Birth Story - International Cesarean Awareness Network

There’s No Such Thing as a Failed VBAC- A Letter to the CBAC Mom

November 7, 2015 by info

This post was submitted to us by writer Aprille Donaldson. The original post can be found on her website www.beautifulinhistime.com.

Dear CBAC Mom:

I just want you to know that I get you.

For nine months you carried your baby within you. And for nine months – maybe even longer – you dreamed about pushing that baby out of your body with your own strength.

You planned. You prepared. You hired a doula. You probably spent hours reading books and websites, making sure you were making the right choice for you and your baby.

You exercised. Maybe you changed your diet.

Maybe you had to fight. Maybe you had to drive a long way for your appointments and birth. Maybe you had to explain your choices to the naysayers.

You prayed.

At one point or another, you were probably afraid.

You wondered if you could do it. You wanted to believe you could.

You wanted to believe that this birth would be different.

But for some reason, it didn’t happen.

Your breech or transverse baby didn’t turn. The cord prolapsed. You got chorioamnionitis. Your baby went into distress. Your placenta didn’t move. Your body didn’t dilate – again. Your baby was too big, or maybe stopped growing. Your blood pressure went up. Your uterus ruptured. You pushed and pushed and that baby still. just. wouldn’t. come. out.

A call was made. and you said, “Yes…cut me open.”

I hope that your beautiful baby is safe in your arms.

I hope that you realize how brave you are. You made a choice to try something that very few will try to do.

But when it came to the safety of your baby, you made the best choice:

You said, “I choose you!”

And that makes you a success.

I hope you know by now – I hope all of your children have taught you this:

Moms have to make hard calls. Sometimes, you have to make choices that others will judge and scorn as less than best because they are the best choices for you and your baby. Making those choices is just part of being a parent.

It’s okay to be disappointed. It’s okay to say, “This is not what I wanted.” It’s okay to grieve and cry.

But there’s no such thing as a “failed VBAC.” Because you cannot fail at birth. You cannot fail at bringing a child into the world.

Look into that baby’s beautiful face. You made that! You did that!

You are brave. Strong. Competent.

You are scarred, but you are not broken.

This post was submitted to us by writer Aprille Donaldson. The original post can be found on her website www.beautifulinhistime.com.

Sharing our birth stories with our children: Katy’s CBA2C

June 29, 2015 by blog

Guest post birth story by Katy Rank Lev for Brain, Child Magazine.

I joined my local ICAN chapter after my first son was delivered via cesarean. Over the next five years, I became a leader of ICAN of Southwestern PA and the organization supported me through my next pregnancy and VBAC attempt… then they supported me through my physical and emotional recovery from my CBAC. When I became pregnant with my third son, I stepped down as a leader because I knew I would need my ICAN family to support me as a pregnant mama attempting a vaginal birth after 2 cesareans. Here is the story of my third son’s arrival.

CBAC story

“Will Mommy be the next person in our family to die?” my five-year-old asked my husband as I lay on the sofa, drugged up on Vicodin. My grandmother had died a few weeks earlier and we’d just brought our third son home from the hospital. The birth had frightened my husband and me—a crash cesarean, blue baby, initial Apgar score of 4.

We’d done pretty well preparing the older kids for labor, we thought. We explained the essentials of a baby’s arrival, told them I’d be making some sounds at home as my muscles squeezed and we’d drive off to the hospital, where I hoped to push the baby out of my vagina. Late in my pregnancy, this concept caused my sons to barge in on me in the bathroom and beg, “Let me see up in there,” thinking they could catch a glimpse of their new brother while I peed.

I told my boys there was another way babies entered the world. “Sometimes, if things seem unsafe, a doctor has to cut the baby out from Mommy’s belly,” I told them. “That’s what happened with you and your brother.”

There’s nothing like a new pregnancy to spur young children to ask about their own entry into the world, and since my boys each arrived after long labors with nurse-midwives and doulas, followed by heart decelerations and hurried cesareans, I found these questions the hardest to answer.

Was I born the wrong way? Was I sick when I was born? Did I hurt you when I came out the slice in your stomach?

I’ve been wading through my own sadness, my own lasting fear at hearing my babies’ heart rates slow until the inevitable distress surgery. I hadn’t considered how it would feel to share these birth stories with my actual babies. I can’t seem to find a way to explain without upsetting them.

After my new baby was stable, my mother left me at the hospital to pick the big boys up from daycare. My oldest and most sensitive son immediately asked, “Did they have to cut the baby out?”

He sighed deeply upon hearing they had. “Oh. Just like us.”

Our older boys came to the hospital to visit, and they felt uneasy seeing me in bed, a tangle of tubes and wheezing compression cuffs. They wanted to hug me, but couldn’t figure out a way to get up close. They walked around to my least-encumbered arm for a squeeze and a smile. As the doctor came in to check on me, my oldest asked to see his scalpel.

My kids came to visit each day in the hospital, and each time a staff member entered the room, my son asked to see the scalpel that had delivered his brother to us. Eventually, one of the midwives sat down with him to explain that the blade from the scalpel is discarded after each operation, that the handle remains in the sterile operating room, and nobody can go to see it.

Not until his question about my dying did we really understand his fear and concern about his brother’s arrival, possibly his own, too. A birth affects everyone in the family, we realized. It’s his story, too.

We saved my placenta to plant under the hydrangeas in the back yard, and when our doula came to the house to visit, she spread it on the dining room table and explained every bit of it to my wide-eyed boys. She showed them the umbilical cord where the baby was attached to me on the inside. She showed them the sac where the baby lived. She showed them the placenta that nourished the baby while he grew. Finally, she showed them the incision that cut straight through the middle of the placenta, where the obstetrician worked so quickly to bring their youngest brother Earthside.

This hands-on experience seemed to bring some closure to everyone. We showed the boys my incision and told them how every day, my body felt a little healthier. We talked about how each of them is healthy now, and how their baby brother was just fine after he got a little extra oxygen.

I tell them it’s ok to feel afraid, because remembering it all makes me feel afraid, too. Not every baby slides into the world peacefully. Thankfully, our family has lots of arms and shoulders to hug when we feel sad about that. As I press their tiny bodies to mine, I feel their hearts pounding in their chests and each day, the stinging fear of their frenzied arrival echoes with less force.

By Katy Rank Lev, for Brain, Child Magazine. This essay originally appeared on Brain, Child: The Magazine for Thinking Mothers.

Katy Rank Lev is a freelance writer based in Pittsburgh, PA. Her three feral sons inspire her work covering parenting, women’s health, and family matters.

Photo Credit: Jeni Benz Photography

Birth Story in Africa: a birth without fear

April 21, 2015 by blog

Guest post written by Sarah S.

homebirth in Africa

In order to tell the birth story of my firstborn, I have to back up a bit. Actually, I have to back up a lot. For as long as I can remember I have been afraid of pregnancy and childbirth. My mother threw up the entire nine months of all four of her pregnancies. She was even hospitalized for a week while pregnant with my youngest brother because she was so dehydrated from all the vomiting. I was certain that I was doomed to face the same fate if I ever became pregnant.

When I was nine years old I watched a video of a family friend giving birth to her 5^th child. Although I remember the mother being radiant and calm and even excited enough to ask to see the placenta after it was delivered, I was horrified by the reality of giving birth. Can you blame me? Every TV show or movie that shows a woman giving birth shows her writhing in pain at the first contraction and eventually screaming at the baby’s father while he stands there like an idiot, completely helpless.

So, by the young age of 10 years old, I decided that pregnancy and childbirth were not for me. I absolutely loved babies, but decided that I would acquire all of my own babies through adoption. I continued to stand firm on that decision until I actually got married. Deep down I knew I would probably feel differently if I ever got married. But, I was still full of fear about pregnancy and birth.

A few days before my 2^nd wedding anniversary, my husband, Sam, and I moved to the Democratic Republic of Congo in Africa for two years. A few months before our 2^nd wedding anniversary we felt strongly that we wanted to start a family. After a lot of [reflection], seeking counsel from older, wiser people and several tears, we decided we were going to stop using birth control. If I became pregnant while living in Congo, then that was what was supposed to happen. We moved to Congo in July and I found out I was pregnant with our first baby in November of that same year.

We were extremely excited and extremely nervous. The Democratic Republic of Congo has one of the worst reputations for healthcare. We lived in a teeny house with no running water and limited electricity. The closest hospital with decent care was about a three hour drive away on horrendous roads and also had no running water and limited electricity. Prenatal care was very basic and attending a childbirth class was not an option. Although most women in Congo labor and deliver at home with a midwife, many mothers and babies die during the birth process because of limited resources in an emergency. There were many things in my situation that had the potential to add to the existing fears I had about childbirth, but Sam and I knew that our only choice was to trust our situation to overcome fear. So we continued to surrender.

It was decided that I would give birth in the neighboring country (Central African Republic) with an American doctor who worked at a hospital with much better resources and more staff than the hospital in our area. Medical resources would still be limited and an epidural would not be available to me. A Congolese doctor friend of ours visited me once a month for prenatal care which really only consisted of weighing me (if there was a scale available), listening to the baby’s heart (with an old-school pinard horn like they use on the TV show Call the Midwife) and measuring my belly. So Sam and I decided to learn everything we possibly could before the birth of our child. A midwife friend of mine suggested I read Ina May’s Guide to Childbirth by Ina May Gaskin. I devoured that book in the first few months of my pregnancy and my husband read a few of the chapters as well. We read and worked through a used Bradley Method workbook and managed to get our hands on the book Husband Coached Childbirth by Dr. Robert Bradley a couple of months before my due date. We read and talked about childbirth and practiced relaxation exercises every day. I wanted to know everything I possibly could about managing pain during birth since I would not be able to have an epidural if I wanted one. Sam wanted to know everything he could in order to help me relax and manage pain and be my coach and voice during the labor and delivery. I prepared my body for the “big day” and we both prepared our minds.

A month before the due date we left for Central African Republic and stayed in a guest house and waited for our baby to be born. Dr. Tim, the doctor who would deliver our baby, lived a short walk from the guest house and we met with him several times. He told me I could deliver the baby in the guest house if everything went well and he agreed to everything we wrote in our birth plan. If there were any problems, the hospital was about 200 yards from the guest house and I would quickly be moved there if a cesarean was necessary.

The day before the due date I started to have a “bloody show” and the Braxton Hicks contractions I had been experiencing for a few weeks were increasing throughout the day even though they weren’t painful. By about 2:30pm I started tracking how often the contractions were coming and they were irregular at that point but coming consistently. That day was Sam’s birthday so we made dinner together and I stopped every 10 minutes or so to breathe through a contraction. After dinner was over we realized the contractions were coming every 5-10 minutes and were getting stronger so Sam went down to Dr. Tim’s house and let him know what was going on. Dr. Tim checked me at about 8pm and I was 70% effaced but hadn’t dilated yet so we had a long night ahead of us. I did feel a bit discouraged at that point because I hadn’t dilated yet and had no idea how long everything would take. We attempted to use Dr. Tim’s phone to call our parents back in the States to let them know labor was starting. The reception was terrible but we managed to chat for a couple of minutes. Dr. Tim, his wife Ann, and Jan (the wife of the other American couple who lived there and a nurse) came down to the house to set up a bunch of medical things in case I did deliver there and then they left us alone for a couple of hours.

We both attempted to sleep and Sam did for about 45 minutes, but my contractions got more intense and I walked around the house a bit and then just laid down to relax and breathe through each contraction. We spent the rest of the night in the bedroom with the lights low, mellow music playing (I had made a “labor and delivery playlist” on iTunes for this exact occasion) and Sam sat at my side next to the bed watching my every move, massaging my legs and back, and applying pressure to my back during the contractions. He coached me through my abdominal breathing and was the most incredible support, even though he was exhausted.

Dr. Tim checked me around 11:30pm and I was already at 5cm, which surprised all of us. He came back around 1AM and just stayed the rest of the night in our living room which allowed Sam and me to labor in the quiet bedroom in privacy, with little interruption. Sam talked me through everything as the pain increased and consistently encouraged me. I didn’t need anything or anyone else in that room to keep me focused and relaxed. Around 3:00AM I was at 7cm and Dr. Tim said we might have a few more hours ahead of us and he wasn’t sure if we would deliver at the hospital or in the guest house.

Starting at about 4:30AM the contractions and pressure in my pelvis became very intense. I was having a hard time breathing and staying relaxed during these big contractions that were coming about every 3 minutes. Sam was particularly amazing during this time to keep me breathing from my abdomen and relaxing my muscles when I felt like I couldn’t control what my body was doing. When my mind began to wander to a fearful place, thinking, “How long will this last? I can’t relax!” he calmly reminded me to breathe from my stomach. I started to lose feeling in my arms, hands, legs, and feet because I was hyperventilating a bit and then my hands began to spasm. This part was the only “scary” moment because I couldn’t make my body relax. Dr. Tim came in again around 5:30AM (I think…things were a bit fuzzy around this time) and with surprise in his voice announced that my bag of waters was about to break and he needed to gather his delivery team. As he got up to leave he said, “If you feel the urge to push… don’t push until I get back!” (By the way…that is the worst thing to say to a woman in labor!)

Within minutes Dr. Tim, Ann, Jan, and Julien, an African maternity nurse, were in the room getting set up to deliver my baby right there in the bedroom. I repositioned and Sam sat on the bed behind me for my main support and I began pushing through the contractions. The adrenaline rush during this time was incredible and a relief. I could finally work with my contractions and it felt amazing! They broke my water and Sam held me up, helped hold my legs and coached me through about 4 more contractions with pushing and then my first daughter, Hannah Margaret, appeared at 6:40AM! I held her right away and Sam was behind me the whole time as we ooed and awed over our beautiful daughter. I felt like Sam and I had both worked to get Hannah here safely and that was one of the most incredible feelings…to know that Sam was just as much a part of the process as I was.

homebirth in Africa

A couple of hours after Hannah was born, I clearly remember telling Sam that I would like to do that again. (Not immediately, of course). My experience of giving birth to a child was nothing like I had feared. It was peaceful, smooth, and while it was intense, it was nothing like the pain I had always seen depicted on TV shows. We truly felt peace overcome fear during the entire process. And because we had learned the specifics of what was going to happen to my body during labor and delivery, we felt empowered during the process and therefore able to focus on keeping my body relaxed.

homebirth in Africa

Hannah is almost three years old and Sam and I still talk about her labor and delivery often. The memory of working together to birth our first child is an incredibly sweet and intimate memory that I imagine we will talk about for the rest of our lives.

Guest post written by Sarah S.

FREE Viewing of the Film ‘Trial of Labor’ for ICAN Members!

March 9, 2015 by info

Beginning on March 20, 2015, ICAN will be providing its members with a FREE viewing of the film Trial of Labor, directed and produced by Rob Humphreys and Dr. Elliot Berlin, until March 30th.

ICAN will also be hosting a number of screenings for the general public in select cities beginning in April.

Look out for details on public screenings coming soon.

Not a member of ICAN? Become a member before March 17th to access your free viewing! https://www.ican-online.org/join/

‘Trial of Labor’ follows a small group of pregnant women and their journeys back to trusting themselves and their bodies after previous births ended in unplanned surgery. Each woman has chosen to plan a vaginal birth after cesarean, and the uncertainty of their imminent births evokes in each a personal reckoning: finding a path through unresolved feelings and difficult decisions to the ultimate, unpredictable event of childbirth.

—Thank you for your generous support!—

Your membership will help us to fulfill our mission of improving maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC).

View the trailer below!

Overturning a VBAC Ban in Western PA

January 22, 2015 by info

By Katy Rank Lev and Lauren McAnallen

Amy had a successful VBAC with her second child and would have faced a coerced cesarean for her third delivery. She said she is so thankful ICAN helped to get the ban lifted—she had a vaginal delivery with Lydia, supported in the hospital by CNMs.

In late 2012, ICAN of Southwestern PA started getting calls and emails from women living in Mercer County, PA, about an hour northwest of Pittsburgh. Apparently, one of the hospitals there was instituting a VBAC ban! Some of the women contacting our chapter had already had successful VBACs in the city of Pittsburgh and had been looking forward to birthing closer to home, supported in the local hospital by a CNM, for their next babies. For them, the VBAC ban was upsetting. How could they choose between coerced surgery or driving an hour into the city for each prenatal appointment (with young kids in tow) and driving while in labor?

But then, our chapter learned that this particular hospital served the local Amish population and that they were transferred to this hospital for cesareans. Many of them felt safer birthing in the hospital for subsequent babies. This became an important factor for many reasons: these women felt called to have many children, however it simply isn’t a safe plan for a woman to have 8 or more cesareans. These women also did not carry health insurance. They would have to pay out of pocket for hospital procedures. Coerced cesarean delivery would mean tens of thousands of dollars per Amish family per child. Some Amish do not drive automobiles, so even though the tertiary hospital in Pittsburgh, where VBAC was supported, was only an hour away by car, this was not a practical option for families whose primary means of transportation is a horse and buggy.

We immediately reached out to the ICAN board of directors for advice. While we waited to hear back, we started a letter writing campaign, addressing our letters of concern to the patient advocate at the hospital as well as the head of obstetrics. We found some letter templates in the chapter leader guidebook and tweaked them to fit our situation.

Soon after, ICAN’s legal counsel got back to us. She felt that since Amish women in particular were being affected, this meant we had solid legal ground to approach the hospital administration persuasively. She began to draft a legal letter to the administrators, outlining how and why a VBAC ban was discriminatory against this religious group.

Meanwhile, we needed to find mothers who were willing to speak up against the VBAC ban. We found a few women who spoke with legal counsel, gave their stories and talked about how the VBAC ban affected their family planning and their own autonomy. A big challenge for us was to find Amish women who would speak to ICAN’s lawyer since our chapter leaders were located in the city, over an hour away, and many of these women could not access Facebook.

Thankfully, a CNM working in the hospital was willing to risk her job to help the cause. She created surveys and asked for community support and gave patients ICAN’s contact information so they could reach out to us for help. And, by winter, some Amish families did! Pregnant Amish women walked miles in the freezing cold to use a payphone and tell their story. One Amish woman pleaded with legal counsel, “My sister had a cesarean, and I saw [everything]. Please don’t let them cut me open like my sister!”

ICAN’s legal counsel developed the letter to be sent to the hospital administrators, which was about ten pages long, and called for an immediate lift of the ban. We were dismayed when they failed to respond.

At this point, ICAN’s legal counsel urged us to begin looking for an attorney who would take the case probono (we certainly didn’t have the funds to pay for a lawyer) to sue the hospital system. Our chapter decided it was important to get an ICAN person on the ground, closer to the women being affected, and so one of the mothers who originally contacted us agreed to start a new chapter: ICAN of Western PA.

Lauren McAnallen found out the day after her daughter’s first birthday that the hospital where she was delivered had instituted a VBAC ban. She says, “I was devastated. I didn’t really know where to start. At this point I was not an ICAN member; I had only attended one in person meeting and a handful of online webinar meetings, but this ban was hitting really close to home. Reaching out to ICAN was the first thought that came to mind.

“I got in contact with Katy and she soon put out a call to action for any mothers affected by the ban to write letters, spread the word, and to speak with ICAN’s legal counsel. Katy supplied some fantastic guidelines for writing my letter to the hospital’s patient advocate – simple but important things – keep it short, share how this directly affects you, quote current medical stance on the safety of trial of labor after cesarean, and encourage the hospital to reverse the decision. I quickly drafted my letter, dropped it in the mail and began to encourage my friends and family to do the same. I signed a petition in one of the local care provider’s office and kept in contact with Katy and ICAN’s legal counsel as we waited to hear if our efforts were making any waves or if they were being heard by the hospital administration.

“It took a while for my letter to receive a response, and when it came I was shocked by their reply. It seemed to be a copy/paste letter that neither covered any of my concerns nor was any bit empathetic to my personal experience or the impact of the ban on my family planning – they basically told me that there are other hospitals in the area that offer the services I want and that I can just go there. This was not the answer I had expected from a respected hospital and especially not the answer I expected after I put my heart and major concerns into writing a letter – I was furious to have not received a letter with even just the smallest bit of compassion. It was then I recognized how important it was for me to bring ICAN to my community and in March of 2013, I joined ICAN and took the steps to start a local chapter, ICAN of Western Pennsylvania.”

Over the next few months we continued to reach out to friends and family to write letters and did as much networking via social media as we could. The new chapter started holding monthly meetings and hoped to get some local interest in ICAN and fighting the ban. Also during these months news came that a different hospital would be closing their maternity department entirely. Since this time, three other hospitals have closed their maternity departments, funneling birthing mothers to the tertiary hospital an hour away. Options seemed to be diminishing for families in the area – until August 2013 when the almost miraculous news came in that the VBAC ban had been lifted.

There was little word about the ban before it was reversed. Things were really quiet for months before the news came through. It seems that the Amish community did most of the fighting. Two women came to the hospital in labor and quietly but powerfully declined repeat cesareans. They were treated respectfully by all staff, and both had successful VBACs attended by their midwife with the support of an attending physician. Soon after those births, the ban was lifted. Providers, anesthesia and nursing finally worked together to ensure the safest coverage for those desiring VBAC, advocating the lift of the ban at every staff meeting.

Our local ICAN chapters took all the steps we could to bring attention to the ban and did our best to get the community involved, and in the end it worked.

Keeping the ball rolling was the difficult part and ICAN’s board of directors and legal counsel provided the Amish mothers a voice and informed them of their options, because it really appears that they were the ones who fought the hardest.

Because of that fight the women in Western Pennsylvania have their option to birth their babies safely in a supported hospital environment. Although some women were caught unfairly in that painful period, and there’s no good excuse for that, finally common sense and autonomy prevailed!