing isn't supposed to happen until you are fully dilated (10 cm), and this caused my cervix to swell.  The pitocin was causing such strong contractions that I couldn't stop the pushing!  (I admit though, the pushing felt good.  It was a relief after all the hours of build up to that point...) 

I finally made it to 9.5 cm at about 6am on the 25th.  (We had checked in to the hospital at 7am the day before, so this was getting to be quite drawn out, and up til this point I had elected to have no epidural or any pain meds at all.)  I was not progressing past this point, so Lauren and James talked and they decided it would be best for us to get some rest, and told me that I needed to get an epidural.  I conceded.  The anesthesiologist came in and got me set up, and said that it could take as long as 15 minutes to kick in, but it was literally only about 10 seconds and I didn't feel a thing.  I was lucid.  It was, admittedly, very nice. 

We laid down to rest, and even though my contractions were still happening every minute, I didn't feel a thing.  The next nurse came in about 9am and checked me, and I was still at 9.5 cm.  She and my OB decided that we should try to push past the last 1/2 cm, and so we got to it.  The next thing I remember is them telling me that they were having a difficult time tracking Lydia's heartbeat, and so they checked me again.  I was 8 cm.  Then I was 7 cm.  Then they checked me again and I was 6 cm.  She had retracted back up into my uterus!  They told us it was time for an emergency C-section.  I asked for a couple minutes with James, and we prayed and I cried.  This was not at all what I had imagined. 

All of a sudden, all these people in scrubs started coming at me, (I think they must have been hiding behind the doors and curtains, just waiting for the cue), they doped me up, painted me with Betadyne (sp?), shaved me, slapped my butt and sent me to the OR.  I couldn't feel a thing from my chest down.  Poor James barely had time to react, they had him running all over trying to stash his work laptop and all our stuff (we'd been advised to bring everything but the kitchen sink with us to the hospital).  From what I understand, he barely made it to the OR before they had to operate.

They put a drape across the top of my belly so we didn't see what was going on.  They had my arms out to my sides (like a cross) and weighted down with heat packs.  With my carpal tunnel syndrome, they fell asleep quickly.  I guess the operating staff don't like to work in silence, so they asked James what kind of Pandora station he thought would be good, and he said Christian Rock or something like that.  A few minutes later, as Casting Crowns' Until the Whole World Hears came on, we heard her cry for the first time!  It was 10:47am.  Everything else is a blur of tears, hormones, and sleep deprivation.  I remember them asking me if I wanted to hold her, but my hands were asleep so I said that James should. 

As we touched her skin and looked at her perfection for the first time, we cried and cried and cried...  What a moment!  She was gorgeous, the mostbeautiful thing I'd ever clapped eyes on.  I will never forget how seeing my daughter at last just seemed to erase the events of the last day: the pain, the frustration, the horror at hearing that a C-section was necessary.  But, as I have said a hundred times since that day, the end result is the same.

Or is it?

Me holding Lydia for the first time!  What a moment...