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Negotiating Laborland

She could take me down with her pinky finger.

Her body was strong.  Her mind was sharp.  She carried a gun.

Thankfully not during her labor.

Her motto was “To serve and protect.”

When I walked into her home, shaking off the adrenaline from my speedy drive, I found her deep in her labor dance.  She was leaning over her bed and swaying her hips.

Things had moved rapidly since I’d visited her that morning.  That morning we had laughed about her spacey contractions and she prepared to go shopping.

It was 4pm.

The first words she said, “I’m not strong like you.  I can’t do it.”

“Crazy talk.  You are MUCH stronger than I am.  And you ARE doing  it.”

Her husband, who also carried a gun, was mastering the fine art of the double-hip squeeze.  I caught his eye and sent him telepathic messages:  she is close.

And she was.  I arrived during mom’s transition stage; when her body was releasing adrenaline to prepare for pushing.

And there was a problem.  This beautiful police officer, in that strong police officer voice that I’ve spent a lifetime respecting says, “I want an epidural.  I am not leaving this room.  I’m absolutely not getting in the car.  I can’t.”

I look to her husband but he is suddenly very involved in double hip-squeezing.

I’m on my own.  My usual pep talk with murmurs of encouragement fly out the window.  This woman is practical.  I give it to her straight.

  • A) I’ll call a midwife and we’ll have the baby right here.
  • B)  I’ll call an ambulance.
  • C)  We will walk to the hospital you did not want to use (1 mile away)
  • D)  We walk downstairs, get in the car, and drive to your hospital and your doctor.  (45 minutes away)

Negotiations begin.

I know we don’t have time for negotiations.  I channel my inner police officer.

I send Dad to load and cool the car.  He also fortifies himself with a Red Bull.

When Dad returns, I give him “the look” and I run to transfer my things to their car.  This birth will be my first time driving the getaway car!  Usually I follow in my car but this one is too dicey.

Somehow Dad gets her into the car and we’re off.

I’m driving two police officers to the hospital.  And one is pushing!

Holy cow, what a ride.  Mom is on her knees with her faced smushed up to the window.  Dad is still rocking the double-hip squeeze.  I’m handing back a chux pad in anticipation of her water breaking.

We were still a good 25 minutes from the hospital when the pushing sounds began.

Then I hit stupid Wade Hampton Rd.

When I pull up to the hospital doors, I jump out, grab mom, and bolt.  I hear knocking and look back to find Dad stuck in the backseat which can only be opened from the outside!  I rush back and let him out.

We get upstairs, there is flurry, there is some chaos.  Mom is a VBAC so there is extra flurry and extra chaos.  I catch the eye of a nurse I know and mouth “which room?” while Dad deals with check-in.  She points and I go.  As soon as we walk in, Mom’s water breaks.  I strip her clothes and toss on a gown.

She crawls into the bed on her knees.  Baby crowns.  I hear one of the nurses say to another, “I’ve never done one in this position.”  Too late.

The nurse receives the baby, mom flips overs and takes baby.  No one clamps the cord until the OB arrives 10 minutes later.  I guess the OB has to have something to do, right?  She doesn’t even get to suture since Mom’s perineum is perfectly intact.

Baby was born 15 minutes after we pulled in.

This woman’s first birth:  a 40 week induction + cesarean + NICU.

Second birth:  a quick birth without assistance.

I think that women can be just completely surprised by the change in them from giving birth—you have something powerful in you—that fierce thing comes up—and I think babies need moms to have that fierceness—you feel like you can do anything and that’s the feeling we want moms to have.” –Ina May Gaskin, midwife

Locals: busy Saturday!

We have two exciting events this Saturday and I know I’ll see many of you there.

First, the Great Cloth Diaper Change.  The cloth diaper community is trying for a Guinness World Record: the most diapers changes simultaneously.  And, of course, the event will raise awareness about sustainability for Earth Day.

Natural Baby is a host location for Greenville.  Please take a bit of time out of your Saturday to join us–your friendly neighborhood changing station!  Even if you don’t cloth diaper, you can join in.  Just check the appropriate box on the registration and a cloth diaper will be provided. 

Go here to register and print your eticket.  The event begins at noon but arrive 30 minutes early please. 

After you’ve changed your baby’s diaper, go for a walk and have some lunch.  Then come back at 2pm for our April Blessingway.  April is Cesarean Awareness Month.  We’ll hear Erin’s Greer Hospital VBAC story and Angie’s planned cesarean story.  Our local ICAN leader, Jenn Anderson, will talk about steps to achieve a VBAC in the upstate.  Of course, little ones are always welcome! 

See you there!

After the cesarean

I hear:
  • Everybody tells me I should just be thankful I have a healthy baby. 
  • I wish I hadn’t taken a single class or read any books.  I wish I hadn’t known so much.  Then I wouldn’t care. 
  • Could I have made different choices? 
  • Would this have happened with a different provider?  Different place? 
  • Is there something wrong with my body?
  • What if [fill in the blank]?
A couple of times a month, I get emails from women who have had cesareans –usually for their first baby.  Some have just given birth.  Some gave birth years ago and contemplate pregnancy.  Some are soon to birth again.  They tell me their stories.  And they ask their questions.  I do not have answers.  I am not qualified.  But I’m the one hearing the questions and the grief from these mamas who are healing from their cesarean births.       
 
The mindful women, the ones who educate themselves about birth, the ones who make good choices during their pregnancy–these women, after having a cesarean birth, often mourn. 
 
And there is little space in our culture for mourning such an experience.  Because, after all, you had a good outcome; a healthy baby.  Why should you feel sad or disappointed?  It is challenging to find the language to express these feelings.  Many women lose faith in their body.  Some lose faith in the medical system.  Some get angry.  Some give up. 
 
Perhaps the first thing to do is to begin processing these feelings.  Surround yourself with stories of vaginal births after cesarean (VBAC).   Watch VBAC clips on youtube.  Create space to mourn and to heal through writing, art, or ritual.      
 
And then, when your spirit is renewed, find the research and information to plan your next birth. 
 
ICAN is a good place to begin.  Find your local chapter and reach out to these supportive women.  The Greenville group is full of resources and incredible stories.
 
I’d love to hear from you on this one.  Thoughts?

Bait and Switch

“Yes, we support natural birth.”  Knowing full well that most first-time mamas are induced so it is a moot point entirely.  The average gestation for a first time mama is 41 weeks 1 day.  When do most OBs start suggesting induction?

“Yes, we support VBAC.”  Until you fail to follow the standard protocol and suddenly you’re told (in LABOR!) that you can no longer have a VBAC.

“Yes we welcome birth plans.”  Until you submit yours at 38 weeks and the OB crosses a line through the things she won’t do.  And it is awful tricky to find a new OB willing to take you (the difficult patient) after 38 weeks.

Think I’m exaggerating?  Think I make this stuff up?  No.  The families I work with are handled this way all! the! time!  I have so many stories.   

Let’s take today, for example. 

My student switches to a practice recommended for their wonderful VBAC support.  She cancels her regular prenatal appointment because she believes she is in labor.  She is told to go straight to the hospital with her bags packed. 

Her contractions are just 1o minutes apart.  This may be a practice run.  This may take a couple of days.  She decides to stay home awhile.  And then a receptionist calls to tell her she will no longer be “allowed” to have a VBAC since she didn’t go in when they said. 

How do you disallow someone from having a VBAC?  The baby will come out.  There is no stopping it.  It is a normal, bodily process.  It would be like telling someone they were not allowed to digest their lunch. 

This manipulative and insulting treatment has got to stop.  It must.

Statistically Speaking

At yesterday’s Blessingway, we had 11 women who had given birth

Out of those women, 4 had VBACs (vaginal births after cesarean).  That may not sound like a big number but it is challenging to find support for VBAC.  I only recommend one OB group and even then it can be tricky.  With VBAC, you are guilty until proven innocent.  Any blip on the screen or any hesitation in dilation seems to give license to perform a repeat cesarean. 

It is interesting to note that all 4 of these VBAC babies were born out-of-hospital. 

Also, out of the 11 women, 2 were pregnant and planning VBACs.

If you want more information on VBAC, join our local International Cesarean Awareness Network (ICAN) forum.

Story

I’ve added a new birth to the birth story section of my blog.  Check it out!

Bri’s VBAC homebirth

And speaking of cesareans

Time Magazine has released a timely article on VBACs.  A quote from the article:  “When the problems with multiple C-sections start to mount, we’re going to look back and say, ‘Oh, does anyone still know how to do VBAC?'”

Curious about which hospitals ban VBACs in your state?  Check out ICAN’s new database.  The closest hospital to my house makes the list.  Ahem, Palmetto Baptist Easley.  I was surprised to see AnMed on the list of “de facto” bans.  I know of at least one VBAC at AnMed in the past year.  I hope this listing is a mistake.