Anniversary of a Freebirth

It's been a little over one year since our little miracle entered our lives.  Everyday she helps us in ways I didn't even know we needed.

Her birthday brought up so many memories.  All that happened just to get pregnant with her, all the emotions of that whirlwind pregnancy, but especially her birth.

Her pregnancy and birth were the single greatest things I've ever done.

To preface, freebirth isn't for everyone.  It isn't meant to be.  We decided before we even got pregnant that freebirth was something we were very interested in, and once we got pregnant, it felt like the best decision for our family.

The beginning of the pregnancy I felt safer seeing a provider than not.  I had some bleeding and I needed to see my baby. I had three ultrasounds from six to eleven weeks, and discovered I have a bicornuate uterus in the process, but that is for another post.

I saw a high risk OB an hour away, and once I felt safe on my own, I cut care.

From eleven weeks on, I did my own care.  Every four weeks I did an actual "prenatal", but only to satisfy my curiosity.  I loved knowing what my body was doing.  I loved being in charge of what happened to me.  I didn't use a Doppler, only a fetoscope, and that was an amazing experience.  I got to know my baby.

I was able to hear her placenta, her cord, figure out her position, what she liked and didn't like.  It was incredible to me.

At 27 weeks I was admitted to the hospital.  I got the same stomach bug that hit my oldest daughter, and when I get dehydrated, I contract.  A lot.  By the time they were able to insert my IV, I was contracting every two minutes.  Some medication, fluids, and rest and I went home.

From that point on, my baby sat very low, and I contracted all the time.  I was cranky.

The biggest issue with a bicornuate uterus is a very high chance of breech, and I was prepared (and even a little excited) for that possibility.  However, my baby was head down at 22 weeks and stayed firmly that way.  Probably for the best, I didn't need another thing for my mind to focus on.

Time went on, I stayed pregnant with no other major issues, and finally it was time for our birth.

I labored mostly on my own.  Every now and then I needed some pressure on my back, but until I started pushing I was good just being left alone.  I was laughing and talking until an hour before she was born.  Once I started pushing, I needed my husband.  He held me while I leaned onto him.  I couldn't focus, the only thing I knew was that I needed to push and that baby needed to be out of me.  Nothing could have stopped me.

In hindsight, it's probably best we chose to have a freebirth.  By the time active labor hit, I would have refused to move, and it was only about 40 minutes later she was born. 

The moment she was born was phenomenal.  Having had a cesarean, seven losses, and then my body actually did what it was supposed to do was incredible!  I couldn't believe it.  I couldn't believe we actually had a baby.

All the trials, the losses, the four years of trying to get pregnant, and here she was!

Fourteen months later I still am in awe half the time.

I haven't written much on that pregnancy, though I do have my birth story up HERE, and maybe someday I will.  That pregnancy tested my faith, my hope, my everything more than anything in my life.  Her birth healed it and so much more.

It isn't often that one simple act can change how you see past events, but her birth did that for me.  My cesarean is seen in a different light, my losses, our pain.  Everything is now different because of her.

Her birth gave me back something I lost a long time ago.  Her birth gave me back my hope.

What Happens When Your Water Breaks and You Don't Deliver Within 24Hours: Part 3: Birth Story

"This birth is cursed!" I announced after hanging up the phone and then commenced sobbing dejectedly. Almost three whole days since my water had broken, and I STILL wasn't in labor. Less than twelve hours and I wouldn't have a single study to back up that my baby was not really at risk. Three days of believing in my body and that all I needed was time and good energy and thoughts and my body was still letting me down! Now, I call our doula to let her know we were going to the hospital (the drive of shame I called it nastily in my head) only to find out she had just fallen and possibly broken her ankle. (No way she could drive or be on her feet for my labor all day.) Because she's an amazing professional, she'd already arranged a back up doula to cover us, but the thought of having another stranger there to witness my possible failure (my chances for a successful vbac were about to be a bit decreased by the introduction of pit at the hospital), was too much. I just couldn't stomach having a stranger there. (Now I kind of wish we had had her there for the pushing stage, but hind site is 20/20 and who knew that alone would last over four hours?)

The hour and twenty minute drive to the birth center seemed like an eternity since I wasn't in labor like I had planned to be on the drive. For someone who had worked really hard to not be "in her head" so much this labor, having almost three whole days to do nothing but think and wait had been agony. Because my natural coctractions were so strong, I went ahead and sat in the back seat so I could kneel or squat whenever they hit, but my last minute hope that active labor would just strike like lightening during the car ride was not to be. We arrived at the hospital, went up to the birth center floor, and went directly to triage, a place I had sworn I would skip because I would be in such advanced labor before I even left the house, where I was tested to see if the fluid really was amniotic even though it had pretty much stopped flowing over twenty four hours before (we think it was a high leak and the baby moved to block it). It was positive (duh!). I was an emotional mess. I cried before the midwife and midwifery student even had a chance to get more than "hello" out. My heart rate was high because I was so upset. (Once I did some hypnotherapy on myself it dropped right down.) I felt humiliated and like a failure. Suddenly, having another c-section and a hysterectomy no longer seemed like far off possiblities. I kept most of those fears to myself and tried to dispell them as best I could.

Something I am grateful for is the completely non-plussed attitude the midwives had about how long my water had been broken. While my OB during my last birth had panicked because it had been fifteen hours since my water had broken and my contractions were steady, but I was not in completely active labor, my midwife took for granted that my body was fine. I had no signs of infection. My baby showed no signs of distress. No cervical check was done. Just the swab for the amniotic fluid and that was all. In my distress, I had even forgotten my birth plan, but my midwife had already scanned in a copy, so they just printed one out from their computer. They were also very respectful of me. They not only got me into a tub room and found me wireless monitors (I was only being monitored because of the pit) so that I could be as active as I wanted to be and get into the tub when I was ready, but they also found me a birth ball and gave me a chance to eat a meal before hooking me up to pit.Normally they encourage mothers to eat as much as they feel they need to during labor, despite hospital policies to the contrary, but when on pit, it's clear liquids only. At every turn, whenever they knew they were veering off my birth plan, they apologized and made sure that I gave the final okay for everything. It was made clear to me that although the circumstances of my birth were not as I had planned, this still was my body and my birth. I felt safer being treated with so much respect. I remember a moment when my husband left the room to check on our son and the nurses left the room to get something before finishing hooking up the pit and I could almost hear my heart beating out of my chest and the waves of shame that I was going to "need" pit to have this baby washing over me. I decided in that moment that there was no more room for shame or for fear in this birth. I actually decided to "bless" the pit and let it know what I did and did not need from it before it could enter my body. It felt a little silly, but equally important because I wanted to feel in control of my birth again. So, I said a quick prayer and then I said, "Okay, pit. I just want to let you know where we stand. I know that I cursed you as an enemy in my last birth, but you are going to help bring me stronger contractions so that my baby comes to me a little more quickly and for that I thank you. For every wave of pain you send my way, I will thank you until my baby is in my arms. You are here not because I am broken, but because my water has broken a bit early. I do not need you, but I welcome you. You will not give me contractions that are too strong for me, because I am stronger than you. My body gives you your power and it will give me my baby. God is with me. You will not over power me."

They then hooked up the pit and because I am a VBAC, they told me that they would use very minimal doses and up them every half an hour or so until I was in active labor. It took two hours and four doses before the "pit" contractions became anywhere close to my natural contractions that were still occurring randomly. My husband and I walked together around and around the circular birthing center, and as I walked the contractions got stronger and closer together. I tried to teach him how to give counter pressure on my hips during the contractions. After three hours on pit, the contractions were two minutes apart, were lasting at least a minute each, and were powerful enough that I needed to vocalize to get through them (they would continue at this pace for the rest of my labor . . . another twelve hours). The wireless monitors were also running out of juice, so we had to return to the room and I sat on the birth ball or got into different squatting or all fours positions to get through the contractions. It was at this point that the midwife shift was about to change and the midwive coming on was none other than *my* midwife. The midwife I had seen exclusively at her one day a week shift at the location closest to where I lived (about 45 min from my home). I was so glad to see her, I almost could have kissed her. She was the one thing that seemed to be exactly right. After she came on shift, I requested my first cervical check, just to see if I was far enough along to get into the tub. She checked and I was at a four. A four!?!?!? A four. I know women who get to fours without ever feeling a contraction and here I was drowning in powerful ones and I was only at a four. Not even half way there. My labor still felt so fragile at that point, so ephemeral. My VBAC in general seemed so illusive I couldn't stand it. I had wanted to feel the power of my body, to get caught up in birth, but despite the power, intensity, and regularity of the pit contractions, I still felt that at any moment it all could be over and I could find myself in surgery. The perfect trust I had had in my body all during my pregnancy had been shattered by my days of waiting after my water broke. In fact, I had received a text shortly before going into labor in which a well meaning loved one had meant to assure me that the birth that needed to happen would happen and that I should not hold myself to blame for whatever did occur, but the words that had been used were "some women are just broken and need help in birth." The word "broken" just reverberated in my soul. When I heard I was only a four; I heard that word "broken" repeating in my ears again. I started crying. My husband couldn't understand what was wrong; my midwife couldn't understand what was wrong. My doula who continually kept calling to check on us and was a nervous wreck waiting for news told us that the first four centimeters are always the hardest. Still, I pressed on, but fear had started creeping back in. It wasn't until about twenty to thirty minutes later, that something happened that forever changed the trajectory of my birth and made it possible for me to have a successful VBAC despite the obstacles and challenges that were still to come.

I was sitting on the birth ball, breathing and vocalizing through my contractions. I was using an "ahhh" sound this time to relax the back of my throat and the sound that came out actually became (through no direction of mine) a bit of a song. I would sing my way through my contractions for most of the rest of my labor. Suddenly, I felt the baby drop and shift just a tiny bit and I felt pressure in the back. I knew that I was not far enough along to push yet, but it was a sensation that I had never felt in all 29 hours of labor with my first child. Suddenly, right in the middle of a hellishly strong contraction, I found hope. I felt that bit of pressure and I thought, that's it. That's the right position. This is new. This is different. This VBAC is going to happen. That was the moment that made it all possible. Come what may.

Just an hour or so later, I started showing signs I was in transition and I moved into the large birth tub to help ease the pain. There I sang through every contraction and sniffed lavender and other essential oils my midwife prepared for me. I also drank some raspberry leaf tea. From here on out, I become pretty unsure of times, but I probably entered the tub around 9 or so and exited a little before midnight. While I felt pressure, I still did not feel it was time to push quite yet. My midwife eventually asked if I was willing to leave the tub and give another position a try. I tried laboring on all fours in the bed, but the midwife suggested maybe I should try lying on my side and rotating from side to side every other contraction. I think she wanted to get the baby in a little bit better position and it must have worked because fairly soon I did feel pressure to push. At some point, she had checked and I was at 9 1/2 centimeters which it felt awesome to hear because that was further than I had gotten in my first birth. Laying on my side had really hurt, but it seemed worth it. (I would not feel that way the next time I was on my side.) Feeling the need to stand I got up from the bed and tried leaning against my husband and the nurse, but when the next contraction hit, I found an urge to squat through the contraction. The midwife suggested making my song's notes go lower more like grunting to help power the energy downward. She suggested I go ahead and try a push if that's what I felt like doing. (I did!) Pushing felt amazing. It was such a relief to work with my body rather than against it. Because it was not yet midnight, I foolishly dreamed maybe I would only need to push a few times and the baby and I would share a birthday. Alas, that was not to be.

After a few pushes, my midwife got a little bit of a worried look on her face and said she thought I migh

t have a cervical lip, so she tried to hold it out of the way during the next push, but it was stubborn. A veteran of over twenty five years, she seemed like she knew what she was talking about so when she told me that it seemed particularly "spongy and stubborn" and that I should stop pushing and lay down, I listened to her. In my first birth, I had reached a dilation of 8.5 and then after bearing down too much, too early I had started undilating and had ended up with my ceasarean. I did not want history to repeat itself. I had come to far to do that again. So, I consented to laying on my side again this time with my legs closed and rotating some more to keep the baby in a good bithing position. I have been through a root canal, I have had two molars pulled with only partial pain relief, I have been through (a collective total of both of my births) over 30 hours of un-pain medicated pit labor, I have gone through two abdomen surgeries (a c-section and gall bladder surgery) with no pain medication after the initial surgery except ibuprofen and tyenol and I have never felt pain like the pain I felt lying on the bed after pushing. To fight to relax my body after being able to work with the pain of the contraction was incredibly painful and holding my legs together felt impossible. I felt like my body was going to shake apart from the strength of those contractions. Adding to the misery, there was absolutely no respite from the pain. In between contractions, because of the position of the baby I was in a solid block of pain that was only intensified during a contraction. The best way I can think to describe it is being stabbed by a knife and then having the knife almost slid out to relieve part of the pain, only to have it plunged back in. I shudder thinking about it now, four months later. It was at this time, I finally broke and started crying. I just wanted a short respite from that pain. I didn't think I could continue without some sort of a break, but here's the thing. I did. It was bearable. Even though, in the moment, I was afraid it wasn't. It was. I was stronger than that incredible pain.

Finally, I felt that if I didn't push I was going to die, that the contractions would simply break me in half and my baby would come out that way. I begged the midwife to let me push and she offered to check, but I could tell by her voice that she didn't think my cervical lip was gone, but to her surprise, it was. She told me on the next contraction to push. I was so relieved. I glanced at the clock and realized that it was past midnight. The baby had chosen to wait for his own birthday to be born. I had been on pit about 11 hours. The nurse and midwife installed the squat bar over my bed and with the next contraction I pulled myself up and pushed. Although it hurt, it felt much, much better to push. As the baby squeezed low under my pelvic bone, my hips began to burn like nothing I had ever felt before, but then the baby would slide back. I would push into the pain and then the baby would slide back, peek a boo. The midwife helped me learn how to direct my pushes so they could be more productive, but still the baby was not coming out. This went on for hours. I want to note that I was not panicked. I was not under the impression that I could not do it. With every push, I felt like this was the one that would get the baby's head out, but each time, it wasn't.

After awhile, I noticed my nose felt runny like it sometimes did when I went to the gym and I was a little embarrassed about that, but since nothing could be done, I just pushed through it. I noticed my husband starting to look worried, and I tried to be reassuring, but that was hard when all my real energy was on pushing. I noticed drops of blood all over the bed and thought it was from the pushing, but I learned later the blood was from my nose. It turned out that every time I squatted to push, my nose would gush blood. When the midwife (who was going between rooms because another mama was pushing as well) returned, she told me she wanted me to lay down to push for awhile, but didn't tell me that it was because my nose was bleeding so much. I would lay to push the rest of the time. (This is VERY unusual for my midwife practice, but was done simply because of the stress I seemed to be under vertically.)

I am uncertain exactly how this next part happened, but eventually I realized I was having a lot of trouble breathing. My lungs felt really tight and no matter how deeply and slowly I tried to breathe there was never enough air. I was so focused on living push to push that the sensation sort of snuck up on me. It was a little surreal because I was too focused to even panic about it. It took me a long time to even vocalize that it was happening because the two twin goals of pushing and breathing were so all encompassing that it was all I could do to keep up with them. Talking was too difficult. The midwife and the nurse could tell something was wrong, though, my heartrate was going up and my oxygen (although it stayed pretty high) became a little erratic. Eventually, I was put on oxygen, but that did little to help. I remember just feeling completely washed in the sensation of drowning; I was lost in a sea of pressure, pain, and pathetically little air. I became aware that I was becoming very foggy. Again, I did not panic, the sensation as strange and horrible as it was had something familiar about it that I couldn't put a name to with all my focus on getting the baby out. I began to wonder if I was going to be able to stay concious, fighting for every breath the way I was and struggling to stay aware. Still, the siren song of the need to push kept calling and I was powerless to resist. Even when my midwife began to tell me that I was pushing too hard and I needed to take every other contraction off from pushing, my body just could not obey. My contraction would come and my baby would call and my body would push, with or without my help, so I would take the deepest breath I could and I would push myself as hard as I could because to do otherwise would have been to waste what precious energy I had left and I, even in my foggy, dissassociated state, knew that I would run out of energy eventually. The only point where I did get a little panicky happened after what I guess was a particularly hard push in which I had a very brief break with reality and momentarily lost where I was and what I was doing. I remember looking around and thinking: where the heck am I and what in the world is going on? I think I may even have attempted to say it outloud because I remember seeing everyone look at each other really concerned. I thought at the time I might have passed out and came to quickly, but eveyone present swears I was awake the whole time. Fighting to breathe and fighting to push, I was in no position to argue with anyone if someone had said that a repeat cesarean was necessary. I was completely at the mercy of my provider. Looking back, I am very happy that I was so picky and insistant about finding a provider I believed in and who I thought would support and believe in me. As much as I wanted to be powerful, in charge, and independent during my birth, my breathing difficulties and my fatigue made it impossible. I told myself that I was going to push on and on and on and on until I had a baby in my arms or I passed out and woke up in an operating room. I could not assess which would be my outcome, but my midwife saw strength and resiliance in me that I could not see in that moment. She saw me as a powerful woman facing only seemingly insurmountable trouble and she told me I could do it. I couldn't even hear her voice, but I knew she was in my corner and had not lost faith in me. So, on I pushed and pushed and pushed. Each time amazed that I could still rise to the contraction's call even as the air seemd to grow thinner and thinner. (The baby's stats remained strong throughout no matter my distress level.)

Sometime later (an eternity? an hour? two?), the head was finally emerged enough that I could touch it and remembering I had expressed a wish to do so, my midwife encouraged me to feel my baby's head. She had what seemed like an endless supply of hot evening primrose oil and it seemed to me that she was doing everything she could to preserve every micrometer of progress I made with my pushes. A few pushes later, she told me that if I wanted it, she would perform an episiotomy just to help me get the baby out faster. She stressed that it was my choice and she was only offering it because I seemed so distressed. I told her "yes." Anything to make this eternity of airlessness and pain come closer to an end. (I learned two days later that it was only the second episiotomy she had ever performed in over 25 years of being a midwife and the only one she had performed because the mother seemed distressed.) She performed it and the very next push my son was born. Although I had always been told the shoulders were the worst part and the ring of fire was something to behold, both sensations were nothing compared to the pain of laying on my side trying to get rid of my cervical lip or the burning my hips felt as I pushed the baby out. In fact, I never felt the shoulders at all. As soon as the head was birthed, I did not need to push again. The baby fell out and was quickly placed on my chest. Although he would remain there only seconds as we both breathed raggedly, stunned to finally be there, it is a moment I will never forget.

It was at this point that we veered yet again from my birth plan and the baby was whisked to a pediatrician who had been called in because I had been in such obvious distress while pushing. His umbilical cord stopped pulsing mere moments after birth and as soon as it was cut, he was taken over and examined in the incubator. My breathing was becoming easier, but I could hear that his cry was strange and his breathing seemed "off" somehow. I birthed the placenta without even pushing and as the midwife stitched me back together, the pediatrician on call (our doctor was back in the town where we lived almost an hour and a half away) came over with my still crying baby and told me that the strange cry I was hearing was because my baby might not be "tolerating the conversion to gas oxygen well." He thought that the best course of action for the time being would be for me to give him lots of skin to skin and to suction him as much as possible. He would return in an hour to check the baby's progress unless the baby seemed to get more distressed in the mean time. He encouraged me to nurse whenever the baby seemed interested and ready and that he would not take the baby from me and into the NICU unless he got worse. It seemed that there would be no respite from worry in this birth.

However, an hour later found the baby still crying, freshly nursed, but breathing better. Another very thorough sunction from the pediatricican and I finally saw my baby at peace. We lay together, skin to skin, heart to heart, battered lungs to battered lungs, both a little shocked, amazed,and thankful that we were there, together, and still breathing. Exhaustion washed over us both and we slept.

Two days later, it hit me why the sensation was so familiar. My struggle breathing had been an asthma attack. Because of the noise of the baby's monitor and, later, the whir of the oxygen tank, no one could hear the tell tale wheezing of my lungs. Having an asthma attack while in labor is exceptionally rare; less than one percent of asthmatic women ever experience it. Yet another crazy statistic in this crazy birth. I talked to my midwife about it and she was relieved to hear what had happened had an explanation. She felt awful for not recognizing the signs for what they were, but she had never experienced any patient having an asthma attack during labor, either. "Next time, if there is a next time, I'm going to put it in your chart. Puff and then push". I couldn't agree more.

There is line from a Margaret Atwood poem that ends "I don't want this/but I want this also." In the hours and days after my second son's birth, those lines haunted me. After I looked up the poem, I realized why they haunted me, although the poem is ostensibly about the love the speaker has for her lover whose body has been broken. I realized that it perfectly encapsulated how I felt about my body after birth. I was not the birth warrior/goddess I had always thought I could and should be, but I did it anyway. I was adequate and adequate was all we needed. I don't love this story I have written for you. I wanted something different. It is not full of power and self assurance and victory the way I imagined it would be, but I love and want this also because it is the story of how my son came into this world and how I birthed him with my imperfect body that was still enough.

Final Stats: 

Second baby boy born 82 hours after water broke

7 lbs 8 oz

20 1/2 inches long

On his due date the day after my birthday,

5:11 am March 10,

15 hours after pitocin introduction

Thank you for reading,
Shawna

The Road to Healing

Every year my oldest daughter's birthday comes around and I am taken back to when she was born.  I rework her birth story, add more understanding and less anger.  Though nothing could have prepared me for how her birth would feel after having my Freebirth.

Her cesarean has always been hard for me to deal with.  I'm able to talk about it most times now without stumbling and crying, I can talk to some of the people that caused the reasons for her cesarean without wanting to run away, but now knowing that my body was never broken, that it simply needed no one to mess with it?  I now have an entirely different perspective.

I know that most women won't have the birth I did.  Unassisted Birth, or Freebirth, isn't for everyone.  It isn't meant to be.  You take an even more direct approach to your own care, and you have to reach deep down to become in tune with your intuition.  Some women need another person in charge to rely on.  Others don't want to take completely responsibility for their birth.  Even more don't care.

However, my Freebirth almost eight months ago opened my eyes.

Six years ago I was told things would end differently.  A supposedly term baby, a very "unrisky" procedure, and the possibility of a cesarean if she didn't turn from breech.  I didn't think much beyond that.

Every bad thing that could happen did.  I had a cesarean, my "term" baby couldn't breathe, and I had PPD/PTSD for months after.  I didn't bond, didn't feel much of anything for her other than responsibility.

Now having had my Freebirth, having had that instant bond, I know a few things in the shadow of six years.

The procedure before could have killed her and was completely unnecessary and even more dangerous now that I know about my bicornuate uterus, but the cesarean I despise saved her life.

That may not sound like much, but this is a huge step for me.  One that I see is a step in the way of healing.

They saved her life and inadvertently created the birth of my second.  I don't know if I would have found this path without the trauma caused, but I can now be a little bit grateful for it.

What Happens When Your Water Breaks and You Don't Deliver Within 24 Hours: Part 2: My Pre-birth Story

Okay, so Part One was all about the research that went into the decision I made not to go to the hospital even after my water had been broken for over 24 hours. This is my personal story.

It was Wednesday, March 6. Like all wednesdays were at the end of my pregnancy, this one was busy. In the morning, was my son's library story time (a highlight of his week), followed by a rush to make lunch and get dinner in the crockpot, than get my son down for his nap, then head out to a town 45 minutes away for my now weekly midwife appointments (there was only one midwife at that location, the closest to my home, and she is only there one day a week), than another 45 minute drive home when I would rush in to get dinner finished and on the table. This had been my routine for three weeks. As I was placing dinner on the table that night, though, something different happened. I felt a small gush of warm liquid. I'm not going to lie. My first thought was, "Crap. Not again. I don't want my water to break when I am not in labor yet!" My second thought was maybe the baby (always low in my 39th week) had put pressure on my bladder. I went to the bathroom and there was no more "leaking" so I thought maybe I could stop it with my kegels and that it wasn't really my water. However, immediately after leaving the bathroom, I started to feel squirts every time I took a step and there was no stopping them. It was my water breaking before labor. Again. I asked my husband to finish setting the dinner table, went upstairs, changed my clothes grabbed a poise pad (I had convieniently bought two large bags of them just in case) and told my family over dinner that my water had broken. My husband wanted to call everyone immediately, but I held him back knowing that labor could take awhile in coming (little did I know how long!). In the end we made four phone calls that night, one to each of our mothers as a heads up we could need child coverage that night, our doula, and our midwife practice because I wanted to make sure that a tub room would be available for me. We then double checked our labor bags, set them by the door, got out all our "birth day celebration" goodies we had bought for our son and his grandparents to decorate the house with while we were at the hospital birth center and went to bed early to rest up for the big day. Around ten, I started getting moderate contractions lasting about a minute and coming every five minutes and this lasted for about three hours, and I tried to rest through them knowing that active labor would be much harder. Gradually, they petered out and I started the next morning still not in active labor.

Thursday March 7

Still, I knew from research that something like 90% of women have their babies within 48 hours of their water breaking, so believing statitics to be on my side, I did not worry. In fact, I even felt a little proud of myself. Here was my chance to do what I thought I should have done my first labor, stay home longer! I did make a call to my chiropractor whom I had been seeing weekly and she agreed to adjust me just in case labor was slow in coming because of some positioning issue (I had been doing the daily exercises from spinning babies every day since my 31st week, and I continued to do those, but I figured chiropractic help couldn't hurt!). She came in on her day off to do it (because the doctors at Volz Chiropractic are awesome like that). I then decided to gently encourage labor by doing some walking and our family of three went to the mall to walk (or in my case, waddle) and invite our fourth member to join us. We walked for a few hours, with me staying well hydrated and making frequent stops to change my pads and to breathe through some decent contractions. We then came home for lunch and I took an after lunch nap with my son to rest up for the big show. However, by the time we hit the 24 hour mark, my natural contractions had increased in intensity, but were still very sporadic and I was no where near active labor despite bouncing on the exercise ball post nap and doing tons of labor "visioning." At my husband's insistance, I called to check in with our midwives (we'd been touching base with our doula all day) and the midwife on call told me that it was their offical recommendation that I come in for pitocin if I was not in active labor at the 24 hour mark. I spoke with her about the research I had done about pit increasing my risk as a VBAC mama for uterine rupture and the study I had read that found that women who had their babies up to 72 hours after their water had broken showed no increase of infection if they stayed at home until they were ready to deliever and had no cervical checks. She agreed that I was making the best medical decision for me and my baby, reiterated the signs of infection that I should be monitoring myself for and I agreed to check back in at 48 hours if I was not already in the birth center at that point or holding a newborn in my arms. I then went for a long walk and had a good cry because despite the fact that I was sure my research was solid and I was doing the best thing for my baby by doing nothing, I still was starting to feel like my body was letting me down by not going into active labor yet. However, I decided that either I trusted my body and God or I didn't and I would just have to trust a bit longer. That night, my contractions intensified during another three and a half hour session and were five minutes apart lasting one minute or longer, but once again, alas, they faded out.

Friday March 8

The second morning, I was feeling a little bit more panicked. I wasn't sure what the response would be if I checked in with the midwives that night and was still not in active labor. Luckily, my amazing doula came over and calmed me down. She brought with her a list of gentle, natural encouragement methods (from Susan Weed's herbal book) we could try that would be far less dangerous than pit for me. Although I am not in favor of induction at all in normal circumstances (I know there are certain medical circumstances in which it is advisable, but in general I feel it's best to let nature take its course), I figured my water breaking was a sign that my baby was ready to be born and maybe just needed a little encouragement. So, that day, I:
1. Did an intensive hypnotherapy session with my doula creating new birth goals and relaxation while having castor oil applied topically to my belly and benefitting from essential oils.
2. Did some homeopathic induction therapy
3. Walked again. A lot. While staying hydrated and taking breaks.
4. Bounced on the ball again.
5. Went to an acupuncturist for the first time. This did bring on some mild contractions, but nothing like the natural contractions I would have very randomly that were intensifying ever so slowly. It was a very strange, awkward experience and one day I will write that story because it is very funny and worth telling.
6. Did nipple stimulation three times. This brought on the best contractions, but they would always peter out after a few hours.
7. Did more aromatherapy with essential oils my doula had brought for me.
8. My usual positioning exercises only doubled.

Still at 48 hours, we were not in anything close to active labor. I called in as promised and got the midwife I had been seeing for the duration of my pregnancy. I was feeling pretty defeated and would have done anything she asked me to do, and she could hear the defeat in my voice (a first for me in the entire time I had been planning this VBAC). She told me that she did not think I was in the right mental place to face pit (a chemical I had privately labeled my nemesis in my last birth) and that she was not worried in the least that I or the baby was not okay. She knew I was monitoring myself and that my "home" bacteria were the least compromising bacteria I could be around. She told me that it was her "official recommendation as a midwife in the practice and a representative of the hospital that I come in after 24 hours of no labor after my water broke" BUT as MY midwife she thought I needed to rest, do whatever else I thought I needed to to induce labor gently and naturally and to come in the next morning or even the next evening for pit if I felt that was what was right. I agreed to do just that and asked directions to try castor oil (the only thing I had not tried yet); she gave me her recommendation and I hung up. My husband was freaking out at this point. He had been sure that we were going in that night for pit (as had I) and felt panicked at the thought of staying home even longer, but we had a long talk and I told him what I knew to be true. I was fine. The baby was fine and would remain fine and I needed rest and a new outlook if I were to have a successful VBAC in the near future.

That night, the night before my own birthday, I took castor oil shots chased with orange juice which aided in my nipple stimulation induced contractions and thoroughly cleaned me out, but did not put me into active labor although by morning my natural contractions were extremely strong, just still random. The next morning we woke up, walked the dog, I opened two birthday cards from my husband, kissed our son goodbye with many tears shed by all (this was far from the labor at home until the very end, leave only for the birth itself and then come home as soon as possible labor plan I had from the begining of my pregnancy), and headed on the road to the birth center to be put on pitocin once again. It had been about 63 hours since my water had broken. My "birth" story will be told in part 3.

Thanks for reading,
Shawna

What Happens When Your Water Breaks and You Don't Deliver in 24 Hours:Part 1

First and foremost, I'll be honest; I am not a doctor or a midwife. I'm not giving you medical advice just sharing my experience and some of the resources I used in making my medical decisions with the support of my midwives. Only you can make your medical decisions based on your body and your unique pregnancy, but this general information is not that well known so I want to share it.

Most women (about 85-90%) will have their water break during the course of labor usually close to delivery. For about 10% of women, however, their labor begins with their water breaking. Be it a warm trickle, a series of squirts, or a big gush, the sensation of having your water break outside of active labor beckons the more familiar feeling of accidentally wetting yourself (in fact there are occasions when babies drop hard on their mother's bladder and cause the bladder to release making the mother wonder if her water has broken when it hasn't). A good rule of thumb is that if you can squeeze your kegels and the flow stops, it is probably urine, if it doesn't, it's probably amniotic fluid. You can also usually tell by the smell. Urine is pretty unmistakable in its smell. Healthy amniotic fluid is clear and either has no smell or only a light smell that is not gross at all. (If the fluid is yellow or greenish and does not smell like urine but does smell bad, call your practitioner because those are signs of meconium in the fluid and that is a sign the baby is in distress. Another time to call immediately is in the case of your water breaking prematurely before you are term (before 36 or 37 weeks) this is called PPROM and there are different risks associated with it.) If your water does break pre-labor, you may be tempted to rush in to your birth place immediately, but you don't have to medically. For mothers whose water breaks when they are term before contractions start, it is not a real emergency and studies have repeatedly shown that you do not have to go in right away. Women who deliver up to 72 hours after their water breaks show almost the same infection rate as those who deliver within 24 hours if they do not go in and get their cervix checked immediately. The studies that did show that it is a great risk of infection to not deliever within 24 hours were actually timed AFTER the first cervical check (an action that introduces outside bacteria into the area and it is that cervical check that actually makes the risk of infection jump). If you don't go in and get a cervical check right away, the clock is not really "ticking" on infection, yet. In fact my midwives confirmed, you are safer staying at home with bacteria you are accustomed to while you wait for labor begins. Although I already knew this when my water broke with my first labor four years ago, what I didn't know then was that even if you do not deliver your baby within 24 hours it STILL is not an emergency. And am I ever glad I did my homework because this time my water broke really early and all my research after my last baby was absolutely critical in the success I would eventually have with my VBAC. Most women (somewhere between 80% and 90%) who have their waters break before labor begins will go into labor and deliver their babies before 48 hours have passed, so chances are that you will be having your baby soon and quickly without augmentation if you do choose to wait for labor to begin naturally. Another 6%-9% will go into labor and deliver between 48 and 72 hours. Then another 1%-4% will go beyond the 72 hour mark. I was part of that small percentage with my recent VBAC.

I want to say that having the right kind of support team in place before your water breaks is an absolutely necessary piece of the puzzle. If your provider has a hard and fast rule about "having" to deliver within a certain time period, and will not respect you if you decide to make a researched medical decision and a calculated risk to give yourself more time, than you are left with two choices (A) not letting them know when your water broke/that your water broke before labor began or (B) go in when they tell you to (often as soon as your water breaks) and hope that your body complies to whatever time constraints are placed on you. However, if you are in the enviable position (as I was) of having a provider who not only believes in the body and its intrinsic ability, but also believes in women and their ability to make decisions than there is a third option, you can wait until labor begins with the knowledge and support of your provider. Even though I ultimately chose to go in to get my labor augmented with pit (after not going into active labor for almost 63 hours after my water broke), because the choice and the timing were clearly mine, I felt stronger in facing the augmentation and the (very slight) increased risk of repeat c-section and uterine rupture it represented for me and that is what made me capable of getting through the fifteen hours of pit labor including over four hours of pushing it took for me to have my successful VBAC. Yes, you read those numbers right. My provider believed in me enough to support me coming in over 60 hours after my water broke, supported me in an additional 11 hours of dilation, and then over four hours of pushing and did not take me in for an "emergency" c-section as many providers would have and considered it a true emergency. I was even "allowed" to get into the tub to ease my discomfort during labor and was not placed on "preventative" anti-biotics because I and my baby showed no sign of infection and never did come down with any kind of infection.

You should also know that there is a slightly increased chance of some serious infections if you do decide to wait after the 24 hour mark even if you don't go in for a cervical check, but the risk is way lower than going in for an immediate cervical check and then going over that same mark. If you do make the decision to wait it out (as I did), you should follow these guidelines to limit your chances of infection and keep both you and your baby healthy.

1. Stay hydrated, you will be making a lot of fluid to replenish the fluid that is leaking. (Note: You will more than likely never run out of fluid. Your body will constantly replensih your amniotic fluid as long as you stay hydrated. It will also continue to leak throughout your pre-labor and labor until you have the baby. If it is a really long time before you go into labor, you might form a "pocket" where the flow slows down or even seems to stop (as happened in my first labor where my water also broke before labor began) or it can even seem to stop altogether for days if it is a high leak and the baby moves into a position that blocks the leak as happened in my VBAC labor) .
2. Do not go swimming in a public pool or bathe in a hotel bathroom. You do not want to introduce any bacteria that your body isn't used to because that is the kind of bacteria introduction that is most likely to cause infection.
3. Do not allow anything to enter your vagina after the water breaks. No tampons, limit or avoid cervical checks, and no intercourse as an induction method.
4. Monitor your temperature. Any fever is a sign of possible infection and you should go in immediately.
5. Monitor your baby's movements. Any significant decrease in movement should be taken seriously, particularly if you are not yet in active labor and under the direct supervision of your care provider. Alert your care provider to any changes.

Most of all, try to stay calm and rest. You are going to meet your baby very, very soon although the time between your water breaking and active labor beginning may seem to drag on forever. I know because I've been there. Twice. The second time for days. My personal story that led me to this resource will make up part two!

Thank you for reading!
Shawna

Letting Go of the Fear of Birth: Three Writing Activities to Let Go of Your Fear and Pain

Currently, I am 34 weeks pregnant. Although I had already thoroughly researched my VBAC vs repeat C-section options, had already researched providers and had even made the decision to choose a midwife practice covered by my insurance, but with the nearest office located 45 minutes away and a birth center located over an hour away, about six weeks ago, I sat down to write my birth plan, and freaked out. I found myself looking at my first birth plan (the one that had actually ended in a c-section with my son three and a half years ago) and I found I could not stop crying. Panicked, I called my doula. "I need help with my birth plan! I said I'd discuss my birth preferences with my midwife at our next appointment and I can't seem to stop crying!"

After a few moments of questions, my doula gently pointed out that she didn't think I was quite ready to be writing out a birth perferences list yet because it sounded like I still had some fear left from my birth experience. I was shocked. I knew my body was strong. I was no longer afraid of the pain of labor (having already experienced that for over 24 hours in my last birth). I knew I could trust my midwife practice because I had thoroughly researched them. I thought I was ready, but what I didn't realize is that while I knew I could birth this baby with my head and my heart, I still felt the fear and the pain I hadn't fully dealt with yet from my first birth and, like it or not, it was bubbling up as soon as I even thought about my next birth. I may have read all the books. I may have thought and planned circles around myself, but labor is not an intellectual acitivy and I was not able to intellectualize my way out of my feelings. They would have to be "felt" through. My wise doula pointed out that the good part was that this was coming up long before I was in actual labor and so I had time to deal with my feelings. She suggested some fear release activities and, even though some of the ideas seemed a little kooky, I decided to do them. Figuring it was better to work on this now rather than when I was in the midst of labor, I decided it would be worth it to try them. That decision has made all the difference! Six weeks later, I feel like I am in a much more peaceful and stronger place to face labor in three to six more weeks. I have finally come to a place where I am giving myself permission to do anything I feel I need to do to make this birth happen and then when I am full term, I will let go and let God and this baby show me the birth I'm supposed to have. This is huge for me. I am a bit of a control freak. This is especially true when it comes to my babies, but letting go is probably the most important thing I can do when the time comes and that is what I'm working to do. I know that by letting go of my fear and my pain, I have paved the way to let go in labor. So, take some time alone for yourself and try some of these activities for yourself and see if they help.

Activity 1: Writing Letters

The first assignment my doula gave me was to write a letter in pencil to myself really letting myself express everything I felt I had been repsonsible for that had gone wrong in my first birth. She also suggested I write a letter to anyone else I felt I needed to talk to about my first birth or anything else that was coming up before my labor (any issues with men, authority, family, etc.). She then said that I should read each letter three times aloud to myself and then burn them. I know, I know, it sounds a little crazy, but she said the smell of the carbon in the pencil burning and the act of hearing my own voice say my fears would give my body permission to let go of those feelings. I have to say, there was definitely some satisfaction in watching those hurtful, painful thoughts burn. Afterwards, it just doesn't seem like those old painful thoughts and memories have the same power over me and whenever I think of this new birth now, I just don't see it as connected to those old feelings of regret from my first birth.

Activity 2: Mind Shifting
This is another kind of strange activity that seems a little kooky, but can yield some surprising things about what you really believe about yourself, about birth, and about life in general. The key is to pick an aphorism that you want to believe or that you think you should believe, but aren't sure you do, yet, and to write it multiple times until you hear your mind either arguing or agreeing with it and then quickly write those thoughts down, too, switching back to writing the aphroisms whenever you feel yourself running out of things to say. So, for example, you could write "I believe that birth is natural and safe and doesn't require thought," "I believe that birth can be successful in any environment," "I belive that I am strong enough to birth my child any way my baby needs to be birthed," or any other aphroism that appeals to you. This was actually very powerful to me because I did it awhile after I did the first activity and after I'd already done some serious soul searching, so I felt empowered by the lack of new things that came up for me. It made me realize just how far I had come and how much more mentally prepared I was to make this a new birth.

Activity 3: Birth Visualization (Two Variations)
This last activity took the most time and was probably the strangest one for me. Because I had taken a hypnobirthing class during my first pregnancy and had already started listening to some of my old hypnobirthing tracts to prepare for this birth, she suggested I get in contact with a local hypnobirthing practitioner about coming up with a special, individualized tract for this birth. I got in contact with the practitioner and she suggested that what would be most effective would be for me to write a tract for myself, record it, and then to try to relax and listen to that tract everyday. She also sent me some of her class materials (she is not offering any classes right now, but I really wish she was because her class seems amazing) and in her class materials, she talked about writing a letter to a close friend post dated about a year after the baby's birth detailing all the positive things I wanted to happen during the birth, after the birth, and in my family over that year. The letter is to be read daily until the baby is born and can be written very early in the pregnancy and can help set your mind to focus on the positive over the next year and to commit yourself to making those things happen. So, I did that immediately and it was actually very fun to imagine the relationship my children would have with one another a year from now and how I could feel about this birth a year afterward. I even wrote about how awesome I hoped my relationship with my husband would be at that time! She had told me that my birth visualization tract would probably be most effective if I listened to it in the last four weeks or so before birth, so I found this script online and I changed it into first person and added personalized details and things I really thought it was important for me to hear and I recorded it. I'm not going to lie. It was really surreal to record it and it felt a little weird saying some of that stuff aloud, but ultimately I feel the more times I allow myself to envision my body giving birth naturally, the more I give my body permission to give birth when the time comes. It couldn't hurt anyway!

Ultimately, I have no way of knowing exactly what shape this birth will take, but at least when it is all said and done, I can tell myself I did everything I could to make the birth I felt I, my baby, and my family deserved and if I end up with another outcome, I will give myself permission to say, "I did everything I could. This was just what was meant to be." That seems like a much more healthy place to be than where I was before!

Thanks for reading!
Shawna

Time To Break The Silence

Two months ago, I had a freebirth, and it was the best experience of my life.

Since, it hasn't been the easiest transition with breastfeeding and having a five year old that is used to undivided attention, but I could always look back at my birth and remember how empowered I felt, how amazing it felt, and just remembering the moment I pulled her out of the water could make me smile.

Since having my freebirth (after having a cesarean with my first), I haven't been shy about telling anyone and everyone about it.  I was nervous the whole pregnancy about discussing our plans because of fear and worry, and honestly, I didn't want people to judge me or call me brave or discuss the risks I was taking.  Ever since?  I can't seem to shut up about it.  Which is how birth should be, in my opinion. Women should want to share their experiences.

Anywho, I have had no trouble since she was born discussing her birth, why we chose to have a freebirth, who was there, what we did to prepare, and all that jazz.  Most people would change the subject if they got uncomfortable with it, or they would say I'm "brave" (an entire issue all in itself).  Some have made fun of my baby by giving her a nickname based on the color of the pool water when my husband sent out the announcement text (probably 15 minutes after she was born so I was still in the pool and yes, it was red, but yes, to me it was the perfect announcement).  Others just talk behind my back.

Until yesterday.

I went to the CNM in my area for a diaphragm, and the nurse took my history, finding out our second daughter was born at home, but she thought it was really neat we informed ourselves and made the choice right for our family.  Then comes the CNM.

She looks through my history, sees the homebirth information and asks which midwife in the area we had at the birth.  I told her we didn't have a midwife, and so she decides to go on a rampage about how she had a dead homebirth VBAC baby come in last week and if we have more children we need to rethink the risks we are taking because they are very real, very dangerous, and it's likely one of us would die if we tried again.

Now, this was just after we finished talking about the seven babies we lost inbetween our daughters.  I know how much it hurts to have a baby die.  I've lived that over and over.  I would never take that big of a risk just to have a freebirth.  I knew my limits, I knew my baby's limits, and in the end, we rocked it.  I would have transferred in a heartbeat if I even felt something was off.

After she told me this, I couldn't even speak.  I know a lot of VBAC moms get played the "dead baby" card, but they are normally PREGNANT when it happens, not holding their 9 week old and just asking for birth control.

I left the office after so angry I was almost in tears.

I've had a lot of bad providers in the last five years.  Some that wouldn't listen, others that just patted me on the head, but this?  This was the worst.

It made me realize something though.  Providers only go as far as we let them go.  I needed to get the diaphragm, so I couldn't leave the office yet before she did the exam and ordered it for me.  So she kept talking.  Had I left or been able to leave?  The situation would have been entirely different.

How many times as women are we forced to sit through a situation where someone talks down to us and we aren't able to leave because we either need something, want something, or are just too afraid of the consequences?

Providers won't learn if we keep sitting through it.  Providers are still telling women their baby will die, and hoping they scare them enough they stay.  Providers are hoping that we sit through it, and some of it seeps into our mind and stays there.

Pregnant women are prone to worry more than others.  You're caring for two people at the same time, one of which is your growing baby.  It's easy to scare a pregnant woman.  I don't know anyone that would risk the life of their baby simply for an experience, but along the same line, providers shouldn't be downplaying that experience just so women don't walk out the door.

No, I didn't get a medal for my freebirth (though I think I totally should have ;) ), but that experience can never be taken away from me.  Instead of treating women like patients that don't know what they're doing, providers should be treating us like we are in charge of our births, because we are.

It doesn't matter where you're birthing, if you have an OB, an MFM, a Midwife, or no one at all, you should be getting the respect you deserve.

And if you're not?  Find another provider.  Interview, ask doulas in your area for recommendations, ask midwives or doctors what other providers they recommend.  The interview process is crucial to finding your fit.  You do not want to be sitting at an appointment wanting to punch your provider, but knowing you can't run away.

That is not how this system is supposed to work.

And if in the end you have no other choice, or feel like you have no choice, file a complaint.  I felt trapped listening to the CNM blather on about how my baby could have died, but that doesn't stop me from filing and hopefully helping her realize it is not okay to scare women.  We shouldn't be letting this cycle continue.  In the end, we might be the difference between a provider continuing the way they are or maybe stopping for one second before they say something.

We can't be silent any longer.  That starts for me today.

"No Greater Sacrifice:" Cesearean Birth

Recently, I recieved a message from a friend of mine on my personal facebook page that started like this: "So I see all the stuff you post about vbac and natural childbirth and a few of them had made me feel you think less of moms who have had csections. I had one and it was terribly disapointing but I also needed my child to arrive here safely [. . .]" The message really stunned me because I am currently in the process of planning a vbac in about nine weeks (or less) and am a cesarean mother myself. I realized that, perhaps, in my own exuberance at the chance of giving birth naturally once more, and in making my own emotional struggle with my cesarean largely private or on here only, I may have missed the chance to be clear about how I feel about cesearen birth. I do realize that cesarean birth can seem like it has a bad reputation with mothers who want to experience "natural" birth. I will admit that I, and many of my like minded friends, probably post links about natural birth, its beauty, and how to avoid unnecessary cesarean sections so often that we may forget that people may not always know where we are coming from. So, here is where I'm coming from.

A few months ago, I attended a screening of the film "Freedom For Birth: The Mother's Revolution: Women Take Back Childbirth," in addition to being a great film, the discussion afterwards featured a comment that made me cry and not just because I'm pregnant. A Certified Nurse Midwife, Sameerah Shareef, the only nurse midwife who attends birth in the entire city of Lansing, where we currently live, made the comment that she could think of "no greater sacrifice" in birth than that which a birthing mother makes when she births on an operating table instead of naturally. She went on to describe the heartbreaking desecration of laying youself prostrate and allowing yourself to be cut open not just spiritually, or emotionally, or metaphorically, but literally in order that your baby might live and be born. It was the first time I found myself thinking of my son's birth as something other than shameful and I cried tears of relief to hear her words. I wish I had been able to record them so that I could share them all with you, but I didn't and while the literal words have left me, the spirit hasn't.

A mother who births through a c-section is an unsung hero. At no other point in your life will you have a major surgery performed on you (with all its risks and side effects) and not only have no one really pay attention to your recovery, but will also be told repeatedly to be thankful for it (even though it causes you great daily pain and has permenant repercussions emotionally, mentally, and physically for you). "Healthy mama, healthy baby," is the mantra I was told over and over again, but I have to tell you that post c-section, especially if that c-section was unexpected and the recipient is not sure if it was or wasn't completely necessary, most mothers feel anything but "healthy." When you go in for a c-section, you sacrifice a lot. Often you sacrifice your ability to be the first one to hold your baby, you sacrifice your ability to hold your baby skin to skin right away (in our case, my husband was allowed to step in and give my baby that, but it tore me up to see that I would have to wait), you sacrifice your own health, you (sometimes) sacrfice your ability to breastfeed successfully (I was lucky in that I did not have this problem, but it is very, very commen for women with c-sections to have all sorts of post-surgery delayed milk production and other breastfeeding issues), you sacrifice your own mental and emotional health (many women find that the trauma of a c-section is much more than they ever thought it would be; not all, but many) and sometimes you allow yourself to sacrifice your own ability to say you "birthed" your baby, preferring instead to say your baby was "delivered" (I still struggle to think I "birthed" my baby through a c-section). I've met many women (me among them) who felt that their agency in the birthing of their own children had been negated just because they had a c-section. I often have found myself apologizing or giving excuses for my c-section as if I had let everyone down (most of all myself and my child), by allowing myself to be lain on a table and sliced open to give birth instead of managing to do it on my own. Sameerah's words did much to reshape that image in my mind.

A mother who births through c-section is a warrior in her own right because she fights not just during her birth, not just during her immediate physical recovery, not just through her emotional recovery (which can often take longer), but also through any subsequent pregnancies where she now faces increased risks both if she chooses VBAC or she has necessary repeat cesarean. In fact, in the paperwork the hospital where I am planning my VBAC had me sign, the risks for maternal death, infant death, and other serious complications are the same no matter what course she chooses and those risks are increased compared to mothers who have not had a cesearean. That is a lot of physical, mental, and spiritual work for any woman to have to take on, and currently in this country around a third of all women who give birth face just this challenge. (A third! When in many developed nations both maternal and infant mortality rates remain lower than the US AND cesarean rates are less than 10%!) No one is denying that c-sections save mothers and infants, but many are dedicated to making sure that the c-sections that happen are absolutely necessary and do save lifes.

So, make no mistake, if those who advocate natural birth are anti unneccesary and uninformed c-section and are very vocal about it, it is not because anyone feels that women who birth through c-sections are lesser than or somehow not as strong as mothers who birth vaginally. Most (like many of the women on this site who gave birth through c-section and are intimately and painfully aware of just how strong and hard c-section mamas have to be) are actually motivated by the sacrifice and pain women go through and want to make sure that the only mamas who go through that kind of pain and sacrifice are the ones who need to in order for them and their babies to live. Mothers who birth through cesearean sections are amazing, strong, and face challenges that mothers who birth naturally often do not have to face. I am in awe of them. I am in awe of myself. I have come so far and been through so much and am taking on so much more in planning my VBAC that I can have nothing but respect for mothers who birth through c-sections. We are a very strong, resiliant group of women to allow ourselves to be permanently scarred, broken open, emotionally torn, and under appreciated all while performing all the duties that new mothers must perform to keep our babies thriving. I have nothing but love for women who must birth through c-section, but I also want to make sure that no one goes through all that without reason, including myself.

Thank you for reading,
Shawna

If Not For You, Then For Our Daughters

Social Media has done so much.  You can get information at the click of a button.  You can make friends with people on the other side of the world.  You can “like” someone or something just by sitting on your couch.  You can spread your message in your underwear and people will come read it.

And yet, how much are we truly accomplishing?

I mainly work with the birth community within social media.  I follow all the birth blogs, I read, I comment, I learn.  But, how many of the non-crunchy crowd are doing the same thing?  How many of the people that aren’t radical like me are even caring what we write?

The cesarean rate is going up daily.  Regardless of what I write on this blog, or my twitter, or my facebook.  The number of women being induced is going up.  Again, regardless of what I write.  The number of epidurals or pain medication being used is going up.  Women that want these things don’t read my blog.  They don’t read the birth books or blogs I do.  They are sheep.

They believe that the things we write are done out of spite.  That we hate hospitals, OBs, midwives and everything they stand for.  They think that we make up risks, that the movies we recommend are just to scare them.  That we are hippies who don’t know any better.  That their way is right.

Over the last few hundred years, we as women are bringing ourselves down.  First welet men push us onto our backs for birth so they could help better.  Then we took their drugs.  Then their idea that the hospital was safer.  Then we let them knock us out to drag out our children.  Then they told us that once we had a cesarean, that was the only way we could birth, that vaginal is unsafe.  Now, we are doing everything we once did.  We are letting others control our bodies.

Over the last 100+ years, we have demanded change.  We didn’t want to feel pain.  So they answered.  We didn’t want to have a wrecked vagina.  So they answered.  And now, we want to birth.  Now we want to feel.  And because of our past ignorance, no one takes us seriously.  We are the minority.  We want change.  And yet, we aren’t listened to.  After all, we are the hippy nuts that want to feel the pain and stretch so our husband’s don’t want us anymore.

We preach empowerment and informed consent and refusal.  We try to educate women that their choices have a profound impact on their confidence as a mother.  We try to inform on the risks of procedures, that they aren’t safe like we are told.  That nothing is the same as what your body can do naturally.

And yet, we aren’t being listened to.  Women that are doing these, don’t care.

After all, it is their body and their choice.  They know what they are doing.

The thing is, they really don’t.  They talk about how a healthy baby is all that matters.  That it doesn’t matter how the baby gets here.  It makes you wonder, why don’t they think they matter?  Why don’t they think that their choices are important?

Even women with dementia and those so old they don’t remember their names, they remember their births.  They remember how they were made to feel.  They remember how they were treated.  They remember.

Choosing an induction or a cesarean isn’t about information.  It is all about impatience and fear.  Impatience that your body will never start.  That you just want to be done.  Fear that you will tear, or be cut, or need an assisted delivery.  Fear that your body is flawed.

1 in 3 women leave the hospital with an incision in their abdomen.  1 in 3 women are told that this was the way their baby had to be born.  That their body did something wrong.  70% of women are told that their body doesn’t know what to do and they need labor induction or augmentation medication.  That their body is stuck.  That it needs help.  Even more are told that they don’t know how to push, that the better way to push is on their back, that the epidural is completely safe and won’t interfere with the birth or after.

And we believe it.

We are sheep.

All because we don’t have a medical degree and they do.

How bad will this have to get before all women see what is happening?  Will 50% of women need to be cut?  85%?  100%?  How many more women will have to die before we say it needs to end?  How many babies?  How many women need to have problems from their cesarean for us to admit it isn’t the better way to birth?  How many women need to be told they can’t do it before we all begin to question?

We as women have lost our power.  We have lost the goddess within ourselves.  We have made it so when we are pregnant, even if we have never needed help before, are automatically in the mindset we need tests and ultrasounds and pills.  We are thought to be sick and weak.

We put ourselves on a clock.  40 weeks and we are done.  Anything over that is dangerous.  That we are overdue.  We imagine that the baby is ready at 37 weeks and is just late coming out.  We never think that there is more to this process than just their lungs being ready.  No one ever questions if you labor prematurely.  They know the risks then.  But if you are 37 weeks, things should be fine.  We don’t question.

I didn’t question.  A NICU stay later, I wondered.  And then I knew I had failed my child.

Does it only take a bad experience to let you know something is wrong?  Does it only take being battered daily with birth information to realize there is something better?  Does it only take being open to the idea to know the system is flawed?

When will we as women stop holding ourselves back?  Pregnancy, birth, and raising children are some of the greatest things we can do.  Why are we being told by doctors or midwives that our bodies forgot how to do it?  And why are we believing them?!

Pregnancy and birth used to be sacred.  Something only women could do.  The highest form of respect to the next generation was a supported birth.  Back when we believed in the goddess.  Back before we lost our power.

We need to take back our power.  We need to take back respect.  We need to take back our births.

Even if no one reads this that doesn’t agree, the great thing about social media is it is out there.  Sure, it might never help anyone.  But either way, my words are there.

We need to change the way we birth.  We need to do this now so that our daughter’s aren’t facing something worse than we are.  We need to control ourselves.  We need to know that we aren’t sick.  We need to know that we as women hold the power over ourselves.

No woman should ever be told her body is flawed.  No woman should leave the hospital with an incision, whether in her abdomen or her perineum.  No woman should have to wonder what might have been if she had just said “No” that one more time.

No woman should be used.

Educate yourselves.  Empower yourselves.  Inform yourselves.

If not for you, then for the next generation of birthing women.  They need a better birth than what we have settled for.

My Birth Art

Recently I discovered wordle.com and quite accidentally composed this word art (click to see full size).

The site asked for me to enter my blog address to choose words and as luck would have it that day I posted about labor induction.  The site randomly chose the words, sizes, and placement, and when I saw it I had that peculiar knocked-on-your-ass feeling.  The words it emphasized reflected so much of what I feel about birth as well as what I want from it.  In many ways, this art represents my birth journey thus far - my cesareans, my desire for normal birth, my unfailing belief that I can achieve it.

This picture is who I am as a birth advocate, but I felt compelled to make one more when I saw it.  So I made this picture.

It's the birth story I posted when this blog was in its infancy.  I wanted to get it in writing.  I thought seeing it would be hard, devastating even.   I imagined the words c-section, failure, epidural - everything horrible and unwanted about that birth - would take center stage. And I was surprised.

I was surprised because it just looked like birth.  And strangely for the first time I really realized that I birthed my babies.  Not in the way I had hoped and I pray this is not how future births look, but look at those words - contractions, pain, cervix, hours.  I gave birth to my children.

Words hold power to me.  The labels we use to describe ourselves.  The notes on our charts, margins, scraps of paper.  The stories in our books.  I love words.  I love the stories they tell.  These are my birth stories - my birth art.

In the future I will add these words - joy, power, vagina, trust - and all the words that come with them.

A Call to Labor

Meet my daughter - the big baby.  The one that would surely clock in at over 10 lbs.  She was called "fat," "macrosomic" and "chubby" before she ever graced this world with her adorable presence.  Unfortunately for the doctor, the big baby card didn't fly with me, so I started getting told about cord prolapse, dystocia, stillbirth until my confidence in my own instinct was worn down and I agreed to go in for induction, which resulted in two, yep two, inductions, and a repeat cesarean.  I was told the cards were stacked against me, but the biggest card was losing my faith in myself.

Connected Daughter arrived after several bags of I.V. fluid and who knows how much pitocin, weighing 8 lbs, 11 oz on her due date.  By the next day, her weight was down to 8 lbs 4 oz, which I believe would have been her birth weight (Henci Goer discusses how intravenous fluids artificially inflate birth weight.)  So much for that big baby I was sure I could birth vaginally if I was just left well enough alone.

Despite education, my birth didn't go as planned, and I will be the first to admit there were risk factors, but three months later there is one thing that haunts me.  My decision to allow them to induce me.  In that moment I gave over control.  Something I regret.  Control is something so many caregivers believe they need.  Even caring, informed caregivers fall victim to this need for control.  And the easiest way to ensure control over birth is to induce labor.

I'm still kicking myself for giving up control over what may be the most important aspect of birth - the start of labor.  Because that decision instantly removed all hopes for normal birth. Normal birth cannot begin with induction.

I should pause for a moment and say that there is a place for induction.  There are truly situations that develop that require this intervention, and I do believe women should try for that before electing for a cesarean.  However,  truly necessary inductions are about as rare as truly emergency c-sections.  No one ever needed to be induced for a big baby, or discomfort, or getting too close to their due date.

We're being sold on induction in this country by physicians who want to control the spontaneous process of birth.  Take a moment and ask yourself how many times you remember hearing of a woman going into labor recently.  Now how many times have you heard of a woman being induced?

The desire to induce isn't part of some maniacal ill will toward women by doctors.  I think that somewhere we've started to believe that women's bodies have forgotten how to birth babies.  Instead of laboring in birth, we're laboring under the false assumption that fetal monitors, pitocin, I.V.s, hospital beds, and sterile rooms are necessary for birth.  The reality is that doctors have forgotten how to attend birth.  Many of them never even learned how.  Because a birth attendant needs to know one thing: what normal birth looks like.  When we were interviewing midwives, we met with CPM Anita Woods, former President of ICAN, and she said something that has always stuck with me.  The FBI doesn't learn how to spot counterfeit money by studying counterfeit money.  They learn by studying the real thing.  They can spot counterfeit money because they know, really know, what the real thing looks like.  A good birth attendant works the same way.  They are so well-versed in normal birth that they can spot a problem days, weeks, sometimes months in advance.  By becoming so quick to induce, doctors no longer have that knowledge.  Instead of treating birth as a normal, natural event, it's a crisis from the get go.  The most important thing we can do to change birth practice in America is to stop inducing pregnant women.  We must get back to the normal process of childbirth.  Doctors need to see normal birth and women need to experience it.

Recently I posted a piece on Coping with Birth Disappointment.  It's been by far the most read piece on my site.  What a bittersweet accomplishment.  I'm so glad I could offer encouragement to women struggling with birth disappointment, but so sad to see how many women it affects.  In America, we so often treat the symptoms without curing the cause of a problem.  I hope my thoughts on birth disappointment touched women dealing with it, but it is my duty as a birth advocate to take this issue a step further.

What I'm proposing is radical, because not only do I believe that we must stop inducing women, I believe me must stop patronizing physicians who actively use unnecessary interventions.  It's a simple economic principle.  If you want to see results, hurt them in the pocketbook.  Obstetricians need to realize that lip service to changing ideology is not enough and that we will hold them accountable for their decisions if we hope to teach them the patience necessary to stand back and observe birth.  We have to get birth back to normal if they are ever going to learn what truly normal birth is, only then will they be able to differentiate between high-risk, emergency situations and the process of birth.

Now I realize this is all such a lovely, impractical idea.  After all, am I asking you to fire your OB and hope everything goes a-okay?  Not at all.  I'm suggesting you find a provider who has seen normal birth, whose studied it, who attends and promotes it.  Find a midwife.  And if you're an OB reading this, I'm asking that you consider how important this truly is.  I'm asking for the humility in a profession of arrogance to recognize how you are failing your patients and then I ask you to go find a midwife and do a real internship.  Learn how to let birth happen. 

Above all else, if you are expecting or trying to conceive, get to know your body.  Listen to it.  Nourish it.  Marvel at its complexity.  Revel in your cycles, your fluids, your twinges and feelings.  Rediscover your own awesome, natural power.  So that when the moment comes you know your body as well as an old friend who's sentences you finish, and you know the right decision, because truly you are the person most qualified then to make it.