More Business of Being Born: VBAC

So, as a normal healthy birth advocate, I feel it's necessary to bring up some things that people don't talk about. It is a controversial issue.... the issue of VBAC (vaginal birth after cesarean). I was recently watching More Business of Being Born, and they have a whole DVD devoted to VBAC. I was absolutely astounded by the information that was presented. It inspired me and I feel the need to share my thoughts on it.

*Just a quick note, I DO NOT judge women who have had cesareans (wether necessary or not) or women who choose to have a repeat cesarean. I understand that sometimes it is absolutely medically necessary to have a cesarean, and there are times when women do not want to attempt a VBAC or they are simply not a good candidate for a VBAC. Whatever the reason, I am in no way judging anybody. I am simply putting the information out there as something to think about... it's a very serious topic, and women need to know what options they have, and if they are a good candidate for a VBAC.*

As an aspiring birth doula, empowerment is my big thing... my "mantra" if you will... So naturally, I feel it's necessary that women feel empowered when they give birth, no matter which road they take. Women generally have an idea or vision of how they want their birth to go. Some of these visions may look like this: labor starts, pack the car, get to hospital and settle into the hospital room, labor beautifully with family and friends by your side (or just hubs and hospital staff), give birth either naturally or medicated to a beautiful baby and live happily ever after. I may be wrong, but I feel like unless a c-section is planned, most women probably don't go in expecting for their delivery to end with a cesarean. Just a thought...

Anyway, there are many reasons for this ridiculous rise in cesareans. Legal risks being the number one reason in my opinion. Dr.'s have to protect themselves from medical malpractice suits, so naturally they make the best decision they see fit for you and your baby should there be a medical emergency. But there are times when this is taken a little too far, and it's sad that Dr.'s have to walk on eggshells trying to do their jobs, but this is the reality. Dr.'s might deem your pelvis too small to birth a baby, or perhaps you've gone over your allotted "time limit," or maybe you've simply been pushing for too long or your baby is just "too big"... whatever the reason, women sometimes feel bullied into the OR. I have never had a cesarean, and hope to God that I never do, but this is just what I'm getting from the women that I've spoken to who have had cesareans and they don't know "why" or aren't sure they were sectioned for a valid reason.

It's just tough to say, and as humans we love to point fingers and pick out people to blame. I feel like nobody is really to blame but the people who invoke the fear into medical professionals... Really that's what it comes down to in my opinion. Why can't we just let Dr.'s be Dr.'s and let women be women and let them birth babies the way they want to? If only it were that easy.

Birth is normal and it's sad that when a woman chooses to have a VBAC it turns into this crazy situation that should never be treated anything but normal in the first place. At the end of MBOBB (More Business of Being Born... I'm going to use the acronym from here on out) they posted this little and very interesting tidbit: In 2010, ACOG (American College of Obstetrics and Gynecology) revised their Practice Bulletin, stating that more women should be considered appropriate candidates for VBAC including women with two previous cesareans and women carrying twins. Why is it still so difficult for women to have a VBAC?

Let's explore this a little bit... women who go to the Dr. during their subsequent pregnancy (or pregnancies) and present the desire for a VBAC either receive full support with a nice little disclaimer, or their Dr.'s simply won't even entertain the idea. (Some Dr.'s would love to allow VBAC's, but their insurance simply won't cover them during VBAC if they allow their patients to have one). Here's the disclaimer: You may attempt a VBAC but just know that there's a chance that your uterus will rupture killing both you and your baby. Okay... so lets take a look at these numbers. The risk of catastrophic uterine rupture is less than one percent. According to Pamela Paul, a journalist interviewed in MBOBB, only 1 in 2000 VBAC's result in catastrophic uterine rupture (meaning that mom dies, baby dies, or both die). 1 in 100 cases of uterine rupture aren't even discovered until after the fact... meaning it's literally just a tiny tear in the uterus. So let's go back to the first stat... 1 in 2000 VBAC's result in catastrophic uterine rupture... Did you know that the risk of killing a baby doing an amniocentesis is way higher than having catastrophic results from a VBAC? Yeah.. neither did I because women do them ALL THE TIME. Pamela Paul stated that the risk of fetal death from an amnio is 1 in 200-400 cases. WAYYYY higher than a bad outcome from a VBAC. Just something to think about....

Just a few other interesting tidbits: According to Pamela Paul, in the 1990's VBAC rates went up to as high as 28%. Today, 8% attempt a VBAC, and about 75% of those who make an attempt have a successful VBAC. That's a large number of successful VBAC's!! However, 90% of pregnant women just go for a repeat c-section. So then if you look at the risks of having a repeat c-section, it just gets worse with every cesarean. It's just crazy. Just to spare any of you moms out there reading this who have had more than one section, or are going in for another even after two or more previous sections, I will not include the horrifying risks that increase after each section. I will say, that in the last 30 years placenta accreta has increased 30 fold. You can research it on your own if you like, this information is courtesy of MBOBB and from what they've conveyed about it, this is a life threatening condition.

So given these statistics and given that even in the best of circumstances, why is it so hard to get a VBAC? Hospitals can handle all sorts of traumas but not a VBAC? Something really needs to happen here because in my opinion this just goes all the way back to medical malpractice insurance dictating the way Dr.'s can practice and I think that is just plain wrong. Maybe I'm wrong or my information is off, but that's just the way I see it. Women need to have the opportunity to have the birth they desire, and Dr.'s need to be able to practice medicine without fear of being held liable for something that should be considered completely normal and natural. As stated by Dr. Stuart Fishbein, OB/GYN, they're trying to prevent bad outcomes by preventing choice. He also noted that of women who have a successful VBAC, the complication rate for mothers is less than repeat c-section. Interesting thought.

As far as those women who do suffer catastrophic results from VBAC, I think it's important to note wether or not that woman was a good candidate. According to Dr. Suzanne Gilberg-Lenz, OB/GYN, women who had a breech baby and had a c-section, or women who had ruptured their membranes at 36 weeks and ended up with a c-section are actually very good candidates. Again, very interesting.

What's important here is that it is crucial that women think about this before they get pushed into a decision they may regret later. Women do have options in most cases, and they need to look into them. A lot of midwives will accept VBAC clients... but ultimately, all of this information is useless if the expectant mother does not have the desire to VBAC. That's totally okay!! Some women are totally fine with doing repeat c-sections and that is just fine. BUT, the fact of the matter is, women who want to VBAC and do things as naturally as possible, should have the right to do so or at least be given the opportunity to try if they are deemed a good candidate. And again, I can't stress this enough, a woman needs to have a whole hearted desire to VBAC. This is the only way she will be given an opportunity or even have a slightest chance at success.

I'm going to make one last little note here... I had absolutely NO intention of scaring the wits out of anyone who decided to read this, so I left out a few things that weren't completely necessary to include because I feel like anyone researching this topic would know about all of the scary complications from cesareans. I just learned all of this as I watched More Business of Being Born and I felt the need to put it out there. I know a lot of women who've had c-sections and I doubt they knew any of this information or even thought they may have any options for their next delivery/deliveries. (If you did happen to know all of this information, that's fabulous I'm glad you did your research!!). If I upset you, I apologize. If my facts are wrong, please feel free to correct me. I'm always interest in learning the facts, but from what I've read and researched on my own, I've really come to trust the information in the Business of Being Born documentaries. I recommend them to everyone!! Again, my apologies to anyone who may find anything in my blog offensive. I just really felt it on my heart to lay this all out. :)

Ultimate empowerment...

When I found out I was pregnant with my second baby, I was absolutely overjoyed. I was also terrified. I had no idea how this pregnancy would go down, and I was equally as terrified of the delivery. I couldn't let the same thing happen again.

The pregnancy went pretty smoothly...  Had a few minor complications in the first and second trimester but other than that it was very enjoyable. I had one bout with pre-term "labor" but honestly it was like having really regular braxton hicks contractions. I was given an injection in the hospital to stop them (incase they ended up causing unwanted progression), and it worked for all of 8 hours. The next day I was called back in for an exam and my Dr. prescribed a medication to take at home when I feel them coming on again.

I filled the prescription, went home and found myself having contractions again. I took half the recommended dose and that's when the trouble happened. I was highly sensitive to the medication and my blood pressure dropped. I felt sick, dizzy, lightheaded, and I found myself focusing on staying awake... just like when I had the epidural. When it finally wore off I was scared to death and decided to throw the meds away. I was terrified thinking about what could have happened had I taken the full dosage.

At my next appointment my Dr. asked how the medication had worked for me. I told him it made me feel like I was going to die. Ultimately, I realized the epidural was no longer an option for me and I needed to prepare myself mentally and emotionally for a drug free completely normal and natural birth.

I came across some very informative material. "The Business of Being Born" was a huge inspiration. There were so many wonderful women that opened their hearts and shared the most intimate details of their experiences, and provided the viewers with the comfort in knowing it can be done. Also, the BEST book I've ever read on this topic was by the most incredible midwife ever... Her book titled "Ina May's Guide to Childbirth" (by Ina May Gaskin) totally changed everything I thought about childbirth and the mind body connection. After reading all of the stories, information, and facts about natural birth, I actually felt prepared... excited if you will!! I felt ready. I felt ready to give my daughter a relaxed, safe, and normal entry into the world... because it was best for her.

As the time got closer, I did start to freak out a little about what I was about to go through. At this point, I knew I had done all of the necessary research and all that was left to do was pray. I prayed constantly, and I felt at peace.

From about 37 weeks to my 39 week check, I had been walking around at 3-4 cm and almost fully effaced. My Dr. was very surprised that my waters were still intact. At 38 weeks Jeff came home from his guard drill on a 4 day pass because we were concerned he was too far away to make it to the birth. Another week passed, and Jeff was having a hard time dealing with the leaders in his company. There was talk about him possibly having to go back and potentially missing the birth. So we went to my 39 week check and talked to my Dr. about our options. We decided to schedule an induction for early the next morning via artificial rupture of membranes. In an attempt to help get things going, my Dr. did an intense membrane sweep. Instantly I was having mild contractions that stayed very irregular and very sporadic.

At that point, I ruled early labor out because I was totally in denial. We came home, got everything together and took Joey down to his grandma and grandpa's house so we could get some sleep before the big day. We put Joey to bed, and then we went home. I tried to relax but I was way too anxious. I was absolutely exhausted though, so thankfully that worked in my favor when I finally went to bed. I was still having random contractions that had begun to get a tiny bit more uncomfortable.

Somewhere around midnight, I woke up to a very strong contraction. I had to breathe through it, and Jeff woke up with me to help me through. As soon as it was over, I was asleep. This went on every 40 minutes to an hour until we got up at 3:00 am. I got up, got ready, and didn't have any contractions at all until about 4:10 am. They hit me like a freight train and I had to really focus on relaxing to minimize the unnecessary pain. We called the hospital to make sure our induction was still on time, and they pushed it back to 7:00 am. We tried watching a movie and getting some sleep, but I was extremely uncomfortable. By the time 4:45 am rolled around, Jeff and I decided it was time to go as my contractions were then 8 minutes apart for 35-ish minutes. We called the hospital back and got in the car. Not ten minutes away from home, my contractions began coming every 3-4 minutes and were intensifying.

Our one hour drive took us only 40 minutes (as Jeff was speeding), and we were immediately taken back to a room. As soon as the reality hit that I was in labor and about to have a baby, I got sick. I threw up everything in my stomach and some and I had never felt sicker. There is nothing more difficult than trying to relax (and breathe) through contractions while puking. After a while, they inserted the IV catheter and left it at that as I had NO desire to have my mobility compromised by an IV line. The nurse checked my progression and hooked me up to the monitors for a bit. I was already 7 cm. This was MUSIC TO MY EARS. I was so happy I had already progressed so far. After I had been monitored for a while, Jamie, Jill, and Maddy arrived. They were such a huge help!

Finally I was able to get in the tub and attempt some relaxation. Everyone was so supportive. I labored in there for a little while. It was so nice, and it helped me SOO much. I highly recommend it to anyone attempting a natural birth.

As soon as I hit transition, I knew it was probably time to get out of the tub. It got very intense, and very difficult. I didn't lose my ability to cope though because I was overwhelmed with support. I was still very proud of myself.

My Dr. finally came in and broke my water, and at 7:50 am (maybe 5 minutes after my waters were ruptured and only two pushes) my gorgeous and perfect baby girl was in my arms. She was perfect, and she let out a nice big cry and came out flailing around. It was the best sound I've ever heard. That moment when they placed her on my chest and I knew she was just fine and they weren't taking her away, was absolutely the most incredible thing. I knew that I had given my daughter the best start at life that I could have, and it helped me to have a little bit of closure after the experience I had with Joey. At that point, I knew I could handle anything, and I knew that I could forgive myself for not staying strong for Joey. It was absolutely beautiful, and I would do it again every day of my life in order to have a safe and healthy baby.

I had never experienced anything so powerful and intense in my life. I knew how strong I could be, and I am proud of the fact that I chose to have a natural birth, and I stuck with it. I did what 95% of women in America do not do. It was awesome and I can't wait to do it again.

Empowerment means so many things to me. But that is the only word to describe what I got out of my experience aside from the most beautiful and wonderful little girl I could have ever asked for. Women don't always realize that birth does not harm them. It is natural, normal, and totally okay. It is not an illness or a problem. It is wonderful, and it can be incredibly rewarding.

After I had Annabelle, and had some time to think about both of my experiences, I decided that I had to find a way to get through to other women. To help them through the process, learn about their options, and learn about their body and what happens during labor and delivery. I decided to take a birth doula class and I realized that if this is all I do with my life as far as a career goes... I would be fine with that. I don't think I could love a job more than one where I get to help women find empowerment and do the one thing they probably didn't think they could do. I think every woman should have the love and support that I had during my deliveries. I could not have done it without my family there. It was beautiful and it was perfect. If I can give that to another woman, that would be my dream job.

SO. There you go. Empowerment. THIS is why I did what I did and do what I do. That is why all I want to talk about is birth and how incredible it can be if only proper love, support, and information is made available. I think it's very important for women to know about all aspects of birth. Aspects that sometimes health care providers do not talk about. **I am in no way saying that health care providers are to blame for all that is bad in the way we give birth, but sometimes they are either unable to provide the information or it's just not conveyed properly to their patients.** It is the woman's responsibility to know these things... it's important to make informed decisions and to know what's going on with your body as well as what's going into it.

I do hope that one day there will be a change. That more women will have more support, and that they too will support and empower more women. This totally sounds super earthy and maybe even a little hippy-ish... but it's what I'm passionate about and it's right from my heart. Women are capable of giving birth naturally. They just need support, and they need faith. They need to know that someone loves them, supports them, and has faith in them.

Just thought I'd add a few photos from this empowering experience that I definitely did not post on Facebook. These photos mean a lot to me. They say so much. A picture really says a lot about a moment.

This one was taken shortly after we got to the hospital. 

The fruit of my labor. Our first moment together was absolutely priceless. The pain was completely gone, and I had the most incredible little girl in my arms... she captured my heart. 

A glimpse into my heart.

So, many people often ask me why I'm so drawn to pregnancy and childbirth... why that's all I seem to want to talk about... the answer to that question is simply that I have no short answer, and for me to sit and tell you every reason why could turn into a scattered confusing mess of word vomit. (Word vomit- a group or cluster of words that project out of my mouth into one of your ears and out of your other ear. Often lacks any kind of structure, and sometimes does not make any sense whatsoever).

I feel like since many of my blogs will relate to my views on pregnancy and childbirth, it may be beneficial to share my experiences in this area so people will have a better understanding on how I came to my conclusions. My sons birth has always been difficult for me to talk about, so keep that in mind friends. (It may not seem that bad to some, but his birth was traumatic to me and it took me a long time to process even a little bit of it).

Going back to the first experience I had with birth... my fascination started when I witnessed my nephew's birth. It was the most incredible thing I had ever seen in my entire life. To see a new life come into the world, so pure and innocent, so new, and so precious... This experience was a gift to me in and of itself. At that very moment when he was born, I knew that there was more to the birth process than meets the eye... something profound, something worth exploring.

When I found out I was pregnant with my first baby, I was flooded with emotions, thoughts, and feelings that I had never experienced before. I was about to embark on the incredible journey to motherhood. Each journey is totally different... and mine went nowhere NEAR how I pictured it would.

I went into this thinking it would be easy and breezy... countless women had done this before me, I was no different from them and it would come totally naturally to me too. WRONG.

My mother gave birth to me completely naturally. She labored with me for a very long time, and just hearing her talk about her experience when I was small led me to believe that labor was something to fear. However, when it came time for me to decide how I wanted to do things, I made my decision (without doing any research at all) to attempt a natural birth too. I had witnessed one, my mother had done it, and my mother in law had done it too. I decided that it was a good thing, and that it was the best and only way. After some bits of negative feedback I began to doubt my ability to cope with that amount of pain. I decided I'd still give it a good shot anyway.

So here's the story as I recall it... (Just a quick note, everyone who attends a birth has a different story of the birth, and mine is no exception. My recollections are different from those in attendance, and I may have perceived the events a little differently than everyone else). It was May 18th, 2009 when it all started. It was late in the evening, and I was feeling sorry for myself and felt quite discouraged and huge. I was sitting in my rocking chair and then my water broke. We hung around the house for a bit then I got anxious and we went to the hospital. Since it was late we rolled in through the ER, and then we were led back to labor and delivery. The minute we walked in, the nurses had me on the bed, all the lights on, hooked up to monitors, did their intake exams, hooked me up to IV fluids and had us filling out paper work. After a while, contractions suddenly hit me like a freight train. It was hard, intense, and more painful than I had imagined. Not long into it I lost all ability to cope and could no longer hear the supportive words of those around me. In my mind, I was thinking "How the hell am I going to do this for two days like my mom did? These contractions are long, hard, and back to back to back. I NEED relief!!" I got the epidural. (It was later brought to my attention that a good portion of my difficulty to cope may have stemmed from the fact that my mom was not there for my son's birth. She was gone, and before his birth I struggled with the fact that I was having my first baby without her. It has been hard to overcome the sadness in knowing she will never know her grandchildren, and they will never know her).

After about 4-ish hours (not really sure how long, but my whole labor start to finish was 8 hours) I was awakened to somebody telling me it was time to push. At this point I was beyond out of it. People would literally be talking to me and all I heard was gibberish as their mouths moved. I had never felt so helpless and out of control in my entire life. I had no control over my thoughts, movements, emotions, or what was about to happen to my body and my baby.

After 15 minutes or so, Shirley (my nurse) told me to look at my baby because he was here! I did not even know he had been born because I couldn't feel anything from my chest down. I was propped up and I looked. He was blue and limp and didn't make a sound. He was briefly placed on my chest, and they took him away quicker than I was even able to look at him. Still no sound. I had absolutely no clue what was happening other than that the only thing I could think about was how frustrated I was that I couldn't hold him. Nurses were clustered around my baby and I could not see one single part of him. Jeff and his mom looked terrified and I had no ability to feel anything physically or emotionally. My mind was completely gone.

After a few minutes he was moving and the nurses slowly stepped away. Joey finally made a noise and was monitored for a few minutes. When he was finally placed in my arms all I could do was cry. I finally had some feeling back. All I knew was that he was perfect and I was in love.

The next several hours went well... we held him, snuggled him, kissed him, and celebrated his arrival. The mood started to go downhill quickly after the first several hours... I had some side effects from the medications I received during delivery. My blood pressure plummeted (among other complications), and it caused me to pass out. Shirley was a huge help to me and I ended up back in bed the remainder of the day.... a few other things happened after she left, but I'm sure everyone will be okay if I leave those details out. Later in the day, Joey started having trouble breathing. He snorted, his breathing seemed labored, and he was making some very strange noises as he would exhale. I knew something was wrong, but unfortunately the nurses we were assigned to after Shirley had gone had absolutely no desire to appease me and examine him. They said it was something cute that he did. No joke. Cute? Seriously?

The next day, Joey's breathing got worse. I was still stuck in bed, and somebody finally checked him out. Nothing serious. Okay. So they gave him saline drops and maybe ran some tests... I can't remember.  I was still out of it. The next day was where it got rough. Joey was really having a tough time, and in the early morning hours one of the nurses took him back to the nursery for observation. There he was hooked up to an IV line and I believe they did a chest x-ray only to find he still had some fluid left in his poor little lungs. I believe they intubated him for a while... that whole day I stayed in my room. I couldn't bear to see him because I firmly believed it was my fault, that I had done this to my son.

Sometimes when things like this happen, they happen for no reason. Sometimes people have done nothing at all to cause these things, and sometimes even the worst of the worst can happen for absolutely no reason. In my case I firmly believed it was in my own weakness that I became selfish and lacked concern for my child when I signed the consent form to receive my epidural.

In the days following delivery, I felt shame, worthlessness, unworthy of my son, bitterness, defeat, and complete sadness. I was not happy with how things went, and I was extremely angry with myself for how I had handled my labor. I felt judged by everyone... even though the only one judging me was myself.

After a while, I had experienced enough grief and was able to move past it for a while. I chose not to dwell on the past. Instead I chose to enjoy my son, rejoice in the fact that my baby is here before me and had not been taken away. I am so grateful to God for my little boy. (BOTH of my babies. I can't imagine my life without them). I am grateful that Joey taught me about faith through all of the heartache I felt... I learned to have faith in Him, and faith in myself. Even though it was not a major horrible event to some people, it was hard for me to swallow. To come that close to another potential loss was a lot for me. I've experienced a lot of loss in my life... more loss than most people my age. I feel justified in my feelings... anyone who has been through what I have would have felt the same way.

Joey's birth was one part of my life that was both incredibly joyful, yet incredibly terrifying at the same time. It was hard for me to acknowledge those events because I blamed myself for what happened to him. Granted, majority of medicated births do NOT include the same chain of events that occurred at mine. It does happen, but it's not super common. Medicated birth just does not work for me. No judgement to others, but I was left completely unfulfilled, and I did not feel empowered. I felt cheated. I felt like I had cheated myself. And I did... I did not give myself a chance and Joey and I both paid for it.

Well... I definitely decided not to let that happen again. And I didn't, because I had proper knowledge and I have some very incredible individuals in my life that give me undying love and support. :) Here comes the empowerment part......... well, at a later date. That's a whole other story. (May I just say, I do have extremely fond memories of my sons birth. It was one of the best days of my life. Holding him for the first time, looking into his eyes and knowing that he's my gift from God was perfect, it was the bumps along the way that hurt me, but I use those as a learning tool and I've recently begun sharing my story with others in hopes that they will take it to heart and do some research to make an informed decision unlike I did). My apologies for any word vomit. :) To be continued.....