Delco Doula | Lori Daley | Birth and Post Partum Doula Services | Childbirth Classes | Delaware County | Main Line | Greater Philadelphia Area |
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Info and Support for Preventing Primary Cesareans

7/21/2014

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Today I want to say that ICAN is about supporting the first time mom, too, not just those hoping for a VBAC. It is a great resource for preventing that primary cesarean birth. As is the VBAC facts site and Jen Kamels who runs it and teaches a workshop around the country and online.

http://www.ican-online.org
www.vbacfacts.com

Our local ICAN of SEPA:
http://icanofsepa.wordpress.com
https://www.facebook.com/groups/411506922273373/

I'm also linking a story here that offers a great explanation as to why we fight so hard to help mothers avoid their primary (and too often unnecessary) cesareans and to birth vaginally. It details the risks and dangers to mothers of multiple cesareans. This mother is not alone, more and more of these examples are making news because they are becoming more prevalent problems in pregnancies and in the OR. Just to be aware, though, I had tears in my eyes the whole time while reading. She does a great job writing so that the reader can almost feel her fears through what was a very scary experience. To clarify, MOST 1st and even 2nd repeat cesareans will be manageable by most hospitals and with what blood they have on hand for possibility of transfusing...I do not want to scare moms facing a repeat cesarean where they NEED to trust and depend on a doctor to keep them safe, but this story also shows how a mother did her homework to do just that - be in the best place with the best team to make sure she'd be going back home to her kiddos. This was simply the situation she ended up in during her 7th pregnancy. Her placenta became deeply implanted into her uterus and cervix after multiple previous surgeries to her uterus. 

As a doula, I never want my clients to have any good answer to the question, 'what else could I have done to prevent my first cesarean?' This is especially important when moms desire a larger family. I have had friends and family members tell me that their doctors never once mentioned to them before, during, or after their first cesarean that they'd need to consider limiting family size due to having that surgical birth and the increased dangers of multiple pregnancies and cesarean births following. And not just that, but that they'd not been offered a chance to VBAC and instead told that it is dangerous to try, safer to schedule ANOTHER cesarean, and just accept having 2 children or at most 3 if she really really wants to risk it, but no more! Women are being told this AFTER their second cesareans when their options are nearly nil at that point! It's infuriating. And sad. More women need doula support through their first pregnancies and births, good information, supportive care providers, and to visit their local ICAN group before having their first babies if we want to stop this trend from continuing. Women need the truth! They need their options! They want to make informed choices! 

I recently met a nurse who told me there is a doctor on her floor who frequently says all babies should be born by cesarean and has no problem recommending tube tying after the second to all mothers. I seriously hope he is in the extreme minority. But I have a feeling that while we do have docs who truly believe in the safety of and support less medicalized vaginal birth, the number of docs seeing their norm everyday be cesarean deliveries is increasing by the day. This will just continue to have an effect on moms and babies (physically, mentally, emotionally!!!) if we don't advocate for ourselves and surround ourselves with professional support and evidence based information. 

And while I'm thinking of it. Hug another woman today. Love her with that hug, if even for just a few seconds. We don't always know each other's journey. 


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Sienna's birth (unmedicated hospital birth, first baby)

8/18/2013

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My husband and I had a baby girl on Sunday, May 26! Overall, it was an amazing experience, and I could not have asked for a better birthing.

I was in the shower at 5 pm on May 25 when my water began leaking. I was 38.5 weeks and feeling huge, but my expectation all pregnancy was that our baby would arrive late. I was kind of shocked when it kept leaking and I started to have irregular contractions. My sister Ellen--my birth partner, in addition to my husband—and her fiancé were already at my house, so we just kind of waited it out knowing we were going to go out to dinner once Garrett got home from work. I threw some things in a bag in case this WAS it and started bouncing on my birthing ball. 

I called my doctor at 8:30 as I was leaking more and more. My contractions were all over the place--anywhere from 5-10 mins apart. But they were not painful at all-in fact sometimes I did not even notice them beginning and ending. My OB was on call and asked that I come in immediately so they could confirm whether my membranes had ruptured. I was pretty worried to be going in so early with what felt like such minor contractions, as I anticipated that I would end  up on Pitocin immediately. I was admitted to Delaware County Memorial Hospital at around 9:15 and had my first cervical check at 10 pm. My OB confirmed my membranes had ruptured. I was 3 centimeters dilated and 100% effaced (I was 90% effaced at my only cervical check before that at 36 weeks). 

My OB said with such erratic contractions she would normally start pitocin, but she knew I really wanted to labor naturally, and agreed to return to check on me in a few hours to see if labor would progress on its own. I moved around a little through the first stage, but my first nurse—who I didn’t really like(!)--really wanted me to stay on the monitor as much as possible, so I spent more time in bed and pacing right next to it, than I would have liked. I also tried resting while my contractions were not painful because I missed dinner and knew I would be up all night. I did eat a couple protein bars and some snacks while I was there, but not much because I knew I was breaking the hospital rule!

I did begin to progress on my own and by around 1 a.m. my contractions were getting more difficult. I used breathing techniques from Lori’s class as well as Hypnobabies tracks. As the contractions got harder, I bounced on a birthing ball for a bit and Garrett or Ellen applied counter pressure on my sacrum. I also drank a LOT of water. My 2 am cervical check revealed I was 4 centimeters dilated.

When the nurse came in to check on me at 4 am, I asked to use the birthing tub. She said no and that because my membranes had ruptured, she didn't "think" it was safe. I was pretty ticked and let her know that! She vowed to "check the policies" but basically did not return until 6 am right before her shift change. I was also checked before shift changes and I was only 5 cm dilated. I honestly thought that was a joke—how had I only progressed 2 centimeters after 8 hours—and a sleepless night of hard work!? :( My contractions were so strong, I felt as though I had to be further along. My OB did inform me I could use the birthing tub though and that my next nurse was going to get it ready for me--that was good because I was feeling a lot of pressure on my back at that point. She also introduced me to the doctor who was taking over her shift. 

My new nurse was great and encouraged me to stick to my plan and labor out of bed as much as I wanted to. It was such a relief! I got into the tub around 7am and did not get out until 9. It was great as it relieved the pressure on my back and I think it really helped the baby move down. The only problem is, I continued to drink tons of water and eat lots of ice chips while in the tub...so when I got out, I had to pee a lot! And I couldn't empty my bladder all the way because of the baby's position. 

The doctors had wanted me to progress to 7 centimeters dilated after the tub, but I was only at 6. My new doctor recommended Pitocin. We asked for more time to think about it. That's when two unexpected emergency c-sections pulled the doctor away for more than 2 hours. It was really a blessing for me because I was able to labor on my own without a doctor hovering or suggesting I wasn't progressing quickly enough. I stayed out of bed and remained active, laboring in different positions, often using the birthing ball. By 11:30 when she returned, I was 7 centimeters dilated (they wanted me to progress a centimeter an hour at this point). I felt like I needed to pee so badly but I could not. 

From around 11 until I started pushing, I was in the most intense pain. My Hyphobabies tracks were no longer helpful. Ellen and Garrett were very supportive, but I could tell they were worried about my pain (and I later found out they were worried about the growing crowd of family and friends in the waiting room). I started talking about getting an epidural and we started weighing the options and asked the nurse about it. I felt like I could handle all the pain, I just couldn't handle the extreme pressure on my bladder and not being able to relieve it by peeing! The thought of "erasing" that with an epidural actually sounded great. I eventually decided against the epidural with my husband's support. I had made it that far and would hopefully be ready to push soon...and I wanted to be able to feel pushing, and get up and walk soon after delivery. And I had prepared for a natural birth for so many months!

I don't remember vividly the time between 11 am and 1:30 pm, except the excruciating pain from having to pee! I got on the toilet so many times but with no luck! At 1:15, I was measured at 9 cm. They suggested a drain catheter to remove some of the urine from my bladder and hopefully get me to 10 cm. Both benefits sounded great to me, so I agreed. It didn't do much to relieve the pressure on my urethra, but it did get me to a 10. 

I didn't have an incredible urge to push, but the baby was low enough that I wanted to start pushing. We started around 1:45 pm. I tried several positions for the first few pushes. I ended up laying on my back (which I truly did not expect to like) because that's where the pressure on my bladder was minimal and where I was pushing most effectively (go figure!). I did tilt the bed up slightly so I wasn't completely flat. I was told I was an excellent, controlled pusher, but I attribute some of that to the fact that they normally deal with women who have epidurals and can't feel themselves pushing! The other part I attribute to going in knowing what to expect from Lori’s class!). 

The doctor came in at 2:15 -- she offered me an episiotomy, but I declined. I continued pushing while Garrett held my leg and Ellen gave me words of encouragement. I gave birth to our baby girl at 2:55. I had a 2nd degree tear and baby girl came out with her hand up by her face.

She weighed 7lbs 8.5 oz and was 19.5 inches. We wanted to delay cord clamping but compromised with the doctor for about a minute and thirty seconds. (We knew in advance this was something we did not agree on, but they would not allow skin to skin until cord was cut.). She was healthy with 8/9 Apgar scores. We did get skin-to-skin and she latched on right away. She had jaundice in the hospital, but it was on the cusp, so she never needed the light or formula.

Overall, I feel so empowered that I was able to realize my dream for a natural birth. It was so amazing to be able to let my body work just the way it is supposed to without all the interventions that have become the norm in hospital births! Since our baby girl came home, she has been a happy, healthy and thriving baby!

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Danny's birth

5/21/2013

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Our son joyously arrived at 10:08pm on Monday, April 29th.  He came on his due date, which happily is the first of my expectations he decided not to fulfill.  I had told people for months that we would have a May baby, but he had other ideas.  My husband and I were lounging on the couch in the afternoon of the 28th when I felt a sudden desire to rush to the bathroom.  I knew immediately that my water had broken and remembered to note the color, smell, etc. like Lori had told us.  Water continued to seep from me for the next eight hours or so, in varying amounts.  The amount of water surprised me!  Good thing I had a bag of sanitary napkins on hand.  

Dan (the husband, not the baby!) and I frantically packed our bags and called The Birth Center in Wilmington, which is where we were planning on giving birth.  Because I am Group B Strep positive, the midwife (Durenda) requested we come in and start an antibiotic.  I felt high and expectant on the ride to Delaware.  I had not had any contractions yet.   When we arrived  Durenda confirmed that I had experienced premature rupture of membranes (PROM).  I was about 2cm dilated and 60% or so effaced. She suggested that we take a walk and get something to eat at a local restaurant, which we did feeling anxious and gleeful.  After dinner, we considered getting a hotel, which would have meant that we would have to come back to TBC every four hours during the night so the antibiotic could be readministered.  Durenda suggested we sleep there, saving us the hassle.  Very nice!  

During dinner and the walk, I had several slight contractions that felt more like the Braxton-Hicks  variety with little pain.  Things were going slowly so we were reminded that if active labor had not begun within 24 hours of PROM we would be transferred to Christiana Hospital. After we returned to TBC, Durenda suggested taking some homeopathic tablets to help speed the process of labor.  She also presented castor oil as an alternative.  After consulting with Lori, I decided to try to castor oil immediately and try the homeopathy in the morning if it was needed. In hindsight, I should have done everything suggested immediately, but at the time I wanted to sleep a little and thought contractions would begin very soon.  I slept on my left side that night with my belly hanging over the edge of the bed to try to help Baby Danny position himself in the ideal position, with the knowledge that he had been on my right side for the majority of my pregnancy.  The castor oil did not kick in until early the next morning, and I had mild contractions through the night and was able to sleep pretty well.  

The next morning, midwife Sarah gave me the homeopathic herbs and Lori arrived with breakfast foods from Wawa. I was still only about 3 cm dilated and a little more effaced, but satisfactory progress wasn't being made.  I started to feel slightly desperate with the thought that we would be transferred, so after some more castor oil I tried nipple stimulation in the shower, which brought some better contractions.  After about thirty minutes in the shower, we tried taking a walk and doing some pelvis-opening stretches, but another exam revealed that I still wasn't 4cm dilated, which had been our indication that active labor had begun.  Sarah told me that we would need to be transferred, which was heartbreaking to me because I saw a C-section at the end of the ordeal.  I had a good cry, then we packed up and went to the hospital.   

As soon as we arrived, my contractions became more painful.  I was incredibly frustrated with the paperwork in triage, including seemingly irrelevant questions like the name of the county in which I was born.  Apparently, my husband, who took over after I showed clear frustration with the questioning, was also asked three times, "Are you sure she has no Spanish heritage?"  Not sure why this was of interest to them.  Finally, Sarah spoke up and asked if I could go to our room and we were told we could. We arrived in the room about 2:00pm.  As soon as we arrived an IV was started and I was given Pitocin to induce more contractions. The nurses were kind to all of us; I didn't feel any animosity about our wanting to do things as naturally as possible.  The nurses even seemed to respect Sarah and Lori's perspective and knowledge. I think they would agree.   

I found not being able to walk, squat, or move in general very difficult.  I turned to my left and waited between contractions. I experienced very little sensation in the front of my body, but the pain in my back was sharp.  Luckily, Dan never left my side and massaged both sides of my spine during each contraction.  Lori or Sarah stayed in front of my face, while the other stroked my leg or applied pressure on pressure points to help the contractions speed along.  

A habit I developed that Lori later said was unique: during contractions I sang or repeated phrases.  In the beginning, I said things like: "OPEN" in a firm, calm voice; "somos juntos" ("we are together"), a phrase that resonates with me after a trip to Mexico a couple of years ago; "ganbare!" ("go for it!" in Japanese); "there is no bliss like this" (a favorite affirmation from yoga practice); and simply "YES!"  I also told myself to be calm and that what I was feeling was a pain that creates, not that destroys.  As the contractions increased in duration and frequency, I sang long high notes or scales and didn't repeat phrases.   Lori told me I also sang "Somewhere Over the Rainbow." I could not have made it through without this comfort measure, which made me feel powerful and as though I was still in control of something.  At one point, the nurses explained that they were concerned about the baby's heart beat, so they wanted to use an internal monitor.  This device sticks into the baby's head using a piece of wire that looks like a screw.  Lori and Sarah said it was a good idea, and with the idea that a healthy baby was the goal I agreed.  

Around 9:00pm someone asked if I was feeling pressure in my bowel, which I said was true. The pressure increased with each contraction, and Lori was coaching me not to push but to use puff breaths during each contraction to avoid the urge.  During the puff breaths, I began to push uncontrollably.  The pushing felt like a sort of muscle reaction that I could not control, similar to what I imagine a seizure might feel like.  Someone (a doctor?  I never saw her again) said that I was fully effaced and dilated, so everyone agreed with smiles that I could start pushing.  A bar was used across the bed for me to put my feet on and the OBGYN on call arrived.  He said the pushing was going very quickly.  I commented to Lori and Sarah that this part was very satisfying and almost pleasurable because it was empowering to feel I was getting things accomplished.  Several other nurses joined us and everyone was shouting "Go, Sara! Push!" which really helped me stay motivated.  The hospital nurses commented that it was unusual for me to be smiling and seemingly enjoying myself. I think around this time I said to Lori, "I am a warrior" and she heartily agreed with an encouraging smile.  

I expected to be shocked by my baby, so had done a lot of visualizing during pregnancy of the moment when he emerged.  There was no shock involved, he felt like mine and someone I already knew. I don't think the visualizations had anything to do with this feeling; I just think it was the first hormonal reaction of motherhood to know that this creature is mine and no one else's, not even my husband's in the same way as he is mine.  

The placenta came away quickly, though I think the doctor had something to do with that as his arm was somewhere inside me just before it emerged.  The stitching process was not pleasant; I had a third degree tear because our baby was on the larger side (9lbs, 14 ounces) and came out with his arm wrapped around his head. I am disappointed with doctor's performance; he was by far the least caring member of the team and did nothing to keep me informed of what he was doing.  He almost seemed annoyed by my questions.  Our baby spent the next 3 and a half days in the NICU, which is another long story!  If anyone is interested I'd be happy to share.  The end result of all of this is currently asleep on my lap.    :)

Last thing for all you first timers who might come across this: a short list of recommendations.
1.  Hire a doula.  I VERY HIGHLY recommend Lori.  If possible, also have another support person plus your partner for a total of three.  I know that these people's presence there meant that the interventions were kept to an absolute minimum.
2.  Pack a bag in advance and pack as though you'll be gone for several days.  Better to have to much than too little.
3.  Get in shape NOW.  Even if you're already pregnant, find something to do that will keep you fit.
4. I hate to say this, but expect to be disappointed in the doctors you meet.  Find others to trust.   

THE END! Ah, but also a huge beginning for our family!  
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Birth StoriesĀ 

6/22/2012

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A collection of birth stories are posted below. Variety is included - medicated and unmedicated births, unplanned cesareans, VBAC's, homebirths, hospital births, birth center births, waterbirths, large babies, midwives, OB's, with and without doulas and more!  From a first birth to a fourth, these are real stories of women's birth experiences, told by the women themselves. Thanks to all who have shared already!  Others learn so much from hearing all the variations of labor and birth.  It is encouraging to read and hear other women's stories of birth - it builds a sense of community that we are sometimes missing in our 'real' lives since most of what we hear and see of birth from other women nowadays is on t.v. or negative, scary, dramatic events people like to share sometimes.  If you'd like to share your birth story on my site, please email me and I'll add it.

***For a collection of stories specifically about changing care providers, read here.***

   
Birth Stories

1) Rory's unmedicated hospital birth (3rd baby)

2) Isaiah's unmedicated hospital birth (1st baby - BIG baby)

3) Jonah's homebirth (4th baby, 2nd homebirth, born in the caul!)

4) Lakshman's birth (first baby, birth center) - Momma Rupal's blog "From Doctor to Mother

5) Nonah's homebirth (first baby, 10 lb baby!)

6) Luke's birth (first baby, hospital, cesarean)

7) Julia's hospital VBAC (Luke's sister!)

8) Gabe's birth (third baby, RCS)

9) Leo's birth (unmedicated hospital birth, 3rd baby, after a traumatic 1st birth and 2nd baby loss)

10) Lilliana's birth (postdates hospital induction after birth center transfer)

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Gabe's birth story

5/25/2012

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Thank you to Tracy, my dear client who is sharing with us her latest birth story and photos. She has had quite an amazing journey.  I felt connected to her and her husband from the first time I met them at an ICAN meeting. They were so full of passion after all of their past experiences and they were determined to make truly empowered decisions this time around, hoping for a VBA2C.  When we met for our prenatal appointments, it was so obvious how much they LOVED each other and how they thought and worked like a TEAM. I was lucky to join their team and be a part of their third child's birth...Gabriel. After an rollercoaster of events in the last couple weeks of Tracy's pregnancy as she navigated quite gracefully through a pretty nutty bait and switch routine from a supposed supportive doc, Gabe was born via a second repeat cesarean, delivered by another doc she trusted and very much on her terms for many reasons...finally. It was a beautiful moment watching her meet her son. I was and am so happy for her and her husband Brian (who was such an awesome support). I also thought it was cool that Gabe now shares a birthday with not only his dad, Brian, but also my son, Keegan! :)
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Gabe’s Birth Story

To tell the story of the birth of my 3rd child Gabe I have to begin with the births of my first 2 children. Lucas was born in 2007, after a comfortable and very uneventful pregnancy. I had done everything that all of the books and pamphlets tell you to do, I had all the tests done, I went to birthing classes at the hospital, I took a breastfeeding class, I was ready to give birth, and anxiously awaited the moment that I would realize that labor had begun. That moment never came. I had fallen while I was walking our dog when I was 38 weeks pregnant and it was discovered then that he was in a frank breech position. When a doctor from my group finally came to see me, I asked for an ECV and was instead scheduled for a section 2 weeks later. I pressured them for another week to try to turn him and they finally consented but it was too late, my ECV was the day before my “elective c-section” and they wouldn’t perform it because I was just too far along, Lucas was too big, and I didn’t have enough fluid. So they sent me off to get pre-op blood work done. I sat in the waiting room crying, my mother sitting next to me trying to tell me that it was going to be okay, but I didn’t believe her, How did this happen? To me of all people, I was so ready to feel the pain, and wonder that childbirth had to offer, and was ready to see the life that had grown in my body enter the world. There was a middle aged woman sitting across from me in the waiting room and she asked why I was crying, my mother told her, and with the best intentions the very nice woman told us she had 4 wonderful children all born by cesarean, and that she had never been in labor and that it was going to be ok. My response to this was even more tears, I didn’t want to go through life never knowing what it was like. The next day my beautiful son was born, delivered by a doctor I had never met, I saw him for a few minutes and then he was taken away from me for more than 4 hours, because “that’s just how they do things.” Later on (4months later) we discovered that Lucas had a cranial defect that also would have prevented a vaginal birth, regardless of his presentation. This still didn’t make me feel better about anything.

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The calm and kind anesthesiologist took the photo :)
About 5 seconds after Lucas was born I started planning and hoping for a VBAC, something that I had read about, and seen on TV’s various birth shows. I was going to VBAC and that was that. I left the practice that had delivered Lucas, and found Midwives that I really liked and felt very comfortable with. When Lucas was 13 months old I became pregnant with my daughter Lilly, I had talked to my midwife about VBACing and she told me their hospital policy is strict about who attempts a VBAC and that I would have to speak with the head OB later on in the pregnancy. I did go to speak with him, he was polite, and kind, but disclosed that because of various reasons they are only able to provide VBACs to women who had already VBAC’ed or delivered vaginally before their c-section. My husband and I decided that after all we had been through with our previous OB that leaving and trying to find another provider would do more harm then good, and that since we felt safe and cared for by our midwife and her partner OB that we would stay and have another cesarean. I still cried about it . . . A lot. My hope for a natural birth experience was dead, gone forever I was marked with the scarlet C, I would never know what a contraction felt like, never know what the burning felt like, never know what it was like to see my child emerge from my own body and into my arms. In my head I told myself that this was okay and that for some reason babies just aren’t supposed to come out of me that way, but that I get to be a mom and have a healthy me and a healthy baby. In my heart I felt as though I must be being punished for something I did in another life to be robbed of something so normal, and I began to really dislike people who I deemed to be unworthy of their own vaginal births, those that didn‘t appreciate what they had been given. Lilly was born in 2009, she was perfect and healthy just as I had expected, and this time she wasn’t taken away like her brother was she was with me right away in recovery, and overall this birth was much better then my first, I was in less pain both emotional and physically, and I was at peace with my lot in birth, and had stopped loathing the scores of women around the world who delivered vaginally, because really that was kinda unreasonable to begin with.

It’s 2011 and I’m pregnant again. Not even thinking of VBACing this time because I know that no one will touch a woman with 2 prior uterine scars, so I sign up for a repeat cesarean before I even get the first ultrasound. It wasn’t painful this time to sign on the dotted line, to willingly have my baby cut from my body, because I thought that there was no other way. Fast forward 5 months, I’m in my kitchen doing dishes and it hits me like a Mack truck, the tears start coming and I can’t make them stop, all the pain and mourning that I had avoided and pushed away with my other 2 births was here, now, in my kitchen, torturing me. My heart actually hurt, all the hope, anticipation, fear, happiness, sadness, defeat, and anger that I had carried within my body came out in one violent moment. Once I was able to collect myself enough to speak in full sentences, I called my husband, and poured all of this out to him, he told me that he knew in his heart that I could push a baby out, and that if there was a way we would find it. Our search began, I had papers and printouts of doctors, their on-line reviews, I found ICAN and after all this research we had finally found a doctor that was supportive of our attempt to VBA2C. I broke up with my midwife, which was really hard to do because I had such a good relationship with her, but it just wasn’t a journey she could take with me, we both knew that. Are parting of ways was gracious and she extended her best wishes and told me the door was always open to me should I want to return. I was 6 months pregnant at this point.
Our new provider, an OB, was very optimistic about our VBAC. I asked him lots of questions at our consultation, about various things that effect VBACs, post dates, baby’s size, baby’s position, duration of labor . . . He had all the “right” answers, both anecdotal and research based (and who doesn’t love a good meta-analysis??). My last trimester went quickly as I had expected it would, and was rather uneventful. We met and hired the most wonderful doula. As my due date approached with each passing week I began to worry, if the VBAC rug was going to be pulled out from under us yet again. If all my searching and hoping was going to be for nothing . . . Again. My husband, our doula, and even the OB assured me that we were all on the same page and that everything was on the up and up, everyone was really excited about the birth, and how great it was going to be, eventually myself included. At 37 weeks my OB requested that I get and ultrasound to access the size of our baby, he wanted to me to get it done in the 39th week. I scheduled it, reluctantly, but since he, the OB had stated to me before that he had several VBACing moms deliver large babies, I wasn’t to frightened that it would effect our vaginal birth. Our doula accompanied me to my next doctor’s appointment, and I asked him point blank if the ultrasound results suggested a larger baby if that would end our VBAC attempt, he said no it wouldn’t and that he was merely gathering information so that I could make a decision based on “informed consent.” The next week I had the ultrasound and low and behold, I grew another 8lb + baby, I wasn’t shocked because my other 2 children had been the same size. I also wasn’t worried about our vaginal birth disappearing because of the conversation I had with the OB the previous week. Two days after the ultrasound, and 5 days before my due date, my phone rang , I didn’t get to it and it went to my voicemail. The message was from our OB, and in it he said that because of the size of our baby that he was no longer going to be able to support us in a VBAC attempt, but that he wanted to “honor our agreement” and that he would let me go until my due date, since he was going to be on-call and would be able to be there to deliver me if I went into labor prior to that day, but after that he wanted to section me. So here I am in the kitchen, on the floor, completely lost and broken . . . Again. The next day I got a call from the office telling me that they had scheduled my c-section for my due date, Tuesday 3/20, I declined to confirm it until I had a chance to talk to the OB to find out why he had changed his mind. When I did speak to him he was cold and unrelenting about performing a c-section on that day. When I brought up all the things he had told me about all those other women that he delivered with big babies and all the studies about fetal size, and due dates in relation to VBAC he told me that I couldn’t hold him to conversations that we had months before and that he could produce studies that stated the contrary to the ones I had, I asked him to e-mail me the information he had . . .I’m still waiting. After a long attempt to negotiate another day for the section and him not budging I agreed to it, to try and buy more time to figure out what to do and to keep him happy so that if I did go into labor in the next 5 days I would have a happy doctor waiting for me at the hospital. I called my husband who was shocked, and we agreed that we were going to cancel the surgery on Monday (all this happened the Thursday before I was due), because it seemed as though his motives were not completely medical. I called our doula, who was equally shocked, all 3 of us worked together and came up with a plan of how to handle this now very complicated situation. The next 5 days came and went and despite my best efforts at DIY labor induction I remained pregnant. On Monday 3/19 I called and cancelled the section, which of course sent everyone in the office into a tizzy, I was on hold I was disconnected . . . Blah blah blah. When I did speak with our OB he was less then pleased with my decision and told me that he wouldn’t be able to be my doctor anymore after Tuesday and that we would have to find another provider, and that it was going to be impossible for us to find someone to take us at 40 wks and that no one would touch us if we still intended to VBAC. We conversed back and forth for awhile about this, he told me that if I were to show up to his hospital in labor that I would only be offered a cesarean, and I told him that I accepted and understood that, but that since there was no danger in my remaining pregnant that I wouldn’t consent to a scheduled section until I was 41 wks, which was when I had decided that I no longer wanted to pursue a VBAC, because of the decrease in success rates ( I had already decided this long before all of this had happened). He continued to persist that I had to be sectioned the next day, it wasn’t until my husband joined the conversation on speaker phone that our Ob changed his tune, to “of course I won’t abandon your care” and “of course I won’t deny you pre-natal care” and “we will work something out.” I had my 40 wk prenatal visit scheduled for Wednesday 3/21. On Tuesday 3/20 late in the afternoon I got a call from the OB’s office saying that I had an appointment that they had scheduled for me to see a perinatologist I hadn’t been informed of a need to see one nor had I consented to see one. When I asked them why I had to see one they said they didn’t know and that the OB had requested it. I kept asking why and got no answer, so I called the perinatologist and was told by their receptionist that it was a VBAC consult. I saw no need to go but wanting to be compliant I went, the appointment was just before my prenatal checkup the next day. My 2 kids and I spent an entire hour listening to him read off stats that I already knew and when he realized that I was clearly intelligent enough to discuss this and not be intimidated by his power point presentation (yes it was a power point print out he was reading) , he decided that he was done with our consult. I will say that although some of his information was old and outdated, he was very polite and professional. I went down one floor and checked in for my prenatal appointment. I saw the nurse, and during the BP and urine check she also prepped the vaginal ultrasound wand. I asked her why she was doing that and she said that the OB had asked her too. I told her it wouldn’t be necessary because I wasn’t consenting to a transvaginal ultrasound, unless I had the medical reasons behind it explained to me, and even then I would only think about it.

Enter my OB, he checked baby’s heartbeat and did a cervical check and then with my children present proceeded to tell me that I was ruining his personal like and his professional life, that I had the hospital in an uproar because I was refusing to be sectioned. He told me that if I were to go into labor that I would surely have shoulder dystocia and a ruptured uterus, and that he didn’t want to get sued. He said that when I came into the hospital either for a section or in labor that my reception would be cold at best. My interpretation of that was that I wouldn’t get the same care that everyone else was receiving or the care that as a human being I was entitled to . . .do no harm I think is what it‘s called. I told him that my intention wasn’t to ruin anything but to only protect my body and baby from an unnecessary surgery, or a surgery of convenience. Of course if I needed a c-section I would consent but that I didn’t believe based on the information that he gave me that it was indeed necessary, since the main reason was that he wouldn’t be on-call and another doctor would have to deliver me, and “they” weren’t comfortable with VBA2C patients, yes my OB had said this exact statement in our conversations/recorded voicemails, that had taken place. .He called me self-serving, and demanded that I consent to schedule a c-section for the Friday 3/23. I told him that I would have to discuss it with my husband because I don’t make these decisions without him, we do things as a family. He told me that I needed to find another provider, but that we wouldn’t find anyone to VBAC us, let alone take us at 40+wks. I told him that I would of course let him know if we were able to find another provider, and that I would let him know about the section for Friday, I then told him that we were finished talking and asked him to leave the room. Oh and that vaginal ultrasound, I guess it wasn’t medically necessary after all. It was during this visit that I knew that this man was not going to get anywhere near my baby or my body, ever again. I left the hospital, called my husband and we made a decision of what we were going to do, I called our doula, told her what happened, and what hubby and I had decided to do. She was on board of course, because she is the best doula EVER! I got home and got on the phone. I called my old midwife, yes the one that couldn’t VBAC me. I knew that calling them meant a repeat section, but I was quickly approaching the end of my VBAC comfort zone anyway, and it was becoming impossible to dodge our now very persistent OB. I knew that I had always felt safe in her care, and that her partner was a great surgeon, and also as caring as she is. I told her a watered down version of what had transpired and asked if she would be able to help me deliver via cesarean, because I did not feel safe going to the OB anymore and did not feel safe at his hospital. She agreed to try to get me in, she called me back about an hour later and told me that of course they would deliver me, and that I was now scheduled for Friday 3/23, also my husband’s birthday. I went in the next day saw the OB to sign some papers, again told the watered down version of what happened, he hugged me, told me he would keep us safe. Friday came, we checked into L&D, talked with the midwife and OB, went over some things that we wanted for the birth, and they obliged. They allowed my husband and doula to be with me in the OR, they lowered the drape at the moment of birth, I saw my son enter the world, saw him breath air for the first time, I still can‘t verbalize what that was like without bursting into tears it was so moving I can‘t explain it, they delayed clamping his cord, and they kept him with me in the OR for quite a while. We were only separated for what I can guess was 20 minutes or so. My little Gabe weighed 9lbs 1oz. And was perfectly cooked.

So in the end, a baby didn’t come out of my vagina, even though I had hoped and wished for it, for a lot longer then this story documented. Am I disappointed that I never labored? Never pushed? Never had any of that burning that everyone talks about? Well I’d be lying if I said I wasn’t disappointed a little. I’ll always wonder, always imagine what it might have been like. But I have a birth that I am proud of. I not only experienced things during Gabe’s birth that I never thought I would see or feel, but I found strength within myself, to stand up for what I knew was right. I was not bullied, I was not a victim, I chose to birth my way, on my own terms. There are people who thought I was crazy for having done all of this, only to end up back to where I started, but I needed to take the road less traveled, and stay on it just once. It led me to a place where I feel peace, I feel strong and I feel empowered, all things that anyone would want out of the birth of their children, and after 6 years, and 3 children I finally have them.
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