Thursday, February 11, 2010

Birth Stories Part 1 - DS1 and DS2

So, I’ve been asked if I have a birth story anywhere…again. It’s something I get asked a lot. Apparently, when it comes to the female reproductive cycle, I am an anomaly….a bit of a freak, if you will. I have had the absolute pleasure and utter curse of being the unique lottery winner and numbers beater when it comes to pregnancy and birth. It is for that reason that it has taken me so long to actually sit down and write about my pregnancies and births. I will sit here and write and drink some wine and revisit some very bright and some very dark places. My recollection has faded in some areas while other places are too permanently and too deeply etched to ever forget.

DS1

After losing a child at just 12dpo, I became pregnant again the following cycle. I was very excited as well as nervous. Once you’ve had a miscarriage, having a completely worry free pregnancy becomes an impossibility.

I called the Arlington diocese to ask if they could recommend a good pro-life OB. I was immediately referred to Dr. Bruchalski. I now look back on that call with a twinge of regret; however, I’m not sure if 1) I would have ended up in a different place w/ a different OB; and 2) would I even have taken a different approach if I had been w/ a different OB. Either way, I had found the practice to start my new journey.

At my first appoint w/ Dr. Fisk, I was excited to be offered an ultrasound (u/s). WOW…to see and hear my baby’s heart rate was amazing. It’s a feeling and moment I will never forget. However, sometime during the u/s, Dr. Fisk paused and just kept quiet for a very long and uncomfortable time while looking around. He then told us that he thought he saw a uterine anomaly in the forum of a septum (septate uterus…google it if you’re curious). I wasn’t told much beyond that and was told to just take it easy…no exercise etc.

I went to see a specialist for my 20 week u/s. Long story short….1)The baby is a BOY!; and 2)the doctor couldn’t see any anomaly.

At my 34 week appointment, I told Dr. B. that I thought DS1 was breech as the top of my bump felt very hard. He said we would check at the next appointment.

At 2:30 am, at exactly 37 weeks, I got up for my normal middle of the night trip to the bathroom. Just as I sat down, my water broke in a HUGE, red gush. Wow….I was NOT expecting that! I yelled and yelled for Randy but he was very much asleep. I gave up and just waddled to the bed w/ a towel. I shook Randy and told him my water broke. You would have thought someone had shocked him with electricity. He jumped out of bed and started running around like a madman. He frantically started packing up the list that I had typed up but not yet gotten around to doing.

In the meantime, I called the OB and found that Dr. Anderson, whom I had never met, was on call. I told her I was heading to the hospital right away. After the call, I was the polar opposite of Randy. I calmly hopped online to let my friends know “this was it”.

Off to the hospital we went with nary a contraction in sight.

At the hospital, I was checked for amniotic fluid which was positive (of course). I was put on a monitor which showed no contractions. When I met Dr. Anderson, I told her of my suspicions of DS1’s position, she did an u/s and confirmed that he was, in fact, breech. Then, without further discussion of options or risks, she announced that I was to have a c/s. Being as ignorant as I was, I immediately agreed (and was actually happy…a vaginal birth was scary and painful!).

I was taken to the OR and given an epidural. Randy was then able to come into the OR. I was flat on my back with no feeling from the armpits down. I had a drape in front of my face so that I couldn’t see anything.

I remember the nurse discovering the toe ring that I had forgotten about. I remember being scared to death of the epidural as I’d heard how painful one was (it wasn’t bad). I remember hating the feeling of no feeling. I remember starting to feel nauseous and the very nice anesthesiologist saying that he would take care of it (he did). I remember hearing the first sound my firstborn child made. It was absolutely amazing and shocking and unfathomable. It was a sound from an unseen child…a child that was being handled by strangers. A child that I heard but did not see.

6lbs. 7oz. Wow…that’s pretty small. The nurses gasped but I had no idea why and I didn’t have the power to move to find out why (turns out his foot was turned inward pretty sharply…he outgrew it). Apgars were 9 and 9.

DS1 was finally brought over to me and held up to my face. I couldn’t hold my new baby but I could stroke his face with my finger. I remember thinking that the moment was really something that was way beyond what I could possibly feel or comprehend at the time. I had a baby!

DS1 was then taken to the recovery room while I had to remain lying on the table so that I could be sewn up. Randy was torn but I quickly told him to go with DS1…I was fine.

In recovery, DS1 was making the rounds…being held by everyone but me. I was on the bed and too shaky from the drugs and operation to feel comfortable holding him.

After a while, I finally felt better and said I wanted to hold my son. With the nurse’s help, I was able to BF him. Despite missing our God-intended bonding time, a painful recovery and one nurse who suggested formula at 3am (boy, did she regret that!), DS1 became a champion nurser and continued to nurse for 3.5 years.

Dr. Anderson later told me that she checked my uterus during the c/s and found no anomalies.

DS2

When I became pregnant with DS2, I was still very much into a repeat c/s (RC). I had moved and met up with a great group of women in a natural families group. I was the super-sog of the group who I think went a little crazy every time I mentioned how I wanted another c/s. They would mention things and lend me books on natural, vaginal births but being as stubborn and thickheaded as I am, the harder they pushed, the more I dug my heels in. I did read some of the books which may have opened my mind just the sliver needed but I can’t pinpoint for sure when the ice first cracked.

At the end of 2006, Randy and I had to make the decision of which health insurance to go with. I had grown up with Kaiser MD/DC/VA and I’d been happy with it. Also, the total cost for a pregnancy and birth was $100 so we chose Kaiser. If I were ever given the chance to go back and kick myself, this would be one of those times.

Through the grapevine, I learned that Dr. Martin from Dr. B’s office was now with Kaiser. I was so excited as she’d always been so sweet. Also, she knew, understood and believed in NFP and thus knew charting. With DS2, I had ovulated on cd23 and thus the standard cd14 wheel that is so popular with OBs would be wrong.

As anticipated, Dr. Martin was so, so sweet and used my charting date rather than the LMP date. We talked a bit about a RC and a VBAC. She said she was supportive of both. She also mentioned that she had no problem with inducing a VBAC (!) and that they begin to get concerned with heads (babies’ heads) when they get over 14 inches. That should have been my hint to run. I still wish I had.

As I was now pregnant, I knew that the decision to VBAC was now at hand and that I couldn’t put it off anymore. I started reading more of the books leant to me by friends (especially Henci Goer’s OB Myths Versus Research Realities) but remained undecided. However, the pivotal point came during a prenatal yoga session in my home that was being generously given by a friend (we had a large number of pregnant Mamas in our group at the time…enough for a full class. lol). I remember sitting there just breathing and spending time within myself when the decision was just made. I wanted a VBAC.

From that moment forward…I was focused. This baby was NOT going to born via c/s. I was completely comfortable and happy with this decision. Dr. Martin didn’t seem resistant.

Without going into the extensive details of the socialistic nature of Kaiser’s system, I will say that it was time to see other doctors as the hospital I wanted to deliver at (Fair Oaks) would not allow Dr. Martin to attend.

I thus saw Dr. Buzzel. She wasn’t thrilled that I refused the STD test and pap (I knew I didn’t need either) but she could tell I was fully researched and informed and thus let it drop. I was also quite clear that I was going to have a VBAC.

Soon after that appointment, I received a call from a Kaiser nurse informing me of the c/s they had scheduled for me. I will never, ever forget that moment as it was, for me, the point at which my absolute mistrust of OBs began. I was shocked. I felt like I had been kicked in the chest and was, above all, PISSED. Not only had they scheduled a RC without my permission but they had scheduled it for just 36 weeks!

I told the nurse to cancel it as I would NOT be there and that NO, I was not about to schedule any c/s. I was having a VBAC. Period.

I was shaking when I got off the phone. My focus at that point changed from studying the birth process (though, I still went through Bradley stuff w/ Randy) to a defensive posture. My birth research changed from the physicalities of a natural birth (I had decided that if I was going to go with a vaginal birth, I might as well go drug free too) to the legal rights of a laboring woman. Instead of focusing on the writing of Ina May Gaskin, I was now learning the ins and outs of EMTALA (wonderful law, BTW).

My appointments w/ Kaiser OBs just went downhill from there.

The next doctor kept saying over and over that a natural birth meant no painkillers. Yes, lady, I get that. That IS the point.

The male doctor (who Dr. Martin said was so great) started out just wonderfully by calling chiropractic care “voodoo” (how professional). He then pushed and pushed and pushed scheduling a RC. Apparently, the first 50 times I refused just wasn’t clear enough. How silly of me to get a bit annoyed at having to repeating myself.

I then was *thrilled* to learn that Kaiser had a midwife (a CNM…not a CPM). I thought I might have found an ally. Upon meeting her, the first words out of her mouth were, “Why don’t you just schedule a c/s?” AARRRHHH!!!!

I was quickly learning that Kaiser’s self-proclaimed VBAC supportive philosophy was a bunch of crap. It’s a wonder any woman could have a VBAC with this organization.

Then I learned that DS2 was, in fact, also breech. I was devastated.

I tried and tried different techniques to get him to turn. I then decided that I wanted an ECV to try to get him to turn. It was then that I fully learned how bad a choice I had made with Kaiser.

The first doctor I asked refused. The second doctor agreed then later refused. I tried Dr. Martin but she refused saying I had a miss-shapen pelvis and had big babies (Huh?? How would she know the shape of my pelvis? Further, my first baby was only 6lb. 7oz!) I made an appointment with the head of the department. I had done my research and knew that even the ACOG didn’t consider a VBAC a contradiction to a version. Despite that, the head OB refused due to my VBAC status. The appointment was an easy 2 hours long. He would try to argue a point and I would counter with my research (which I had thankfully brought with me). I absolutely had him when it came to what the current medical research said and what the modern standards where but he refused to consent.

I wanted a referral outside of Kaiser but he would only do so to a few specific doctors which he conceded would not consent to a version. Randy and I finally got it out of him that he could not/would not refer me to someone else simply due to contracts. I couldn’t believe that my medical decisions were being dictated by non-evidence based policies as well as business contracts.

My following appointments were horrible. I had dead baby stories and lies repeatedly thrown at me in order to get me to consent to a RC. I would leave the appointments shaking and really, really pissed off. My blood pressure would always be much higher at the appointments than at home or anywhere else.

I finally canceled all appointments after 37 weeks as I knew the stress was not good for me or DS2.

My wonderful doula and friend did tons of research for me…looking for different options. She even found a MW in PA that might do a version. She also sent directions on a breech vaginal birth in case my labor went too quickly to reach the hospital (which was 1.5 hours away). I began to secretly wish for that quick birth on the side of Rt. 66. That way, I would have my VBAC and NO doctors would be involved.

I knew…I could feel…that my time was running out as were my options. Going into the weekend of my 38th week was met with a sense of urgency. I was frantically trying to find a way to turn DS2.

At about noon on February 16th, I started to loose my mucous plug. It was tinged with blood. At 3:30am on the 17th while sitting in my office and emailing my doula, I felt and heard a pop. I went into the bathroom and sure enough….my water had broken. I knew then that a RC was imminent. Yes, I could go in and refuse a c/s but my research had shown that it was very dangerous to be attended by a doctor that had no true experience with a vaginal breech. Unfortunately, (due to faulty research) the vast majority of doctors today do not have experience and/or training with a vaginal breech. I just didn’t feel that it was safe to have a vaginal breech birth at a hospital.
I called my doula and told her what was going on. She asked me if I still wanted her to come along. I didn’t know what to say…I just hadn’t contemplated having a doula in a c/s situation. I just hadn’t thought that anything but a VBAC was going to happen. I told her she was welcome to come. I’m so grateful she did.

Randy called Kaiser to tell them we were coming in. They actually had the audacity to call back to say that if I came into the hospital that I WAS going to have a c/s. It was like throwing salt onto a huge wound. I knew they legally couldn’t force the issue but like I explained, it was a moot point and I wanted to make the best out of the situation and not spend the time beating their legally ignorant heads into the ground.

At about 4:30 (while we were packing for the hospital), the contractions started setting in. This was a bright spot as I had never really gone into labor w/ DS1. Not only did I really want to experience labor but I also wanted DS2 to experience labor as it was so good for him (the hormones, the squeezing etc.).

Soon thereafter, we met our doula at her house. We almost had to pull her little VW bug out of the ice and snow covered driveway but she was able to get it out and we were on our way to the hospital. The contractions really stated to pick up and hurt. I remember my doula pulling up alongside us to see if I was ok (I couldn’t sit still during contractions).

At some point, my parents arrived to support me and to pick up DS1 (who would be away from us overnight for the first time…this made me so sad).

At the hospital, I remember meeting Dr. Curan for the first time. You could tell that my reputation had preceded me as she was very standoffish. Once she realized that I wasn’t the devil incarnate, she warmed right up. It was close to 6am and her shift was ending but she decided to stay for the c/s. It’s a decision that I’m sure I’m not alone in regretting.

The contractions were getting much harder and coming on very quickly. I was having a very hard time finding a position to deal with the pain of the contractions. I can still feel my doula’s awesome pressure on my back (breech labor is very similar to back labor). I remember doing the labor dance with Randy.

The forms to read and sign were endless (I declined a lot of stuff for DS2). There was a lot of ink but nobody really went over the risks verbally with me. It was hard to go over everything as the contractions were coming so fast. The nurse kept trying to stick a needle in me (I was somewhat dehydrated) but my doula would have her back off when a contraction hit.

I remember walking down the hall to the OR. I’m sure that I was in transition by this point as it is very tunnel like in my memory. A huge contraction hit and I dropped down into a crouch and told the nurses, “Wait a minute”. The contractions were coming so hard and so fast…it was like DS2 was doing everything he could to keep me from having a c/s. I will never forget that short walk. It was like a walk to the gallows.

I remember sitting on the operating table and another huge contraction hit. I let out a yell. In my memory, it was like the last hope was escaping me. Then the spinal set in and all was quiet and numb.

The c/s started and I had Randy and our doula sitting by me as I was sliced open again.

I recall thinking that things were taking longer than when DS1 was born. There was also more tugging. The normal chatter had stopped. Dr. Curran asked for a stepstool (why??!!). Someone was being paged STAT. (???!!!) Randy’s face was the most intense I had ever seen it. Someone was telling someone, “Come on…breath”. I was paralyzed….physically…mentally. What the hell was happening?? I couldn’t see anything with the damn drape in front of me.

Finally, the most beautiful, wonderful sound in the world….my baby crying.

Along with my baby, I started breathing again. I began to cry as did Randy and my doula.

I have one picture (taken by our doula) of DS2 right after he was born. He was blue and very lifeless. His first apgar was a 4.

I remember looking over at the scale and seeing 9lb. 5oz. No…wait…I was misreading it. It said 5lb. 9oz. So, so tiny! Thank God I didn’t agree to a c/s for 2.5 weeks earlier.

Randy went with DS2 down to recovery. My doula sat with me and held my hand the entire time I was being stitched up. Her presence is what kept me sane while my son, who had almost just died, was in a different room from me.

While being stitched up, the anesthesiologist decided that she should scold me about the dangers of going into labor with a breech baby. (Excuse me…do you not recall that my son just almost died??!!) It was to her extreme benefit that I was physically unable to reach her otherwise I might still be in jail. However, as I was only able to use my voice, I quickly made it verbally clear that her comments were unwelcome.

I finally was taken to recovery. I was pleasantly surprised to find both Randy and DS2 there. I thought for sure that DS2 would be taken to the nursery. The nurses said that he was doing so well that he didn’t need it. Randy later told me that they had wanted to but he told them no. He had remembered that I said to never leave DS2. I love having a husband with a backbone (and one of steel at that). Thankfully, he was also there to catch the nurses as they tried to put eye ointment on DS2 despite my verbal and written instructions to the contrary.

While in recovery, I tried to nurse DS2 but he wasn’t latching. Ultimately, DS2 never was able to nurse efficiently enough so I pumped for him exclusively for a year (NO formula…ever!). I still wonder if it was due to his traumatic birth.

When Dr. Curran came in, she explained that when she was pulling DS2 out, my uterus clamped down around DS2’s head. She pulled and pulled. She even climbed up onto the operating table (thus the need for the stepstool). She finally had to cut a vertical incision into the contractile portion of my uterus in order to get him out. She said it was something that she had never seen before (my later research indicated this is more common than she admitted).

The next day, Dr. Curran told me that there was something not right about my uterus but she wasn’t sure what. She said something about the two halves not connecting or something smiliar while the outer part of my uterus looked normal. She did an u/s but saw nothing unusual. She said she still suspected a septate uterus. In the operative report, she later wrote that she diagnosed a bicornuate uterus (which is illogical if the exterior portion of the uterus was normal).

Dr. Curran went on to tell me that, due to the vertical incision, I should never labor again. She even recommended I never get pregnant again. She gave me no statistics…no research…just an order. My doula told me later that she laughed inside when the doctor told me this as she could tell that the doctor’s words went in one ear and out the other.

Silly doctors. Do they not realize how well they taught me that it is unwise to take their words at face value?