My story is a long one because I felt it important to share how I became involved in ICAN and used the things I learned from going to meetings in the telling of my story.
After my cesarean birth in April 2012, I found ICAN through a co-worker and friend at nine months postpartum. I wasn’t sure what I was going to get out of the meeting, but decided to go. After sharing my birth story with the group and experiencing what it felt like to be truly emotionally “held”, I decided I was hooked on the meetings and that ICAN had a lot to offer. I learned so much by watching women plan their VBACs, discuss their emotional and physical trauma and status, and talk about their providers and appointments. I learned I needed to get my hospital records from my cesarean; I learned that I could choose to not share my due date with family or friends when I became pregnant again; I learned which books I should read; and learned that I was in charge of so much more than I ever honestly understood.
I experienced an early 8 week miscarriage around 20 months postpartum. I could feel it happening and understood what was happening in my body before I was able to get in at my doctor’s office, and before my husband believed me that I was having a miscarriage. Although the outcome was unfortunate, it was a true lesson that taught me I know my body best.
Fast forward another year and I became pregnant again and had also become an ICAN chapter leader in the meantime. My body felt good, but having miscarried before made it difficult to bond and feel connected to baby. I struggled with whether I should find a doula first or a new provider. While my original provider supported VBACs and even told me at my 6 week postpartum checkup that I was a great candidate, her office was no longer offering obstetrical services as their other OB had recently moved. I decided I could always switch providers later on down the road, but that I really needed prenatal care before a doula. I landed in a very VBAC supportive practice that had both OBs and midwives offering services.
I began reading Ina May Gaskin’s Guide to Childbirth and learned that even with the most supportive and knowledgeable of midwives like her, she still had a 50% cesarean rate for babies with a brow (face first instead of top of the head first) presentation, which was the reason for my first cesarean. I skimmed and read a handful of other books, but read every resource on the ICAN website as I began preparing for my VBAC.
My pregnancy was uncomplicated and I was happy with the level of prenatal care I was receiving. I had a doula I was interested in and she suggested a quick 10-15 minute phone call just to feel out if we’d be a good fit for each other before scheduling a time to meet in person. I was on the phone with her for an hour and a half, and had reached a turning point in my pregnancy during that conversation. Something she said had given me permission to make a connection with my baby and become invested in baby. I hired her before the call was complete and my heart was so happy. I was traveling weekly to Syracuse for prenatal yoga and even pressured my prenatal care provider to live up to offering the “VBAC class” that they advertised on their website. It was at the VBAC class that I heard my husband answer the question of “Do you think your wife can do this/do you have any hesitancy in your wife having a VBAC?” He said “I already know she can do this. I’ve seen her body labor. She can do this.” Nearing the end of my pregnancy, this was a huge boost to my confidence! I already felt like I could do it, but to hear it spoken out loud in front of others was another pivotal moment.
I made it a point to see every provider in my practice, though it was clear that the midwife was becoming my favorite. I even saw the doctor who had become part of the practice since my first birth. She had been training during my first birth and had performed a forceful cervical exam without my consent when they were determining what was happening with the position of my baby. I would have never been able to make this connection if I had not received and read over my hospital records. This same doctor had also become topic of conversation at ICAN meetings the year before for her poor bedside manner during prenatal appointments for those pursuing VBAC at the time. I made the decision to meet with her for a prenatal appointment, but after I had decided she would not attend my birth. The midwife had asked me if I wanted her to attend my birth….of course I did! I had learned through ICAN that you can always ask for this, even if they may say no. The midwife beat me to it! She put in my records that I wanted her attending my birth and that they would notify her.
Although I had read the literature, knew the uterine rupture statistics and was confident in the mission of ICAN, I still had a nagging concern about the “what ifs” of uterine rupture. I decided I needed to face this fear with information and have an honest conversation at one of my appointments with the midwife. I said I want to know what happens during a uterine rupture. She said that they rush mom to the OR to get baby out and to get both baby and mom stable. She indicated she had never lost a mom or a baby during a rupture, and that she was confident in the abilities of the hospital to continue on that path. We had finally talked about what felt like the elephant in the room for me and I felt so much better about it.
The day before my “unknown to everyone but us” due date, labor began with mild contractions very early morning just like my first labor. It was slow yet methodical. I was committed to this labor for the long haul as my first was about 40 hours. We took our daughter for a walk at our favorite park to pass some time. We came home near lunch time and I was confused at what my body was doing. Contractions had shifted so that they were sometimes more intense but spacing out. I had some lunch and checked in with my doula on the next steps. She suggested going to lay down for a rest. When I went to lay down on my bed, I had the largest and most intense contraction I’d had since labor had begun. I decided it was time to begin making the transition to the hospital. Our doula met us in the parking lot of the hospital and it was incredibly comforting to see her there.
I really don’t like triage for labor and delivery. I’ve arrived incredibly uncomfortable in both of my labors, and they seem completely incapable of understanding just how far along someone can arrive in labor. Both times, I had to have the triage nurse move the monitor down several inches to get a heartbeat on baby. Also, why do we fill out all the paperwork ahead of time just to fill it out again when we arrive at the hospital? Why do they also ask us what brings us in today? Ummmm…? I understand there are a variety of situations that warrant a mom to head to L&D, but asking such an obvious question feels so condescending. Almost as if to say, we don’t believe you’re in labor so we have to ask you. Over it. I was ecstatic to find out that my favorite provider, the midwife, was on call for my practice when I arrived. I was relieved that she was the one to be able to do a cervical check on me and said that I was at 8cm. Wow, I had not expected that. Because my labor was so long with my first, and much of my contractions were similar all morning long to my first labor, I had not envisioned them working more efficiently. I had had a conversation with my midwife earlier in my pregnancy where she encouraged me to try to come to the hospital during that “sweet spot” that is not too late that things are very hectic, nor at the very beginning where labor could stall during transition to the hospital. I think she was a little stunned I was at 8cm as well but by then, baby was coming regardless.
I had to sign another hospital waiver stating that I was having a VBAC. I don’t think I actually signed it until AFTER baby was born with all that was going on. My nurse informed me that she had 2 VBACs. This felt comforting to me too. I can remember leaning on the edge of the bed riding out some of my largest contractions and I said “I’m not sure I can do this” and she reminded me “You’re already doing it!!” Another confidence booster. She was right. I was already doing the hard work of labor. I could keep going, I was almost there. We hung up my birth affirmation banner above the back of the bed, and situated the plant I’d brought from home that had been divided from one that belonged to my grandma. I can remember thinking I’d like music when planning for my labor and birth, but I’m not sure I would have heard it. I was very inside myself with my breathing. And then as contractions continued to be hard, I became vocal. It felt so good. I felt like a lion letting out all my rage. This continued as I transitioned from leaning against the back of the bed to squatting over the squat bar at the end of the bed as I began pushing. It might sound odd, but I had a slight out of body experience while pushing. It was as if I blacked out for a moment and was watching a movie play in my head. When the contraction stopped and I sort of “came to” it was like I woke up and wasn’t sure what was happening. I can remember my midwife suggesting to me that I might be putting a bit too much energy into vocalizing when I push. She said that soon baby would be here and that she’d be giving me specific instructions that she wanted me to hear. I laid back in the bed and let her guide me. It felt good not to hold my body up and let the bed hold me instead. I don’t remember pushing for very long like this. My midwife told me that I could reach down and touch baby’s head. It was such a surreal experience, feeling the head and the hair on it! She said one or two more pushes and baby would be out. I don’t really remember how long the pushing part took except it felt like right after that baby slithered out and was on my chest in an instant. It was a blissful moment!
The midwife indicated I had some tearing she was going to stitch up and that I should hold and snuggle baby while she did it. It had been about a half hour and I realized we didn’t even know what gender our baby was! My husband and I finally looked together to find out we had a boy! I feel like the staff let us be for a while and then after about two hours encouraged me to get up to use the restroom. I told them part way through walking to the restroom that I felt like I was going to pass out. Two nurses were helping me to the toilet and as soon as I sat down I passed out. I woke up to smelling salts and a handful of doctors in my room. I was able to use the restroom and be helped back to my bed. They gave me fluids and a while later they tried again but the same thing happened all over again. This time they wanted me to work my way up to sitting on the edge of the bed and then standing for a minute on my own. Ultimately, I just couldn’t do it. At about 5am (12 hours after having had the baby), the midwife came back in and said she was concerned that possibly I had a hematoma that was causing my blood to pool. They said that I may need a blood transfusion but they try all other avenues before doing so. They scheduled me for a CT scan I believe, but all came back ok. They did a blood sample and found my blood levels were within “normal” range but on the low side and that because I was so symptomatic that they were going to do blood transfusion. As I was receiving the blood, I began to immediately feel better. A few minutes after I had all I needed, I was able to get up and walk on my own for the first time in about 20 hours. Up until 5am, I had still been sitting in the same gross sheets I had given birth in. After I stabilized with the blood transfusion, it felt like there was hardly a moment’s peace with nursing students and doctors checking on baby and me. I was grateful for the experience, but not for the hospital setting.
And as much as I’d wanted recovery from my VBAC to be easier than my cesarean, I can’t say that because for me those two recoveries were just different. This is common and I know it, and I would still do my VBAC again in a heartbeat. With my cesarean, I had no core strength for a long time and needed help the first couple of days just to get out of bed. With my VBAC, my perineal area was sore for more than 6 weeks. I also had been having random pains in my belly. Some of which turned out to be gas, and others I think that were my uterus shrinking and my organs getting resituated. It was more painful than I would have anticipated, but overall I felt stronger after my VBAC.
Lessons I learned:
– obtain and review hospital records from previous birth(s)
– YOU know your body best – trust it!
– discuss and research your biggest fear
– hire a doula
– ask for what you want
– Nobody needs to know your due date unless you want them to
– do what makes you feel comfortable