"Ask me for strength and I will lend not only my hand, but also my heart."
~ Unknown

Monday, July 22, 2013

My Journey to Home Birth after 3 C-sections - Part 1

I am overwhelmed and pleased to share the birth stories of my dear friend, Melissa Pate.  Her strength and perseverance is beyond inspirational.  I am proud and humbled to call her friend.  (Please note: this story takes place in the USA)  Melissa requests that you feel free to share the link to her story far and wide as her goal is to reach out and help other mothers throughout the world!  It makes it worth all of the pain she endured.
Love, Michelle
I have had THREE c-sections. 6 weeks ago I gave birth to my fourth child in my bedroom. It was an amazing miracle. I sit here knowing, I want to share my story with the world. But where do I start? It is all so overwhelming. The stories are long and such a part of who I am. I have tried to write them so many times, only to stop in the middle and say, “It’s just too long and hard.”  I could write a book, and still may someday. I have tried to shorten it as much as I can without leaving anything important out. I have included links to information that helped me on my way.  These are the stories of how I became a mother of three, through surgical intervention.

When I found out I was pregnant the first time, I was a little surprised but so excited. I knew I wanted to be a mother for a long time before it happened. I had a partial placental abruption when I was 25 weeks pregnant. It was very scary. I spent 10 days in the hospital and 10 weeks on bedrest and tocolytics. Even though I was a doula before becoming pregnant, through all of this I lost faith in everything I had learned about birth. I thought I was broken and could not possibly do what I knew other women could. Through the bed rest and around the clock meds, I almost went crazy. At 38 weeks pregnant I was offered an induction and I took it.

Watching the monitor

I had spent so much time believing my baby would come early and was convinced outside was a safer place for my baby to be. I arrived at 5 am to start pitocin. I was dilated one whole cm and 50% effaced. At 7 am the doctor came in and broke my water. No turning back now. I labored all day only to have my son's heart rate drop. They turned off the pitocin and it came back up, but was showing very little variability. So the OB came in to tell me it was time for a c-section, because I was only 4-5 cm dilated. He said if I had been at 8 he would have let me continue. I was absolutely devastated. They prepped me for surgery and I sobbed. The OB thought I was being too emotional and snapped at me to "Get it together!" Because it was "not good for my baby."
Waiting to be taken down to the OR
 They had just finished two c-sections in their L&D floor operating rooms and they were dirty, so I had to be taken down to the main OR. It took a very long time for them to dose my epidural high enough for surgery. They had a video camera on my abdomen. I was able to see him born. He cried even before his 7 lb 4 oz body was out. I briefly got to hold him. Then my husband took him upstairs to the nursery. As he was leaving I began to throw up, which is really hard to do when you are numb from the neck down. Then I went to recovery, where I shook uncontrollably. I didn't see my baby for another 2 hours.     
Meeting my son for the first time
When I finally did see him I couldn't hold him for very long because of how much pain I was in. Because I am allergic to morphine they ordered demerol, which was not kept in stock on that floor. We had to wait over an hour for it to come up from the pharmacy. I briefly attempted breastfeeding but I was in so much pain. I was given tordal shots for the pain and went home with massive bruises from the injections. Breast feeding was very important to me.

We got it down only for me to have to return to my job as a Registered Nurse when he was 8 weeks old. I pumped but it was never enough. Even though it hurt my heart, we supplemented with formula. It was a horrible introduction to motherhood and I struggled to push through.

My first scar
When my son was 16 months old I became pregnant again. I was in a very stressful job situation and it made being pregnant very hard.  I knew I wanted a VBAC, but I was tentative. I didn’t even ask my OB about VBAC until I was 20 weeks. I didn’t do very much research or preparation, as I really felt I didn’t want to put a lot of effort into it if I was going to just end up with another c-section. I had a lot of contractions starting at 36 weeks and so my doctor started checking for dilation every visit. Of course there was none, but after weeks and weeks and weeks of hearing the words “no change” I relented and scheduled the repeat c-section for my due date. That night I lost my mucous plug. By the morning I was contracting regularly. I went to the hospital midday, only to get checked and be told “well there is a dimple.” I asked him if I should just go home and he said "Do you think your husband wants to take you home in this condition?" Kyle agreed, he did not. It was so hard to move forward with no one believing in me.I walked the halls until I felt nauseous and wanted to retreat to a private place to labor.
Between contractions. All hooked up and ready to walk.
In the room, the nurse told me she needed to monitor the baby. I was sitting on a birth ball and agreed she could do it while I sat there. She rebuffed and told me I HAD to get in the bed, because she could not get a good strip if I was up and moving. I relented and got in the bed. I wanted to be a good patient and, being a nurse, I knew she had a job that must be done. It hurt so much more in the bed. Shortly after, I heard and felt a pop and water gushed all over the bed. Kyle said "Melissa there is so much, is that OK?" As I was reassuring him, the doctor returned from his office hours to check me. The contraction pain went up exponentially after rupture of membranes, and when he again said “no change,” I just lost it. I started climbing the bed and screaming "Just make it stop!" He stated “I’m not watching this anymore. We are doing a c-section.” As soon as they let me off the bed, I felt like I was once again in control, but then it was too late. I went to the bathroom, my husband was against the door and the nurse anesthetist was waiting outside the door with a wheelchair. All I wanted to do was close the door and hide, labor alone, and have the baby alone. I felt cornered. With all the courage I could muster it was off to the OR again. The surgery itself was much less traumatic, but my baby was still taken from me and sent to the nursery to be warmed by an isolette instead of me.

Crying for Mom
I begged to them to let me see his first bath but was refused. Instead I was waiting alone in my room with a tray of clear liquids. Which I greedily ate, as I was not even aloud ice chips while in labor. Only to barf them shortly after. I should have been meeting and bonding with my newest child, but instead I was utterly alone, vomiting. My son weighed 8 lbs 6 oz. The nurse in recovery said, “aren’t you so glad you didn’t try to push that big baby out?” I felt like it was inevitable, and I had done the right thing. At that point I decided that if I had any more children I would just schedule the c-section.

So drugged up on pain meds, I can barely open my eyes.
When my second son was 1 year old, I had a heart to heart conversation with a really great doula (Michelle). I cried and cried, realizing how much I was not good with my two c-sections and I did NOT want to do it again. Was it even possible to have a VBAC after two c-sections? I had so much work ahead of me. Two months later I was pregnant again. I found ican-online.org and researched and researched. Then, I called the local birth center midwife. I knew she did not usually provide care for VBA2C but I thought maybe she would at least be supportive or help me find someone who did. Boy was I wrong. She was horrible to me. She came at me from every angle and essentially told me I was a bad mother, a bad wife, a bad nurse, and a bad person for wanting to kill myself and/or my baby by attempting a VBA2C.  I knew she was wrong, but the conversation cut me to my soul. So I returned to the OB that had led me to the OR twice already. I looked into homebirth but knew my husband was not comfortable with that, and only dreamed of circumventing the birth assembly line by staying home. 

When I went in for my 28 week checkup I presented my doctor with a letter explaining that I wanted a VBAC and three things I felt would make me successful. One, to have intermittent fetal monitoring to facilitate movement in labor. Two, I wanted to be able to eat in labor. Three, I wanted to be able to push in whatever position I felt best. He shot them down one by one using a story about a VBAC hopeful who “left a bad taste in the mouths of the hospital staff” to make me want to comply. He also had many choice one liners, including “do you want to aspirate and die?” and   “well, next time don’t grow um so big. You know, 8-6 is really big.” Then to put the icing on the cake as he was leaving the room he said “Do you know what your husband needs to get you for Christmas?" pause for affect... and punch line. "A new cervix.” Then the Nurse Practitioner delivered the real demoralizing blow with, “Yeah, one that works.” I was so hurt. I knew I was never going to be able to have a vaginal birth with him in control of my care. At this point my husband was livid and willing to do anything to avoid their condescending “care.” 

I made an appointment with the only homebirth midwife in town. I was never really comfortable with her but I really felt she was my only option.  I also hired a doula and asked a midwife student I knew to be there with me during labor and birth. I continued to see the OB and his NP “just in case” I had to go the hospital, but I decided on homebirth. Because of the past history of my cervix not dilating and the possibility it could be scar tissue from cryo surgery and a very difficult insertion of an IUD, I consented to let the midwife “massage” my cervix to break up any scar tissue while I was in labor. In my mind it would be a one time thing, and I would carry on undisturbed after that. Well I was wrong again. She manually dilated my cervix and pushed every hour to do it again and again and again. 18 hours after labor started she pronounced me “ready to push.”
Kyle holding me.  He was my rock.
One of the reprieves from the midwife's prying
I would have done just about anything to get her hands out of me, but that was not to be either. I had an anterior cervical lip and she told me she had to hold it back while I pushed. I begged her to just get her hands out of me. I pleaded. I cried. What was going on? This was supposed to be my beautiful peaceful home birth. I pushed for six hours with her hand inside me. Not in whatever position I felt was right as I had asked the OB for, but in the position that was most  convenient for her, flat on my back on my bed.

Pushing and pushing and pushing
After trying inversions and walking my stairs and enduring many verbal assaults from the midwife, I could physically take no more. I was sure if I continued, I was going to die. When I told the student midwife this, she made everyone understand I needed to go to the hospital NOW. We called my OB and told him what we had done and he called my husband names and hung up on him. I had to just take the OB on call. I didn't care. I needed it to end. In the hospital they treated me like a leper. When I was getting the spinal I tried to lean on the OR nurse for support. She pushed me and said “don’t touch me!”  Upon entry into my abdominal cavity they discovered a 10 cm by 8 cm uterine dehiscence. The only thing keeping my baby in my uterus was peritoneum. My 7lb 1oz daughter was born.  I remember all but nothing of her first moments. I was nervous because the spinal did not feel the same as last time. So they gave me versed (a drug with very strong amnesic properties) to calm me down. Very shortly after she was born they whisked her off to the NICU for “labored breathing.” Even though her apgars were recorded as 8 and 9. There, they took her blood sugar and made my husband feed her formula. I didn't see her for another four hours. They kept telling me they would bring her up so I tried very hard to hold off on the narcotics for my pain. I wanted to be present when I met her. I couldn't wait any longer and was high as a kite when I finally met my beautiful daughter.

This is when I saw my daughter for the first time.
They performed a newborn assessment in her plastic
 bassinet, before giving her to me.
I feel this picture embodies everything I felt.
I wanted so badly to be happy; but,
I was in so much physical and emotional pain, I could not.
Finally getting to touch her.
Because she had been given a bottle she wanted nothing to do with breastfeeding. We eventually figured it out, but we suffered through 8 weeks of thrush (caused by the prophylactic antibiotics). The physical and emotional pain put me into a dark depression. For many weeks after her birth I had overwhelming symptoms of PTSD. The first time my husband and I tried being intimate I had flashbacks of pushing with her hand inside me. It was so scary for us both. Forming a real bond with my daughter was extremely difficult. I was just going through the motions. I knew what it should feel like because I had two other children, but it just wasn't there. Though I was able to create a very strong bond eventually, I was still dealing with looming depression 10 months later. At that point we were NOT planning on having anymore children. Despite our plans, I realized when she was very young that there was another child to come to our family. It was all so very hard for me. On one hand I really wanted another child, but on the other, I knew I could not endure another c-section. So many questions so often overtook my thoughts. Was it really necessary? Were we really as close to death as they said? What if I had just had more strength to keep pushing? What if I had not let her manually dilate my cervix? WHY??? Why did I let, yet another, "care" provider violate my body and trample my trust? What is wrong with me? I connected with birth groups online. In my desperate hours, I reached out to Michelle, and she encouraged me. I wrote out my feelings and prayed for relief. When she was 10 months old I wrote this-
All of that pain. Pain inflicted by her hands. If I am fine and my baby is fine. No one is to touch me. EVER! What you were doing was supposed to make it easier. HA. So much pain. You HURT me! YOU not my baby, not my body ,YOU. I would have endured ANY and ALL pain to get her here, into my arms instead of a sterile field. You took advantage of all I was willing to give, to speed it up so I wouldn't tire out. I did tire out. I told you all I couldn't do it. I was right. I could not endure you hands inside me. I dug to the depths of my soul. And you mocked me. “Almost there. Almost there.” I gave all that I had and it wasn't enough. I was willing to give it all for a chance at the amazing euphoria. To feel my baby girl come through me into life apart from me. I wanted to tell her how the heavens sang as I held her in my arms, on my chest, against my breast. I don’t even remember the moment she was born. I was given amnesic drugs that have erased it.
Then, my sweet daughter, they took you from me. All I wanted was to feel you, smell you, feed you, touch you, comfort you. Be your mother. Instead I was drugged, in pain, and alone. I wanted so badly to be coherent when they brought you to me. I held off on the pain medication as long as I possibly could. But they would not bring you to me. They gave you formula. Your first food was from a bottle. The ONLY time you would ever have a bottle.
It has been 10 months today and my baby lies asleep in my arms, laughing in her sleep. As I sob. This is the first time I have written anything about that day.
Read Part 2 HERE
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