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

Monday, September 16, 2013

My Journey to HBA3C - Part 2

The response we received when we posted the first installment of Melissa's story was unbelievable!  We are so thankful for all of your words of encouragement.  Here is the much anticipated second part to My Journey to Home Birth After 3 Cesareans.
When VBAC hopefuls find out I gave birth at home after three c-sections, they want to know, “How did you prepare?” Each person’s road will look very different, but this is mine.

After I knew I wanted a fourth child, I felt like a huge mountain lay before me. I had to realize even if I climbed every obstacle, I may not ever make it to the top. I had to accept that I may never have a vaginal birth. I may be forced by circumstances, or worse, my health; or the worst, my baby’s health, to have yet another c-section. The fears rolled in... Maybe I didn't want another child. The introspection had begun.

I had already tried this twice. How would this time be any different? I thought I had done everything right when I tried for home birth the first time. I had prepared myself by reading countless books.

And these were just the books for my “failed” attempt at home birth. I had read every research article I could get my hands on. Starting with the ican-online.org white papers and continuing to vbacfacts.com. I had immersed myself in all things birth related. I have always been enthralled with the subject but it then had a real purpose, to get me prepared. I had ingested and inserted vaginally evening primrose oil starting at 37 weeks. I did foot zoning to help me let go of the emotional baggage I carried. I thought I had done it all, but I still had a c-section. What more could I do to “prepare”  for yet another try at this vaginal birth thing? I had no idea. I asked myself questions. Was it even safe to get pregnant again after such a large uterine dehiscence? Was it safe to try for vaginal birth again? Where could I find the answers to these questions? I started with the doctor that had performed my last surgery. I scheduled a consult and brought in a list of questions. His advice was “Sure, go ahead. You can get pregnant again. But you MUST have a c-section. We will check for signs of uterine dehiscence with weekly ultrasounds starting at 35 weeks. Any sign of a problem and you go straight to the OR.” This gave me medical permission to have more children. Which in and of itself was reassuring, because when I asked for the referral to speak to him from the military GYN, she said “I’m sure he thinks you shouldn't have any more kids.” None of this sat well with me. Doctors deciding the future of my family just felt wrong. Didn't I know what was best for my family? Wasn't that between me and my husband? My trust in them had been violated so many times. Why was I returning for more? I felt like saying “please sir may I have another?” I started looking for information anywhere I could. I posted questions on Facebook groups. I searched research databases. There was very little information about vaginal birth after three c-sections. And there didn't seem to be any concrete information about pregnancy after uterine dehiscence. I couldn't get hung up on stats and stories and suggestions. I had to look inward and upward. What did I want and what did God want for me?

Before I became pregnant again I found a book that tied birth to my spirituality. The Gift of Giving Life: Rediscovering the Divine Nature of Pregnancy and Birth by Felice Austin et al. It was the only book I read this time around. It gave me new perspective and hope. I could not only bring new life into the world, but I could also become closer to my Father in Heaven through this process.

The physical things I did also started before I became pregnant. I started to improve my diet by incorporating more fruits and vegetables and cutting out processed foods. I learned about essential oils and used them for me and my family. Then I asked the person that taught me, what she would suggest for strengthening the uterus before getting pregnant. At the time I was still breastfeeding and my period had not returned yet. She suggested trying vitex (chaste tree berry). My husband was across the country for a 60 day job training. So I figured I had some time to try it before I could even get pregnant. He joined our family again and because my period had still not returned I was sure I had more time. I still needed to clear my emotional baggage and find a provider who would go along with my "crazy" idea of VBA3C. I got pregnant pretty much the moment he got home. Even though I knew I wanted another child, when I say that positive test I sobbed. My amazing husband held me while I cried. I cried for so many reasons. All the pain and fear came flooding back. I felt so unprepared. Could I really do this again? I started to feel my only chance at a vaginal birth was to try at home again. K was NOT going to do that again. He was afraid of losing his wife and had trouble (rightfully so) thinking we could trust another midwife. Even though he had stanch reservations, I was going to try to find support. Support for what I knew deep down inside was the right thing for me and my baby, vaginal birth. I knew it was going to be hard, at best, to find someone to help me with that. So I started prenatal care with the doctor that performed my c-section. I knew bringing up the subject with him with be entirely futile, so I completely avoided it. Pretending I was good with another surgical birth was hard; but, I didn't see another option.

Then, I took a big gulp and called a midwife in a city two and a half hours away. I had lived in this city for college. This is where I lived when I trained and worked as a doula. I knew the birth culture there was much better than my city. I told her my story and she seemed encouraging. She thought she could help me. A better diet, some chiropractic, she could fix my problems. Then I told her about the uterine dehiscence. She didn’t know what to say. She would have to talk to her back up doctor and get back to me. Ok, at least she didn’t say no, right?  A week later she called to tell me she had discussed it with her colleagues and they all agreed it was best for me to have another Cesarean. I tried not to feel like the rejection was personal, but to me it was. My body was broken and the only way to safely deliver a baby was through surgery. They all agreed, but my heart did not. And again I sobbed. My poor husband tried to be supportive and did very well but all this was taking a toll on him too. Why couldn’t I accept my fate? I tried so very hard to believe that a c-section was the best, safest option for us. For a time I resigned myself to this and it brought so much sadness. I prayed to know what to do. Each time I would pray I would get the feeling I just had to keep trying. I never got the feeling that everything was going to end the way I wanted it to. But I felt I had to continue trying, no matter how hard it was for me to do so.

Through all of this, life outside my all-consuming journey continued. And I tried desperately to enjoy my completely complication free pregnancy. I continued prenatal care with the OB. I had an ultrasound at 18 weeks and learned my baby was a boy.

I also learned my placenta was posterior. I almost got off the table and did a happy dance when the tech said that. All my others had been anterior and I felt like it was a small victory and another little step towards normal uncomplicated birth.

So now what? I had heard the midwives in a city 5 hours away were very good and might help me. Getting rejected over e-mail didn't seem to hurt as bad, so I tried that. One responded saying it might be possible but her words and tone were one of extreme apprehension. I needed someone who believed in me wholeheartedly and could buoy me up when I inevitably had doubts. So I did not respond. The other midwife did not respond via email, so I got up the courage to call. After I told her my story she also seemed optimistic, but felt she should consult with a VBAC friendly OB as well. I waited and prayed. Then her call came. She could not help me. She relayed that the doctor would not even do it in the hospital. Which she said surprised her coming from this doctor because she was so supportive of VBAC. She asked if her daughter, a Doula, could contact me to help me find a hospital that would give me a family centered Cesarean. I told her to give her my number, hung up, then broke down once again. My past mistakes in trust had made it impossible for my body to do what it was physiologically made to do. It hurt so much. I cried to my husband who took part of his day off from work to comfort me. Not long after this he made it clear to me he was done with this search for a home birth midwife. He was not willing to do this at home again. I asked him what if I could find a doctor and hospital to support me. He was not enthusiastic but said I could try.

After posting on several Facebook forums about my situation I had a couple suggestions. One of the doctors actually contacted me and asked me to call her. We had a very good conversation about the risks and benefits. She seemed apprehensive but said if I did not find someone else by 32 weeks to call her back. This gave me a small glimmer of hope, a doctor at least willing to consider it. But she was across the country and I did not have close family there I could stay with. The OB I had heard nothing but amazing praise about, was next on my list to contact. He was 5 and 1/2 hours away from where my sister lived and I felt it was a real possibility. I called his office and faxed my records to his receptionist. She said he would read them and call me back. Two months of back and forth and reassurance he was truly going to call ended with a phone call from the office manager with news that he would not take me as a patient. When I asked for some kind of explanation she again said he would call me. K was furious. He called her back and told her what they had done was inhumane, dragging me along for months just to cut me off with a rejection and no explanation. This left me at the lowest I could get. I was questioning my very worth as a person. All my insecurities came crashing in on me. Was I not even worth a phone call? Maybe all the mistreatment I had endured to this point really was my fault. Others gave glowing reviews of the people who had wronged me. Why had they treated me so badly? What was wrong with me? The questions swirled through my head. I agonized over it all to me sister, who reassured me that if I scheduled a c-section she would be able to be here for me. I know she was sincere in wanting to help but once again hearing that a c-section was so much better brought me even lower. I quickly dropped to my previous state of depression. It was even harder than normal to sleep that night. I woke to go to the bathroom and knelt in prayer. I pleaded for peace and guidance. I woke with a new sense of hope, confidence, and a plan. I was going to drive with my three children to one of my sisters' house, fly to another sister's house, and drive 5 hours to his office and make him take me as a patient. Yes, looking back I see how insane this sounds. K looked at me like I was absolutely insane, but said if that's what I felt I had to do he trusted me. After a week and couple more phone calls to his office, it became apparent my plan was crazy and was not going to work. Traveling cross country to maybe get support was not good for anyone. I decided I would rather have a c-section. I actually felt liberated in a way. I had tried every single available option to have my VBA3C in a hospital. So where did that leave me on my journey? Well, there was just one more person I could try. She was a home birth midwife 3 hours away but she was across the border in Canada. I basically begged K to let me try just one more time. He very reluctantly agreed. I called her... I barely got three words out and started to cry. I had planned to be brave and professional, but I couldn't even keep it together for a full sentence. The way she responded was amazing. She told me it sounded like I had been through a lot and she would love to listen to my story. We talked for the next two hours. I felt so loved. I had never felt this from any care provider, let alone one I had never even met. We both agreed, our paths crossing was a miracle from God.

The next thing that happened was probably the hardest part of my entire VBAC journey. K fought me. He did not want to do this and found many reasons why we couldn't. The biggest one being, we had no money. If I went into the hospital for a c-section it literally cost us nothing. He thought I didn't care about my family and all I wanted was a vaginal birth. That I was going to do this no matter what the cost, and not just money. He thought I was willing to sacrifice our marriage for this. I was flabbergasted. How could he think this? Wasn't it obvious I was doing this for our family? I needed to be able to care for everyone after this baby was born. We both knew it was near impossible for me to do it after my last c-section, physically and emotionally. Mothering through the haze of depression is so very hard. Why didn't he understand? It got so bad he wouldn't even look at me. He avoided me in doorways and spoke only when it was absolutely necessary. It broke me. I was not going to lose my husband over this. I called the midwife and told her we could not meet. She tried to tell me not to make it about the money. I told her it wasn't me. Through sobs I apologized and hung up. I could barely stand from the weight of it all. I wanted to hide. Almost immediately K was following me trying to tell me something. I couldn't even look at him. I told him no, it was over, just let me deal with it alone. He finally got me to listen. "We can do it. Maybe it makes me a bad person, but I just needed to see you were willing to let it go.”

Now I want to make something very clear. He is by no stretch of the imagination a bad person. He is a loving husband and father pushed too far by a system that makes it near impossible to make good decisions about maternity care. I know that our argument actually had very little to do with money, and everything to do with his frustration, at his utter lack of control over how his wife and baby would be cared for. It blows a person's mind to know that intervention and surgery will cost nothing, but staying home and having someone safeguard my bodily integrity will put us in the poor house. I also know he wanted to trust me, but knew I had so much emotional hurt tied up in this. It was such a very difficult decision to make.

Copyright Kimberly Guardipee •www.guardipeephotography.com

After that emotional roller coaster I could barely speak, let alone call the midwife and tell her we had decided to go forward with plans for home birth  I told him he had to call. He called her back and luckily she did not think we had absolutely lost our minds, but was understanding and supportive.  Now I had to work on letting go of my demons. I prayed to be able to trust, the courage to forgive those that had hurt me in the past, and to feel peace throughout the remaining weeks until my baby would be born in my home.

~ Melissa

... Check back for Part 3, coming soon!

Copyright Kimberly Guardipee •www.guardipeephotography.com
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