Birth

Sibling Love. And postpartum rambling.

She's here!
our final photo from the pregnancy series

We are home and getting settled a bit as a family of four.

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Our first family photo. Norah is about 25 hours old here, and Jude about 31 months.

Having two under three years old isn’t crazy chaos all the time, but it is definitely crazy chaos sometimes. We are rolling with it though, and Jude is being super sweet to little sister.

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The first time they met, last Saturday night.

I have so much to say, and I am dying to write the birth story, but everything happened really fast once we got to the hospital, so I’ll need my doula’s timeline and photos to write a proper one. I’ll say that it made me feel high and powerful and vindicated and confident and all of the things I thought it would. As it turns out, I’m not broken after all. My body works and it works best without intervention. Last Friday was an amazing day.

But I am finding myself sad in a different way about my cesarean lately. The postpartum hormones don’t help, I’m sure. But before, I was sad for some lost early moments with my son, but mostly just sad for myself if I’m being completely honest here.  I had such a pervading feeling of failure and inadequacy that is completely erased now.  But after Friday’s moments of holding my baby just as she came from me and pulling her from that water myself to lock eyes with her for the first time, I am suddenly reminded of that missing moment in my life with my firstborn.

And then I worry that he will grow up to know how powerful his sister’s birth was for me and how disappointing his was in ways.  And it doesn’t mean that I am disappointed with him in any way, of course.  I would hate it if he grew up to think that.  And I’m sure I am overanalyzing all of this since he is a boy after all, and he doesn’t want to know his mom even has a vagina, much less how I feel about babies coming out of it.  And in this haze of postpartum hormones, I know I am a little sad to see him feeling “left out” or not special anymore, even for a moment.  And that is spilling over into my memories of my kids’ births now, too.
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But what I am realizing is that it took a certain path for me to get to that place I was at last Friday afternoon.  The feelings of joy and elation and amazement are there for every mother, I know.  But my particular joy only came from the path I walked to get there.  I had to walk that road to bring me to that moment.  And I will never be grateful for how it all began for me, but I am so grateful for the path it took me down.  For the experience it gave me and the lessons I learned.  It shaped the type of mother  I became, and that person is still growing and would not have begun this path without what happened in October of 2009.  And that moment, crushing though it was at the time, made me a mother.  And as amazing and transforming as last Friday was for me, that is a claim Norah can never make.  My first birth made me a mama and that is a joy all its own.

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Birth

The VBAC Question, otherwise known as the chip on my shoulder

Stopping by today to post something I wrote 5 weeks ago.  Now that I am out of the pregnancy closet, so to speak, I can finally publish it. Most of these statistics and facts can be found in numerous places, but I’ve sourced a few references here to be direct.  It’s an issue that I never thought would affect me and one that affects one in three American mothers.

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As I write this, I am only 7 weeks pregnant and haven’t told many people at all that there is an exciting new chapter ahead for my family.  I also can’t muster the energy to think about a nursery or baby names or much else that lies at the end of this part of the story because I’m right in the thick of that pregnancy icky-ness that overtakes you at about this stage of the game.  The fatigue.  The “morning sickness” that sticks around too late in the day.  The sore boobs.  The tiny cramps that make you wince in anxiety when it’s probably just the expected growth taking place in your body.  I can’t think much about the end or how this baby will arrive here and how I’ll be at that time.  But despite my inability to really focus on that, I know one thing for certain.  I want a VBAC.

Want really isn’t even the right word to use here.  I yearn.  I hope.  I pray.  I need.  And I have for the past 23 months and two weeks and some-odd days that I’ve lived in my post-cesarean body.  Every time I undress and step in to the shower and glance at that scar, I pray for a VBAC.

Some people surely think I am unhinged, and I’m becoming okay with that fact.  But that doesn’t change my feelings on the issue or what I want for my life as a mother, what I want for the beginning of a new life with the tiny one I’m growing.  It’s so hard to explain to people, why my cesarean threw me so off-track.  Why I hate that it happened.  Why I still cry about it at times.  And the truth is I don’t know why some of us are so affected by surgical birth and some women don’t mind it or even prefer it.  Some movies probably make you cry hysterically, and I don’t even bat an eye.  That’s life.  I don’t know why humans are different beings affected differently by the world around us, but we are.  And I wish I didn’t have a chip on my shoulder about this, but I do.  It’s a wound that heals and reopens again and again, and I expect it to be that way for a long time.

The best I can explain it is that I feel like I missed it.  Like I wasn’t even there for the birth of my own firstborn son.  I wasn’t under general anesthesia, so I was kind of there, I suppose.  But it doesn’t feel that way for me.  My arms were tied down like a crucifix, and my baby was extracted from me.  When I think back to my son’s first moments of life, that is what I remember.  Then the anesthesiologist knocked me under without asking my permission, woke me up three hours later, told me my gown was so bloody my family would think I was massacred, and stripped me naked to change me in the bright lights of a busy recovery room.  Then my husband walked up with my baby and there he was: my newborn son.  I could not touch him or hold him where I was, so we went to get settled in my postpartum room where I could hold him finally.  And as the days passed, I was so grateful for the 20 or so hours of intense pain and real labor that came before surgery because they seemed to tell me that he was really mine and I was really a mother.

I am fully aware that some of you reading this are thinking I should shut up and be grateful for a healthy baby, and you might tell me so in the comments.  And to that I say, I know.  I know I should be grateful for his health, and I am.  I know there are women who don’t have healthy children to tuck in at night and women who have years of trouble conceiving those children in the first place.  And of course my pain would multiply ten times over if he’d emerged from that surgery with health issues.  But grief is not a competition, and while I hold a lot of gratitude for so many things in my life, I hold a lot of grief for the abrupt way that motherhood began for me, for some lost moments and feelings that won’t ever be returned.

Still though, despite a healthy baby, I spent the next month of my life crying daily about how I was defective and my body didn’t even work and I didn’t deserve a baby because I was not a real mother.  I don’t talk about it much, and only my husband and close family really saw the full psychological result of my cesarean, but it was intense and painful.  And slowly these wounds have healed, but I am swallowing a knot in my throat as I type this, so there is still so much work to be done.

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As I was being prepped for the OR after almost four hours of pushing with an occiput posterior baby, I vowed VBAC for my next one, and I heard two voices in the room – both medical professionals – responding to me.  One said, “Oh, VBACs are too dangerous.  Nobody does them anymore” and another said “Of course you can and that would be better than repeat surgery and they are totally safe.”  So immediately, I became acquainted with the VBAC debate, and I have researched so much since then.  You have no idea (or maybe you do for those of you who know me well) how much this issue has consumed me.

In part, I was simply confused.  Typically the medical community can agree on such a straightforward thing, right?  Yet even as I was just beginning discussion of the idea, right there in my labor and delivery room, I was getting two vastly different answers.  My cesarean was really emotionally scarring for me, and I yearn for a vaginal birth to replace some of those memories with a birth the way nature provides, but I also know that doing something dangerous would not be the solution, and I truly wanted to make a decision that (my emotions and baggage aside) would bring us the best chances of a safe outcome for mother and baby.  So as the months have gone by, and I am reading and reading and reading every medical article I can get my hands on, I find this:

  • ACOG endorses vaginal birth after cesarean (or VBAC), and ACOG is the governing organization of every OB in America. (source)
  • Yet it is estimated that between 50-80% of OBs in America refuse to do VBACs. (source)  I speak from personal experience that here in Atlanta, it’s more like 95% won’t even touch it.
  • VBAC is an assumed course of action in other countries such as England, Australia, and the Netherlands, and every study you see lists their maternal care rates as far higher than ours.  We have one of the highest cesarean rates in the world, and our maternal morbidity rate is the worst of any developed nation.  (source)
  • As a woman with a scarred uterus, I have a 0.4% chance that my uterus will rupture during labor.  (Some studies show a bit lower for a mom with only one prior cesarean.)  To put that in perspective, I have a 99.6% chance that my uterus will not rupture in labor.  By comparison, as a first time, unscarred mom, I’d have a 0.7% chance that the placenta will detach from my uterine wall (source) which has dire consequences like hemorrhage, yet none of us think about that going in to labor, and doctors don’t just section everyone to avoid it.  As a first time, unscarred mom, I’d have a 0.5% chance of dangerous placenta previa occurring (source), yet doctors don’t say surgery is necessary for all unscarred women and we should all avoid labor just in case it happens.  Are you following me here, reader?  American women are repeatedly cut for fear of uterine rupture when other dangerous complications are actually more common, yet we don’t worry or sign up for surgery to avoid those risks.  Essentially, the risk associated with VBAC is about the same, or in some cases lower than, the risk of various other complications in birth.   This table explains what I’ve just said in a simple and perhaps more easily understood way.
  • Cesareans do not come without physical risks.  It is major abdominal surgery where your internal organs are removed and reinserted.  Compared with a vaginal birth, cesarean mothers are at a sharply increased risk for hemorrhage, blood clots, bowel obstruction, and infection.  (source)  None of these things are harmless or pleasant.  Future reproductive problems also sharply increase with each cesarean birth – placenta accreta, ectopic pregnancies, and placenta previa. (source)
  • While I thought I was bizarre and defective for feeling so many psychological implications after my surgery, I’ve since found that there is a correlation between cesarean sections and rising rates of postpartum depression.  While every cesarean mother doesn’t feel this way, many of us do.  In fact, even orangutans with cesarean surgeries often don’t recognize their own offspring.  (source) Clearly I am not a monkey, and I sometimes feel like I bonded with my son even more powerfully in a we-went-through-hell-together sort of way in those early days.  But my point is that nature provides an exit route for our babies, and the cocktail of hormones that facilitate early bonding doesn’t happen with a cesarean.  It makes the early days much, much harder for many mothers.
  • It is essentially common knowledge by now that babies born by cesarean are more likely to have asthma, allergies, and breathing problems for the rest of their lives. (source)
  • Infections result from cesareans in about 1 out of every 20 surgeries.  (source)
  • I am three times more likely to die from a cesarean birth than a vaginal birth. (source)

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So if VBACs are safe, I hear you say, why do doctors refuse to perform them?  Litigation, ignorance, insurance.

VBACs were in vogue in the late 80’s and early 90’s here in America, and doctors were using Cytotec constantly in VBAC inductions.  (For more on the dangers of Ctyotec, read here.) If you look at the statistics from that time period, using Cytotec to induce a VBAC patient multiplies their risk of rupture more than twenty times over.(source)  Yet instead of just assuming it was the off-label use of the drug that led to ruptures (eventually realized because nobody uses Cytotec any longer, even on non c/s moms), doctors stopped doing VBACs all together and assumed they were dangerous. [Tangent, but the drug is supposed to be used for the treatment of ulcers.  It wasn’t even developed for use on pregnant women, and the packaging actually lists a warning that pregnant women should not use it, but it was used by doctors in labor inductions for over a decade!]

So fast forward a decade or two, and you have the National Institute of Health, the World Health Organization, and the American Congress of Obstetricians and Gynecologists all telling physicians that VBAC is safe and even preferable, yet most obstetricians still won’t touch the VBAC question, and they’ll quickly tell patients that vaginal birth would just be far too dangerous because of a risk that is 99.6% likely NOT to happen.  As Dr. Shelley Binkley says, “It’s a numbers thing.   You don’t get sued for doing a C-section. You get sued for not doing a C-section.” (source)

So safety and the recommendations of professional accrediting organizations are cast aside, and my personal health decisions are left to the preference of insurance companies and doctors who have more regard for litigation-shaped practice than they do for research-based practice.  Obviously, some doctors see a problem with this, and the debate continues.  Dr Robert DeMott of Bellin Memorial Hospital explains, “Patients are being hoodwinked into choosing cesareans by overblown fears …… Putting it bluntly, it’s unethical to recommend a practice that leads to more patient deaths.” (source)

So this pregnancy, I am driving 50 minutes to and from my provider for standard pregnancy appointments.  On the way there, I pass countless other offices who refuse to do VBACs or say that they do, but records indicate they see only a handful every year which is not a level of expertise I am comfortable with.  If you want to go with a tried and true VBAC provider in the metro Atlanta area, one who has seen hundreds and is experienced in how to handle them and how not to handle them, you have two choices.  Two.  In a major metropolitan area swimming with babies and obstetricians.

So do I have a chip on my shoulder about the VBAC issue?  Absolutely.  But not because I am some nutcase who measures my macho maturity by my ability to push a baby out my vagina.  Not because I am willing to put my baby’s life at risk for my own experience.  I have a serious issue with this subject because I am forced to fight so hard to achieve something that is a standard of care in many other developed nations, something that major research institutions have proven is safe.  Something that, plain and true, leaves me with a lower risk of death and complication than the alternative.

I don’t think well-informed women who choose a repeat cesarean section are necessarily making the wrong choice.  They are entitled to choose what works best for their health and their own family.  What I desire is that same choice for myself.  If a vaginal birth is possible and, according to leading health agencies, not posing incredible risk to myself or my infant, I should be entitled to make that decision about my own health and my own body.

Birth comes with no guarantee.  It can go beautifully with absolutely no complications (as it usually does) or difficult and dangerous things can happen.  I find that’s the case with most things in life though, no?  All we can do is research, make the decision that leaves the lowest foreseen chance of damage, and trust that things will unfold as they should. For me and for the baby I’m carrying, I’m confident that choice is to pursue a vaginal birth.  And do I know I will have a vaginal birth?  Of course not.  It’s why I am giving birth in a hospital with an OR in the case that I need to have surgery to save the life of that baby.  But unless that surgery is truly necessary, I don’t see why I should sign up for something that is no trivial matter.

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ETA:  I did have a beautiful vaginal delivery about 7 months after I published this post.  To read my birth story, click here.

Birth

Not much to say today….

Things have been quiet here because things have been not-so-quiet at home, and I’ve not had the time to write.  I’ll be doing that soon though.

For now, I’ve not got much to say, but I would like to share this video with you. I’m honored to be a part of one of the organizations featured here, and of course it’s a cause close to my heart.  I don’t think most women realize how constricted my choices are in terms of birth, and this film does a great job of conveying that.  I love that Atlanta is featured in this film, but I ache for the women who don’t have any choices at all.  And I can’t believe that TWO reputable physicians doing VBACs in Atlanta is a high number compared to other US cities.

Anyway, I’ll stop rambling so you can watch.  It’s not embedding for me, so you’ll have to click here to see it.  Yes, it’s 24 minutes long, but it’s worth it.

(Oh, and I should add that the triplet mama you see in the video did deliver them vaginally a few weeks ago!)

Baby, Birth, breastfeeding, motherhood

Jude’s Birth Story – Part 3: The After

This is the third part of the series.  Be sure to begin with chapter one and chapter two to get the entire story.

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This chapter, in ways, is the hardest for me to write, but also the most important, I think.

The weeks that followed my delivery were rough.  There was the physical healing with both an incision and some vaginal tearing as well, and there was so so much disappointment.  I’m not saying that cesareans are like this for everyone.  I know plenty of women who prefer them, and I understand that every woman’s situation and response is unique; all I can write is my own story and what it was for me.  I think women who have a hard time healing emotionally after a cesarean birth are often seen as crazy people who care about the vaginal birth above the health of your baby.  This is not the case at all, and I understand that surgical birth can save lives that would have been lost a few generations ago.  Nevertheless, I feel like a hole is carved in the memory of my son’s birth.  I will never feel my first-born, warm and fresh, laid on my chest.  I will never be the first one to hold him.  I will never feel him pass through my body on his entrance to the world. It is a moment I can never get back, and one that I craved not because I’m selfish or because it’s a medal of honor or because I wanted to feel pain but because I am a mother, and that is how my body is designed to begin that journey.

Yes, I was in love with this beautiful boy and admiring him more everyday, but what surgical birth robbed me of is the feeling of confidence and contentment in my own body, my own abilities as a mother. I’ve written here before about my problems breastfeeding, and that certainly added to my self-doubt.  I can remember one instance where my mother and sister came by for a visit, and Jude was something like a week old.  I sat on my couch in my dirty, sweaty, stained pajamas and cried about how I was defective.  My body didn’t work.  I was not capable of pushing a baby out, and now I couldn’t breastfeed.  I truly felt, at that moment, like I wasn’t cut out for motherhood and I didn’t deserve my baby.  My cesarean robbed me of joy I should have taken from those first few weeks, and that is something I can never, ever get back.

In the end, it took many things from me.  What did it give me?  A healthy baby boy first and foremost, but a few other things as well. It gave me an appreciation for my hours and hours of intense unmedicated labor.  It is because of that time spent working through every rhythm that I can remember Jude’s delivery as ours alone.  When I think back to his arrival, it is those 22 hours spent in a dimly lit room focusing and breathing with my husband and my doula that I reminisce on.  Many women look back at natural childbirth and remember pain pain pain.  I sincerely appreciate that pain and will do it again gladly.  I am not sure I would have that admiration for the process of labor if mine had not ended the way it did.  My cesearean also gave me a ridiculously stubborn determination to breastfeed. I’d like to think that, even with a perfect natural birth, I would have kept fighting until we got breastfeeding right, but one thing I know is that I craved that confidence in my body and my abilities, and I refused to let my surgery take away my nursing relationship with my son.  It was a lot of crying, a lot of pain, weeks of hard work, a pediatric ENT, a frenulectomy, and 5 lactation consultants, but in the end, I felt relieved to have us back on nature’s path that I felt was right for us.  Lastly, my cesarean has left me plugged in to the birth community in a way that has proven so helpful.  My local chapter of ICAN is very active, and their message board has been infinitely interesting and useful for problems big or small.  My interest in birth, ongoing as a result of my cesarean and the choices it has left me with, is blooming in to an interest in informed parenthood that is continually connecting me with others whose stories and advice make me a better mother everyday.

So at the end of the day, what do I know for sure? I know that birth is a natural process. I know that every woman’s body is different, and nature  knows what is best.  I know that medical intervention is necessary sometimes, and at that moment, it was necessary for my Jude to arrive safely. I also know that medical intervention is overused, and we have to change the way we view birth in this country.  I know that, when you really look at the research, VBACs are indeed safer than repeat cesareans. I know that sometimes life is completely unfair and it absolutely sucks.  I know that a delivery that was so frightening and so difficult has bonded me with a little boy in a way that I never dreamed was possible.  I know that breastfeeding does more than nurture a baby, it heals a mother, too.

I believe that every baby has the right to choose his or her birthday. I believe that every mother has the right to refuse medical intervention that is not absolutely necessary.  I believe that even informed women can be bullied into decisions they know are not right.  I believe that doctors who intimidate women  into deliveries that are “convenient” and overly-controlled make us feel powerless, and they should be called to task for this.  I believe that birth is a rite of passage, one of the rare moments in life that women remember for every second thereafter, one that changes who you are in a single instant.  I also believe that one day, I will have  a beautiful, natural delivery that will validate my body’s abilities and be a source of redemption for me as a woman.

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One of the things I love about the blogging community is the inspiration I find from all of you.  Kelle Hampton’s approach to life’s obstacles sheds light on my own challenges every time I read her posts.  In comparison, my birth story does not hold a candle to hers and neither does my situation, but she wrote something once that hit me at my center.  She said birth is a beautiful transformation, “Especially when it’s a little bit scary. It rocks you to the core. Picks you up, smacks you down hard and then rebuilds you with all new parts…..the minute you welcome [a baby] into your life, you inherit a thicker skin…because the bus will hit you plenty of times to the point you’ll think you damn near died. But you don’t. You pick yourself off the ground, dust off your knees…and move on. Because beauty awaits. The beauty that fills in all the holes and rough spots.”

And rough spots there are.  The scariness, the ugliness, the overwhelming unfairness is what really began my journey to motherhood in a big way.  I cannot forget that.  I cannot pretend it didn’t happen.  But for now, I can dust off and move on and cherish all that it taught me.  I can’t say I’m grateful for it yet, but we’ll get there.  In the meantime, there’s too much joy to dwell on the ugly and too much love to be weighed down with disappointment.

Baby, Birth, motherhood

Jude’s Birth Story Part 2: The During

If you’re starting here, be sure to read the first chapter as well.

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First I have to admit that relaying this part of the story is only possible because of the timeline my doula provided and the details my husband and sister remember.  While I remember most of it in one way or another, the idea of time is completely and totally foreign to me when I think back to that day.  I also have to admit I had to let go of a lot of vanity showing these photos, but at the end of the day, I am so, so grateful I have them.

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Checking in to the hospital, they confirmed all of my medical information and verified that I was being admitted as a result of low fluid levels.  I said, yes, my fluid was a 7, so it had gotten progressively lower, but I explained that I didn’t feel that urgent.  The nurse glanced at me, smirked, and said the doctor had written fluid level of three on my forms, but that he had a habit of “fibbing a little to speed things up.”  This bothered me immensely, and it certainly did nothing to calm my nerves, but it did verify that I, in fact, was right in knowing that a seven was nothing of concern.  She completed a cervical exam though, and I was 100% effaced and 3 cm dilated at check-in, so that was good news.  At 6:30 pm, they inserted Cervadil and told me to get some sleep.  Scott and I talked, called my doula, and generally wasted time and watched television until we decided to try to get some sleep.  The hospital had offered me a mild and safe sedative, and I took it hoping to calm down, get some rest, and have energy for a Pitocin drip at 7am the next morning.

I dozed from something like 10 pm until 11:45, but some intense cramping kept waking me.  At midnight, a nurse came in and stated that I must be dehydrated because I was having contractions. (Nothing to do with my being 41.1 weeks pregnant, I’m sure.)  She hooked up a bag of fluids to my i.v. port and left the room.  I’d been drinking water all day, mind you, but on came the intravenous fluids. These pains continued to get stronger and stronger, and I certainly couldn’t sleep through them.  At 1:00 a.m. , the same nurse came in and removed the Cervadil after telling me that I was, for sure, in labor.   So my induction consisted of about 6-7 hours of inserted synthetic prostaglandins, but that’s it.  No intravenous Pitocin! I woke Scott at about 2:30 to tell him I needed help focusing and getting through these contractions.

By 3:15 a.m. things are moving along faster than I expected, and we call my doula, Pam.  She arrives at the hospital by 4:30, and according to her notes, my contractions are steady at every 2-3 minutes. By 6:30 a.m., my sister arrives as part of my labor team and my contractions are coupling, as Scott said at that time, “It’s like aftershocks after earthquakes.”  A nurse tells me to lie on my left side to regulate them.Things start to get a little hazy here, but I remember a lot of back labor and some very focused breathing.  My water breaks – in a steady drip, not a gush – at 8:30 a.m., and my amazing husband is behind me all the way. My contractions are definitely felt in both my belly and my back.

At 9:10 the on-call doctor comes in and is so welcoming and encouraging.  Her exam shows that I am at about  8-9 cm with a noticeable anterior lip of cervix. She manually breaks my bag of waters (what was left) hoping that will speed things along and help me get over that cervical lip.  The baby is a -1 station which is still a bit high for this stage of the game.  I have an awesome nurse named Tracy who is letting me go off the monitors fairly often and move around to ease the pain.  She’s also holding them to my belly as I bounce on the ball which is amazingly supportive.

I remember bouncing on the ball and saying, “Everyone leave me alone.  I need to go to the bathroom.”  I get up to head that direction and nurses in the room scream, NO. One asks if it feels like I need to poop which is usually not information I willingly share, but I assure her that yes, it does.   The nurse informs me that I could be very, very close to push time, but that I need another check before I get the okay.  They check me again and I am at, as my doctor describes, a 9.5 – that damn lip still won’t move. During my next contraction, my doctor tries to manually move the anterior lip, but it won’t budge. She tells me to open my pelvic floor as best I can, but fight the urge to push.  If you’ve been in labor, you know what this means.  It’s like saying fight the urge to vomit, not to mention that opening your pelvic floor while fighting the urge to push is opposite in nature.

This is where things get really, really fuzzy.  They catheterize me (ouch!) to move things along faster, new people come in the room with all the baby lamps and gear, my doctor places the covers over her shoes. Everyone is saying I’m almost there, and one nurse tells me that she knew from the moment she walked in hours ago that I would make it all the way.  “I could just tell when I saw you, I said, ‘she’s going to do it.'”  I start to cry saying I will meet him soon and this is really hard not to push.  I want to see him.  I just want to hold him.  I want to push. Can I please push?  I am going to push?  I’m trying so hard.  This is so hard. Then we find that we really aren’t that close as my body refuses to fully dilate.  Some time between 9:30 and 11:00 a.m., I go from feeling a little pushy to oh-my-god-I-am-going-to-push-this-baby-out-I-can’t-help-it.  The urge to push at that point is the most overwhelming physical sensation I have ever felt in my life.   Eventually I find myself lying on my side on the bed with Scott behind me, and I am kicking my legs like scissors as hard as I can with every urge to push.

The rhythm of things at this point is urge to push, contraction, rest between contractions. Urge to push, contraction, rest between contractions.  Again and again. I remember feeling the contraction swell like a wave and being so grateful for the pain, loving the pain, relishing the pain because that meant that the pushing feeling would disappear. I loved the rest between contractions , too.  But I would get scared after a few seconds because I knew the pushing feeling was coming.  I’m telling everyone I am so scared because I am pushing.  I can’t help it.  I’m pushing. The nurses start to look concerned.  My doctor comes in,  She tells me that she knows I didn’t want to go this route, but that an epidural may help to open me up.  Fighting the urge to push is keeping things tight.  She also warns that tearing my cervix would lead to major swelling and we really don’t need for that to happen.  She leaves the room, and I say there’s no way I am getting an epidural when I have made it to a 9.5. Then some more time passes, I don’t know how long, and I say I can’t do it anymore.  I get an epidural or I push this baby out.  Now.

So the anesthesiologist is called, and it seems to take her forever to get here, but she finally does and the epi is inserted.  I hate it, and it feels so weird and disconnected, but I am not trying to push him out.  I am not yelling or crying or kicking my legs like scissors, so that’s good.  Scott is relieved.  I don’t blame him; being the spectator cannot be easy.

Notice how incredibly swollen my face is. Ugh.

Time is so weird when you are in labor. For some women, they think it’s been hours when it’s only been minutes.  For me, time was racing without my realizing it.  The clock had been covered in our room since about 4am.  I honestly thought it might have been something like 11 or 12.  When my doula told me it was past 4pm and that I had fought the intense urge to push for 5 hours, I was shocked.  No wonder everyone else looked so exhausted.

By 6:10 pm , I complete dilation, so my doctor’s suggestion of an epidural, in this case, was a very good one.  She warns me, though, that Jude was still quite high, and it might be a good idea to sit up in the bed and “labor him down” for a while and make pushing easier.  I agree, and at 8:30, we finally had the go ahead to push.  The first couple of pushes, I can’t feel anything, so I tell the nurse to turn down the epi. Every time she turned it down, I tell her more, more because it is so incredibly weird to feel so much so intensely and then nothing at all.  So by the time we are really pushing, I am feeling the pain and the urge – although not nearly as strong as before.  The first hour or so of pushing, everyone is cheering me on and they sometimes say “That was a good one!” or “You brought him down.”  They give me a mirror for motivation, and soon we see hair!  Not far down; he certainly isn’t crowning.  But up a ways, we can definitely see hair.  I am so happy and relieved after almost 20 hours of labor; I know I will see him soon.

But after a while, a weird thing happens.  He doesn’t seem to be moving anymore and people stop congratulating me.  My doctor is trying to get her hand as close to his head as possible and I am bleeding from some internal tears.  No one is really saying anything.  Scott is cheering and motivating, and my doula is patting my leg and encouraging me, but I can tell something has changed.  My doctor mumbles something I cannot hear, and my sister looks at me and said, “He’s posterior, Katie.”  Okay, I say.  So what do we do? Should I change positions? My doctor explains that she doesn’t think he’ll get out “this way,” but that his heart rate is okay, so I can keep trying.  In hindsight, I know she knew where this was headed, but I am forever grateful that she allowed me to make this as much my birth as it could have been. I decide I am not done yet.  I push for another 40 minutes or so.  Finally I lie back on the bed and just say, okay.

My doctor says hold on a minute and puts her hand up me.  I know she is pushing him back up.  The urge to push is back, and I want to do it so badly.  I suddenly realize I am really, really exhausted.  I start to cry and say it hurts. My doula rubs my leg and says, “You are so strong. You’ve done so much, but we have just a little more work before the end okay.”  The doctor leaves the room.  The lights go on.  The room fills with people I haven’t seen yet.  They pull up my hospital gown and shave me.  Another anesthesiologist comes in and doses the epi really high. I start shaking uncontrollably.  Like seizures shaking, seriously, out of control.  I vow VBAC for my next baby, and I am told “They don’t do those anymore.  They are too dangerous.” I am wheeled in the hallway and to the OR.  The surgeon shakes my hand (my doctor is assisting him).  I’m just crying and I say, I tried so hard. I tried so so hard. I’m still shaking uncontrollably.

I hate this photo so much. I've never shown it to anyone. Hate hate hate it.

I feel them tugging.  I smell burning.  My doctor pulls my baby out of me at 11:46 pm. My husband shows him to me.  He is beautiful, but I cannot touch him or hold him.  I am shaking too much.  Scott tells me he has my eyelashes, and that is the last thing I remember.  I wake up 2 hours later, and my husband and son are next to me.  I am a mess. It was only the next day, that I could smile like this.

Somehow the ugliness, the disconnectedness, the unfairness of my delivery melts a little more every time I look at this photo.  I worked so hard, and I loved him so much already.

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So what caused my cesarean? I guess I’ll never know for sure.  For a long time, it was my belief that Jude was not positioned correctly and that in a few days time, he probably would have maneuvered to the right fit and labor would have begun.  No woman has ever been pregnant forever, and I would not have been the first.  I’ve read that Cervadil is stronger than it’s given credit to be and that it can, in fact, induce labor.  When I read those sorts of things, it’s my belief that my induction led to my cesarean. Worst of all, I feel like I was bullied into the induction and can remember that sick feeling in my stomach when I knew things were going down the wrong road.  It’s hard not to blame myself, to feel stupid and a little broken.

On the other hand, I’ve read – and even been told by a reputable midwife – that if my body responded to Cervadil in a few short hours, I was ready to go and in early labor anyhow and it most likely had no effect on the outcome.  I know other mothers who ended up in the operating room for a stubborn posterior baby and had no medical intervention at all. When I hear those sorts of things, I believe that there was really no “cause” and that is perhaps even more frustrating than playing the blame game.

I can question every decision made along the way.  What if they didn’t break my water?  What if they never gave me fluids? And the big one, what if they had just let me push despite the large lip?  Why would nature give me such a srong urge if it wasn’t time? Even in hindsight, there are so many uncertainties. I know a few things for sure though: I certainly didn’t grow a baby too large for my pelvis (one that was over a pound less than estimated, by the way).  I wasn’t incapable of giving birth vaginally because God made me some odd way.  I don’t think my body is a lemon, but I did for a really, really long time.  The road to healing was pretty long, and for more on that, read the third chapter of my experience.