My Cesarean Births
With my first pregnancy, I tried to be as prepared and educated as possible. I took 12 weeks of Bradley Childbirth classes with a wonderful husband and wife team of instructors! I had a well-written birth plan that I gave to my doctor before my due date. I keep that plan in her scrapbook because it is comical. EVERY item on that list went out the window during labor. I was so easily made to believe that all of the things my Bradley instructors said I should avoid would actually HELP me birth my baby. On September 11, 2001, when the world was upside down, I was 2 days past my due date and had an appointment that morning. Even though I specifically had in my file that I didn’t want my membranes stripped, the doctor spent 30 minutes explaining to me that since I was past my due date, I HAD to get my membranes stripped or I would end up with pitocin, and if I wanted a natural labor, I didn’t want pitocin. I finally agreed to this “natural form of induction”. I went into labor that night, but it was not efficient. My baby and I weren’t ready. I went to the hospital the next night, more than 24 hours after my membranes were stripped. I thought I was in transition, but I was only 1cm. I requested to go home. The next morning, the hospital called and asked why I hadn’t come in again. My husband told them there was no change. They demanded I come in to be checked. I was 3cm and they had me get into the shower to get that last cm so they could admit me. After my admittance, what followed was the “cascade of interventions” my Bradley instructors had told us about. I progressed slowly, with a “bulging bag of waters”, so I was made to believe if my waters were broken, I would progress faster. I let them break my water because when you are in labor, you will believe ANYTHING they tell you will get you through it faster. My labor didn’t change. Without even thinking, I allowed them to put the internal fetal monitor on my baby. Then I was told that if I had pitocin, they could get my contractions closer together, though they were so strong, you couldn’t see the tops of them on the monitor. 24 hours of hard labor on my own and I gave into pitocin, couldn’t handle the increase in pain, so I asked for an epidural. The epidural didn’t work. I couldn’t move my legs, but I could feel every contraction. Finally, I asked them to turn off the epidural because I knew I wouldn’t be able to push when it came time. After 34 hours of hard labor, I was told I was 8cm and I had one hour to dilate to a 10 or surgery would be performed. I was still strong, there were no signs of distress in the baby, so I asked my husband to go out and talk to the doctor. I said, “Ask her ‘why one hour? Why not two?” After all that time, I still had some fight in me. My husband came back from his conversation and told me he felt that the doctor was right. One hour later, when I was still 8cm, I was wheeled into the Operating Room. EXACTLY 12 hours after my water had been broken, my daughter was surgically removed from my body. I was on a clock and I didn’t even realize it. I was educated enough to have foreseen all of this, but in the middle of the most vulnerable time in my life, I was easily lead away from what was so important to me. A natural birth for my baby.
I couldn’t complain about my recovery. My baby nursed beautifully, and 2 weeks after her birth, we took some friends on a drive south to see Portage Glacier. When she was 3 weeks old, we found out my husband would be deploying as a result of the events of 9/11 and I never once thought I wasn’t strong enough to handle single parenthood. My second cesarean was completely different.
I worked hard to try to VBAC with my second daughter. The doctors in Goldsboro, NC said they would be happy “to allow me a trial of labor”, but at the end of my pregnancy, they estimated by ultrasound that my baby was 9lbs 7oz. At that appointment, the doctor said, “Now, you’re not just risking her life with a VBAC, you’ll break her collarbone when you push her out. You need to book your c-section today.” I went home, cried and because I am a “good mom”, I booked my surgery. I booked it for my due date (the latest they would allow) in the hopes that I would go into labor on my own before then, but the morning came anyway. My husband and I woke up early, drove to the hospital and walked into the Operating Room. I said, “I’m here for the birth.” I was so nervous. The though of being cut open was so scary, but I was happy to be meeting my beautiful daughter soon. They hooked me up to an IV and shaved me. I was wheeled into the operating room and was asked to get up and lie down on the surgery bed. The bed looked like a cross. There were places for me to put my arms to have them tied down. I got into the bed and all I could think was that I was being sacrificed or crucified. They put the spinal block into my spine and I was drugged up and ready to go. They poked me a few times to see if I could feel anything and then started the surgery….
Pictures of my second cesarean
(WARNING: these pictures are graphic.)
“I’m here for the birth.” I was excited to meet my baby, but not too happy about the surgery.
I thought it pretty interesting when I watched the video of her birth afterward, that she threw her arms out like this when they pulled her up into the air. She looks like I did… like she is on a cross. Welcome to this crazy world, baby girl.
We finally meet. Our newest daughter has her first family picture just like her big sister did… a big blue sheet and me, looking like I have no body. I was able to touch her cheek, but that is the last I saw her for FIVE HOURS. They had to sew me up, and it was hospital policy for babies to be monitored immediately after birth and then for 4 hours at every shift change. Yes, this was 2004, but it might as well have been the 1970s. I was so high on the painkillers while they were sewing me up that I actually THANKED THEM for such a pleasant experience!!!
I finally get to hold my sweet baby. FIVE HOURS after her birth.
The sisters finally meet, but sadly, I was so drugged, I don’t remember much of their meeting. Luckily, I have the video. My recovery took 14 weeks. They severed a nerve in my right leg that still feels funny 4 years later. My incision was infected and they had to re-open it… without anesthesia! I brought both of the girls with me to the doctor when I was feverish and my incision was red. I couldn’t figure out why I felt so terrible a month after her birth. The baby was sleeping in her car seat carrier and her sister sat in the corner, nervous about seeing a doctor. I kept telling her they were going to look at Mommy, not her, and doctors are good. The doctor took one look at my incision and had me lie down. He OPENED the incision with a Q-tip without warning me!!! I stifled a scream, keenly aware of my daughter’s presence and worry. He heard my gasp and said, “I knew it would be painful, so I didn’t want to warn you.” I looked at her in the corner and she had a concerned look on her face. I said, “It’s okay Honey, Mommy is okay. There is nothing to worry about.” But she had seen my face. I was just thinking I was glad it was over and I hadn’t screamed when he DID IT AGAIN!!!!!!!!!!! I gripped his arm tightly and he actually (jokingly) said, “ow!”
I vowed I would never let anyone do this to my body or my baby again.
My Home birth after 2 cesareans
When I became pregnant with my third child, I immediately started looking into VBACs again. I went to the hospital for my 12 week appointment and told the doctor that I wanted to VBAC. He immediately brushed my request aside, saying, “I’m sorry, but you have two scars on your uterus. There is no way I can let you VBAC.” He had a student with him and I didn’t want to argue, so I thought I would let him know how serious I was at my next appointment.
When I went to my next appointment at 16 weeks, the nurse reading my chart said, “I see you will be scheduling another c-section.” I was angry. This was my body and they refused to consider my request not to be cut open again! When the doctor arrived, I told him that if he wouldn’t allow me to have my baby naturally there, then he would be forcing me to give birth at home. The doctor expressed his disapproval, but explained that this hospital did not have the capacity to handle my type of emergency. Strangely, they did allow a VBAC after ONE c-section. The emergency they were so sure would happen with me could happen no matter how many scars a uterus had (although rare in any case). My research (using ACOG studies) said my risk of rupture only increased slightly. The argument wasn’t valid. The doctor said he would give me a referral off-base if I could find someone who would take me as a patient.
For two months, I looked for a doctor who would allow me a “trial of labor”. I found only ONE, but he would be out of town and could not accept me as a client because his colleagues would not agree to help me if he wasn’t there. My journey to home birth began.
I found a great team of midwives: Jill Colin and Marvelys Lopez and a wonderful Doula: Melissa Kneen. I also took Hypnobirthing with Anne Swanson. All of these women helped me work through the mental issues I would be dealing with when I gave birth. I knew my body could do this… I just had to believe in myself!
When I was 8 months pregnant, I received a call from the base doctor I had seen. He had somehow found out about my plan for a home birth and told me he had convinced the hospital to allow me to have my baby there. I asked him what restrictions he would put on me. He said I would have to dilate 1cm per hour. I told him I already knew from my first labor that my body would not do that, so I would fail his first condition. He said I would have to have an IV drip and an internal fetal monitor. An internal monitor meant he would break my water immediately, which would put me “on the clock”. I wouldn’t be able to move around and help myself through this difficult process. He said if I went overdue, I would have to be induced. Rule #1 with VBACs: if you want a uterus to rupture, give the mom Pitocin. I told him I would think about it and let him know. What follows is the letter I sent him over email:
Dr. *** (name left out for privacy),
I want to thank you for your concern and for your efforts to allow me to have a VBAC at the base hospital. However, I have decided to continue with my birth at home.
When you and I originally discussed my desire for a VBAC in September, I specifically mentioned that if the base did not allow me to VBAC there, then I would be having my baby at home. At my mention of a home birth, you expressed your disapproval, but said that the only thing you could do was give me a referral to an off-base doctor willing to take my case. Though I had a few promising leads, my requests were denied by each doctor, and I ended up with a choice between surgery and home birth. It truly amazes me that women can choose to have a cesarean for no medical reason and quadruple their chance of death, increase their risk of infection, increase their risk of hemorrhage, as well as increase their baby’s risk of injury, breathing problems and nursing problems, but at the same time, I could not find one doctor in Las Vegas who would give me the opportunity to have my child naturally. When faced with the choice between surgery and home birth, I chose home birth because it was the better of the two options. Today, after your much delayed offer to VBAC in your hospital, I am choosing home birth because it is the best of every option.
Your specific reasons in September for not allowing me to VBAC at the base hospital were: 1) the base hospital does not have enough blood for my type of emergency, 2) the base hospital does not have a NICU and 3) the nurses in your hospital would not be prepared for my type of emergency. I am honestly confused why, four months later, and only after you discovered I will be doing a home birth, the hospital’s capacity to support me has changed. The tone of my email may give you the impression that I am angry with you and the base hospital, but this is not the case. I know your hands are tied in many ways because of ACOG requirements and risk of malpractice suits. However, those hospital concerns should not affect me or my baby when it comes to the best way to bring her into the world. I am thankful that in this country home birth is still an option and I hope that when my daughters have their babies, the option will still be there for them.
I feel certain that the best place for me to birth my baby is at HOME, despite the scars on my uterus. I have looked at my risks and I know that I am healthy, my baby is healthy, and our chances of a rupture are very low. I do not consider myself a “high risk” case, as you apparently do, and my midwife agrees with me. She has attended over 1000 births, 300 of which were VBACs (some after four cesareans!). She has never seen a rupture and has certainly never seen an infant demise. I am certain that she and I will know whether my baby and my body are progressing well in natural childbirth. Her equipment, her knowledge and her personal relationship with me and my baby make her well equipped to know whether either of us is in distress early enough to transport me to the hospital in a timely manner. I know I am in good hands.
I need to be surrounded by people who will be patient with my body, my baby, and our progress in a natural labor. More importantly, I need to be surrounded by people who believe in me. I know the kinds of restrictions that would be placed on me in a hospital. They were clearly outlined by you and by one off-base doctor at my initial consultation with him. ACOG requires you to order many things I cannot agree with. I know that I have the right to deny those “requests”, but I do not believe that continuous conflict with the hospital staff would provide me with the best chance for a VBAC. Even if there was another doctor in Las Vegas that would allow me a “trial of labor”, I believe there is no hospital that would give my baby and me what we need to bring her into this world naturally. I have tried to do this twice, and twice my children have been surgically removed from me unnecessarily. With my first labor, “failure to progress” with an absence of fetal or maternal distress was no reason for a surgical birth. With my second pregnancy, my doctor would not allow me to attempt a VBAC simply because my baby appeared large. I have a strong suspicion that this birth would end the same way if I put myself in the hands of a hospital and any obstetrician “risking his career on me” (as the midwife in your office so honestly put it).
Thank you for your efforts on my case. I know that of all of the doctors in your practice, you were the most understanding and I know you worked hard to help me in the end. I hope you meet more women like me in your future: women who are well-informed of their choices, the risks involved, and who take responsibility for their health, their births and are willing to fight for what they believe is right for their babies. When you do meet these women, I hope you and your colleagues take their convictions seriously from the very beginning. I hope you belay any personal feelings or ACOG restrictions on how women “should” give birth to their babies, and you don’t force them to fight (during pregnancy or during labor) to bring their children into the world the way they believe is best.
Thank you again for your time, your efforts and your understanding.
Sincerely, Alexandra Orchard
My third daughter was born on her due date, a date she chose for herself. My labor was 30 hours long and I pushed for 1 hour and 39 minutes. In so many ways, this labor was similar to my first labor. It took 11 hours of hard labor for my body to efface before I started dilating. I had to fight for each centimeter every step of the way. My labor stalled at 8cm; the point at which they took my first daughter from me. My midwives did so many natural things to help me get through the final stage. Even when her head was out, I was still saying, “I can do this!” Everyone in the room would shout, “you ARE doing this!” My husband and I pulled our daughter up out of the water ourselves and the first thing I said was “I DID IT!” The second thing I said was “I’m holding my baby!!!” I wasn’t able to hold her two older sisters until they were each about 5 hours old. It was amazing, it was peaceful, it was empowering, and I knew in that moment that I had to do something to change birth for women. I knew I had to do something to make sure that my three daughters could bring their children into the world the way THEY CHOSE TO. I started my path to becoming a midwife then. When my youngest was 8 months old, I started my studies and my apprenticeship. I became active in the local chapter of the International Cesarean Awareness Network and the local Birth Year Network. I am determined to be part of movement that is giving birth back to women and their babies. I have to be part of the fight to make sure that my daughters have a CHOICE in how they bring my grandchildren into the world.
The first face my daughter saw was MINE and the first hands she felt on her body were MINE.
I could not have done this without my husband. He never left my side and he was my rock, my constant voice of strength. You can see in the picture below how I knew that we did this TOGETHER.
Our three week checkup. The women who supported me for so long:
(from left to right)
Melissa Kneen (my doula), Jill Colin, (myself holding my daughter), and Marvelys Lopez.
THANK YOU FOR BELIEVING IN ME!