Tuesday, April 19, 2011

My Cesarean Story

This is the story of my daughter's birth.  The easy pregnancy turned rough, an unnecessary procedure turned emergency cesarean.  I decided to rewrite it for Cesarean Awareness month and give it a fresh perspective, with all the emotions rather than the edited down version I normally write.
My pregnancy with my daughter was easy.  We tried to get pregnant for three months before we got our positive, but it never felt like a long time.  From the first instant, I never had a thought that anything could go wrong or that we would lose her.  It just felt right to be pregnant.

I called the OB that my mom had when she had me, and ended up being transfered to the CNM at the hospital.  He had retired a few weeks before I got pregnant (which I am now incredibly thankful for as his name around here was "the butcher". He had an almost 70% cesarean rate) and the CNM had taken all of his clients and was getting calls that used to go to his office.

I never thought of having a midwife.  I knew that I wanted a natural birth, not because of anything I read, but because my mom labored naturally with me until she was taken for a cesarean.  I never thought that pain medication was necessary because my mom never had any.  I set up the appointment, and it was smooth sailing from there.

My family was a bit weird about my having a midwife, but when they learned I was still having the baby in the hospital, they could have cared less.

My pregnancy progressed really well.  I never gained much weight, I had hyperemesis gravidarum (severe "morning" sickness) throughout my pregnancy, but it was never bad enough to be hospitalized, and my plan was to labor without medication and for me to specifically ask for meds and my midwife to approve before I got any.  It seemed perfect.

At 35 weeks, we found out our daughter was breech.  My midwife sent me for an ultrasound to check what position she was in, how much she weighed, and how much fluid there was.  We came back from the ultrasound completely shell-shocked.  My fluid was at an 8 (10 is the lowest they want), she was said to weigh 4 lbs 3 ounces, and was Frank Breech (feet up by her head, butt in my pelvis).  I was put on instant bedrest (which I never followed) and had to have 3 ultrasounds a week followed by a non-stress test to see how she was doing.  It all seemed so unreal.

My care was transferred to an OB without my consent.  They set up a consultation with him to do an external cephalic version (where they manually turn the baby from breech to head down).  I wasn't given a choice.

They told me that we would do the version at 37 weeks 1 day.  If she turned and I didn't go into labor, they would send me home. If she didn't turn and I didn't go into labor we would try again at 39 weeks or schedule a cesarean.  And if I went into labor regardless, I would be either able to have a vaginal birth, or would be whisked for a cesarean.

The days before the version, I was secretly excited.  My mom had two cesarean sections and she was fine.  My brother and I turned out fine.  I almost hoped that I would have one so I could meet our baby and take her home.  Sometimes I think that those thoughts are what lead to my cesarean.

The day of the version came.  I had an epidural placed, an IV put in with fluid and meds to calm my uterus (I had been having braxton hicks contractions since 17 weeks), and had an ultrasound done to make sure she hadn't flipped already, though they did the ultrasound AFTER I had everything already placed.

It took them two tries to turn her.  It was more pressure than the cesarean was.  They had to lift her out of my pelvis, and the OB pushed her head while the CNM pushed her butt.  The second time she spun around beautifully, but I could barely breathe because of how hard they pushed on me.  I didn't notice that they were both sweating from pushing so hard.  They did another ultrasound to make sure she had turned, told me they were going to monitor me for a few hours to make sure she was okay, and they would check me later.

The epidural and medication made my legs spasm and I started having anxiety attacks.  I couldn't breathe and I felt like my chest was caving in on me.  I started throwing up.  About this time they noticed that I was having regular contractions and her heart would slow down during and after each one.  With some her heart beat was completely vanished.  I was given an oxygen mask, pushed onto my left side and left alone with just my husband.

The version was done at 7 am that morning, and by noon, they were getting worried about her heart rate.  I was only one centimeter dilated.  I was told they were giving me a cesarean and I didn't have to consent because before a version, you sign papers saying that you agree to a cesarean section should it become necessary.  I had to have a second dose of epidural medication, and they had to give me three times the dose because it wasn't working.

My daughter was born at 1:41pm.  It turns out that when they did the version, they pulled part of her placenta off.  I remember a lot of tugging, throwing up because of the pulling and pressure, and then just silence.

My daughter didn't cry.  A few minutes later I heard a tiny cry, and she was instantly whisked away to the level 2 NICU, and my husband with her.  Then, darkness.

I woke up in Recovery, not knowing what had happened.  I didn't believe I had a child.  I tried to ask if she was okay, but then darkness again.

My husband called everyone to tell them about our daughter.  He got to hold her and be with her.  I was alone for almost 4 hours after her birth.  One nurse brought me a really crappy Polaroid picture of her, but it was blurry and I couldn't believe it was my baby strapped to that many wires.

My husband came back and told me what she looked like, what she weighed, and how long she was.  He told me that she was on oxygen and couldn't breathe.  And the worst part is that part of me didn't care.  She wasn't my child.  She was just someone people were talking about.  Someone I hadn't met.

When she was seven or eight hours old, one of my postpartum nurses came in to see how I was and asked if I had seen my daughter yet.  I told her no and she was furious.  She told me every mother should see her child no matter the situation.  She got me into a wheelchair with my IV pole and my catheter and took me to her.

 She had hair all over her body.  She was so tiny at 5 lbs 13 oz.  They told me that she looked much earlier than a 37 weeker.  She had tubes of oxygen in her nose, an IV of sugar water to keep her nourished, a pulse oximeter to see how her oxygen levels were, and a monitor for her heart and lungs.  She had already had an X-Ray to see if she had pneumonia.  She was bruised on the entire right hand side of her body.  She had two vaccuum spots because they couldn't get her out of the tiny cesarean incision they had made with just their hands.

She didn't feel like my baby.

I was only allowed to stay with her for an hour, and had to leave her alone in the NICU.

The next day, my parents and my husband's brother, his wife, and his grandparents all came.  I got to hold her for the first time.  She didn't even make a noise.  I was told she had had another X-Ray and her oxygen levels had almost reached the maximum they were allowed to give at a Level 2 NICU.  She was so red because she was trying so hard to breathe.  The nurse only let me hold her for thirty minutes and said that I had to put her down before I hurt her more than I already had.

The next afternoon my daughter was life-flighted to a Level 3 NICU an hour away.  We followed close behind with my husband's parents.  My parents showed up at the hospital a little bit after we got there.

Instantly she looked better.  She was almost 3000 feet lower than at the old hospital, and just the shift in altitude helped her breathing.  She was still at a very high level, but things looked a lot better.

I pumped every three hours and the next morning, my milk came in with a vengeance.  In the three days I pumped at the NICU, I was able to store almost 150 ounces of milk.  The day my milk came in, she was finally able to take a little bit of it through a tube.  They slowly increased her stomach size for three days until her stomach could hold about 50ml. When she was 6 days old and finally off the oxygen, we finally figured out nursing (after she pulled out her tube in a fit).

When she was a week old, we went home with six oxygen tanks, an oximeter, and an appointment to meet with her pediatrician to decide if she was okay to come off the oxygen since we were 3000 feet higher than the NICU.

It took me a long time to feel like I was her mother.  It took me a long time to truly love her.  I didn't bond with her at all, and she just felt like some baby I was nursing.

I hated how I felt.  We tried to keep her in her crib, but I couldn't stand it and finally brought her into our bed.  I had her away from me enough in the NICU, I wanted to make sure she knew she was cared for at home.

It took me almost 18 months to write her story the first time.  Since, it has gone under many revisions, and has helped shed a lot of tears.  To this day, almost 4 years later, I regret to my very core hoping, even a little bit, that she would be born the day of the version.  I regret not researching for myself the benefits and risks of the procedure.  I regret how she was the one that was made to suffer because I didn't know that I needed to advocate for myself and not just blindly trust someone I was paying.

I still have trouble thinking about her birth.  I celebrate that she is beautiful and healthy and happy, but inside, part of me is still so angry and so depressed about what happened.

Most of me is so glad it happened, though.  If I had had a natural birth, I doubt I would have found my calling as a midwifery apprentice.  I doubt I would care as much as I do about women, pregnancy, birth and breastfeeding.  I am so happy that it happened if only so that I finally found a "job" that I am happy doing.

Since her birth, I have come to realize that I can love her with everything I have, but still hate and mourn the day she was born.  I have come to realize that it isn't about having a healthy baby, it is about having a healthy and happy mother and baby.

My cesarean was so hard in so many ways, and I am still dealing with the scars left behind.  I don't think I will ever just get over most of them.

You can be happy your child is alive and healthy and still mourn.  You can love your child and hate they day they were born.  It isn't black and white.

A healthy baby isn't all that matters.

A healthy mom, inside and out, matters just as much. 

My beautiful daughter, who made me the person I am today


Jennifer P said... [Reply to comment]

Amazing and powerful story. Thank you for sharing such a difficult thing, and for showing how a person can grow from it.

Shawna said... [Reply to comment]

Thank you so much for sharing this! I love love love the ending. I hate the whole "A healthy baby is all that matters" crap!

Kelly said... [Reply to comment]

Thank you for sharing =)

Jenni said... [Reply to comment]

Thank you for sharing your story. I am so sorry for everything that you and your daughter went through. I think it is amazing that you feel inspired to help other mamas and babies. Blessings!

Rachelle said... [Reply to comment]

Thanks for sharing. I LOVE that picture of your sweet little girl! She is adorable!

megan said... [Reply to comment]

Thank you. I also went through something (forced emergency c section after 4 days of pitocin and feeling ignored no matter what i tried to advocate for my baby and myself) It makes me cry to even think about your story. I commend you for your choice to go into midwifery!

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