Tuesday, March 31, 2009

Real Women. Real Lives

Cesarean Awareness Month
April 2009

Alexander's Cesarean Birth Story

Alexander, the star of the show

Please visit http://www.ican-online.org/ to learn more about cesarean prevention and recovery.

In February of 2002, while working as a CNA at a nursing home in Indiana, I got an accidental triple dose of Depo Provera from the charge nurse on duty that caused me to have amenorrhea and seizures.

The Depo Provera had been prescribed to one of the elderly patients at the nursing home who had been experiencing massive, unstoppable uterine bleeding even though she was in menopause. The docs prescribed the triple dose to stop her from bleeding, and the medicine did what it was supposed to do, so the doctors discontinued the medicine for the woman. The charge nurse didn’t realize that it was triple the normal dose for a healthy 20 year old looking to control her fertility, and when I told her that I was planning to go to a clinic to get the shot the next day, she told me that she could give me the shot right then so I didn’t have to waste my time and money. Who knew that a simple 2 second injection would cause me to have four years of amenorrhea and seizures that have not stopped to this day!

Most men would run for the hills when their girlfriend of just a few months started having such serious health problems, but despite all the medical problems, my husband and I married in March of 2002. I was in between stays in the critical care unit of the hospital, I wearing a heart monitor, and a pretty flowered Sunday dress. My husband wore a white shirt and tie with his black jeans. Neither of our local parents approved of the marriage and so we were married in front of the local judge with his two secretaries as our witnesses. There was an ice storm that day, and our tires on the car were flat, so my husband had to fix the tires wearing his dress clothes before we could leave. After the marriage, we stayed in the car for three days because neither of our parents would take us in. We had been staying at his parent’s home before the marriage.

click to view a larger version of our wedding vows

We struggled for 3 ½ years through my health problems, going from one doctor to the next trying to figure out why I was still not having periods after so long… no one could answer the question, and better yet, they all said that the Depo Provera, while being an unfortunate accident, could not have been the cause of my seizures that started the day after I got the shot…. I also was able to, despite my health problems, go back to school to get an Associate’s Degree in Paralegal Studies before moving to Washington state in July of 2005.

When we moved to Washington, my mother suggested that I see a ObGyn who was a specialist in reproductive health and who saw her when she was pregnant with my older sister and I. He actually delivered my sister and I via c-section, and was hailed at that time as the foremost expert in women’s health in the area… that was 25 years before I first saw him for my own problems. He prescribed Glucophage (Metformin) for me to take and I was amazed to see that for the first time in almost four years, I had a period! I was overjoyed and thanked him profusely for returning my fertility and restoring that part of me that I had lost to Depo Provera. That was August of 2005.

I found out July 7th 2006 that I was pregnant. My husband had taken me to the emergency room because I had been having trouble breathing. The doctor wanted to do a chest x-ray and asked me if I was pregnant. I told him, rather proudly, that it was possible because I was sexually active and I had a healthy reproductive system. He knew nothing of my history and thought I was being cheeky, but I didn’t care, I was just happy that I could actually say that I had the possibility of being pregnant. I didn’t think I was, of course, even though we had been using natural family planning techniques to get pregnant for months. The doctor ordered a urine pregnancy test just to be sure before he preformed the x-ray. While we waited what seemed like 15 minutes for someone to come in and tell us that I could go have the x-ray done, we joked about how we would celebrate if I were really pregnant. The x-ray tech came in and said, “Well, I guess we will just have to use a lead shield, now won’t we!” My jaw dropped. I asked him if that meant I was really pregnant and he froze. “They didn’t tell you yet?” I told him that we had not heard anything yet and he turned on his heel and left the room without another sound. He came back with the nurse who had preformed the test and she perfunctorily told us that the test was positive and left. My husband and I collapsed into each other in tears. It was a miracle! WE WERE PREGNANT!!!!

Of course, we continued to see the ObGyn, who we hailed for returning our fertility to us, for my prenatal care. It turned out that I was already 7 weeks pregnant, and so the doctor stopped my Glucophage treatment, as we had only been using it to get pregnant. For the next 3 months, we researched every little thing we could on pregnancy and came to the conclusion that we would be trying for a natural, unmedicated childbirth. When we broached the topic with our miracle worker of a doctor, he told us, before we got to the part about wanting to do it naturally, without medication, that he was sure that we would be needing a cesarean section and got out his calendar to schedule it.

I was floored. Here I was 5 months pregnant, I had gone through every test this doctor wanted me to go through, had been pronounced healthy and praised for my dietary choices and other habits such as the fact that I had never smoked or consumed alcohol in my life, that I had no diabetes, liver problems, heart problems, etc… that normally plague women of considerable size. I had miraculously, and for no known cause, stopped having seizures since I got pregnant. (We were actually celebrating the end of my seizures before we found out I was pregnant, and were attributing the miracle to the fact that I had regained my fertility and thought that the seizures were hormone driven and that they were finally gone now that I was back to normal.) And the doctor wanted me to schedule an elective c-section JUST BECAUSE I WAS OBESE!!!!!

I sat there dumbfounded for several minutes before I could speak, and then all I said was “No. I want to have a normal birth.” My husband was so shocked that he could not even collect his thoughts till we were in the car on the way home. The doctor argued with me for quite some time, telling me that it would not be safe for a woman of my size to vaginally birth a macrocosmic baby, and they were estimating by the ultra sounds that my baby was to be about 10 pounds at birth. I told him that I would still like to at least be given the opportunity to try. He told me that my mother had a small pelvis and that was why she had to have c-sections with her three children, and that it was likely that I also had a small pelvis. I told him to check MY pelvis and make a determination on MY health, not my mother’s health because her genetics only made up half of my genetics. At the time I didn’t realize that pelvic structure is NOT an inherited problem. He finally agreed to let us have our way. We didn’t ever get to tell him at that time that we were considering a natural, unmedicated childbirth.

I started to have sciatic pain about this time, and Dr. Z sent me to a physical therapist who did wonders for my pain. I also started having seizures again when I was 6 months pregnant, because of the stress from the seizures resuming, my blood pressure started to rise. However our doctor said that it was normal for anxiety to cause elevated pressures and was not concerned that I was experiencing pre-eclampsia. He started having me come in frequently to have my pressures checked though, because it could still cause problems for my baby. I also spent much time in the hospital maternity ward having my baby’s heart tones checked and making sure that my seizures were not affecting him. During one of my visits to the hospital, our doctor ordered that I be given Ativan, and anti-epileptic medication, by IV. I told the nurses that I did not have epilepsy and had been on every anti-epileptic from here to the moon and none had been effective. They telephoned the doctor who told them that if I was going against his medical advice that they should discharge me. I was in the throes of a seizure for crying out loud! I didn’t want to be discharged until it was over and we made sure that my baby was fine. I agreed to take the Ativan, with the stipulation that they only give me half of the one milligram the doctor had ordered. They talked to the doctor, who agreed, and we proceeded. Thankfully, none of my seizures throughout my third trimester ever affected my baby.

Despite our growing uncomfortable feelings about our doctor, we continued with him for a few more weeks till we decided to go over our birth plan with him. He had been reading our birth plan, snickering every few seconds, and telling us that we had unreasonable expectations and that it was normal for first time parents to have these wild fantasy births all concocted in their brains but that reality was much different. Then, we told him that we were taking the Bradley Method classes. He stopped cold, and sat completely frozen for a minute before telling us that “Those people don’t like me.” He told us that if we were set on continuing in the Bradley Method that we would have to find a different doctor.

We obliged.

We transferred to another doctor in his practice. OUR FIRST VISIT, she comes walking in the door with a scowl on her face, looked at my chart briefly, and turned to us and said, “Why did you want to switch from Dr. Z?” We responded that it was at his request that we transfer, because he was uncomfortable with our birthing wishes. She frowned and looked again at my record and said, “You know, you will HAVE to have a cesarean because you are fat.” I looked at her incredulously, thanked her for her time, and left.

Because we are on state Medicaid, our choices for an ObGyn were very limited, unless we wanted to travel out of our county…. Or get a midwife. I started calling around to the local midwives and found that only one of them took my insurance…. And she wasn’t willing to take me on because of my seizures and my weight. We ended up at the other ObGyn practice in the county that accepted our insurance. The doctor I wanted, who had been recommended to me by the midwife I talked to because he was very natural minded, was going to be unavailable in February of 2007 when my baby was due, so I was placed with another doctor in the practice. Dr. K was fantastic, he was very congenial and put my husband and I at ease. We went over our birth plan with him and, after making some minor changes, he said that he could accommodate our wishes, unless my or my baby’s life was in danger. We were pleased that our last option for a local doctor was going to be such a nice one.

Dr. K didn’t get a complete medical history from my previous ObGyn. He got the chart notes and test results…. That was it. Based on the fact that an ObGyn had prescribed Glucophage to a woman, he wrote in my notes that I had Gestational Diabetes, completely disregarding the fact that my glucola test came back normal and that the Glucophage had been discontinued at the beginning of my pregnancy. He also, looking at the recent rise in my pressures, diagnosed me with pre-eclampsia, and did a 12 hour protein urine test on me. (I had to take a large bottle home with me and every time I peed for 12 hours, I had to put the pee into the bottle.) The test came back with a slight elevation in protein, that was still too low to diagnose pre-eclampsia, but combined with my blood pressures, he told me that we were going to treat me as if I had pre-eclampsia. I didn’t know the whole story behind it, and when I asked him what the treatment entailed he said that it simply meant that when I went into labor that they would put me on IV magnesium sulfate. That was it, that was all there was to it... he said.

When I was 36 weeks pregnant, Dr. K told me that he wanted to induce me at 39 weeks because of my pre-eclampsia... somewhere in the last 2 months I had gone mysteriously from “We’re going to treat you as if you had pre-eclampsia.” to “You have pre-eclampsia.” Where, I don’t know, and to be honest, I don’t even think I protested, as it was such a gradual change… and because of “fetal macrocosmia”. They were predicting that if I went to full term, my baby would be between 11 and 13 pounds. They scared me into believing that it was impossible to push out such a large baby and that if I was not induced, I would have to have a cesarean. I was NOT going to have a cesarean! I had worked too hard to avoid a cesarean! So I agreed that if I had not gone into labor by February 22, that I would agree to be induced... At least he was not telling me to have a planned cesarean… I had had a hard enough time arguing with my family members who thought I was crazy for NOT scheduling a cesarean when they found out that my baby was to be a big boy.

Final pregnancy photos

My labor pains started naturally, on their own, on the 12th of February. We timed them, excitedly, as they grew stronger and closer. When they didn’t go away after we tried all of the things that are supposed to make false labor go away, we called the doctor. It was 8am on February 14th.

Looking back, I would have stayed home throughout the first stage labor and transition period... It probably would have saved me from having a c-section… Ah the excitement of youth and ignorance! We were told to go to labor and delivery at the hospital to see if the contractions were real or false labor. We were admitted at 12 noon on February 14th.

We had managed to retain the services of a Doula. Well to be exact, she was a massage therapist who was also taking classes to become a Doula…. She was a Doula-in-training and was providing her services to me at no charge, because she had to attend so many births before she could graduate. She was also providing me with massage therapy. She had told us to call her when we were on our way to the hospital and that she would meet us there. When we called, however, she told us to call her later, when we were “in real labor”.

When we got to the hospital, we handed out a stack of our pre-printed birth plans. We posted one on our door, had one put in our chart, gave one to every person who was working and had extras for all the people on the next shift. Several of the nurses commented on how thorough the plan was for being only one page long single spaced. How it covered everything, how it was easy to read and skim through to find what they wanted to know. Then we heard those same nurses snickering in the hallway about how unrealistic it was to want a natural, unmedicated, vaginal birth. Comments about my weight were thrown about as jokes. Bets about how long it would take me to cave and ask for drugs were thrown around right outside my door. I was livid.

Dr. K. came in to check on me and saw that they were indeed real labor. He suggested that we induce my cervix that night to speed up the process, as I had been having contractions for 2 days and was only at 1 centimeter dilation. My husband and I agreed because we had already gone into labor… what could go wrong?

He told me that they would insert Cervadil that evening at 5pm, and that 12 hours later they would take out the Cervadil and put me on IV Pitocin. He said they needed to start an IV now though to make sure I stayed hydrated.

I remember mentioning that he agreed to my birth plan and that it stated that I wanted to have free access to light food and water or juice… and was told that it was not a good idea, just in case I wanted pain meds or had to have a cesarean. I told them that I wasn’t going to have a cesarean and that I had my own methods of dealing with the pain, but they ignored me. He was going back on his agreements! This was the beginning of the end… Dr. K also told me that he was leaving that night to go on a family vacation and that Dr. R would be taking care of me.

Boy did they have a time starting the IV! They stuck me 9 times trying to find a good vein! I tried to tell them that they should just start the IV in my hand as the veins there are better than the ones in my arms, but they had to try anyway just to try and prove that they can start an IV in the hardest patient. Finally, they brought in the supervisor who started the IV in my left hand, after popping a vein in my right wrist. I ended up having to have the anesthesiologist come in to adjust the IV later, but it all turned out ok in the end.

As soon as the IV was in, they told me that I couldn’t get up except to go to the bathroom, and then I had to have a nurse present to do so. They hooked me up to the fetal heart monitor and the soothing, rhythmic sounds of my baby’s strong heartbeat comforted me as I was told to not move… for some reason they had trouble keeping the heart tones… later we found out that it was because I had a condition called polyhydramneos (too much amniotic fluid) and my son was swimming away from the ultra sound waves created by the heart monitor… every time they adjusted the monitor to find his heart tones, he would move away. LOL, I should have trusted my baby! He knew that the monitor was bad news!

As soon as everyone cleared the room, I called our Doula back. I wanted to tell her that we were in real labor and that we would appreciate it if she could come down to the hospital and help support me through it. She was in a massage therapy appointment when I called, though, and quickly told us that we should call her the next day when I got put on the Pitocin. Disappointed, yet again. I hung up. It was about 3pm.

Between 3pm and 5pm, three separate people came in to offer me IV pain meds. When I reminded them that my birth plan was very specific about my not wanting pain meds even offered, they each told me that the meds were designed to help me relax and to move things along.

During my Bradley classes we had learned that pain meds can actually slow things down and also can make the baby’s heart rate decel, both of which would move me closer to the dreaded c-section. I tried to explain this to them, but they all tried to persuade me that just a little wouldn’t hurt…. I was reminded of two things…. Drug pushers on the street selling drugs to kids, and crabs on a beach… if you have ever been crabbing at a beach you know what I am talking about. If you haven’t then I will tell you the story:

You can dig a small hole just big enough to put your bucket in to hold it still, so the sand comes halfway up your bucket. Put a little water in your bucket and then start throwing crabs in. They will NEVER get out. No matter how many crabs you put in the bucket, they will never get out. The reason is that as one tries to climb up, the others pull it back down to the bottom in their fury to get out. They never work together to solve the problem, they just keep each other at the same level. Really it is quite sad. It seems the same way to me with some women. They can’t stand the idea that someone might be able to labor without drugs… they couldn’t, so why should anyone else? After all, we all know how horrible labor pains can be, a person would have to be masochistic to want to endure the unendurable… right?

At about 5pm a nurse came in to insert the Cervadil to start my cervix dilating and effacing faster. When she checked my cervix it had dilated on its own to a one. I was excited to see that my body was doing its job and told her that if I was progressing so well that I would appreciate it if they wouldn’t mind letting me continue without being “sped up”. She told me that she HAD to insert the Cervadil because it was doctor’s orders, but that she would call the doctor and ask if it could be removed. She inserted the medicine and left.

She never did call the doctor.

I asked her at about 8pm when I needed to get up to go to the bathroom, if she had gotten any news from the doctor and she told me that she had forgotten to call about it, “You aren’t the only woman on the labor unit you know!” But she did manage to ask me if my pain meds were working well. I told her that I didn’t have any pain meds, and she interrupted me in shock saying that she would remedy that… there’s no reason to be in pain when we have such wonderful medicines out there. I reminded her that I didn’t want pain meds and she scowled at me and tried again to tell me that the meds would have no effect on my baby and that I needed to relax and let my body work uninterrupted… I declined again and she left.

We went through the night having fairly painful, but not unmanageable, contractions about 30 seconds to 2 minutes apart. However, because we were not allowed to move, we were not allowed to listen to our birth cd…we had brought a stereo for our cd, but didn’t know the stereo had to be checked by maintenance before we could plug the darn thing in, we weren’t allowed to eat or drink, because they had a hard time keeping my baby on the heart monitor, I was not allowed to turn on my side, so we couldn’t use massage or counterpressure, or use any of our other means of pain control except my husband just being there… The nurses came in every two hours to “check my progress” which was also painful, as they were nowhere near what I would call gentle. Not to mention the constant barrage of nurses and aides who just wanted me to accept pain meds, it was completely draining emotionally to fight them, and my doula was a no show. By morning we were both exhausted.

A nurse came to remove the medicine at 5am, she checked my cervix again, it had dilated to one and a half. All that work all night long and all we got was a lousy half centimeter! She went away and left us to have breakfast before she started the IV of Pitocin.

Breakfast consisted of one slice of dry toast and 1 cup of lukewarm chicken broth with parsley in it. My husband went to get himself some breakfast. With my contractions slowing down, I managed to sleep a little. I woke to a powerful contraction and my husband sitting next to me watching the spikes on the contraction monitor. Apparently, they had started the Pitocin while I was asleep.

I called my Doula, again to tell her that they had started the Pitocin, and she said that she had some people coming for massage, but she would be there as soon as she could. I wasn’t holding my breath at this point.

My dreams of my ideal birth were being blown away in the windstorm of reality. I began to realize what Dr. Z had been talking about when he said that my dreams were unattainable… I almost wished that I had taken him up on his offer to schedule a c-section just so I could avoid all the disappointment… almost… it was just a desperate wild thought of a starved, stressed, tired, laboring woman who had been on constant defense against the nurses for hours… It was no wonder I had not progressed much, my body was telling me that I was not in my safe place, my cave had been invaded…

By noon, my cervix was dilated on the outside to 3 but on the inside only to 1. I was told that they would be coming in a couple of hours to break my water. I wasn’t progressing fast enough and they had to do something or I would be “timed out” and have to be taken in for a cesarean for “failure to progress”.

After two hours, and one more painful vaginal exam and three offers of pain meds, they came in to break my water. FINALLY!

I was done.

I had nothing left to give, I was exhausted physically and emotionally, starved, thirsty, beaten down by the constant barrage of offers of pain meds, bereft of comfort from a fellow woman, worried about my poor husband who was exhausted as well and obviously in pain. He suffers from DJD and Fibromyalgia and sitting in the chairs at the hospital was not kind to his body.

I was SO READY to be done with this labor. I wanted my baby. I wanted to have “the prize” the whole reason that I had endured the endless hours of torture… I was holding on to the last shred of my dream that I would push out a beautiful, healthy, big baby boy and hold him in my arms and nurse him… to look in his eyes and be able to bond with him… to know that it was for him that I would walk through fire for…

But it was not to be.

It was 2pm on February 15th. Despite my distress , in the last two hours my cervix had dilated to 4 centimeters. However, when they started to break my water, they found that my baby had not engaged in the pelvis at all, in fact, he would float away when they touched his head! They did another ultrasound and determined that I had Polyhydramneos… too much amniotic fluid. They could not break the water with him like that because his umbilical cord had the risk of prolapse.

We talked to Dr. R, and she said that I had a couple of options. We could continue the Pitocin, and wait till I had completely dilated to ten centimeters and check to see if my baby had engaged, although she had to warn us that this was dangerous because my water could break on its own and prolapse the cord. She also said that after dilating to a four he should have been engaged and might not be engaging because of his size and the fact that all the pre-pregnancy belly fat that I had had settled at the bottom of my belly causing a smaller area for him to engage in.

On the other hand, we could do a C-section now, which would be preferable because then we would not have to worry about my baby dying before they could get him out and my husband would definitely be at the birth, whereas if I had an emergency cesarean and had to be knocked out, he would not be allowed in the O.R.

Yeah, she pulled the "dead baby" card on me...

We told Dr. R that we had been trying for the last nine months to have a natural, unmedicated childbirth so that we could give our baby what we believed to be the best start in life. We explained to her that we had researched and attended the Bradley Method classes, argued with family and friends about the benefits of a natural childbirth, done all that we could do to stay low risk and healthy, we had even changed doctors three times to find a doctor who would work with us to achieve that goal!

She countered by saying that we had been trying for four and a half years to conceive a child, did we really want to risk his life because we wanted a natural, unmedicated childbirth? She told us that we were being incredibly selfish and told us about other babies who had died before they could perform the cesarean because of the parent’s selfish unwillingness to do what was best for their child just so they could have the “birth of their dreams”. She told us that our primary concern should be for the welfare of our child and that if we were to be parents we couldn’t let selfish desires cloud our ability to make the right choices.


We asked Dr. R. to give us some time to discuss the matter. After many tears and heartfelt prayers about what we should do, we decided that we could not risk our baby’s life to satisfy our desire for a natural birth experience. We called in Dr. R. and informed her of our “decision” such as it was.

She wrote in the record that we requested an informed elective cesarean… we were bullied, cajoled, lied to, shamed… it was ANYTHING but elective!

At least I was allowed to get out of bed! They let me get up to pee and then sat me down in a rocking chair and strapped the monitor back on and told my husband to keep pushing on it so the baby's heart tones would be read... but at least I was off my back!

I called my grandmother and asked her to call my mother and let her know that I needed her and that we were going to have a c-section. Then I called my doula… when I told her that I was having a cesarean she said, “Well, I guess you don’t need me anymore!” and she quickly got off the phone. She never came. I saw her at church a few months later, and she fawned over my baby and crowed that she had graduated from Doula school… I wanted to tell her that I hoped that she never offered her services to another poor person again. She was not trustworthy… I NEEDED HER!!! I needed her support and guidance and her energy… I needed her even more when I found out I was having a cesarean! I needed emotional support and she was nowhere to be found. I guess you really do get what you pay for…

My mother and grandmother came and said that they were glad we had made the right choice... they stayed with me to comfort me and to listen to my tears. They told me that I could have saved myself a lot of trouble by just listening to Dr. Z at the beginning... even my father said later when I called him that Dr. Z had a way of knowing which women would have a cesarean...

An hour after our “decision” we had the epidural placed and at 4pm I went into surgery. My husband had to get all dressed in surgical gowns and cap to go into the surgery, he looked so proud that he was going to have a son...

Dave, me and my husband just before the surgery

All I could think was that we had lost everything we had fought for. It was stolen from us. I thought back over the last two days and realized that I really never had the chance to have the birth I dreamed of. They had decided just by looking at me that I couldn’t do it, and they were against me from then on.

Dave, the anesthesiologist who fixed my IV when none of the nurses could get it to work the day before, also was the anesthetist for the surgery. We really liked his sense of humor and his gentle touch. He was so sensitive to our needs… we had talked to him while he did the IV the day before about our dreams for our birth, and now he nearly cried with us as he had me lean forward over the table so he could place the epidural. He asked me to tell him if it was off center, and when he stuck me the first time, it was off to the right just a tad and he gently pulled it out and stuck a new needle in the right space. Once it was in he told me that I would feel cold creep up my back and down my hips from the medication. I was grateful that he, out of all the people I had to deal with at the hospital, was kind and willing to explain everything as it was happening and make sure that I was absolutely comfortable. I think he could see how depressed and forlorn I was.

I was laid down on the bed and had to wait fifteen minutes for the epidural to take full effect. Dave stayed with me the entire time, talking to me, explaining what the cesarean would be like. Assuring me that I had done my best. Smoothing my hair back and holding my hand... listening to me cry and telling me that it would all be over soon... I was so thankful for him.

Then I was wheeled into the O.R. where I stayed on the same bed to have the cesarean. When Dr. R. began to cut, I felt the knife cut into my skin. It was a curious sensation, not painful at all. It felt like a pencil being draw across my skin. I mused to my husband and the anesthetist that it was as close as I would come to feeling the birth of my son. The anesthetist promptly told them to stop cutting, kicked up the drugs, and removed any feeling from my body before telling the Dr. to continue.

I cried. I WANTED to FEEL something!

My surgery

Dave stroked my hair and I caught a tear rolling down his cheek. My husband held my hand and tried to see over the separation curtain to see the surgery. The adrenalin that he put in the epidural to keep my blood pumping and keep me from going into shock made me shake like a leaf in autumn. My husband thought I was having a seizure until Dave told him about the adrenalin. Amazingly, throughout the entire ordeal, my entire six days in the hospital, I didn’t have a single seizure.

Dr. R. preformed a high vertical C-section because of the position of my baby and as soon as she opened me up she started calling for more suction and commenting on how much water there was. Apparently, the normal amount of fluid present at full term is about a half liter, she said that she would estimate that I had about three liters! That is why my baby would not engage in the pelvis! He was floating! She said he was in a swimming pool, there was so much water. Dr. R. said that no matter how long we waited, he would never have engaged in the pelvis because of the amount of water there was, and breaking the water was too dangerous, so it seems that the c-section was inevitable.

I later found out, from a midwife, that Polyhydramneos is easily resolved by the careful birth attendant who pokes a tiny hole in the bag of waters and letting the water to drain slowly out, allowing the child to gently engage in the pelvis. The belly fat issue that so concerned Dr. R. was another lie, as fat is squishy and easily moves aside when the baby comes. Also, if they had broken my water and the cord prolapsed, there is a 30 minute window where they can safely deliver the baby either vaginally or by cesarean before the baby is in any real danger… babies are born all the time with their cords wrapped around their necks… my perfectly healthy baby boy was never in any real danger of dying in the hospital, with emergency services on hand.

When they lifted my son out, my husband stood up saw the baby, followed the cord down to my body and promptly sat down. He later told me that it was the most awful thing he had ever seen. They had opened me up from navel to pubic hair, taken my uterus outside my body, where they did a low transverse cut on it, yanked my baby out by his head, and cut the cord.

Our son was born at 4:12pm Thursday, February 15, 2007. His first cry is engraved on my memory in a way that I will never forget. I was shaking so hard and uncontrollably from the adrenalin, but when I heard him cry it was like time stood still. I stopped shaking, my heart seemed to skip a beat, I couldn’t even breathe! His voice was so pure and beautiful, it was the most heart-stopping moment of my life! I remember thinking that I wished I could have seen him and felt him at that moment. But I couldn’t, I had to wait.

My first glimpse of my son just before got taken to the nursery

After cutting the umbilical cord, they showed Alex to me, he was so pudgy and cute! I reached up and touched his head, but then they took him away to be examined by the pediatrician. He scored perfectly on his Apgar test. I actually heard Alex sucking his hands from across the room. The pediatrician said that he came out with a great sucking reflex… Another lost moment, I could have used that sucking reflex to start the breastfeeding relationship! Everyone commented that he was so big. He weighed in at 9 pounds 12 ounces, and was 19 inches long. He was quite bloated though from sitting in so much water. They asked if we wanted him circumcised and we both responded vehemently that we were not mutilating our son’s penis. They backed off. That was one point we were NOT negotiating on and they understood that at once... I only wish we had been so determined about the rest of our wishes!

Alex's inspection

After the pediatrician saw him they wrapped him up and let my husband bring him back to me so I could see him again before he took him to the nursery to be cleaned up and have the necessary procedures done while they removed the placenta to be reviewed by the pediatrician and the ObGyn, sewed up my uterus, stuffed it back inside me, sewed up my muscles and stapled my skin back together, inserted a drain bulb, and sent me back to my room to recover. Dave stayed with me the whole time. I was grateful for that. I can't say enough about Dave.

My husband would not let the nurse carry the baby to the nursery. My mom told me later that he was so protective of Alex that he wouldn’t let them touch him without thoroughly explaining each move first. He gave Alex his first bath, and then because I could not breastfeed him immediately after birth as we had planned, Alex’s blood sugar came back a little low, he called me up and told me that they would have to feed him at least 15 cc of formula to get his sugar up before allowing him to come to my room, so we decided to give him soy formula because my mom said as a baby I had lactose intolerance. They did not put the drops in Alex’s eyes before my husband got an hour of bonding time with him, at least my husband was with him, even if I could not be.

I continued to cry. Comforted by people who kept assuring me that "At least you have a healthy baby!" and continued to crow over how perfect he was.... I felt forgotten. I had served my purpose. The baby had been born. I was not necessary any more. My feelings weren't important. I was told by several people that I should be happy, that I should be feeling that baby high, that I should be.....

In recovery, one hour after the birth, I get to see my son again

In recovery, I was made to lie on my back completely flat for the whole first hour. The doctor came in and administered antibiotics and more magnesium sulfate. Alex was brought to me an hour later and I was allowed to be sat up at a 15 degree angle to hold him briefly before my mother and grandmother snatched him away to cuddle with him.

The proud Grandma and Great-Grandma

I then tried to latch him on, but couldn’t get him positioned over my sore belly well enough, so the nurse laid me down flat and I rolled painfully to my side and the nurse manhandled my breast to get Alex to latch on. But when she did, the boy went at it like a pro!

We never had problems breastfeeding, he came out knowing how to do it! We had also been to a few La Leche League meetings during my last trimester. I met some fantastic women there who helped me learn the ins and outs of breastfeeding. At least I could do that right. I clung to that. I made it my mission to breastfeed my son. Even though I resented him...

The doctor came to see how I was doing the next day and when she saw how fast I was healing she was a little surprised. Apparently high vertical c-section patients take longer to heal than low horizontal patients…no one told me that… if they had known I didn’t know it, they probably would have told me just to ruin my confidence in my body’s ability to heal after crisis... they had already taken everything else away...

My husband was so exhausted from taking care of Alex and me, night and day. He did not get much sleep, I think about 8 hours the whole time we were in the hospital from Wednesday at noon till Sunday at about 4pm. We roomed in with our new baby, refusing all attempts to take him to the nursery. We didn’t want them to take him out of our sight. They might have given him sugar water or a binky or ignored his cries, or not brought him to me when I wanted him or done God knows what else... we weren’t taking the chance.

I was up the morning after the surgery to have a sponge bath at the bedside. Then that afternoon I had the urinal catheter that they had to put in when I got the epidural for the surgery taken out, but I got dizzy before I could take a shower and nearly fell down. So I had to wait a couple of hours before getting back up to the shower.

The nurses came in frequently to ask if I wanted more darvocet, which I gladly accepted, I wasn't fighting anymore. They pampered me and cooed over my baby, telling me that I had a beautiful baby and glowing over how healthy he was.

I kept thinking, yeah, but I wish I could have had him normally… I wish I could have held him skin to skin with me moments after his birth…. I wish so many things were different… They couldn’t understand my morose attitude. So I began putting on a cheerful face whenever anyone was in the room, the nurses, visitors, the lactation consultant, doctors, even my husband… I was tired of being told I was doing it wrong. Inside I was dying to break down and cry.

They came in that morning to do the PKU test and to administer the first of the series of Hep-B vaccines. My husband and I had not decided whether or not we wanted to get the vaccine or not and we told the nurse and the pediatrician as much. They responded by saying that it was hospital policy that every baby had to be vaccinated with Hep-B within 24 hours of birth… we didn’t know they were lying to us and we caved.

I asked if I could breastfeed Alex while he had the heel prick and shot done, but they refused and took him to the other side of the room, stripped him naked, surrounded the little table so neither of us could see our baby, gave him the shot and pricked his heel. The first prick wouldn’t bleed enough, so they had to prick him twice more to get the necessary amount of blood for the PKU test. Alex screamed as they tortured him. When they were done, they dropped him, naked and covered by his own blood, into my husbands arms and left the room.

My husband cried as he cleaned him up and dressed him. He had had enough stress to make the toughest man drop to his knees. He gave Alex to me after he was cleaned up, and I nursed him as my husband left the room. I broke into tears after I knew he was out of earshot. I cried for a half hour while I nursed my son.... alone physically and emotional.

That night when my husband returned, he had gone home and had fallen asleep, we had a rather large heated argument about my being so depressed. He said that I needed to cheer up and that we had a healthy baby and that I was going to make myself sick if I didn’t get over myself. He also said that babies can sense emotions and that Alex’s constant colicky behavior might be due to my behavior.

I lost it.

I couldn’t believe that he was putting all the responsibility on me. I had done the best I could. It wasn’t my fault that we ended up with a cesarean! He apologized and said that he had just been really stressed out and when he woke up at home and realized he had slept four hours he felt really guilty about leaving me alone with Alex when I couldn’t stand up yet without assistance. We both realized that we weren’t angry with each other, we were angry at the situation, the way we had been abused, the dreams that had been shattered like brittle glass… we apologized to each other and resolved to never treat each other badly because the world was treating us badly. We had to be united, especially now.

Then on Saturday, things were better. I was able to get up on my own to take a shower, although I did need some help from my husband, as I still couldn’t bend over well enough to clean between my legs and I was still passing half dollar sized clots.

Alex’s pediatrician, Dr. H., came in Saturday and asked how we were doing with bottle feeding. We told him that we weren’t using formula, that we were exclusively breastfeeding. He fought with my husband for nearly half an hour on the subject and finally threatened to call CPS and have us arrested for neglect and child abuse if we wouldn’t supplement with formula. He asserted that I was not capable of nursing exclusively because my milk should have come in within 24 hours of the birth, and since it had not, and I was still only producing colostrum, that I was not cut out to breastfeed such a large baby. We grudgingly agreed to give Alex 15 cc of formula, as needed, AFTER every nursing.

Sunday morning I got up and didn’t need any help at all. We were finally going home!
Alex’s pediatrician came in and did a final check on Alex and announced that he had lost one ounce short of a pound and couldn’t be discharged. We told him that I had Polyhydramneos and that Alex’s initial birth weight could not be trusted because he was bloated with so much water… he agreed that it was possible, after checking my record and seeing that I wasn’t lying… but he refused to release Alex till we had been educated by the lactation consultant on how to use the supplemental nursing system (SNS).

We had no choice, yet again.

I had already called my grandma to help us get home, as our car wasn't big enough to take more than us and our new baby home... and she had arrived and we all waited till 4pm for a break in the LC’s schedule.

The lactation consultant got us all set up and couldn't figure out why, even with the smallest tube, Alex was struggling to keep up with the milk flow, so she got him off and squeezed my boob and got a face full of milk and told us to forget the SNS. She told us that she would tell the pediatrician that we were pros with the SNS so we could leave. THANK GOD she was on our side!

A nurse escorted us to our car and watched my husband strap Alex in the car seat and we were off… The first night home, Shawn brought our mattress from the bedroom into the living room because I could not lay flat on my back or on my side in bed because of the surgery. I needed to be reclined, and so I slept on the couch with Alex on a pillow next to me or on my chest, and my husband slept on the mattress on the floor.

Alex napping while I talk on the phone to a PPD Nurse/Counselor

With everything calming down at home and us getting all settled in, the post partum depression sank in with a vengeance… I nearly quit breastfeeding... not because of problems with nursing, in fact, as I said before, Alex came out with a FANTASTIC sucking reflex and voracious appetite and I never had sore, bleeding, cracked or in any other way problems with my nipples, I have never had mastitis or blocked tubes or any other problems breastfeeding, I have had it easy! I really felt guilty for that when I thought about quitting early on, because there are women out there who want so badly to nurse and end up with HUGE problems one right after the other...

The problem was that when Alex was born by c-section, even though I loved him terribly and couldn't even breathe when I heard his first cry there in the O.R. and I couldn't imagine not having him with me, it was hard for me to bond with him at first...I feel a little guilty about it actually.... I FORCED myself to hold him and cuddle with him and nurse him in the hospital because I believed that if I tried hard enough, I could overcome the feelings of detachment that I felt.... For heaven's sake, I had already bought the material for a babywearing wrap and had read all about Attachment Parenting and found other people for a support group! I wasn't going to just give up!

And then when we got home, the feelings didn't subside and I got really depressed and felt like a bad mommy and cried a lot.... it was my husband who kept me going... when I would say I didn't want to nurse him that I felt detached from Alex and didn't feel like there was a bond there and it wasn't like I had imagined being a new mommy would be he told me that there was no other way to feed Alex and he was not going to allow me to starve his son... he told me that this was what we had decided was best for Alex and that I needed to nurse him.... that if I would keep up my end of the bargain, God would do the rest.... and he gave me a blessing of comfort and was there for me and encouraged me when I felt too embarrassed to reach out to anyone else for help, when I would put on a happy face and pretend I was the doting mother for the world to see and really I was dying inside trying not to bust into tears from the depression I felt....

I am really grateful for a husband who would not let me quit because I can't imagine how my life would be without nursing, I LOVE the 2 or 3 times Alex wakes up at night even now, at 26 months old, to nurse… I complain about his drive by nursings because they are irritating but they are also wonderful reminders of what I could have lost if I had given up.

My birth had been stolen from me, and here I was considering giving up on the last thing I had control of… I refused... and plodded along. Things eventually became bearable... My husband received the La Leche League’s Father of the Year award in August, 2008 for his dedication to breastfeeding and his unwavering support of me and our son.

My extended family will probably never know the deep seated pain I carry even today about what happened... I talked to my mother about having a VBAC and she was aghast... why would I do that? "You don't have anything to prove..." She can't understand.

It has been 2 years and 2 months now, since the cesarean… I still grieve over the abuse we endured as a family. My husband and I have decided absolutely that we will NEVER again attempt a birth in a hospital. And since VBACs are illegal in Washington state free standing birth centers… that leaves us with a home birth.

We are still undecided on whether it will be unassisted or if we will be hiring a midwife, though we are seriously leaning toward the unassisted side, since midwives take a lot of chances taking on VBAC homebirths, and they didn't even want to help me homebirth BEFORE I had a cesarean, and Diabetes, and Hypertension...

I wrote this full birth story as a healing balm, 19 months after the cesarean, it was about time I stopped pretending that everything was A OK… it wasn’t. Not by any stretch of the imagination.

Thursday, March 25, 2010
Edited to add:

My incredible healing repeat cesarean


Alisha said...

Great story - thanks for sharing! i can relate having 2 csections! i had so much hope with the second birth but went to a hospital believing that they would help me with my birth plan.

i can even open it or read it and it has been 18 months - i cant even write my birth story down. i just try not to think about it... but i do

choice_spirit said...

Hugs Alisha, I hope you are able to heal.


gerrycammy said...

((((((Jennifer)))))) Your story just aches. I hope that by posting this, it helps your healing as well as others. It makes me so angry for you that the hospital staff treated you so terribly and that even your doula abandoned you. As somebody who would like to become a doula, I will take your story as a lesson in how NOT to treat a mother. Thank you for sharing your story! -Cammy

choice_spirit said...

Thanks Cammy... it really does feel good to post this publicly. I have posted it on the ICAN forum, but that place is full of women who are also grieving for their own cesareans and my story is so similar to theirs...

I hope that some young woman will read this and take warning... maybe it will help her avoid the same agony.

Sara said...

Jennifer-I hope that getting this out..more publically does bring a great healing to your life. I too am just appalled at how your doula treated you, how the hospital staff didn't see you for you, but just "another woman in labor". Big hugs to you. I am so glad you were able to dig in and find the strength to write this and share this.

Missy said...

Thank you for sharing your story. I had no idea all that you went through. It makes me so mad how mistreated you were in the hospital and by your doula as well. You are a strong woman to make it through that and I admire your strength:)

Anonymous said...

Wonderfully written. So honest. You are such a caring mommy. Those who let you down should be ashamed for not treating you like the wonderful compassionate person you are. Lots of love,
Stacy, Alice, and Julius :-)

Kat said...

Thank you so much for writing your story. I struggled for well over a year with my C-section, though I did not develop PPD. Because of rapidly progressing HELLP syndrome, I never really had any other option. In some ways that fact makes it a bit easier to accept, and for that I am glad, but it is still really difficult. One of the hardest things for me was that several other people were the first to see and touch my baby (I even resented that my husband got to touch him before I did).

I am grateful to you for posting your story, b/c I think that women need to see that these feelings are ok. That it is perfectly fine to grieve over a birth experience that is so radically different from what you expected. Maybe if people see that these feelings are normal, they will be more open to sharing their real feelings so that they can get the comfort or help that they need. Congratulations on your pregnancy, I hope so much for you that this birth goes much better!

Michelle said...

Wow, I am really glad I read your story. I am a childbirth educator in training and I learned a lot from your story. Thank you for sharing.

Deanna said...

Here's my video response; http://www.youtube.com/watch?v=au9TU8yz2VI

Thanks so much for sharing your story, I really feel its important to share these things so that we can learn to protect ourselves against all the lies. I hope you will hire a real doula in the future and won't let this experience sour you from them. Mine was a life saver, and I have a feeling your doula-in-training maybe didn't realize that you were actually hiring her, she probably just felt like you were going to let her into the labor room so she'd get experience points. :( So sad... Interview a whole bunch and find one that works for you.