Taking the Scenic Route

Doing some thinking about the birth. 

(*warning*  rather graphic at times)  Very long post written over several days.

Brief History

Before I get to labor, a quick history.  We started trying to conceive in 1995.  I was totally infertile for 2 years.  In 1997, I finally got pregnant.  Between 1997-2001 I went through 7 miscarriages, 1 was a blighted ovum at 14 weeks (missed miscarriage…should have miscarried nearly a month before, but my body didn’t do it so I had to have a D & C), the other 6 were of unknown reason and happened between 6 and 12 weeks.  Finally conceived Zane.  I was so sure I would miscarry him that when my insurance that would cover IVF kicked in, I called to find out how soon after a miscarriage I could start IVF treatments.  It wasn’t until the baby reached the age of possible viability that I started realizing that I might actually have a baby out of this. Hence, it was a very short pregnancy for me.  So, Zane was my 8th pregnancy, I lost my 9th pregnancy to another blighted ovum (except this one I was able to process without intervention), and am now pregnant with my 10th.  To sum up, my body has a history of not being able to handle pregnancy well.

Birth Story – the nitty gritty, not the ‘magic of childbirth’

With Zane, I went into labor naturally, labored for a day or two (not heavy labor, and light enough that I was in denial through much of it because I thought labor was supposed to hurt a lot more) before my water broke.  Once my water broke around 8-9am on the 26th, my contractions were much more intense, regular, and closer together.  I labored naturally for around 16-20 hours after I was in the hospital (this could be off…I have very little concept of time normally, even less so in labor…I am just guessing from some other landmarks).  At some point after I had no progress, they added pitocin, which made labor horrendously painful.  The baby never dropped into my pelvis.  I never got past 3 cm (and the drs. said it was only at a 2 after the nurse reported it at 3) and never moved down in station.  I used every technique I learned in birthing classes…changing positions, squatting, labor ball, relaxation techniques, breathing, walking, ect before consenting to epidural.  Nothing was working and the dr. wanted to see if an epidural would help me relax and show progress since I was hitting the time limit for  ”time since water breaking until I need to deliver”  (strep B positive, so I was laboring with an IV, which sucked.  I needed to deliver within 24 hours of my water breaking) I labored for while more with an epi, but then the baby started showing distress and I was getting near the 24 hour mark.  I had made zero progress with the epi.  I knew something was wrong.  Everything felt wrong.  I consented to a c-section. 

The second I consented to the operation, they slammed up the bars on the side of the gurney and RAN down the hall to the OR.  It was more intense than anything I had ever seen on tv, and I was a major ER (nbc show) & ER reality shows (TLC/DiscoveryTV) fan.  Anybody moving was moving fast, there was no casualness.  They pushed in the medicine hard enough I could feel it burn, and had me open within a minute or two of getting into the room.  They had a VERY difficult time getting him out.  I ended up with 2 people standing on the gurney and the drs. in charge standing on the ground trying to get him out.  They used forceps (or something like them) to finally get him out.  He wasn’t breathing.  His first apgar was 2 and my first glance of him was seeing him a gray/purple color and limp as they rushed him to the resuscitation table.  FINALLY they started getting him breathing and his heart beating.  Zach followed him to the nursery.  After he left, my blood pressure dropped into the teens and I was fighting desperately to hold on to consciousness.  I knew that if I ‘let go’ I wasn’t coming back again.  For the second time, the room was dead silent as they worked to stop the bleeding.  I was kept in recovery for a while because they couldn’t get me stable enough to leave for a while. 

The first days

I only remember maybe 10 minutes worth of glimpses from the entire hospital stay (Dec 26-31st).  I don’t remember the security alarms going off repeatedly and a bunch of people running into the room to make sure everything was ok.  (although my mom remembers)   I don’t remember seeing either his, or my doctors and only vaguely remember the nurses. (and that is mroe from pictures than anything).  I vaguely remember my best friend helping me nurse, and teaching Zach how to help.  (more realistically, she nursed him using my body…I had almost zero feeling and was too out of it to hold him independently.  thank goodness I had a friend that was as passionate about nursing as I was who stepped in to help make sure it happened in those early days.  It was a gift bigger than I could have ever appreciated at the time).  I remember being afraid, in pain, but my mom and Zach always being there with me which meant the world to me.  I don’t remember eating, but I remember mom telling me to keep drinking water. lol.  Even after I went home, I really don’t remember much of the first weeks at all. I remember living in the recliner in the living room, being helped up to go pee, having problems eating, my mom pushing the water so I would make milk (thank you mom), and having stacks of milk soaked nursing pads all over the place. I know that Zane lived in my lap, although I only remember glances of it.  

I am glad we took so many pictures, so I can see it.  It helped me teach my brain that this was my child, because I was having a difficult time bonding.  I was so sick.  I didn’t know it at the time, but I also had gall bladder problems that progressed to a life threatening emergency at 5 weeks postpartum.

I love my son.  I am glad he made it here safely.  I do not EVER want to go through that again.  Labor was horrible, painful, and non-productive.  My body did not do what it was supposed to do, what I trusted it to do.  I utterly failed.  My body failed me.  I almost lost my child.  It was traumatic in a way I can’t describe. 

General musings about my journey so far

So, my first birth did not go well.  I hadn’t yet discovered the “natural living community” with it’s support of normal births, but I had read “Birthing from Within” and “Birth without violence” amongst a large stack of books on natural birth.  I took classes also.  I was completely geared up for a natural birth and was hesitant to have any interventions.  I only consented to interventions after it was obvious my body wasn’t figuring this thing out very well.  I came out of the birth feeling like an utter failure.  It affected bonding and my self esteem.  I can look back and recognize that I should have been diagnosed with PPD well into his second year.  I still cry most of the times I think about his birth.  I am trying to heal, and it is getting better, but with the impending birth I am being forced to face those fears and anxieties.  Like labor, I think the only way out of this, is through it.  So, I need to talk about this and finish what should have been dealt with, emotionally, after the birth.  I should have acknowledged my feelings then, but they were just too big and scary at the time, so I will make the time now.

Some of the other things that make a successful VBAC (vaginal birth after cesarean) seem unlikely 

1. my first birth is obviously something I do not want to repeat.  I think I am more afraid of attempting and failing again than I am of just surrendering to a c-section.  I think another failed vaginal birth would just break me utterly.
2. I was only a bit over 4lbs at my birth.  My pelvis is smaller than average and shaped so that it is very narrow, my uterus is angled oddly, although neither of these is as dramatic as some of the DSS defects, they aren’t normal either.  I have had multiple surgeries in my pelvis, from a bladder surgery when I was 4 (and had a bladder the size of a newborn…they couldn’t even catherise me because I was so tiny) to 3 or 4 endo surgeries which left me with a lot of scarring and adhesions.  I have also had to have nerves cut in my pelvis as a last resort pain reduction so I could live a normal life again (endo pain was so bad I was unable to walk for a week or two every month).  So, it is possible that I don’t have the ‘wiring’ to make everything work correctly anymore. 
3. Despite the fact I was only 4 lbs and a few ounces (3 maybe?), my birth would have ended in a c-section if it happened today.  My mom was in labor with me for a week.  (yes, a solid week.  my younger brother was 2 weeks).  Despite my small size, I was still a high forceps delivery (something that is avoided today) because my mom had problems getting me through her pelvis.  This does not bode well for me.  My paternal grandma did deliver several very large babies vaginally, but was left incontinent for the rest of her life because of it.  One of those big babies also died within a week or two of birth.   My dh was about the same size as Zane (maybe a few ounces bigger) and my MIL almost died during his delivery.  So, there is a family history of possible large babies (including some in the 13-15lb range) and very difficult/life threatening deliveries.  (I know my MILs labor has nothing to do with mine, but the baby size is relevant since it is dh, the father).  So, family history is not on my side.
4. Labors in my family are talked about in terms of days and weeks instead of minutes and hours.  I can not imagine even a midwife (which I am not sure are even legal in this state) would allow a labor to go on that long, and a Doctor certainly wouldn’t.  In theory, I could wait a lot longer before going to the hospital, but I am not sure I am in good enough shape to handle the stress of that long of a labor.  I am not exactly the picture of health here. 
5. I just read about a condition that really matches the symptoms of both my mom and I.  In some people, the lower uterus doesn’t stretch properly.  Some of the signs of this are showing early, carrying high, looking much more pregnant than you are (sound familiar mom?), and baby having a difficult time descending, (I was 4 lbs and a high forceps delivery, my ds never even came close to dropping in my pelvis).  It is a genetic thing.  I also have a good reason to suspect that we might share something like this…endo and a propensity for heavy scarring.  Scars don’t stretch well, and I know that even though I had endo everywhere in my abdominal area, it was very heavily concentrated on my lower uterus and cul-de-sac (lower pelvis, textbook placement if you spend a lot of time standing).  Women with this condition are often told they have a very small pelvis.  I fit every single thing there.  hmmm.  I should ask my dr. about this.

Some positives of a scheduled c-section

1. They can check on the status of my endo, adhesions, and scarring immediately following delivery since I am already opened up.  (I asked about this to confirm this was possible)
2. They would also be able to clean up the sloppy, rushed job and weird scaring from my first c-section.  At least it would be possible that they could make it feel a little less weird all the time. 
3. The surgery would be performed by somebody that has done several of my surgeries.  He is very skilled and stays up to date on surgical techniques, including dealing with scarring and adhesions.  He is also very attentive post-op and takes me at my word when I tell him something isn’t right.
4. Planning it would mean that I would know what to expect.  With a VBAC it would be up in the air until the baby came out, one way or another.  Planning it means I could deal with some of the emotional aspects before and maybe have some peace at the birth.  A failed VBAC would mean that I would be dealing with a whole bunch of really negative feelings immediately following birth AGAIN, while I am trying to heal. 
5. As much as I hate abdominal surgery, I am actually somewhat accustomed to recovering from it.  I have been through it about 7 times already.  With a scheduled c, at least I won’t have the exhaustion of laboring for a few days and then surgery.  Unless there is a complication, it really can’t be worse than that.  I was so flippin’ tired after the labor + surgery last time it was insane.
6. I guess I could get all mainstream and say “it would be more convenient to choose the birthdate” (or something along those lines), but I actually hate that aspect of it.  I feel weird deciding when a  person should come into the world.  It just seems wrong.  Besides, babies aren’t supposed to be convenient.  lol.  It is, however, easier for my parents because my mom could schedule time off (she works at my SIL’s store) and it would be less of a burden on my brother and SIL to cover the shifts since they will have some warning.  (small business, so one employee needing time off is an issue). 

And now the big conflict…the birth I really want

Dark room, meditative music, pool of warm water, Zach & I with a support person.  no meds, no interference from the outside, no talking.  Me inside my head.  The baby resting on my chest immediately following birth, cord attached until it stops pulsating.  wiping off the baby but not using soap immediately…just massaging in the amniotic fluid and wiping off the excess for the time being.  No eye goop, no shots, no blood tests for the first few hours at least.  (the shots, not for a long, long time…giving a newborn a hep B shot is just idiotic!)  lots of skin to skin contact.  Being able to walk around within a few hours after birth and a shorter recovery time would be such a blessing too.

Besides my rather romantic idea of what a birth should be like, there is that sense of connection to women since time began.  Being in labor and giving birth is something that never changes (if in it’s natural state) since humans have been here.  It is a universal connection that crosses time & culture.  It is described by so many women as an empowering and life-changing experience…and I want that. 

That is the birth I want, but my heart knows it won’t happen that way.  I have tried to psych myself into believing it could happen, but my heart knows.  I just don’t want to accept it.  A part of me feels like accepting it will be a failure.  I wish I could make myself trust my body to do this, but no amount of  trying to fool myself is going to work.  I know what I have to do, I just don’t want to.  I want the dream.  Even though I know it is better for the baby (sans complications of course), if I am really honest with myself, I realize that I want it for me more than the baby.  That is the part that makes me stop in my tracks and wonder what the hell am I thinking.  This is not the time to be selfish.  (not that a natural birth is selfish at ALL, it just would be for me in this set of circumstances)

So…

This is the 4th day I have worked on this post.  I have done a lot of thinking in that time.  When I started I was in tears thinking about a c-section.  Now I am more at peace with the idea.  Maybe it isn’t my path to have a natural birth, but to have a surgical birth and take control of that instead.  To take the situation and make it the most peaceful and empowering birth I am able to.  At least I need to open my mind to the possibility that a c-section birth can be as meaningful and beautiful as a normal birth.