Monday, April 30, 2012

6 Year Memories

For those of you that don't know April is Cesarean Awareness Month (CAM) so in honor of that and in honor of recently celebrating my first child's sixth birthday I decided to go back and share in more depth about his birth. I know I briefly shared a little about his story when I first started this blog. After all if he hadn't have been born via cesarean my own journey or path would never have led me to a VBAC.

I really can't believe that was 6 years ago. I have to admit I have a horrible memory. Always have. But I don't want to forget the details of his birth, even though some are painful. Wow, as I just typed that I started to get teary eyed. I thought I was past that but I guess it never does really leave you even though you have healed and even though so much time has passed and a lot of the detailed memories have faded. I guess it will always effect me and I'm ok with that and maybe it is good that I will never forget the hard emotions of that chapter in my life.

I have retold the short version of his birth many times and actually retell it every month at our ICAN meetings but this is the first time in a really long time that I am going to go back and try to remember as many details as I can. I hope my sharing will help others.  So here goes....

After taking 3 at home pregnancy tests I finally believed I was pregnant. My husband and I were full of excitement, happiness, and nervousness as this was our first baby. I decided I wanted to deliver in the hospital with midwives but after a few visits I changed my mind and we decided we wanted to have a homebirth instead. The "due date" came and went with only some days of crampy feelings and small contractions. Another 10 days went and I really thought the day had come. I had even more contractions, pains, pressure, feeling tight, stretching, and heavy. I even had my husband stay at home because the feelings were so much stronger but during that day those feelings slowly left and I was discouraged and emotional.

More days went by and I asked my midwife about natural ways to start labor so I tried blue and black cohosh and other herbs, evening primrose oil pills, castor oil, pumping and homeopathic remedies. Finally on March 16 at 12:00 am I got up and was feeling more uncomfortable at 1:00 felt stronger contractions and at about 2:00 they were increasing more to about 5 min. apart. I made calls to my family and by 3:00 I called my midwife with contractions staying stronger at 5 min. apart and lasting 1 minute. The assistant came to my house around 5:00 and checked my vitals and hung out with us. Around 7:00 my midwife showed up and I was still having contractions but they had spread out a bit. As I changed positions they would get stronger again for a while but then spread out more until I changed positions again. That continued for some time and since things were going at such a slow pace my midwives left for awhile and I went for a walk. As the day went on slowly it seemed like little progress was being made. My midwife called her midwife friend and suggested I get a cervidil to help things along but first we were to get a nonstress test done at the hospital. That evening the test showed everything was fine with the heartrates and the contractions so they gave the midwife the cervidil to put in me to help dilate the cervix. We decided that after such a long, exhausting day it would be best to try to sleep and do the cervidil insert in the morning instead of doing it right then.

I got a couple hours of sleep that night before strong contractions hit again. These were even stronger and more intense than the night before. I waited longer to call my midwife this time and by the time I did they were coming every 3 minutes. They were very intense and I felt it everywhere-into my back and legs. When my midwife got there at 4 am she immediately went to get the tub ready. Everyone was certain the baby was coming in the next few hours that is how intense my labor was. She checked me and I was at 5 cm. At 5 am, I got in the tub, which felt great. I was definitely in active labor--I tried different positions in and was in the tub for about 6 hours. My contractions were coming right on top of each other. We finally decided to get out and after laboring for about 11 hours I was only at a 6 now. After trying to rest for a couple hours laying down in bed, I continued to try different things, sitting on the toilet, walking, sitting on a low birth stool with each contraction. More hours went by. Progress was so slow, painful, and exhausting. My midwife wanted me to try some deep squatting with my bottom just barely off the ground. With each contraction I would lower myself while someone else held me under my arms to help support me and then I would stand up again before the next one hit and then I would squat way down again. That squatting was so painful and tiring to my legs. I did that for an hour-she was wanting me to do for at least 2 hours but there was no way I could make it physically. I finally got to lie down for awhile. She checked me again and even tried having me push a little to bring the baby down lower to put pressure on the cervix but it was too hard. I was only at a 7 now and the decision was made to go to the hospital. That was 7:00 at night. After 16 hours of active labor not to mention the whole day before of laboring and still progressing so slowly and with the exhaustion my body was dealing with we decided we needed to do something. I was upset and it was a hard knowing I was going to transport to the hospital.

At the hospital I got on pitocin and got an epidural in hopes that maybe I could rest awhile so I could physically have more energy and strength to birth my baby. I could still feel the tightening of my contractions but the relief was nice after the long, harsh labor. A couple of times the heartrate monitor showed a drop but the nurses felt it was the babies head being squished as he was moving lower so they weren't too concerned. After many hours a nurse checked me again and said I was at a 9 and would be pushing soon. I was excited and our hopes were finally up. Then the hospital midwife came in and checked me too and said no I was only at an 8 maybe 8 1/2. More discouragement. She decided to up the pitocin level and mentioned if that didn't work by morning I would probably go in for a c-section. I couldn't believe it and I prayed the pitocin would work.

Soon after increasing the pitocin the babies heartrate dropped again fairly low, which worried the nurse. She said the baby must not like the pitocin and so she went back down to the lower dose. A bit later it happened again and this time she took us off pitocin completely. Remembering what the midwife had mention earlier I knew then I only had a couple hours to finish dilating on my own before the possible c-section. This worried me and I asked if there was any other options or positions that might help. Then the heartrate dropped again and she quickly had me change sides and then more nurses came in with the midwife and they had me get on my hands and knees which was almost impossible after the epidural. I could tell they were not liking what they saw. The decision was made that I needed a c-section.

I just could not believe it. I broke down in uncontrollable tears. I was in shock. That was not something I ever expected to happen. We got everyone in the room and my sister called my parents. We prayed. Everyone was so emotional. I was a mess. The doctor even came in and prayed with me.

My husband and I got ready to be taken into the operating room. I really don't remember much of this part. I was still a crying mess. I was given a spinal and then my husband was brought in and sat beside me. Once they got started it was only about 5 minutes before my son was delivered. They held him up over the sheet where I got to see him for the first time and then as they cleaned him up he cried, and screamed. He calmed down as they brought him over. My husband held him and brought him cheek to cheek with me. I was shaking as I reached over to touch his face. I wished I was able to hold him. After I got stitched up and released from the recovery room I finally got reunited with my baby. He was born on March 18 at 5:23 am. A big 9 lb. 6 oz, 22 inches long baby boy.

 I was in love with him the minute I saw him but I was not in love with his birth and it affected me in many ways.  Even though it was extremely difficult I know that without that experience I wouldn't have the same views I have now.  I don't think I would have valued the birth process as much as I do now.  I wouldn't be here today helping other women the way I am now and for that I will be ever grateful.

Monday, April 16, 2012

Another Great Story

This was a great post I was made aware of and so I asked the author if I could share it on here. You can check out the whole story

I love when stories are shared. It can be nice to feel validated in hearing someone else felt similar emotions. So thank you to Amanda Varva for sharing her story will all of us.

One part of her story that stood out to me was:

"Until the moment where my doctor told me that she didn’t think I’d ever have a vaginal delivery, I had no idea how much I had wanted that. I always thought that it didn’t matter how my baby arrived as long as everyone was safe and healthy; but after that day I felt differently. Not that I would have traded my healthy baby for a good birth experience, but that they both mattered"

I know I have talked about those feelings before and the comments about "at least you have a healthy baby" but really both a healthy baby, and healthy mom matter and part of a healthy mom can include physical and emotions well being.

And I love how she ended her story with this:

"I’m sure that most of you, if not all of you, know someone who has had a C-section or traumatic birth. I’ve talked to a number of women who have felt the hurt and guilt that comes with grieving a birth experience. For some women, pregnancy and birth are the means to a wonderful end, regardless of their arrivals. But for others, it means so much more. How we imagine and perceive our births has a profound effect on both our emotional and physical recovery. I’ve learned as a provider to never minimize the feelings that someone has about the experience, no matter how “normal” or “routine” it is. Each experience is unique, and every woman deserves the right to experience something that will make them feel empowered and in charge of their body and their birth, whatever that means to them. It’s taken me until just recently to really understand what it means to trust your body and to make educated and informed decisions."

Monday, April 2, 2012


April is national Cesarean Awareness Month! A few days ago while reading my newest Costco Connections Magazine I saw a little article about Cesarean Awareness Month (CAM) and ICAN. Way to go Costco! I hope you all have found a local ICAN group in your area. I know how helpful it is to find other women who "get it". Since it is CAM I want to share more about my first birth. I know when I first started this blog I gave a short overview since of course that first birth started me on my VBAC journey but I think I will expand more on that birth this month as long as I remember all the details. I can't believe that was 6 years ago! So stay tuned! Oh and here is the link to the Costco article if any of you are interested.

Monday, June 27, 2011

ICAN of Salem

I am excited to announce that my friend and I are starting up an ICAN of Salem group to offer a safe place of support for those who have gone through having a c-section and who are interested in knowing more about VBACs. So if any of you are from the Salem, Oregon area and are interested in attending meetings we will be starting up in September and would love for you to come. I will announce more when it gets closer, we are only in the planning stages right now but we are so thrilled to be starting up this group. If you have ever been to an ICAN meeting I would love to hear what you thought too. Stay tuned for more announcements about this!

Tuesday, May 3, 2011

Get Off Your Back!

What do you mean you had the baby on your side, standing up, squatting, on your hands and knees?

This picture might seem so weird to some people because all they have known or seen is a woman lying on her back, legs in the stirrups being told to push as someone else counts for 10. Isn't that the way birthing a baby is done? Sadly, it is a common picture however it is by far not the most effective or easiest way to give birth. I hope this post will change the way we picture ourselves giving birth and that women will get off their backs!

My picture for my first birth was me in the tub delivery my baby. Reality was that I was laying flat on my back in the OR being cut open and my baby pulled out of my stomach.

My second birth picture in my mind was again delivering in the tub. Reality was that I was lying on my side on the bed with one leg up resting on my midwifes shoulder.

None of my original pictures or the outcoming reality had me laying on my back with my legs in stirrups, and why not? Because I had read about, witnessed, and my midwives had discussed alternative and better birthing positions.

So what is wrong with being on your back and why is it mostly used in hospital deliveries?

I think the main reason it is the most common position for hospital deliveries is purely convenience for the doctor. It is the easiest position for them to see what is going on, and the easiest access. But I think who cares what is more convenient or easier on the doctor. Who is pushing this baby out, the doctor or the mom? This idea should be changed to what is easier, more comfortable, and more productive for the mom. It is amazing to see and hear stories about midwives and doctors who truely focus more on the mom than their own comfort. They are true contortionists and work around whatever position the mom has chosen is best.

When a woman is laying on her back, or in a c-shape where she is mostly resting on her tailbone with her body curved like a c, her pelvic outlet is up to 30% smaller. That doesn't even make sense to me to be in a position that would make the opening that the baby is moving through smaller in any way. We want positions that help open us up, making it easier for a baby to get through.

This position also puts more pressure on the perineum and other muscles that should be more relaxed not stressed, which can cause worse tearing, unnecessary episiotomies, forceps or vacuum deliveries.

Blood flow and oxygen to both the mom and the baby are reduced when laying on your back because it puts pressure on your vena cava, which is a large vein that returns blood from the lower half of the body to the heart.

Being on your back clearly works against gravity. I would want gravity to aid in birth not work against it so this is another reason to get off your back!

There are a lot of other positions that are better for birthing your baby. Again it is best to try them and see what works best for you in your immediate circumstance. Here are some good ones.

Sitting: This is a position that allows gravity to work with you and help bring the baby down. It can also be a relaxing position for many. This might not be a pretty mental picture but this can be done on the toilet or a birthing stool.

Standing: Again this uses the benefits of gravity to aid delivery. This position also helps get oxygen to the baby. It can also help create a pushing urge.

Squatting: This is the best position to help open up the pelvis and again uses the benefits of gravity working with you.

Hands and Knees: This position is especially helpful when birthing a large baby, back labor, or helping turn a posterior baby. Gravity isn't as effective in this position but it does allow the baby's head to emerge more gently which will lessen the chance of tearing.

Side-lying: This position can be more relaxing but again the aid of gravity is less effective when lying on your side. This position puts less strain on the perineum and helps get oxygen to the baby.

So I hope the vision most of us see when we think of birth will soon move away from the back laying position to one of the many alternatives. Stand with me and tell other women to "Get off your back!"

Saturday, November 27, 2010

Andrea's Path to VBAC

I asked one of my friends to share her VBAC story and here it is! Thank you Andrea!

My VBAC Journey
I suppose my story begins with my first pregnancy. It was a healthy and normal pregnancy. My husband and I took a childbirth class which spent one entire session discussing Cesarean Section. I spent most of this session thinking about what I needed at the grocery store. I tuned out because I wasn't going to have a Cesarean Section. I was going all-natural. My prenatal care was with a group of OB's with an outstanding reputation. Towards the end of my pregnancy, one of the doctors told me that I may run into problems with cephalopelvic disproportion. (which turned out not to be the case...) My water broke late at night and I was already tired. As soon as I arrived at the hospital, my OB ordered a Pitocin drip, even though I was in labor and having contractions. After several hours of increasing amounts of Pitocin, I felt like my spirit was broken and caved and had an epidural. My labor lasted into the next day. I was finally fully dilated after 21 hours and began pushing while laying on my back. I pushed with all my might for THREE HOURS. During this time many strangers came in to "observe" it was really humiliating. My doctor came in periodically to bully me. She reminded me that the hospital policy was to only allow a woman to labor for 24 hours after her water breaks. After that she "had to have" a C-Section. I remember during a previous appointment (when the doctor mentioned that I should be prepared for a C-Section) explaining that I didn't want a surgical delivery and he explained that occasionally they obtain court orders to require a woman to have a C-Section against their will. Nice, huh? The baby crowned over and over again. My doctor came in and determined that the baby's shoulder seemed to be caught on my pelvic bone. There was never any mention of changing position or other methods to remedy this. She tried the vacuum three times. When this was unsuccessful she pushed the baby back inside me. To say this was uncomfortable would be an understatement. Then she announced that I was going to have a C-Section and told me to remove my jewelry. They wheeled me in, I was so defeated and sad that I asked not to be awake for it. The anesthesiologist told me that he could do that as soon as the baby was out. He also told me that since I had an epidural, that I would have some dreams. Well, it turned out to be hallucinations, HORRIBLE hallucinations. Thankfully, the procedure went well and the baby was healthy. A few hours later I woke up to find my husband rocking her next to me. I was overjoyed. After the next few weeks I battled post-partum depression, undoubtedly exacerbated by grief over the delivery. I felt a sense of loss, as if I had failed, less of a woman, and missed out on a right of passage. My wound did not heal well. I wasn't able to do much for a couple of months. I had to be driven to the OB's office every week for 6 weeks for the wound to be drained. I remember one night after nursing my daughter, I leaned over to the side of my bed to put her back in her co-sleeper and I dropped her because the pain in my abdomen was too much to bare. I quickly learned that although Cesarean Section is the most common surgical procedure in American hospitals, it is not to be taken lightly. It is a major surgery that leaves physical and emotional scars. When I became pregnant with my second child, I knew I didn't want to have another C-Section. I had moved to a much smaller town, one with only one hospital. Turns out this hospital has a "VBAC Ban". Don't get me started on this! There have been several challenges to the legality of these bans, but I didn't have the time, money, or energy to fight it. I received prenatal care from an OBGYN in a nearby, ironically, smaller town. She was one of the few doctors in the area who would attend a VBAC 'attempt'. After the first half of my pregnancy, however, I left her practice as she didn't seem to have the same goals as I did. VBAC was very important to me, as this was to be my last child and only chance to experience a natural childbirth. She treated me as if the idea was a novelty and at one point told me I had a "38% chance of successful VBAC." I often wonder what scientific formula she used to calculate these statistics. I got in touch with the local ICAN chapter...( International Cesarean Awareness Network) . The woman that I talked to was very understanding of my situation and recommended another hospital in another (much bigger) city. I wasn't too excited about driving an hour each way for my prenatal appointments. I was also uneasy when she told me the group was midwives. I had a vision of a women delivering a baby on a kitchen table, Little House on the Prairie style. I was so wrong, these women were professional, educated, and very sincere. They practiced in a very beautiful hospital next to a group of OB's. The technology they used was modern I and received similar care to what I would expect from an OB. These women just had a different approach. The focus seemed to be on letting birth happen and minimizing interference during labor. I AM SO GLAD I found them. I met most of them over the course of the rest of my pregnancy. By the end of my pregnancy, I felt at peace that whichever midwife was at the hospital when I arrived in labor, I would be in very capable, supportive hands. I believed that my vision for the birth was indeed their vision for my birth. They actually REQUIRED me to have a birth plan.
At one week past my due date, my water broke in the evening after dinner. We left for the hospital and arrived in the early hours of the night, it WAS a full moon, and everybody and their sister was in labor! They didn't have a labor room for me. I eventually got a better room. Progress was slow. My doula came and I got on the birth ball. Later in the afternoon, I got in the shower as the pain was intense and the only birthing tub was in use ...I never did get to get in the tub, even though that was the plan. The shower only helped for so long and it seemed as if there was no end in sight. I tried various positions and rocking in a rocking chair, but eventually decided to have an epidural. I wanted to see if I could go without, but it seemed obvious that I was in for another long labor. It was more important for me to have a VBAC than not to have an epidural...if that makes sense. Finally, at 1 a.m. the next morning, I was dilated and pushed for three hours. After this, they started some Pitocin to get labor to speed up. The OB's at this point came in and sort of threatened a C-Section due, which was stress I did not need. The midwives and my doula were taking care of me just fine, thank you very much....My midwife told me to "get really mad and push", which was easy to do. I tried lots of positions, but finally ended up reclined with my feet on the shoulders of my doula...poor thing had severely bruised shoulders at the end of it all! They could tell I was starting to lose steam and they pulled out the mirror, in which I could see my baby crowning and that was what I needed. I finally pushed out Fiona at 10:08. I can't really describe the feeling, but it certainly empowering. I felt so proud of myself. I had this internal dialog ever since my C-Section that I was somehow incapable of giving birth to my babies, and therefore, less of a woman and a mother. Now that I have been a mother for 5 years, I realize that mothering makes you a mother, not how the child came into the world. However, I am SO glad that I had this experience and wouldn't change a thing.

Tuesday, August 24, 2010

Helpful Pain Managment When Saying No to Drugs

I remember when pregnant with my first I often anxiously wondered how bad is this going to hurt. The thought of pain can be scary! No one can tell you exactly what it will feel like to give birth. It is different for every woman and even for every birth.

When I told people I was going the "natural" route with no drugs I definitely got different reactions. Obviously many not very encouraging with looks of disbelief as if it has never been done, to jokes about how I will change my mind once labor starts, a lot of "good luck with that," or how crazy I was to even try it. I was thankful for those who said "good for you!" Positive encouragement sure can go a long way!

Of course I wasn't going to go into it blindly. I was going to do research on "alternative" pain management. I knew having the right support from people around me would be key. I also knew I needed to learn techniques to help me relax. Being tense in labor will only make the pain more intense. I also decided to take a birthing class which would help me and my husband learn some of these techniques.

There are quite a few different types of birthing classes. These are not the generic birthing class that all hospitals offer. Sadly most of those focus more on how to be a good patient then on ways to actually help a women achieve a non-medicated birth. The most common classes are Bradley Method, Lamaze, and Hypnobirthing.

We decided to take a Bradley Method class. This style focuses more on the natural birthing process and involving active participation of the husband and is even also referred to as husband-coached childbirth. They teach you how a women's body works during labor and are taught how to work with your body to reduce pain and make labor more efficient. The class teaches relaxation techniques, and effective labor and birth positions and how the husband can really support the woman through it all. The classes offer relaxation practice and labor rehearsals. I remember at the time I felt pretty silly doing all that practice and role play but in the end I do think it helped a lot. Especially for my husband because when I was in real labor he remembered a lot of what we had practiced. These classes also cover everything else from nutrition, exercise, phases of labor and delivery, how to avoid episiotomies and c-sections but also covers what happens if you do need a c-section, circumcision, and breastfeeding.

I liked this method a lot because it really focused on how birth is a natural process and taught me how to trust my body. It helped me focus on working with the pain and learning relaxation instead of controlling the pain or ways to just distract from it. One thing I will always remember is how you look at the pain can really effect the way you handle it. If you think of it as pain like breaking your arm where it is just intense, continuous, with no reason or accomplishment it will be harder to work through it. But if you think of it as work, hard, intense, physical work that has a purpose, and a goal, and an awesome accomplishment and reward at the end, you will have a much easier time working through it. They even had us not call it "pain" because of all the negativity that surrounds that word, but rather "extremely hard work."

Besides taking a birthing class there are many ways to help manage the pain. I found it best in both my labors to use a variety.

Water is a great way to manage the pain. Using a shower helps a lot and you can also target the water on any specific areas of discomfort. To me a shower is just relaxing anyways. With my VBAC I spent plenty of time in the shower while sitting on a birth ball. My midwives gave me that excellent idea and it was very relaxing and helped with some discomfort. Along with the shower getting in the tub is another way to manage pain. What women doesn't find a bath relaxing anyway right? The water actually helps decrease the pressure on a woman's body, which helps eliminate pressure and discomfort and makes her more buoyant too.

With both my births I desired a water birth. I labored in a birth tub with my first child and I did really enjoy it. Unfortunately I never got my water birth since I ended up with a c-section. I again wanted a water birth with my VBAC but once again plans changed when right before getting in the tub while getting checked I all of a sudden felt the urge to push. So I never made it to the tub for that birth.

Another great technique that helps ease the pains is counter pressure. We learned about and practiced this a lot in our Bradley classes. It basically is just having another person using significant pressure against you in your specific area of discomfort. It feels especially good with back labor to have someone pushing pretty hard against the small of your back. I had a lot of pains in my upper thighs and hips and I needed someone to just push as hard as they could into my hips and legs.

Massage is also a great way to help with relaxation which in turn will help you cope through the work of labor. It might feel good to have someone massage your back, thighs, or hips. Make sure there is communication going on so the laboring mama is able to tell you where they need the massage and for how long and how hard.

Breathing and vocalizing techniques can help a women relax and focus on working through the labor. Breath through each contraction, don't hold your breath. Remember to use low sounds when vocalizing it once again helps your body to open up the way it needs to and not tense up. My midwives would remind me to keep my sounds low throughout my labor. I never thought I would really be very vocal in my labor but I found that making these low sounds actually did help me to work through the contractions.

Sometimes applying heat to areas of discomfort help ease the pains. A good thing to have on hand would be a rice bag or sock or even hot water bottle that can be placed on the areas of discomfort.

Don't forget to think about what type of environment would help you relax the most. Would it be helpful to dim the lights, have candles, aromatherapy, certain music, etc. For my first birth I spent time beforehand going through my CD's picking out the music I thought would be most relaxing. For me it really didn't make any difference. I actually didn't even realize they had turned on the music. But I'm sure these factors could be beneficial to many so it is something to think about.

Visualization is something else that can help prepare and help a women relax more in labor. We also did some visualization in our childbirth class. It can be helpful to visualize each stage of labor and how you will respond. I think it helps with the anxiety and fear of the unknown which when you get past those fears you are more likely to relax. I remember being encouraged to visualize my cervix opening, the baby moving down the birth canal, pushing the baby out and holding her in my arms.

A variety of birthing aids can be useful for labor pain management. These might include a birthing ball, squat bar, and of course effective birthing positions. I used a birthing ball with both of my labors and it really helped with the pain. I didn't have an actual squat bar but I used the end of a bed and a bed post to hang on to as I squatted. I hated squatting but at the same time it did help and I really did notice the benefits. Effective birthing positions are so important to help get you through labor and delivery. I found a variety of positions helpful and just movement in general was helpful to get through the pains. I will talk more about good birthing positions in another post. Women need to get off their back!

Red Raspberry Leaf Tea has been said to make labor quicker along with lessening the pain.

Acupuncture has been used by many who have said that this technique was helpful with the pain and increase relaxation during labor.

Saline shots are a good way to help with back labor. It is when an injection of saline is put into your lower back. This is also called a subcutaneous water block. It is supposed to last 90 minutes and can be repeated. My sister had extreme back labor with her first child and I remember watching her midwife inject the saline. She said it really did ease a lot of the back labor pain.

As you can see there are so many things you can try to help ease some of the pains with labor. Most likely you will need to try a variety of them and at different stages of labor as well. Also keep in might that what was helpful 5 minutes ago might not be helpful the next 5 minutes, and what you like will change over the course of labor too. The important thing is to listen to your body and be open to trying new techniques. Also remember that with each wave of painful contractions means you are that much closer to holding your precious baby in your arms!

I would love to hear from you what you tried during your labor and if you have any other good suggestions on pain management to share.