I went into labor on May 14, 2012 with my beloved Baby Maddox. I went into labor an hour and a half after my home birth midwife dropped the bomb on me that she couldn't attend my birth. Thankfully I had a backup plan. I'd had backup care with an OB practice that used midwives and had actually seen them earlier that day.
The midwife I saw told me that I was 2cm dilated (as I had been for 3 weeks), but she felt like I could go at any moment. She told me that my favorite midwife at that practice, Jessica Ramirez-Trower would be on call that night.
Let me tell you a little bit about Jessie. Yes, she works for a hospital midwifery practice, but she's amazing and is 100% supportive of natural, unmedicated birth. She is funny, quirky and experienced. I actually told Adam early in my pregnancy that if I could guarantee that I'd get Jessie, I'd be okay giving birth at the hospital. Well...that ended up being a bit of foreshadowing...
We had just pulled into the parking lot of Stride Rite (around 7:30pm) to look for a pair of shoes for Bettie. Once Adam parked, I had a contraction. It was definitely not a Braxton Hicks. It was the real deal. It lasted for about a minute. I instantly dismissed it and we got out of the car to go in the store. As we walked in the door of the store, I had another contraction. It was about 5 minutes after the first. I thought "this is weird" and started looking at shoes. Five minutes later I had another contraction. After 3, I was pretty convinced I was in labor.
We didn't find any shoes we liked, so we left the store and decided to pick up some Mexican food for dinner. The contractions kept coming every 5 minutes and lasted a minute. I kept thinking that they'd probably slow down. No one has their first contractions come regularly. I read birth stories. The body just doesn't work that way.
We went home, and the contractions continued...every 5 minutes. I didn't really feel like eating. I called my mom and let my sister know that I thought I was in labor. I texted Nancy, the home birth midwife and begged her to come and deliver my baby. She was insistent that she couldn't, but offered herself and her assistant as labor support...at a cost of $1200. I was hurt and angry that I was dumped, had no time to line up a reasonably priced doula and felt like I was getting the shaft. I have to say, that wasn't really the frame of mind I'd fantasized about being in for this labor. Both ladies called and tried to offer support over the phone (for free...haha), but I was so angry with them, they weren't helping, so I hung up and called Jessie.
Jessie told me that she had another woman in labor and was heading to the hospital and that she'd see me there when I was ready. Adam asked her how I would know that I was in labor. Jessie calmly told him that if I felt like I was in labor, I probably was (women know these things). He asked how I'd know how dilated I was. She told him that I wouldn't, but if my contractions were coming the way I was describing, it sounded to her like I was progressing. I told her I was going to stay home for as long as I could, and she was fine with that.
I downloaded an app to more appropriately time my contractions. I told myself that I wasn't going to the hospital unless Maddox was crowning because I was so afraid of "encouraged" interventions. I got in the tub, and it made me feel a bit better. I sat in the tub for a long time. My sweet Bettie was pouring water over my tummy and talking to me. Adam was nervous and when Bettie started dumping her cup of water over my tummy from over her head, playing and making a bit of a mess, they got in a fight. She wasn't bothering me, but she was bothering Adam. All I heard was: don't make me count! 1-2-3...BETTIE! Don't make me count!!! Finally I got fed up and got out of the tub. It was around 11pm at that point my contractions were about 2 minutes apart and were lasting over a minute, so I wasn't getting much of a break. I decided I was ready to go. We packed my bag and my sister came over to take Bettie to her house. Thelma came in while I was in the middle of a contraction and looked very concerned. She asked me if it hurt. I snarled at her like a woman possessed and said: NO! IT FEELS F***ING WONDERFUL! When the contraction ended, I apologized. Labor is a funny thing sometimes. I felt like I had multiple personalities. Between contractions, I was pretty normal. During contractions I was irrational and insane!
The car ride SUCKED. It's another reason I wanted a home birth, and I still hadn't gotten over being angry, so I was having a hard time coping. I teach HypnoBirthing. I needed to get into a better frame of mind, but I really couldn't, so I just screamed a lot. To each her own!
At the registration desk, they brought me a wheelchair and took me immediately to a delivery room. I guess I LOOKED like I was in labor with the crazy hair, crazy screaming...I probably had madness in my eyes. I left Adam to finish the registration process, and I was okay with that because he'd gotten really chatty and it was annoying me.
A wicked thunderstorm picked up as I was getting to my room. There was thunder and lightning and wind howling. It set an ominous backdrop.
Once in the room, the typical VBAC stuff happened. The nurse put in a heplock (which I wasn't thrilled about) and put me on the monitors (again...not thrilled). The nurse informed me that I'd have to lay on the bed, on the monitors for 30 minutes. She checked my cervix and I was at 5cm. It was pure torture not being able to move. The supervising OB for the practice, Dr. G peeked in. I wasn't thrilled to see her. She was not my favorite and I had the feeling she'd rather be cutting my baby out than being on standby for a VBAC.
Every time I'd have a contraction, Maddox would move, they'd lose him on the monitor and the nurse would start messing with me. This, combined with my anger and my annoyance with Dr. G was a pretty unhealthy labor cocktail. I desperately wished I'd lined up a doula, but I was expecting that the homebirth midwife's assistant would be my labor support, so that ship had sailed.
Adam came in during the 30 minutes of laying on my back torture (funny how throughout pregnancy you're discouraged from being on your back, but as soon as you hit a hospital, that's how you're "encouraged" to lie.) He held my hand during contractions and got to the point where he'd squeeze MY hand instead of the other way around. He was pretty freaked out, but it hurt!
They finally let me off the bed and Jessie came in. She set me up on a birthing ball. I'd always been pretty modest in the hospital setting, but as soon as I got on the ball, I felt hot and restricted, so I ditched the gown.
Every few contractions, they'd lose Maddox on the monitors and the nurse would start touching me again. I finally looked at her and said: You have to stop touching me. She told me she couldn't. It honestly made me want to cry. Contractions were so much worse with her messing with me!
A few minutes of bouncing on the ball and I felt a POP. I thought I broke the ball, and I freaked out a bit. Turns out, my water broke. It was a really weird feeling. I sat on the ball a little more, still screaming during contractions (and probably scaring people). Finally I looked at Jessie and calmly said: I need morphine. She looked at me like I was nuts and said: I can't give you morphine! I can order an epidural. Adam looked at me and said: You don't want the epidural! You want to do this unmedicated! Think about your birth rage! He may have said something about cascade of interventions, but it's also possible that I was delusional and heard that in my head.
I told Jessie that I didn't want an epidural that I WANTED MORPHINE! She smiled at me and said: No. I looked at her and Adam, completely calm again and said: I can't do this anymore. Then I started giggling (again...feeling a bit possessed). They both looked at me like I was insane. I kept giggling and said: Oh my god...I'm in transition!
Sure enough, I was dilated to 7...almost 8cm. Jessie asked me if I'd like to sit in the tub. I told her that sounded lovely (even though before labor I was a bit skeeved out by hospital tubs, I mean, how do they REALLY clean down in the drain? Ew...). The tub made things better, but things got worse. Jessie came in and said that Maddox's heart rate was decelerating when it shouldn't be and that she'd like to try IV fluids to help him get more stable. I agreed because Dr. G was peeking over her shoulder and I was worried she'd try to bully me. Turns out the fluids did help, and they actually made me feel a little better, too. Contractions still sucked, Adam was still chatty and annoying during contractions.
Finally Jessie checked me and I was complete. I was shocked. She told me I could get out of the water and get ready to push. I'd never done pushing before. Despite the sucky contractions, the end was near, I just knew it. Even though I put on a brave front, I was afraid I'd be a failure to progress...that my body wouldn't work, and here I was! Complete!
I told her I'd like to try squatting. The squat bar wasn't awesome. It just seemed all wrong. It was hard to hold myself up on it. Adam wasn't sure how to support me, my nurse was doing her best, but it was one-sided support. I ended up getting very tired. I kept pushing and then I was so tired my legs were shaking. I finally laid back. I could hear Maddox's heart rate on the monitors dipping and could see how low he was going, which scared me for a variety of reasons.
They started "encouraging" me to push while on my back. You guessed it. Purple pushing. Something I'm totally against. I do feel that at this point I was "encouraged" in a not so positive way, but I was tired, getting scared and so ready to meet my Maddox. Pushing was hurting and when I could see Jessie's hands, they were covered in blood.
Dr. G came in and told me she was going to prep the OR. She said that if I didn't have him out in the next few pushes, with the way his heartrate was decelerating she'd have to recommend a c-section. I knew that was BS, and it made me angry. I pushed and pushed.
I finally looked up and could see my reflection in the picture at the foot of the bed. I could see Maddox's head. He had a head full of black hair. I could also see what looked like a lot of blood. Jessie kept telling me to push past the ring of fire. I told her the ring of fire was nothing, but I knew there was something going on on the right side because it HURT. I'd push and it would look like progress, then he'd go back in. Finally Jessie got in my face and said: if you don't get this baby out in the next three pushes, I'm going to have to cut you. I started crying. I told her I didn't want her to cut me, that that scared me. She told me to PUSH. On the second push, out he came. To this day, I'm not sure if that was a scare tactic or what, but it worked. Within seconds, my squishy FAT, full-term VBAC baby was on my chest. He latched and started nursing like a pro, and I started crying. I had to wait 8 weeks before my baby girl latched and nursed, but this little guy was nursing! I was in awe.
Jessie did have to give me a shot of pitocin because I began to hemmorhage. I could hear the blood dripping, but I didn't care.
We waited until the cord stopped pulsating and turned gray, then Adam cut it (something he didn't really want to do). He did something while he was cutting it and blood managed to land on Maddox's forehead. Adam took his thumb and tried to wipe it off, which resulted in Maddox looking like something out of a ritual with a nice blood smear in the middle of his forehead.
I delivered the placenta and I told the nurse I wanted to take it home. I expected a fight, but she brought me a container. She made Adam transfer it to the "take home bucket" and he put it in the refrigerator in the room for me after pretending to wretch and dry heave. I never got to see Bettie's placenta. It was taken to pathology then destroyed.
Maddox kept nursing while Jessie started on repairs. The reason pushing (and probably contractions) sucked so much was because my dear son wanted to be born with one of his arms across his face with a nuchal hand on the opposite cheek. That's why I felt more than the ring of fire. He did 70 stitches worth of damage (which I will lovingly explain when he's a teenager), but it was all TOTALLY worth it.
When they finally weighed him, about an hour after he was born, he weighed in at 8 pounds 7 ounces. I got my 8 pound baby and some change! He was more than twice what Bettie weighed. He was perfect. My whole labor with him lasted a little under 8 hours from the first contraction to birth. Not too shabby.
I wouldn't let anyone touch him after he was weighed and handed back to me. I put him in the bassinet when it came time to move to my postpartum room and walked him there with my hand on his little chest. When we got to my room, Adam handed him to me, and he stayed on me all night, nursing on demand. I anticipated a fight from the nurses with respect to him sleeping with me, but the fight never happened. A lot of nurses came to see me...they wanted to see the unmedicated VBACer and her beautiful boy with the head full of hair. None of them said a word about Maddox sleeping, nestled in my arms. My boy didn't get a bath until he was 19 hours old because I couldn't bear to be separated from him. My hospital VBAC experience resulted in an amazing birth of a beautiful boy and was so healing after my traumatic birth with Bettie. It wasn't easy, but nothing in life worth having is easy. I wasn't a silent, heroic birthing mother. I was a crazed, screaming, slightly nuts birthing mother, but you know what? It worked for me. :)
Thursday, April 11, 2013
Friday, August 17, 2012
The Midwife Drops the Bomb
I had so many weeks of positive prenatal appointments between Nancy and Triangle, I felt lulled into a great comfort zone. I was excited and looking forward to making it to 37 weeks so I could have my water birth.
I got to 33 weeks and rejoiced. By that Friday, I was more pregnant than I had ever been. It felt amazing! Baby boy was growing and appeared to be happy to stay put.
Two weeks later, I lost part of my mucous plug while in the shower. It was pretty disgusting, and then the cramping started. I went in to Triangle and they measured some good contractions. I was a centimeter dilated and started to worry. I was sent home and told to relax a bit...something that was really hard for me!
Another week came and went, then at 36 weeks and 3 days, I had my midwife home visit. I started getting VERY excited. We bought the birth kit and had all the supplies--hoses, plastic liner for the tub...everything. I couldn't wait to meet my baby boy and bring him into the world peacefully in the water, and surrounded by loving family. Nancy and her assistant checked out my house and proximity to the closest hospital and deemed that everything looked great. I was thrilled.
Adam asked what would happen if I went into labor at 36 weeks and 6 days. Nancy told him I'd have to go to the hospital. I PRAYED that I'd make it at least another 4 days.
Those 4 days came and went, and I hit the magic number...37 weeks. A month more than I had ever been pregnant. I felt awesome and started setting my sights on making it to 41 weeks. I scheduled a work meeting for May 14...two days before my estimated due date because I was feeling confident about going overdue. I told anyone who'd listen that I wanted at least an 8 pound baby. People thought I was nuts. :)
People at work couldn't believe that I was still working at 38 weeks...then 39. I felt good...why stay home?
At 39 weeks and 5 days, I did two webexs. I stayed home because I felt a little tired and my feet were too swollen and unsightly to be seen in public...or at least in a work setting. Bettie was scheduled for school pictures the next day (May 15), so after work, Adam and I took her to the mall to get a new dress and some shoes.
We had just pulled into the parking lot when my cell phone rang. It was my midwife, Nancy. I thought she was calling to check on me. Nope. She was calling to tell me that she couldn't attend my birth. WTF? I was 39 weeks and 5 days pregnant and she was abandoning me. She said she could no longer attend VBACs because things had gotten very controversial in the home birth world in NC. I needed some time to think and try not to get disappointed and sad. Adam was PISSED. I was trying not to cry.
We decided to carry on and get what we needed from the mall, so with all kinds of emotions swirling, we went shopping.
We ended up running into our friends Chris and Cynthia in front of the Gap after finding Bettie an adorable dress. Chris has a knack for sending women into labor. He hugged me the night before I went into labor with Bettie and had the same effect on our friend Laura. I hugged him before we said goodbye. We had to find Miss Bettie some new shoes. We didn't see anything we liked at the mall, so we decided to hit the Stride Rite store near our house.
I got to 33 weeks and rejoiced. By that Friday, I was more pregnant than I had ever been. It felt amazing! Baby boy was growing and appeared to be happy to stay put.
Two weeks later, I lost part of my mucous plug while in the shower. It was pretty disgusting, and then the cramping started. I went in to Triangle and they measured some good contractions. I was a centimeter dilated and started to worry. I was sent home and told to relax a bit...something that was really hard for me!
Another week came and went, then at 36 weeks and 3 days, I had my midwife home visit. I started getting VERY excited. We bought the birth kit and had all the supplies--hoses, plastic liner for the tub...everything. I couldn't wait to meet my baby boy and bring him into the world peacefully in the water, and surrounded by loving family. Nancy and her assistant checked out my house and proximity to the closest hospital and deemed that everything looked great. I was thrilled.
Adam asked what would happen if I went into labor at 36 weeks and 6 days. Nancy told him I'd have to go to the hospital. I PRAYED that I'd make it at least another 4 days.
Those 4 days came and went, and I hit the magic number...37 weeks. A month more than I had ever been pregnant. I felt awesome and started setting my sights on making it to 41 weeks. I scheduled a work meeting for May 14...two days before my estimated due date because I was feeling confident about going overdue. I told anyone who'd listen that I wanted at least an 8 pound baby. People thought I was nuts. :)
People at work couldn't believe that I was still working at 38 weeks...then 39. I felt good...why stay home?
At 39 weeks and 5 days, I did two webexs. I stayed home because I felt a little tired and my feet were too swollen and unsightly to be seen in public...or at least in a work setting. Bettie was scheduled for school pictures the next day (May 15), so after work, Adam and I took her to the mall to get a new dress and some shoes.
We had just pulled into the parking lot when my cell phone rang. It was my midwife, Nancy. I thought she was calling to check on me. Nope. She was calling to tell me that she couldn't attend my birth. WTF? I was 39 weeks and 5 days pregnant and she was abandoning me. She said she could no longer attend VBACs because things had gotten very controversial in the home birth world in NC. I needed some time to think and try not to get disappointed and sad. Adam was PISSED. I was trying not to cry.
We decided to carry on and get what we needed from the mall, so with all kinds of emotions swirling, we went shopping.
We ended up running into our friends Chris and Cynthia in front of the Gap after finding Bettie an adorable dress. Chris has a knack for sending women into labor. He hugged me the night before I went into labor with Bettie and had the same effect on our friend Laura. I hugged him before we said goodbye. We had to find Miss Bettie some new shoes. We didn't see anything we liked at the mall, so we decided to hit the Stride Rite store near our house.
Tuesday, July 31, 2012
Musical Care Providers
Adam and Bettie came with me to my first midwife appointment at UNC. Bettie got FREAKED out when they took my blood pressure and weighed me. She didn't want anyone touching me. It was kind of flattering in a sad way that she was so protective. I hated seeing her so upset.
The midwife was nice enough. We talked about my birth trauma with Bettie (and as usual, I broke down into tears) and she told me about the hospital policies--continuous fetal monitoring, heplock, etc. I hated the idea of the required "stuff", but was encouraged by her attitude towards birth. She didn't think twice about natural VBAC. She didn't dwell on the negative aspects or the horrible things that could happen. It was refreshing. I felt good leaving the office.
On the drive back home (and it was a drive...40 minutes) I started getting nervous. I knew that when I went into labor, I wanted to wait as long as I could before going to the hospital. That drive started seeming even longer. I started thinking about Bettie and the fact that she'd be at least 40 minutes away from me. I thought about how long it would take for Adam to drive back to Cary to get her and then come back. It started a big ball of worry in my stomach.
I had to find an alternative. I knew there was a practice in Cary called Triangle OBGYN that had midwives. In fact, one of my doula clients was a patient there and had an amazing midwife for her birth. The downside was, they had terrible reviews on the web and the first time I called, I got put on hold and no one ever came back on the line. The upside was the fact that they delivered at a hospital about 5 minutes from my house. To me, despite crappy reviews and customer service (initially), that was going to be the best option.
I made an appointment for a Friday. That Thursday I started feeling crampy and twingy. I'd had a lot of stress at work and was afraid that I might be having preterm labor. I called Triangle OB and they got me in. I got to see a fabulous midwife named Jessica, and she put my mind at ease. During that visit, my cervix was showing signs of funneling (dilating from the inside), but it was still closed, so that was a positive. She told me that I needed to take it easy, and that she'd see me the next day for my official first appointment.
That first appointment took FOREVER. Their waiting room was crammed full of pregnant women, so I had to wait for over 35 minutes. The appointment itself was pretty good. I saw Jessica again and was told that I'd have to see an OB during the next visit to get cleared to have a VBAC. I was okay with that. It seemed I had finally found a practice I could deal with.
During my next visit, I saw a female OB. Her bedside manner was only okay. She asked me about the exercise I was getting and flipped out when I told her I was running. She told me to stop running immediately and move on to something lower impact. She cleared my VBAC, but I wasn't fond of her.
I still hadn't completely abandoned hope of a home waterbirth, so having had an appointment with that female OB (and not being 100% thrilled with her), I reached back out to the first home birth midwife, Nancy. She told me she was still seeing VBAC patients and she'd love to see me again.
I met with her and her assistant and was back in love with the idea of home birth. Things seemed to finally be working out. She told me that I could continue with Triangle OB because if something happened during the home birth and I needed hospital care, it would be a good idea to have a practice familiar with me on standby. Plus, Triangle could do any labs or ultrasounds that might be necessary. I was okay with that. I was paying Nancy out of pocket and insurance was picking up my Triangle visits.
Nancy knew I was seeing Triangle, but I didn't tell the folks at Triangle I was planning on home birthing. I knew I'd be bombarded with negativity, so it didn't seem worth it. I was also worried that I might go into labor before 37 weeks, and if that happened, home birth wouldn't be an option anyway, so I was happily prepared no matter what the outcome.
The midwife was nice enough. We talked about my birth trauma with Bettie (and as usual, I broke down into tears) and she told me about the hospital policies--continuous fetal monitoring, heplock, etc. I hated the idea of the required "stuff", but was encouraged by her attitude towards birth. She didn't think twice about natural VBAC. She didn't dwell on the negative aspects or the horrible things that could happen. It was refreshing. I felt good leaving the office.
On the drive back home (and it was a drive...40 minutes) I started getting nervous. I knew that when I went into labor, I wanted to wait as long as I could before going to the hospital. That drive started seeming even longer. I started thinking about Bettie and the fact that she'd be at least 40 minutes away from me. I thought about how long it would take for Adam to drive back to Cary to get her and then come back. It started a big ball of worry in my stomach.
I had to find an alternative. I knew there was a practice in Cary called Triangle OBGYN that had midwives. In fact, one of my doula clients was a patient there and had an amazing midwife for her birth. The downside was, they had terrible reviews on the web and the first time I called, I got put on hold and no one ever came back on the line. The upside was the fact that they delivered at a hospital about 5 minutes from my house. To me, despite crappy reviews and customer service (initially), that was going to be the best option.
I made an appointment for a Friday. That Thursday I started feeling crampy and twingy. I'd had a lot of stress at work and was afraid that I might be having preterm labor. I called Triangle OB and they got me in. I got to see a fabulous midwife named Jessica, and she put my mind at ease. During that visit, my cervix was showing signs of funneling (dilating from the inside), but it was still closed, so that was a positive. She told me that I needed to take it easy, and that she'd see me the next day for my official first appointment.
That first appointment took FOREVER. Their waiting room was crammed full of pregnant women, so I had to wait for over 35 minutes. The appointment itself was pretty good. I saw Jessica again and was told that I'd have to see an OB during the next visit to get cleared to have a VBAC. I was okay with that. It seemed I had finally found a practice I could deal with.
During my next visit, I saw a female OB. Her bedside manner was only okay. She asked me about the exercise I was getting and flipped out when I told her I was running. She told me to stop running immediately and move on to something lower impact. She cleared my VBAC, but I wasn't fond of her.
I still hadn't completely abandoned hope of a home waterbirth, so having had an appointment with that female OB (and not being 100% thrilled with her), I reached back out to the first home birth midwife, Nancy. She told me she was still seeing VBAC patients and she'd love to see me again.
I met with her and her assistant and was back in love with the idea of home birth. Things seemed to finally be working out. She told me that I could continue with Triangle OB because if something happened during the home birth and I needed hospital care, it would be a good idea to have a practice familiar with me on standby. Plus, Triangle could do any labs or ultrasounds that might be necessary. I was okay with that. I was paying Nancy out of pocket and insurance was picking up my Triangle visits.
Nancy knew I was seeing Triangle, but I didn't tell the folks at Triangle I was planning on home birthing. I knew I'd be bombarded with negativity, so it didn't seem worth it. I was also worried that I might go into labor before 37 weeks, and if that happened, home birth wouldn't be an option anyway, so I was happily prepared no matter what the outcome.
Thursday, May 31, 2012
OBs and VBAC Lip Service
We decided to start trying for baby number 2 after my successful surgery in April 2011 to bisect a uterine septum--the reason I had preterm labor with Bettie. I got my positive pregnancy test in September. I still get a little giggle that it didn't take long to get pregnant after being told for years I'd have problems getting pregnant. I guess the doc I saw in my early 20's really didn't know what she was talking about.
Early in the pregnancy, at around 5 weeks, I had some bleeding and got scared that I was going to lose the pregnancy. There was no blood in my uterus, so things were fine. What would a pregnancy of mine be, without a little drama?
I had been seeing Dr. Holton, the doctor who delivered Bettie. He's retired from OB work, so by 8 weeks, he recommended that I find an OB to continue my care. Both he and the infertility specialist who did the uterine septum bisection agreed that I was a perfect VBAC candidate. My c-section was done using a low transverse incision and was sutured using double wall sutures.
I looked at the website of the practice he recommended and it became obvious that they were not pro-VBAC, so I didn't even call them. I decided to reach out to Nancy Harman, a certified nurse midwife who came highly recommended from the home birth community. I exchanged a few emails with Nancy and decided I really liked what I was hearing. I made an appointment with her and saw her at 10 weeks.
Nancy is very earthy and her assistant, Andrea was awesome. I instantly liked both of them. About 10 minutes into my appointment, they got a call from a mother in early labor, so they had to cut my appointment very short. Nancy told me she'd contact me over the weekend to reschedule and chat.
The weekend came and went and I heard nothing. At the time, Adam wasn't totally on board with home birth, so when two weeks came and went without hearing anything from Nancy, I just figured she thought I wasn't a great candidate for home birth, so I started looking for OBs.
While trying to find a practice, I had my genetic screen, and the baby looked good. The woman who did the ultrasound also did my ultrasound with Bettie. I love her. She told me that early markers looked like this baby would be a girl, but not to buy anything pink at that point. Having been burned by an early ultrasound with Bettie (I was told boy at 18 weeks, then girl at 20), I knew better. :)
I finally found a practice in Raleigh that had a lot of pro-VBAC verbiage on their website. During my initial nurse visit there, the nurse danced around c-section and induction rates, saying they didn't keep track of that kind of thing. That was a big red flag. During my first real visit with one of the OBs, they wanted to do a pap. It was less than 3 months since my last one, so I declined. That set off a mild confrontation with one of the nurses. It became really apparent that they wouldn't be very supportive of a woman who stood up for herself, which was another red flag.
When I finally got to see one of the OBs, I asked her about c-section rates. She mentioned that the hospital they use for delivery, Rex, had about a 36% c-section rate. When I said that hospitals don't do c-sections, OBs do, she got flustered. She talked the good talk about being pro-VBAC, but I had a gut feeling that something was off.
When I got home, I researched VBACs at all the local hospitals. It turned out that Rex has a de facto ban on VBACs. No wonder their c-section rates are so high. I knew that my chances of a successful VBAC at Rex were slim, so I decided to look for other practices who delivered at more VBAC friendly hospitals. I requested my records from the Raleigh OB, and found it very telling that in those records, the OB I saw wrote in big, bold letters: discussed the probability of CATASTROPHIC UTERINE RUPTURE in VBAC patients.
Hmmm....first, she didn't say anything to me about rupture, and second, the fact that she indicated "probability" instead of "possibility" and put CATASTROPHIC UTERINE RUPTURE in all caps and bold tells me that if I'd have stayed with them, they probably would have scheduled me for surgery instead of supporting me in a VBAC.
One upside is, the Raleigh practice already scheduled my 20 week anatomy ultrasound, so while I was finding another provider, that was at least on the calendar for December 22, 2011--the day after Bettie's birthday and the day before mine. I had the same ultrasound tech, and we had a great time! She discovered that the baby was a boy and looked absolutely perfect. He was measuring exactly right according to my due date, and my cervix looked nice and long. It was such a great day!
I decided to try to get into the UNC Midwife practice because their VBAC rates are really high. There was so much red tape involved in getting an appointment, it was incredible. It took me 6 weeks to get in, and before I could meet with a midwife, I had to see one of their maternal-fetal medicine specialists to get cleared to VBAC. I saw Dr. Strauss on December 27. It was a little ironic that I had to meet with him because he stopped my preterm labor a week before I ended up having Bettie. He actually remembered me. We chatted and he looked over my records. He ran some numbers and determined that I had a 78% likelihood of having a successful VBAC, so I had his blessing to meet with the midwives.
Early in the pregnancy, at around 5 weeks, I had some bleeding and got scared that I was going to lose the pregnancy. There was no blood in my uterus, so things were fine. What would a pregnancy of mine be, without a little drama?
I had been seeing Dr. Holton, the doctor who delivered Bettie. He's retired from OB work, so by 8 weeks, he recommended that I find an OB to continue my care. Both he and the infertility specialist who did the uterine septum bisection agreed that I was a perfect VBAC candidate. My c-section was done using a low transverse incision and was sutured using double wall sutures.
I looked at the website of the practice he recommended and it became obvious that they were not pro-VBAC, so I didn't even call them. I decided to reach out to Nancy Harman, a certified nurse midwife who came highly recommended from the home birth community. I exchanged a few emails with Nancy and decided I really liked what I was hearing. I made an appointment with her and saw her at 10 weeks.
Nancy is very earthy and her assistant, Andrea was awesome. I instantly liked both of them. About 10 minutes into my appointment, they got a call from a mother in early labor, so they had to cut my appointment very short. Nancy told me she'd contact me over the weekend to reschedule and chat.
The weekend came and went and I heard nothing. At the time, Adam wasn't totally on board with home birth, so when two weeks came and went without hearing anything from Nancy, I just figured she thought I wasn't a great candidate for home birth, so I started looking for OBs.
While trying to find a practice, I had my genetic screen, and the baby looked good. The woman who did the ultrasound also did my ultrasound with Bettie. I love her. She told me that early markers looked like this baby would be a girl, but not to buy anything pink at that point. Having been burned by an early ultrasound with Bettie (I was told boy at 18 weeks, then girl at 20), I knew better. :)
I finally found a practice in Raleigh that had a lot of pro-VBAC verbiage on their website. During my initial nurse visit there, the nurse danced around c-section and induction rates, saying they didn't keep track of that kind of thing. That was a big red flag. During my first real visit with one of the OBs, they wanted to do a pap. It was less than 3 months since my last one, so I declined. That set off a mild confrontation with one of the nurses. It became really apparent that they wouldn't be very supportive of a woman who stood up for herself, which was another red flag.
When I finally got to see one of the OBs, I asked her about c-section rates. She mentioned that the hospital they use for delivery, Rex, had about a 36% c-section rate. When I said that hospitals don't do c-sections, OBs do, she got flustered. She talked the good talk about being pro-VBAC, but I had a gut feeling that something was off.
When I got home, I researched VBACs at all the local hospitals. It turned out that Rex has a de facto ban on VBACs. No wonder their c-section rates are so high. I knew that my chances of a successful VBAC at Rex were slim, so I decided to look for other practices who delivered at more VBAC friendly hospitals. I requested my records from the Raleigh OB, and found it very telling that in those records, the OB I saw wrote in big, bold letters: discussed the probability of CATASTROPHIC UTERINE RUPTURE in VBAC patients.
Hmmm....first, she didn't say anything to me about rupture, and second, the fact that she indicated "probability" instead of "possibility" and put CATASTROPHIC UTERINE RUPTURE in all caps and bold tells me that if I'd have stayed with them, they probably would have scheduled me for surgery instead of supporting me in a VBAC.
One upside is, the Raleigh practice already scheduled my 20 week anatomy ultrasound, so while I was finding another provider, that was at least on the calendar for December 22, 2011--the day after Bettie's birthday and the day before mine. I had the same ultrasound tech, and we had a great time! She discovered that the baby was a boy and looked absolutely perfect. He was measuring exactly right according to my due date, and my cervix looked nice and long. It was such a great day!
I decided to try to get into the UNC Midwife practice because their VBAC rates are really high. There was so much red tape involved in getting an appointment, it was incredible. It took me 6 weeks to get in, and before I could meet with a midwife, I had to see one of their maternal-fetal medicine specialists to get cleared to VBAC. I saw Dr. Strauss on December 27. It was a little ironic that I had to meet with him because he stopped my preterm labor a week before I ended up having Bettie. He actually remembered me. We chatted and he looked over my records. He ran some numbers and determined that I had a 78% likelihood of having a successful VBAC, so I had his blessing to meet with the midwives.
Tuesday, May 22, 2012
The Journey Begins
My VBAC journey started right after the premature birth of my daughter Bettie via emergency c-section at 33 weeks for breech presentation. Many people say breech presentation is a variant of normal and warrants trying for a vaginal delivery, but, as many women have found, locating a medical professional who is trained and competent with vaginal breech delivery can be an ordeal. It's a dying art.
My c-section experience wasn't positive--the surgery, the fact that 10 or more people touched my child before I did, the 18 hour wait to first touch her.... I've written about it here.
When Bettie finally got to come home and we got settled, I got curious about options for possible future deliveries. I knew there was an out-of-hospital birth center in Chapel Hill. I wasn't a candidate for their services with Bettie because of the high risk nature of my pregnancy and the breech presentation. I reached out to them to ask about VBAC and was immediately told that they don't support VBAC unless the primary c-section had to be done under their care.
To me, that meant that future deliveries would need to be managed through a hospital.
I started to research everything I could about VBAC. I learned about the risk of uterine rupture and the fact that, while it does happen, it happens very rarely (less than 1%). There are so many other obstetric complications that have much higher and equally, if not more deadly consequences than uterine rupture in a scarred uterus. I also learned that most uterine ruptures aren't the catastrophic variety. They involve the scar opening up, but neither the mother nor the baby suffer any ill effects.
After looking at my c-section report, I verified that my surgery was done using a low transverse incision, making me an ideal candidate for a VBAC. My records also mentioned that my doctor discussed vaginal breech delivery, which is a lie, but at this point, that's water under the bridge.
I read message boards and talked to people about VBACs. I explored options and watched videos of a variety of births. I decided that should I get pregnant again, I really wanted to give birth in the water.
I taught HypnoBirthing classes and attended births as a doula. I was impressed by the women and families I was supporting and knew that if and when I got pregnant again, I definitely wanted an unmedicated VBAC in water.
My research continued as I tried to figure out how I could have a water VBAC in a hospital. None of the hospitals in my area were supportive of water birth. Many of the hospitals prohibit even laboring in the water once the mother's water breaks. That was a little disheartening.
In talking to folks and reading, I learned about home birth midwifery. I talked to a few women who had had beautiful home water births attended by certified nurse midwives and was intrigued. I wasn't afraid of the idea of labor or delivery. I knew I wanted as few interventions as medically necessary to ensure that I'd get to VBAC and not be coerced into a second c-section. I decided at that point to start talking to home birth midwives.
My c-section experience wasn't positive--the surgery, the fact that 10 or more people touched my child before I did, the 18 hour wait to first touch her.... I've written about it here.
When Bettie finally got to come home and we got settled, I got curious about options for possible future deliveries. I knew there was an out-of-hospital birth center in Chapel Hill. I wasn't a candidate for their services with Bettie because of the high risk nature of my pregnancy and the breech presentation. I reached out to them to ask about VBAC and was immediately told that they don't support VBAC unless the primary c-section had to be done under their care.
To me, that meant that future deliveries would need to be managed through a hospital.
I started to research everything I could about VBAC. I learned about the risk of uterine rupture and the fact that, while it does happen, it happens very rarely (less than 1%). There are so many other obstetric complications that have much higher and equally, if not more deadly consequences than uterine rupture in a scarred uterus. I also learned that most uterine ruptures aren't the catastrophic variety. They involve the scar opening up, but neither the mother nor the baby suffer any ill effects.
After looking at my c-section report, I verified that my surgery was done using a low transverse incision, making me an ideal candidate for a VBAC. My records also mentioned that my doctor discussed vaginal breech delivery, which is a lie, but at this point, that's water under the bridge.
I read message boards and talked to people about VBACs. I explored options and watched videos of a variety of births. I decided that should I get pregnant again, I really wanted to give birth in the water.
I taught HypnoBirthing classes and attended births as a doula. I was impressed by the women and families I was supporting and knew that if and when I got pregnant again, I definitely wanted an unmedicated VBAC in water.
My research continued as I tried to figure out how I could have a water VBAC in a hospital. None of the hospitals in my area were supportive of water birth. Many of the hospitals prohibit even laboring in the water once the mother's water breaks. That was a little disheartening.
In talking to folks and reading, I learned about home birth midwifery. I talked to a few women who had had beautiful home water births attended by certified nurse midwives and was intrigued. I wasn't afraid of the idea of labor or delivery. I knew I wanted as few interventions as medically necessary to ensure that I'd get to VBAC and not be coerced into a second c-section. I decided at that point to start talking to home birth midwives.
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