Born on February 12 at 3:43pm
6 lbs 14 oz - 19.5 inches
Congratulations Chrystal & Jason! I am so thankful that to have shared in your joy from the very beginning to the very end of this pregnancy!
|The Birthing Year||
In short, cesareans are a common happening. Whether they are necessary or not can make little difference if it wasn't exactly what you had in mind for your birth. Giving birth this way can be a lot to deal with - physically, emotionally and spiritually. I do not have personal experience with cesarean, but I have had many friends, family members and some clients come to me in need if a listening ear after an unwanted cesarean.
At first it was my goal to provide information about coping with an unwanted cesarean in sharing the stories of these beautiful women. They have each coped and healed in their own ways and in their own time. They were both amazing and brave throughout their experiences, and after talking with them I've decided to just share their stories and their advice. I feel so blessed when other mothers open up to me and share their journeys. I am thankful for and have been touched by both of these stories.
Natalie shared with me the birth of her beautiful little Danica, born May 16, 2012. "My husband and I had been trying for over 3 years to become pregnant." Natalie had an ultrasound at 19 weeks and found that her baby was breech, unconcerned at this point, knowing that baby had plenty of time to turn. The weeks passed along and at 29 weeks she found that her little one was still ready to be born feet first. Natalie's obstetricians were not trained to vaginally deliver a breech baby. "After this appointment I was so scared, my worst fear was having to be stuck with a c-section. I was not a fan. I was reassured that baby had plenty of time to turn, even on the day of delivery. I hung on to that little bit of
"I was uninformed about preterm labor until 3:00 am on May 16th, 2012 when my water broke at 35 weeks. I called my parents and father-in-law, quickly packed a bag and off to the hospital we went. Luckily, registration didn’t take as
long since I was there only a week prior. I was then taken by wheel chair to the OB floor where they checked to make sure that my water had really broken. After that I was put in a labor and delivery room and where I received an IV. I informed them that baby was breech. You could clearly see her head under my right breast, very high!"
Natalie had an ultrasound to confim that baby was still breech. Upon finding that she was, she was informed that all five of her doctors were off call and that a doctor she had never met before would be performing her cesarean. "There was no option for me to say 'I want a natural childbirth', ever."
Natalie's experience was a little less than ideal for most people, from having the anesthesiologist try a total of nine times for a spinal to uncontrollable shaking. Through all of this she says that she truly felt that she was in great hands. "We all talked, laughed and cried, as my daughter, Danica Lynn Martin was born into the world at 7:00 am, May 16, 2012 weighing 6lbs, 4oz and 18inches long. She was beautiful, breath taking, and I couldn’t wait for them to reach her into my arms so I could kiss those cheeks!"
Danica spent the next 7 days in NICU. "The first two days were spent with oxygen, slowly weaning her hour by hour. The third day was spent on room oxygen, still hooked up to IV. That was my happy day, I was able to breastfeed her for the first time! She was a natural. The fifth day I was given the hope of us getting to take her home, only to be let down when we found out she was jaundice and had to stay. I was able to stay 3 days in the hopsital while she was in NICU. The fourth day they allowed my husband and I to stay in a room in NICU, since I was exclusevily breastfeeding. The last few days I spent at my father-in-law's house close by, since I was unable to breastfeed due to he being under lamps for jaundice. It was the hardest thing I ever had to experience in my life, leaving behind my newborn baby at the hospital. It was a nightmare, yet, looking back I'm grateful for being able to go to a place where I was able to actually take a shower, snack, and let my body have some much needed rest. She was a week old when we brought her home. Finally! We thought the day would never come."
Natalie is still thankful for a perfect pregnancy. She loved and trusted her doctors throughout the entire experience. While pushing herself with little rest after Danica's arrival, Natalie was determined to successfully breastfeed her little girl. During her recovery, the traveling back and forth took a toll on her body. The positives helped make Natalie's experience more
so. "My daughter was worth it. I felt after each breastfeeding session that I had helped her, in some way. The bond we
shared during those moments were the most heartwarming to me. That's why I pushed myself, the traveling back and
forth. I knew her being skin to skin to me let her know I was still there, to protect her and help her get better to come home, where she belonged! My scar reminds me of all those precious moments of her being in my belly."
Natalie also has some thoughtful input and practical advice for other moms facing cesarean, "Try not to compare your pregnancy to someone else's. I listened to cesarean horror stories, causing me to fear the worst with my cesarean. My experience ended up being better than I could have ever imagined, despite her deciding to come early and having a NICU stay because of it. I'd also recommend plenty of rest, don't be afraid to tell family hours they can or cannot visit, you'll need it! My last bit of advice would be to wear the support binder and get up a move around. I pushed a wheelchair to the NICU from my room. If I felt tired, I'd use the wheelchair, otherwise I'd push it the trip and back. I feel it helped me from being too sore!"
Shantana's story is that of another breech baby. She also experienced high blood pressure, proteinuria and severe dehydration. "Our precious Gracie was born July 21st 2012 at 6:16 pm via cesarean weighing in at 8lbs 7oz and 20 ¾ inches long. Looking back upon the entire experience I am thankful to God, for I know that He was with us and that He helped us through it all. My c-section was not the experience I had hoped for when I made a birth plan for my little Gracie."
During a hospitalization at 37 weeks, Shantana went into a relatively quick labor. With a steadily high blood pressure, things went quickly for her once she was dilated 5 cm. "Within 15 minutes I was prepped and ready to go back for
surgery. Ryan (my husband) was given scrubs and enough time to make the needed phone calls to our families. I was thankful that my mom was already there. I was so scared. I can honestly say that life felt like it was going by in slow motion. I could feel my heart beating in my chest. I wanted to cry. I wanted to wait. But, mostly I wanted my baby to be safe. I was wheeled back to the delivery room and given a spinal. Ryan was told to wait outside until they had me prepped.They would come get him. However, because of my swelling the anesthesiologist was unable. After several failed attempts I was put under general anesthesia and Ryan was sent to the waiting room. I remember tears running down
my face, feeling lost without Ryan, praying inside my head and the doctor saying, “We’re ready on this end.”
The next thing I remember was waking up in tremendous pain. I literally thought I was dying. I could feel my wound and I didn't know anything about my baby. I remember crying and asking my mom if Gracie was okay." It would be three hours before Shantana would hold her baby girl for the first time. "I had plans for kangaroo care, I wanted to be the first to hold her, to feel her, to see her beautiful face but it had been three hours and it seemed I was the last. No matter the pain I was in, the sheer excitement and pure joy I felt when I held her in my arms is a feeling unlike any other. In that instant, I realized I was indeed the first to hold her-in my belly, the first to feel her move, and although I didn’t see her face, the first to know her."
"Complications arose shortly after and my Gracie was put in NICU. The doctor explained that because she was born early and because of my blood pressure problems, she wasn’t able to regulate her own blood sugar and it kept dropping
below 30. She spent three days hooked up to every IV in the place it seemed. I had lost a lot of blood during the surgery so I was allowed to stay in the hospital. This was great because I was afraid I would have to go home without my
baby, and that terrified me. I was able to breastfeed her on the second day (although I tried to pump the first day to help my milk come in), within three feedings Gracie’s sugar began to regulate itself and slowly she was weaned from all IVs. Although I was exhausted and sore I wheeled myself down to the NICU every three hours to feed her. That was all I could do for her, but it ended up being the best thing anyone could have done.
After, what seemed like forever, we finally made it home. Mommy, Daddy and our miracle, Ms. Lyndon Grace. I am blessed to have all that I do and although I would have liked for things to have gone much differently, I am glad in the end that Gracie is here, happy, healthy and above all - loved."
As a doula, I live for normal birth. I breath it. It's beautiful. I can't get enough. I often think of cesarean in a negative way, as so many are unecessary. In all honesty, three years and I'm still learning about it. I don't know all that I probably should about cesarean, but I'm getting there. It does my soul good to hear these stories, to see the beauty in these births and the love that these mamas feel for their children.
To my cesarean mamas - Take time to grieve for the birth you had pictured all along. It is entirely possible to be sad about your experience, and SO happy and thankful at the same time for your precious new baby. It's okay to grieve. You'll need time to heal physically and give yourself rest, all while caring for your newborn. So, ASK FOR HELP! Friends, family - anyone - most loved ones will be more than willing to help with cooking, cleaning and older children while you spend time caring for your little one and for yourself. Talk about what you've been through. Write it down. Tell a friend. Tell someone who's been there and heal together. Find a local I-CAN chapter. Let it all out! It's okay to feel what you're feeling and it's okay for others to know. Share here! Your story is beautiful and it deserves to be told.
Cohen is my third baby. This is the first time I've written a birth story! I have considered many times trying to write about Gavin's and Cara's births, but I've waited far too long and the details are fuzzy. I don't think I could if I tried. It feels so wonderful to be able to write this down, so that with this birth I won't forget. It was the amazing experience that I wish all mothers could have.
Cohen Grey was born on October 1, 2012 at 1:26 am, safely (and quickly) at home, weighing 8 lb 6 oz, he was 20.5 inches long.
I had been having contractions on and off for around two weeks. I had once called Jo (my midwife) and her assistants, only to have them spend the night and travel home again the next morning. I was very worried about this happening again. If I knew anything, it was that I didn't want another false alarm. They were around three hours away and I knew how difficult it was for them to travel and lose sleep for no real reason. I was also worried that they may not make it on time if I didn't call, as was Jo, so that's what I did.
One day past my due date, which was September 29th, I began having a few contractions. This was nothing unusual and I wasn't convinced that birth was imminent. It was around 6 pm. I waited for a few hours and by 8 pm I thought it would be a good idea to at least let Jo know what was going on. They were around 5 to 7 minutes apart, so she decided it would be a good idea for them to come. I still wasn't convinced, and again I was very worried that they would be making the trip for no reason. About an hour into their drive, my contractions stopped again. I was extremely frustrated at this point, so much so that I was in tears as I called to let her know. We talked for a few minutes about what I was feeling and decided that it would be best for her to go ahead and continue on her way. It was raining out and it would take her a little longer to get there than it would any other day. I very distinctly remember her saying to me, "Stop worrying so much and just have your baby." I believe that her telling me that helped immensely with the progession of my labor. I also believe that my contractions stopped for those few hours because my body was waiting on her to arrive.
She did so at around 11 pm. I had been having a few contractions here and there for around an hour or so before she showed up. At that point, I still wasn't at all conviced I would have my little bundle that night. I was sitting on my ball as they walked in, hoping that it would help anything at all. I moved to the recliner and we all talked for a while. I honestly don't remember much of what we talked about. I remember Jo sending Nick (my husband) to sleep. I remember texting Carolina (my labor support and very close friend) that she should get some rest, I wouldn't need her anytime soon. I don't remember at what point I was no longer a part of the conversation, but I do recall being in my own little laborsome world, breathing and praying, still unconvinced - when my water broke. I knew that it broke before it did, if that makes any sense at all. I yelled, "Oh my God, my water just broke!" Everyone stopped talking and looked at me, and man did it break. Two seconds after saying so, it gushed EVERYWHERE.
I won't lie. I was a little nervous. I knew that my contractions would become much stronger now, and I was considering that I was 3 or 4 cm at that time. Haylea (Jo's apprentice) woke Nick and I jumped up and headed to the shower immediately. I wasn't in the soothing water for long when I realized that I wasn't able to stand. Nick helped me to my bed. I wanted to lay, to rest. I told him that I just knew that I coudn't do this. He reminded me that I was already doing this, and I heard Jo ask Sandra (Jo's assitant) to please turn the air off - which meant she thought my baby would be here soon. I asked her to check me. I needed to know how much longer I might feel this way. I was 9 cm! Already! The relief I felt was unexplainable. I was also shocked. I told Jo that I felt like I needed to go to the bathroom. She said, "Do you wanna have your baby in the toilet?" and I answered, "I don't care, I have to use the bathroom!" She reminded me how small my bathroom was, that she couldn't fit in there with me and she said, "That isn't poop. It's your baby." Somehow in the last 17 months since I had my daughter, I forgot what this felt like. And then I needed to push.
I was lying on my back and suddenly very uncomfortable in that position. I moved to my hands and knees and pushed for what seemed like an eternity. When his little head was finally out, Jo asked me to push as hard as I could. We needed to get the baby out and it couldn't wait. I didn't know at the time, but he had a nuchal arm (which was why I thought at the time that it hurt so much more than when Cara was born). I have no concept of how long any of this took, I just know that it wasn't long before he was earthside and in my arms. He was very quiet, but perfectly healthy and I was so thankful to just have him there with me - no cutting the cord, no taking him away to have this and that done. He was just there, and I was in love.
Carolina arrived less than 5 minutes after he was born. I had forgotten all about her! It all happened so fast, I was thankful my husband remembered to text her. I wanted her there during my labor so badly. Maybe next time I'll be conviced a little sooner.
Very shortly after his cord was clamped and cut, I really wanted to shower. I still hadn't delivered the placenta, and I felt pretty gross at that point. I handed Cohen to Nick and stood beside my bed to deliver the placenta and once again, it was straight to the shower. I recalled my first showers after Gavin and Cara. I felt weak and light headed those times, but not now. It felt great to be in my own home with my family, surrounded only by those I knew and loved.
After my shower, we all settled into the living room. I snuggled my baby and tried to nurse him. He wasn't hungry just yet. After a while, Jo checked him over and weighed him. When she announced that he was 8 lb 6 oz, we were all shocked. My others only weighed just over 6 lbs. My husband proclaimed that I had "made a real baby this time".. This day was full of laughter.
Then, it was time to check if I needed stitches. Nick was cuddled up to our little guy in the recliner, our others sleeping soundly in the next room, completely unaware of what had just happened. I couldn't wait for them to meet their new brother. I had minimal tearing and needed stitches. Yay. Thanks previous episiotomies and Cohen's arm.
Jo is an excellent midwife, but hadn't had to do a lot of repairs (which is actually a great thing!) so it took a while to fix me up. At one point during the stitches, my cat jumped through the open window and landed directly behind her head. Everyone laughed hysterically while rushing to put her back outside.
After all was said and done, I attempted for the second time to nurse my sweet baby. We had some trouble at first, that
lasted for a few weeks. I later discovered that Cohen has a bit of a lip tie. We worked with it, and now I sit here typing this, nursing this 12 lb 2 month old who has stolen all of our hearts in the short time he's been here. I am so thankful for this experience. Our family has grown and grown closer together with his birth. I wouldn't change anything about it and I can't thank my birth team enough for supporting me in every way I needed and for giving me such positive memories that I will cherish forever.
WELCOME BABY HAZEL!
Born November 26th at 9:36am, safely at home.
8 lbs - 19.75 inches
It was a joy and a pleasure welcoming this sweet baby and attending alongside my favorite midwife, her wonderful assistants and doula Kelli B. Haywood of Birth True Childbirth Education.
Haha! It's looong! Although labor was rather short...Thank goodness...
Monday, July 27th was my 39 week appointment with my midwife. I was 3-4 cm dilated already and 80-90% effaced...Yikes! Jessie was pretty sure I would go in a couple days, but I was really holding out for August! Anyway, nothing happened all week...after I made poor John stay in town instead of working away from the office like he was supposed to.
A cousin of mine informed me we needed to "grease the cake pan". I'll leave the details out, but Friday evening I was having contractions again. Not anything different from the ones I'd had before. Disappointed (sort of), I went to bed. At 1:30 am, I got up with contractions that wouldn't let me sleep, and went downstairs to read and time them. I didn't want to keep John up if it wasn't time to go, and I figured he'd lose enough sleep later. My contractions were all over the boards (9 mins, 5 mins, 2 mins, 7 mins) so I thought it couldn't be time.
I started going to the bathroom between every contraction, and finally felt whiny enough at 4:30 am to crawl back in bed with John and whimper while he looked at my contraction timer and figured out whether or not we should go to the hospital. After I ran to the bathroom again, he decided he didn't want his son born in the toilet like those "I Didn't Know I Was Pregnant" people on tv. So we started getting stuff together...well...he did. I just kept asking him, "Do we have this? How about that?" And trying to breathe through contractions. He was pretty sure if I could remember all the stuff I sent him for, it wasn't time. I called the after hours service, and found out Jessie, my midwife, wasn't on call. :o( I was upset, but, hey, what can you do?
We got out the door, let the dog go to the bathroom while John called my mom from the backyard, drove up the driveway, reversed, got my purse and all my ID, and drove away again. We got to the hospital in record time, hit the registration area where we signed in at 5:32 am. I was having pretty bad contractions at this point and making some noise, so I was embarassed and hid around the corner in the registration lobby. John got me signed in with the lady (after continuous interruptions by yours truly to "COME BACK!"). She freaked when my water broke in her lobby. Anyway, I made it to L&D, where John asked if I could get a room with a tub. I did, but never got a chance to use it, because, lo and behold, I was already dilated to 10 and at a +2 station the first time they checked me.
The nurses had me lie on my side with my legs together to wait for my midwife (they phoned her anyway, instead of the doc on call). The bed rail became my best friend as nurses kept reminding me to breathe slow and deep through contractions, and I gripped John with the other, trying not to break his hand. They tried to get me to move, and another nurse informed them I was "in the zone" and not to bother me. Jessie made it (HURRAH!), throwing on scrubs while complaining that companies don't sell pink and blue emergency lights for ob/gyns and midwives...I love her!
I pushed for about 20 mins. John says. It felt like forever, trying to get Evander's head under the pubic bone. 1 step forward and 2 steps back kind of work. Apparently I cracked a joke about if the baby's ears were anything like John’s, he would get stuck. Everybody laughed. I’d really meant if I could only get the ears out, he couldn’t slip back in! But, oh, well! I knew I was wimping out on some of my pushes, because Jessie kept saying “Push down into your bottom”, but I was so tired, and kept having to readjust my grip on my legs. I think I got about 2 or 3 pushes to a contraction, but they had to remind me to
do it! I didn’t want to push ANYMORE! Finally, someone saw the head…about a silver dollar round of scalp and HAIR. LOL. We’d been sure he’d be bald! They got a mirror on a stand for me to see, and John found my glasses, but you could
still only see when I pushed, and I wasn’t paying any attention during those times!
And then, I felt his head. It was the most intense and terrifying pressure because I knew it had nowhere to go but out. I pushed, and they encouraged, and Evander’s head emerged. They made me stop pushing to suction his mouth, and then
Jessie had me push out his shoulders. I don’t remember if it hurt or not, after the head! He was purple and wet, and suddenly, lying on my stomach. I don’t even know what I said. They rubbed him and he cried a little, not much. Then they
took him quick to check his APGAR scores. He was 7lbs and 11 ozs. John snapped a pic with my i-Phone and posted it for the world to see.
I had a second degree tear, so Jessie stitched me up and John held Evander next to me. They checked my blood pressure and all that, and I could NOT stop shaking. John’s mom and sister were the first to arrive after all the frantic calling earlier. Maggie helped me while all the nurses filtered out and let me try to nurse. It wasn’t working, Evander was way too sleepy, but it was still amazing to have his little pink body cradled against me instead of inside me. Totally amazing. And that was the beginning!
Now for the next step...Evander's breakfast. LOL
For two weeks before Maia was born, I was dilated to 3 and 80% effaced.
Nervous, I took everything as a sign of labor because Vander had been so fast! My midwife had told me this labor was likely to be faster. I was horrified by imagining myself going into labor while I was at school, or starting bad contractions while driving and delivering on the side of the road with a state trooper, and even had a nightmare that I was going into labor at home alone with Vander one night that John was out of town. The school nurse assured me she was eager and willing to deliver me in the school nurse's office (she was an ER nurse and missed the adrenaline!) I stressed over every twinge and movement. In the end, Maia chose as convenient a time as her brother did. She waited until she was 39 weeks baked, and it was the night before Election Day when we had no school.
I had had contractions all that Monday, and I was nervous about going to school, but they weren't strong, and they were about once an hour. So I dropped Vander at school after taking pics of him eating his Poptarts (haha, his last breakfast as an only child...sorry I didn't make waffles or something). I drove to Shelbyville talking to John on the phone, and wondering if I was going to have to make him turn around, since he was driving an hour and a half away to Richmond for work that day. I got to school with nothing else exciting happening so I told him I'd keep him posted. My contractions hit at random times that day, never closer than an hour apart, but we assumed it meant labor was coming within the next couple days...My mother-in-law Maggie came up that night just in case, and my sister-in-law Amanda had already been staying with us in anticipation of Maia's birth...we didn't want to have to take Vander anywhere in the event of a middle-of-the-night departure, which is what ended up happening. At 9, I sent out a trial mass text (I'd never done it before) to let a few people know labor might be starting but that I was going to bed.
That night at midnight, a contraction woke me up. It was enough to keep me awake, excited and waiting patiently for another one. I Facebooked and played Scrabble on my phone. Another hit at 12:45, then 1:00, then they jumped to
every seven minutes. For about three whole contractions. Then they settled into every five minutes. That escalation scared me (thanks to Mom's second labor story when she went from ten minute contractions to one minute contractions with my younger brother). By 2 am, they weren't strong but they were regular, and I convinced John we needed to leave. I really didn't want to walk into the hospital like Mom...crowning. It sounded very uncomfortable to me! John was sure we'd be at the hospital forever. I gathered up all of my things, much calmer than the previous time. The contractions got stronger since I was standing...good ole gravity. I snuck in Vander's room, covered him up, kissed his head, and snapped a pic of him sleeping with my phone. He was oblivious to the big changes that were on the way!
Maggie came with us, and we let Amanda know we were heading out. John and Maggie talked about the possibility that Maia would be the first female President since she would obviously be born on Election Day. I hope not, for her sake! Too much stress... I called my mom and let her know what was up after sending out a mass text to let a select few family and friends know that we were on our way to the hospital. Barry, my brother, was the only one who texted back immediately because he was still up.
The emergency room was not busy, and the nurse at the desk sent us immediately to the Non-Emergency Registration office at about 2:30 am... I don't know what they consider labor if it's Non-Emergency. I kind of disagreed. The lady was nice, and she seemed understanding when I couldn't answer questions through a contraction. We got all our paperwork done, and a nurse came down with one of those humongous wheelchairs. They're so wide, I felt I could have offered her a seat, and we could have wheeled it upstairs together. This time around, I got stuck in triage. The triage nurse had me
pee in a cup...seriously? During contractions? How do people do that? I did the best I could. Then I got stuck on a monitor, and shortly after, moved to a delivery suite. It turned out to be the same one Vander was delivered in. My
nurse Jodi was awesome and cheerful, which was what I needed. Someone to joke with while I was between contractions. John had more time to crack jokes this time, too, and nearly got punched a couple times for it.
The contractions were ramping up, and my hands were going numb in the middle of them. I thought, Great! I'm going to stroke out in early labor. When they finally got around to checking me, I was already dilated to 8. They rushed in
to get blood drawn and INSISTED on putting in a HepLock. I refused three or four times, but the nurse doing it basically just said it was hospital policy and she HAD to. Maybe she did, but I avoided it with Vander (most likely because I came in dilated to 10 and there really was NO time) and I really DID NOT want it. She tried, and blew out the vein on my left arm. URGH. I HATE NEEDLES. Especially in the middle of contractions. She got another nurse to come try, and she couldn't get it on the first try either. I was crying by this point because they were switching sides with the lady trying to draw my
blood. John had been pushed down to the end of the bed, but he held onto my foot when I asked him. I needed someone touching me who wasn't trying to stab me. The second nurse finally got in a pediatric IV needle, and they taped it
down and left me alone. FINALLY. I was very unhappy with all of that.
I think my midwife, Beth, came in about that time. I was really glad she made it! She checked in with us, then went back out for a while. Afterwards, Jodi helped me get down off the bed so I could rock back and forth leaning on it with a couple pillows under my head. She explained that my numb hands were due to the fact that I was blowing out all my air when I was breathing so deeply and that I should release in three short puffs instead of all of it at once. That helped a lot and I could focus on other, more important things. Like the fact that Maia was on her way in a hurry!
Jodi offered me the birthing ball, and since I hadn't had the chance to try anything different with Vander, I said, Sure! Why not? She brought it in and covered it with a giant "puppy pad". LOL. I don't know what else to call them. I sat down on it, and after it squished all the way down into a complete squat, I bolted back up again. WAY too much pressure! I didn't really want to go THAT fast But it had gotten everything started. Maia had dropped into position, the next contraction was crazy, and I felt the need to push. I thought my water broke, a little puddle and some blood on the floor next to the bed. How wrong I was! Jodi and Maggie got me up on the bed somehow, dropped the foot and raised the head so I was basically sitting, and Beth came back in. I was at a funky angle on the bed, but I was ready to push. Then my water REALLY broke. It shot straight across the room like a water park attraction! The relief of all that pressure was amazing. After a contraction and pushing one round in that position, they were able to move me. I was more present
during the labor with Maia than I had been with Evander. I was semi-able to think this time around, and I knew what was happening.
This time, I was determined not to wimp out on my pushes like I had with Vander. I powered through each contraction, pushing as hard and as long as I could. They even had to make me stop once to breathe. I was determined to get
Maia out with more efficiency. Water continued to slosh out in front of her head, and its warmth was soothing. The only thing I regret this time is that I arched my neck during pushes instead of tucking it. Five days later, it's still sore! I remember them telling me the head was out and to take a break while they suctioned her nose and mouth. Then the shoulders. It seemed harder this time, and I know it hurt. I didn't remember true pain with Vander, just pressure. But Maia's shoulders hurt. Maybe because I was more aware. After that, she slid right out, and there she was on my stomach! They wiped her hard with a towel until she cried, and boy, did she cry! She was much louder than
The placenta, which I barely remember with Vander, was easily passed and Beth showed me the "tree of life"--the web of blood vessels on the inside where Maia had been hanging out for about 9 months. It was very pretty in a gross anatomy kind of way! Then the best news of all--no lacerations, no tears, no stitches...which had been one of my goals and the reason I did not want to labor lying down this time. I was able to nurse her immediately, and she latched on like a pro. Vander had just gone straight to sleep when he was born, and we had struggled to keep him awake for a feeding through our entire hospital stay. She was alert and had a cleft in her chin like my dad, dark hair, and while she was swollen from birth, she looked like her brother. Absolutely amazing--after the long and stressed-out pregnancy, I was holding my daughter.
The World Health Organization recommends that the cesarean rate for developed countries should be somewhere between 10-15%. Studies show that the best outcomes for mamas and babies occur with cesarean rates of 5% to 10%. Rates above 15% seem to do more harm than good (Althabe and Belizan 2006). The average cesarean rate in the US is around 32.8% - much higher than the WHO recommendation. The average cesarean rate in Kentucky is actually a bit higher than the national average at 35.4%. The hospital with the highest cesarean rate in KY is Paul B Hall Regional Medical Center, with a rate of a whopping 71%.
Why are cesarean rates in our country so high? More importantly, why are cesarean rates in our state even higher than our high national average? A few reasons come to mind:
- Lack of evidence-based care
- Lack of support for the laboring mother
- High instance of unnecessary labor intervention
- Small amount of care providers who offer VBAC
- Lack of awareness of the harm that can sometimes come from cesarean
- Obstetricians are paid the same amount whether you deliver vaginally or by cesarean. Sadly, a planned cesarean is a great way for doctors to work births around their own schedule.
So, is it even possible to meet that WHO recommendation of 10-15%? It is.. and there is actually a place in our country whose cesarean rate is well below the national average, as well as the WHO recommendation. The Farm Midwifery Center in Summertown, TN has maintained an average cesarean rate of 1.7% from 1970-2010. Of 2,844 pregnancies, only 50 ended in cesarean. This really gives us an idea of just how many cesareans performed in the US are actually necessary, doesn't it? It certainly shows what is possible when evidence-based care and education are provided to mamas who absolutely deserve it! Why shouldn't every mama receive this kind of care?
Before delving into how to avoid an unecessary cesarean, I first want to talk about the risks that come with having a cesarean (whether necessary or not). Most importantly, the maternal mortalitly and morbidity rates are much higher with cesarean than with vaginal birth. Many women who have a cesarean section also sometimes have negative feelings about their birth that last well into the postpartum period. There's the possibility of a reactions to one of many medications that are associated with cesarean (anesthesia, pain medication etc.). With a cesarean, the average hospital stay is 3-5 days - with a vaginal birth it is only 24 hours. Along with the extended hospital stay comes an extended recovery time that can have a negative effect on bonding with baby and breastfeeding. Cesarean surgery itself can cause a delay in the milk ejection reflex, and mamas who deliver babies via cesarean often experience a delay in their mature milk coming in. 1 in 14 mamas report incisional pain six months or more after surgery (Declerq ER , Sakala C, Corry MP. Listening to Mothers: Report of the First National U.S .Survey of Women’s Childbearing Experiences. New York: Maternity Center Association, Oct 2002). There is a risk of scar tissue that can lead to complications in future pregnancies including placenta previa, placenta accreta and placental abruption. Infection can occur at the incision site, in the uterus and in other pelvic organs. There is a chance of injury during the surgery to other organs that are close to the uterus. There is more blood loss in a cesarean than in a vaginal delivery, 1 in 6 women require a blood transfustion (Shearer El. Cesarean section: medical benefits and costs. Soc Sci Med 1993;37(10): 1223-31). Along with all of these things comes the risk of additional surgeries - hysterectomy, organ repair, future cesarean.
The previous mentioned risks are those for mama, there are also risks for baby involved with cesarean delivery. Babies who are born via cesarean are more likely to have lower APGAR scores, reasoning behind this can come from a number of problems with cesarean - the anethesia and the lack of natural stimulation for baby provided by a vaginal birth to name a few. If your due date was not estimated correctly, a baby born by planned cesarean can be born prematurely. Babies born by cesarean are much more likely to have breathing problems and are more likely to need assistance breathing shortly after birth than babies born vaginally. Rarely, there is a risk of injury to the baby during a cesarean. On average 1-2 babies in 100 are cut during the surgery (Van Ham MA, van Dongen PW, Mulder J. Maternal consequences of cesarean section. A retrospective study of intraoperative and postoperative maternal complications of cesarean during a 10-year period. Eur J Obstet Gynecol Reprod Biol 1997; 74 (1): 1-6).
Avoiding an unecessary cesarean, and the risks that come with it, can be done in a number of ways:
- First and foremost, if you aren't in an emergency situation, question your care provider. Why is this being recommended? What are my other choices? What are the risks and benfits of having the surgery? Of not having the surgery?
- Plan a birth that is low intervention and find a care provider who is supportive of natural childbirth and supportive of your decisions. Each intervention in birth (induction, epidural, continous monitoring) greatly increases your chances of cesarean. These things can also sometimes be necessary - but when they aren't you have to ask yourself, is it worth the risk?
- When you find a care provider, be sure to ask their cesarean rate. It may be higher than even the national average and that's never a good sign.
- Educate yourself by taking good (out of hospital) childbirth classes, reading books recommended by your CBE or doula and by asking lots of questions of your care provider and support team.
- Discuss with your care provider spending early labor at home. A common reason for cesarean failure to progress. Usually, when given enough time, mama will progress just fine on her own.
- Avoid continuous monitoring.
- Avoid getting an epidural, especially early in labor.
- Avoid induction, unless medically necessary.
- Hire an experienced, professional doula. A doula will be able to help keep you comfortable without the use of modern medications and will also be able to help you find positions that are conducive to the natural progression of labor. If something does come up during your labor, your doula will be there to answer any questions you have and provide you with accurate information to help you make the best decision for both you and your baby.
- If you've had a previous cesarean, find a doctor who is supportive of VBAC and discuss your options. "Once a cesarean, always a cesarean" usually isn't the case.
While cesareans are scary and come with plenty of potential side effects, they are sometimes necessary can be life saving. Some cases in which a cesarean may be necessary are placenta previa, placental abruption, placenta accreta, uterine rupture, cord prolapse, fetal distress, active genital herpes, preeclampsia, some birth defects and some cases of multiple births (not always necessary). In these cases the benefits of a having a cesarean can greatly outweigh the risks. If you find yourself in a situation where cesarean is necessary, it doesn't have to be a negative experience. Knowing that you are making the safest choice for you and your baby is a great start. Some other tips for creating a positive experience when cesarean is neccesary can be found here.
Following up on my post from yesterday about the option of giving birth at home in our little part of the state, I wanted to share the birth story of a friend of mine who chose that option for the birth of her daughter a few years back. While her journey wasn’t a typical one, it certainly shows how difficult things can be for the mothers in our area who choose home birth over hospital birth. It also shows how very worth it making that decision is for those who feel safer in doing so.
Kristi planned from the very beginning to give birth in a nearby hospital. While searching for a home birth midwife from about 12 weeks on and to no avail, she remained under the care of a local obstetrician up until about 18 weeks, when she says she saw a number of signs that he was not the care provider for her. She sought out the care of another local physician, only to be let down once more, very close to the end of her pregnancy. From the talk of a 40 week inductions regardless of the circumstances and only being given the option of birthing in the lithotomy position, to not being “allowed” out of bed once her bag of waters had broken, Kristi continued her pregnancy-long search for a midwife who would be willing to travel to our part of the state. By this point, she was 35 weeks and considering giving birth at home without the assistance of a midwife. With a sudden turn of events, one of the midwives she had previously spoken with agreed to meet with her at 36 weeks and by 37 she had made her decision. At her 38 week prenatal visit with her current OB, she was thrilled to share the news that she had finally found a midwife willing to make the drive, only to find out that her OB was less than thrilled. Although she was a low risk mother with a perfectly healthy baby and a skilled CNM to attend her birth, her OB immediately released her from her care and that was that.
After a long journey to find the care that she and her family deserved, Kristi gave birth to a beautiful 6lb 12oz baby girl in the comfort of her own home, surrounded by her loving husband and family on March 7, 2008.
Around 12 hours after her baby girl was welcomed earth side, she experienced an unexplained apnea and was taken to a local hospital for observation. While their sweet daughter was perfectly healthy, Kristi and her husband were treated poorly by the hospital staff for the sole reason that they had chosen to give birth at home. She was talked down to, threatened and mistreated, all the while refusing to leave her baby’s side. Their sweet daughter was transferred to a Level 3 NICU over 3 hours away from the Level 2 NICU at the local hospital, because the staff could not explain the problems she had been dealing with before coming into the hospital. After arriving at the hospital, she had no other episodes and after remaining in their care for a long 3 days, baby was discharged with a clean bill of health.
Kristi’s birth story is a repost, and is an official Hypnobabies published story. The original post can be found here.
“The birth of my daughter began almost unexpectedly. I had just gone to my 38-week prenatal appointment, a few days late actually, and I wasn't expecting to begin my birthing time until closer to 39 or 40 weeks – I was still measuring 3cm. We had just switched care to a homebirth midwife, Donna Galati, CNM and we were still planning to travel to Louisville, KY to pick up my mom (hopefully) before everything started.
It was Thursday evening, March 6th and I had just put James to bed. I called my mom back around 9:15PM and while I was on the phone for about 40 minutes, I had three or four mild pressure waves. I figured it was just more pre-birth waves that I had been getting after nursing James to sleep lately and they would go away. I went to bed around 11:30 PM or so feeling good, and not really noticing any more pressure waves, but did notice that my baby had turned into the birthing position.
I woke around 2:30AM –ish to more pressures. I had remembered my dream and it was about me beginning my birthing time, I found it odd, but now I thinking I should have paid more attention. I got up, went pee and thought, maybe I should tell Mike to get some sleep. He was still up playing Xbox 360, and didn't go to bed until after 4AM. I went back to bed and woke again when Mike came to bed, this time the pressures would not let me get back to a good sleep. I got up and decided to eat a bit. Apples and peanut butter sounded yummy and I figured it would give me time to see how close the pressures were coming.
As I sat in the living room eating and timing, James woke up. He wanted to nurse, but that just made the pressures stronger. He settled for laying next to me and holding the nursies. I sat there for about 30-40 minutes and the pressures averaged 5-7 minutes apart. Shortly before 5:45AM, James and I went back to bed. I laid down and listened to my Hypnobabies scripts to try to relax a bit, it worked for a short while but I wasn't able to get comfortable. I settled for just trying to sleep through them and I made it until around 7:20AM when the waking every 10 minutes just wasn't cutting it anymore.
I got up, ate a bit of cereal, and started the computer to get the timer program for my pressure waves. I also thought it would be a good idea to wipe down the bathtub. I timed them for more than an hour before calling Donna at 8:49 AM to give her a heads up on what was going on. The pressures averaged 4-5 minutes apart and lasted a few seconds either side of the one-minute mark. Donna said to keep an eye on things and call her back in no more than 3 hours for an update. I sat around, drank water, ate a bit, and James woke up around 9:30AM-ish. I tried to listen to my Hypnobabies scripts, but James needing me was preventing me from getting really relaxed and into Center Switch. I settled for slow, controlled, and relaxed breathing for each pressure.
I called Donna back at 11:38 AM with not much change. At this point I informed Mike that it would probably be a good idea for him to get up and lay on the couch incase James needed anything, because I had to start focusing more on breathing and relaxing though each pressure wave.
At 11:49AM Donna called me to inform me of bad weather in her area. She didn't want to miss anything or make the nearly 3 hour drive and not be in true *labor*. By this time, my pressures had slowed a bit, so I said I would watch the weather and the pressures and call back in an hour.
I called my best friend Ashley that lived out near Donna and asked for her opinion on what I was having. I told her that since she had had three kids already and would know more about this, I wanted her opinion. She said under the weather circumstances and what I was feeling, it would be best to have Donna come out, because it could take longer than 3 hours for her to get there.
At 1:13PM, I called Donna and talked a bit more. She listed to me during a pressure wave while we were talking and she decided it would be a good idea to head out here.
While I was waiting for Donna to arrive, I continued to drink water/juice and eat as I felt I needed. I also boiled eggs for deviling as nutritious labor food – I had a craving for them and it seamed as good a time as any to make them. As the pressures progressed, I felt them move from hugging my belly to stretching my hips and lower back. Mike would press on my lower back each time a pressure wave was stronger than I could handle on my own. It felt so good and made the pressure in my lower back seam to float away! I sat a bit on my birthing ball and rolled my hips around in between waves, and standing while swaying my hips during a wave felt great too.
Donna arrived at about 4:50 PM and I had her do a quick cervical check before she brought everything in. I was surprised to hear that I was 5-6 cm dilated with a bulging bag of waters! Mike helped to being all her equipment in and James helped set it all up and go through it.
Pressure waves continued and I continued breathing through them. Many times, I preferred to be on my hands and knees either swaying or having Mike apply pressure to my lower back. I had a bit more to eat, Mike made me a sandwich, and Donna and I chatted a bit about how Mike and I got together.
After I was done eating, Donna said we could try to get in the tub to see how that worked on my pressure waves. I got in and it was so warm and relaxing. All the positions that I thought would be uncomfortable in there were what worked for each pressure wave. I spent a little time in there but I kept feeling the urge to pee or something. I got out and spent a good hour or so on the toilet, mostly just sitting there with no pressure on my tailbone. I never understood why women talked about how they enjoyed sitting on the toilet so much before giving birth, but now I know! I got up a few times, walked a round a bit and then returned to my birthing *throne*. The pressure had moved from my lower back to my hips and walking around as if I just got off a horse saddle felt ok, but the toilet was so much more comfortable!
While I was in the tub and back & forth to the toilet, my mother in law, Kim, and sister in law, Elaina finally made it to the house to help with James and watch the birth. Things got somewhat loud here and there, and Donna thought there was a ton of commotion. Everything settled down after they got the shhhhhh from me a few times.
At about 15 minutes before 8PM, Donna thought it would be a good idea to check my dilation again. Before a pressure wave, she said I was 8 cm and during a pressure wave, I was nearly 9 and 3/4cm with my waters still bulging. She offered to break my bag of waters to move things along, but I was a little unsure of just how quickly things would progress. As I thought it over, I returned to the toilet. Mike came up to me at some point and looked at me long and lovingly, stroking my face. All of a sudden I was pushing during a pressure wave and *plop* - *gush* went my waters! It was so strange to hear it! However, no mess to clean up!
We worked our way in to the living room where we had decided to have our baby. I chatted with Kim and Elaina on my way there, laughed a little bit, and breathed through a pressure wave. I made it to the living room and crawled around a bit, finding the most comfortable position. I tried leaning over my birth ball, Donna had me try lying on my side with one leg up, but that wasn't for me either. Soon I was on all fours and getting very primal sounding. It was coming deep from with in me. Each pressure wave brought up a mother lion throaty moan. Just before I began consciously pushing, I got a brief break to lay my head down for a minute or two. I rested my head on my mother in laws lap for that break, and then here came the baby.
As I was pushing, I felt my hips widen and everything stretch to open and move my baby out. As she crowned, I felt a sudden openness – no warmth, no burning. For a split second I remember thinking to myself "what am I thinking, why am I doing this?" Then with two more pushes, she was out! Mike said it took 5-7 pushes to get her out – only around 15 minutes. She seamed to
have come out all at once, head AND shoulders.
Both Mike and Donna were there to catch, but Mike did most of that. I rotated around and sat on the floor, leaning against the couch as Mike and Donna handed me my baby. After an initial rough start in getting a good first breath, she latched on to nurse a few times and passed all her meconium poo before the midwife left that night.
We weighed and measured her there by the couch. She weighed 6 pounds, 12 ounces, 18.5 inches long and head circumference of 13 inches. After nearly three days of life, we named her Valerie Lynn!
Thinking back after being asked if I was in pain at anytime, I can honestly say, "No I wasn't in pain!" This was the most intense activity I have ever done and even though there might have been a TON of pressure in my hips and mild discomfort as my baby
crowned, none of it *hurt* and none of it was un-manageable. I can honestly say my daughter's birth was pain-free!”
As a doula, it is first and foremost my job to support expectant mothers and their partners in whatever decisions they make regarding the birth of their child. That being said, my biggest passion in life is ensuring that the women and families I work with are aware of all of the options available to them during this very important time of their lives. I strive, above all else, to equip these amazing women with a knowledge and full understanding of the potential dangers of unnecessary intervention and also to provide them with the tools they need to achieve a natural birth, if that's what they decide is best for them. Women have a right to birth free of unnecessary interventions. They have a right to give birth in the safest way possible. With these things, comes a right to give birth wherever they choose, whether that be in the hospital or at home. Choosing where to give birth is the biggest and the most important decision you'll make during your pregnancy. There are risks and benefits to each, and I strongly feel that a mother should never be discouraged from giving birth wherever she chooses and with whomever she feels the safest.
I've often found that most women in our area don't consider giving birth at home an option, because of the laws regarding home birth in our state. However, safely giving birth at home with a knowledgeable birth attendant is absolutely an option. Many women in our area choose to give birth at home, some even have the support of an understanding obstetrician who will be there if the need to transfer to the hospital arises. I've spoken with a number of mothers who've had home births over the last few years, including the beautiful mama you'll see pictured above and below. Cerise has given birth at home on two seperate occasions in the great state of KY. Hers is a testament of why it is so very important for the option to give birth at home to be made widely available to women regardless of their location, "I'm happy to share because choosing a home birth with a midwife saved my birth and gave me a healthier child. While I believe the experience is very important - it can make or break a breastfeeding relationship, bonding with your child and postpartum depression - I chose a home birth because after looking at the research, I realized that it was safer for someone like me who is healthy and had a healthy pregnancy. I had no idea my water would break at 36 weeks. Instead of pitocin and a timeclock, I was given time and respect. I believe I would have had either a c-section or a very difficult induction and either way a baby in the NICU. Instead, I had a healthy, easy birth and baby."
When making the decision to have a homebirth, there are many things to consider. There are a number of advantages to giving birth at home. In your own home, you are allowed a freedom of movement that most hospitals policies simply aren't compatible with. This freedom of movement is conducive of the natural progression of labor. Any fear you may have of simply being in a hospital is eradicated. You'll be surrounded only by those you love and trust. There is no "routine" this or "routine" that. A midwife is less likely to be concerned about how long your labor is taking to progress.* You won't have to worry about unnecessary medical intervention. The risk of infection to both mother and baby greatly decreases in the home environment, because there are no foreign germs. Lastly, one of the greatest beneifts, mama-baby bonding goes entirely uninterrupted!
There are some other things to consider when making the decison to give birth at home. In this area specifically, having the backup support of an obstetrician is rare. In the instance that you are able to find an OB who is supportive of your decision, there is no collaboration between midwife and obstetrician, which can increase the risk of giving birth at home. Without the backup of an OB, if a problem arises and the mother must be transfered into hospital care, she will be cared for my a physician she may or may not have ever had contact with.
Weighing these options carefully, after two hospital births and with the support of my wonderful husband, an understanding OB and an amazing midwife, I've decided to give birth at home this coming September. I'm so thrilled to have so much love and support surrounding the birth of my child and I am beyond blessed to have this opportunity. I'm asked many questions on a daily basis by my friends and family and I've found that the one thing that always comes up is whether or not I feel comfortable as a Christian, allowing a midwife to attend my birth in a state in which she could be penalized for doing so. I feel that it is my job to protect my children. The Bible teaches us that children are a gift from God, that as parents, we are intrusted with the care of our children. The Bible teaches that when man’s law contradicts God’s law, we must obey God over man. In choosing to give birth at home, I feel that I'm giving my son the best start at life possible. We won't be bothered with routine separations, breastfeeding issues or talk of medications, vaccinations or circumcision. He will be born into a safe, loving home, that he will always be able to call his own. I can't imagine a better way to welcome a new little life into the world. The care I've received from a midwife is not comparable to that of an OB. I have never felt safer in any decision.
When considering these things, I think we can all see how important the option to give birth at home is to a healthy mother with a healthy baby. The Kentucky Home Birth Coalition is working hard to legalize and license Certified Professional Midwives in Kentucky. In the meantime, that doesn't mean that home birth isn't an option. It just means that, as with anything else, you have to weigh the risks and benefits for yourself and decide what's truly best for you and your family.
I'm actually wrote this post around a year ago, but since I'm moving my website and blog to a new address, I wanted to bring it along with me!
'And the God of all grace, who called you to his eternal glory in
Christ, after you have suffered a little while, will himself restore you and
make you strong, firm and steadfast.' 1 Peter 5:10
For me, the birthing year is the time in which you are
pregnant, give birth and thereafter learn to care for your new little blessing.
All parents, especially first time parents, have many unanswered questions
during this part of their lives. In the future I plan to write about many
different subjects for each part of the birthing year, and today I want to talk
about something that I've always included as part of my teaching in both my
childbirth and breastfeeding classes.
A lot of people don't realize all of the effects of
medications available during labor on mother and baby. This is something that I
really feel strongly about sharing, and I sincerely hope that it encourages
those who read on to make wise decisions concerning their baby's birth.
Most medications that are given during labor and are
given in the first stage. Barbiturates, or sleeping pills, are often given to
help the mother rest, and even sometimes to see if she is in true labor. There
are many side effects for mom, including drowsiness, nausea, low blood pressure,
disorientation, and decreased pulse rate. Effects on baby include respiratory
depression, decreased muscle tone, decreased responsiveness and decreased
sucking ability. Narcotics are often given in labor to take the edge off of the
pain. The side effects of narcotics for mom are the same as those found with
barbiturates, and dry mouth or respiratory depression. Respiratory depression is
also a side effect for baby, as well as decreased sucking ability.Tranquilizers
are sometimes given to reduce tension and anxiety, relax muscles and even to
enhance the effects of narcotics. Some side effects are drowsiness, difficulty
concentrating, low blood pressure and dry mouth. For baby, decreased
responsiveness and slow adaptation to feeding.
Regional anesthetics are most often given to laboring
women and affect only one portion of the body. An epidural is the most common
form of anesthesia that is routinely asked for by name. Most women who request
this drug aren't aware of the serious side effects (low blood pressure, fever,
itching, longer labor, increased risk of operative vaginal deliveries and
cesarean deliveries, and even a risk of paralysis to name a few). When
considering whether or not to get an epidural, one should also consider that
epidurals have a 3% failure rate. The effects on baby can include a drop in
fetal heart rate and an impact on early breastfeeding. Intrathecal narcotics are
also given in the same manner as an epidural (with a smaller needle), and may
cause itching, nausea, vomiting, low blood pressure and respiratory depression.
Intrathecal narcotics can also affect breastfeeding in the same way epidural
I include this information in my childbirth classes for
obvious reasons, and after reading this I hope you can see why I include it in
my breastfeeding classes as well. Medication given during labor can greatly
affect baby's ability to nurse. Labor is painful, but as quick as it begins it
will also end. After your baby is born it will all be just a memory, an
experience that I'm sure you would gladly relive considering the end result!
This is why it is so important to learn all you can and make the right decisions
for you and your baby. Do what makes you feel safe... and if a natural
birth is what you want, there are plenty of ways to make it a joyful experience
without the use of modern medications.