This is a personal post written 10 years to the day of my third son being born. I was also birthed that day into my fullness of voice as a woman and as a full throated advocate for mothers and babies. You see my son was a CBAC (cesarean birth after cesarean) after a failed natural VBAC (vaginal birth after cesarean).
I had a VBAC with my second son, though by other peoples standards might not be said to be wonderful because at the very end of a totally natural, spontaneous labor after arriving at the hospital at 9cm’s with waters having broken on the way in the car, forceps were used by an impatient on call doc after merely an hour of pushing. I was thrilled though it was ultimately less than ideal with a baby overnight in the NICU. I was not broken. An impatient doc who gave me an awful episiotomy could not take it away from me. But I digress. We can talk heinous episiotomy at another time.
Of course when I became pregnant with my third some 14 months later I assumed of course I would have another VBAC this time with no forceps. Of course I didn’t have to think about another cesarean I already disproved the need. There is a piece of information that I was missing though………
My pregnancy goes well. I am terrifically healthy though more fluffy than I should have been. You see my dear husband was laid off during pregnancy and well, I clearly didn’t exercise and eat properly the second half of the pregnancy. A very dear friend and her children were flying in from out of state near my due date. She arrived and I was contracting already. I must have been waiting for her to arrive to round out the support team. She has clinical skills so I ask her to check me and allow her to sweep my membranes (okay stop groaning at me I was already in the beginnings of early labor). I was a few centimeters dilated and well effaced. She wasn’t sure of baby position though.
The membrane sweeping helped move labor along. I was 5 centimeters before very much time once contractions became nicely regular. My husband had gotten a job two weeks prior and was scheduled for work so off he went though I knew I would be calling him before too long. Sure enough contractions picked up very nicely and I could no longer tend to any of the children. I decided to call my husband home.
Around this time I was about 6 cm’s dilated… good news right? WRONG! I also began having severe back labor. I had this with my first and he had an acynclitic head ending in cesarean after 4 hours of pushing. After my husband got home it was so much worse. You see I am a natural birther but this caused a panic stricken heart. I really freaked out. Not from the pain, but thinking OH no not another cesarean. How could this be happening? I was screaming inside my head. Sheer terror actually. I had not prepared at all for a malpositioned baby – I mean I had gotten him to turn vertex at 37 weeks from frank breech on my own. OP how could this be? In my panic I insisted that we go to the hospital though my dear friend and husband thought we should stay home longer. I was about 7 cm’s at this time. My friend now suspected an OP baby but didn’t tell me. Why did they not insist we stay home? I mean I was in no condition to drive myself the 15 minutes to the hospital. I don’t know.
We arrive at the hospital, I am indeed about 7 cm’s and yes baby is OP. No one worries though that I am a VBAC again. Basic monitoring, no saline lock, all is well in l&d land (so it would seem). In my head I am still in sheer terror though from the outside apparently it was not visible. That is still tough for me to comprehend. I was screaming through my eyeballs but I made no noise at all from what I am told.
I tried many positions to get him to turn, and probably would have but……..
At some point during a vaginal exam, my water was broken without my consent. This my dear readers is what caused the downhill slide to a repeat unexpected cesarean. I have since learned I have an android pelvis and without intact waters rotating a poorly positioned baby is near impossible if possible at all. Back to the story.
I cannot say how much time went on for sure, a couple of hours I believe. Somehow in this room filled with two nurses, my dear friend and husband, a complete breakdown of emotional care took place. I felt totally and utterly unsafe, scared, terrified, and without hope. My husband too was overwhelmed and felt displaced in the situation though he admits he allowed it to occur. I did blame him and to some degree my dear friend in the beginning, but I do not now. I didn’t prepare well. I assumed. I didn’t define the roles of support between my husband and dear friend. I was a Pollyanna.
I was now complete and still trying everything possible to get baby to rotate. Nothing worked. I was desperate. By the way, I was unmedicated and only on intermittent monitoring for most of the time. So cannot blame the epidural or being strapped down.
I pushed for over three and a half hours in varying positions. During pushing (I am pretty sure of timing) an internal monitor was put on my son and a scalp sample was taken to check his stress level. Oh, the SAME on call doc that was impatient and used forceps on me during the last birth was my attending. That very much did not make for a safer, happier birth space. At the end of the hours of pushing, she again pulled out forceps to see if she could rotate him or help me deliver him, but my dear friend discouraged it highly since he was still higher up (forgive me the station escapes me without my records in front of me). I was then told the scalp sample came back showing my baby was becoming acidodic, which means he was getting very stressed. His FHT’s were fluctuating quite a bit as well.
At this point I could hardly keep my eyes open. I was in despair, heart broken, and becoming very angry. The doctor presented me with a cesarean consent form. I refused to sign it. I said I wouldn’t sign it but my husband had a power of attorney. I made him do it. I could not do it. I could not agree to another cesarean. Somehow having my husband sign it helped me face it better. Perhaps because then it was out of my control.
So another cesarean for a “stuck” and this time fetal distressed baby. So I was told. I was taken to the OR where the anesthesiologist would eventually place the epidural. I begged and begged and begged for a dose of terbutalin to slow the contractions as I still had the uncontrollable urge to push. He essentially told me I was being a baby. To man up. He would get my epidural in soon enough. He was mean. He was verbally hostile. In between intense contractions, I actually thought over and over as I sat on the metal table with feet dangling of how I could take a swing at him without falling and hurting my son. I wanted to make this anesthesiologist feel pain. Punching him in his condescending, smug face would have been extraordinarily satisfying. I was so angry at how I was being treated. I will never know if he was punishing me for being a natural birther or a failed VBAC mother. Maybe both. He still is in practice and no I cannot be in the room if a client of mine gets an epidural with him as the anesthesiologist. My response is still visceral to his mere presence.
It seemed like a very long interval of time before the I.V was put in, the epidural was placed, the OR team was fully assembled and my husband was at my side. After reading my records it was a long interval. My husband signed the consent form and my son was not surgically born until more than 45 minutes later. Was he REALLY fetal distressed with that long of a wait in between? 45 minutes when the OR was open and available? I was IN there with the anesthesiologist the whole time. That is not an emergency or even emergent. Plainly he wasn’t coming. Yes he was OP.
I was laying on the table, armed strapped down, husband standing next to me watching the cesarean take place. I have no memory of what the epidural felt like. My eyes were closed out of exhaustion, grief and anger. My son was delivered at 535am. His APGAR’s were decent not that of a highly distressed baby. I wonder if during the long wait and the rest period, he normalized. I may have been crying but not for the good reasons. My son was waved by my face. I do not remember seeing him. My husband was heading to the nursery with him. I screamed after him at the nurse, “If you give my baby formula, I will sue you.” It seems the woman who wouldn’t send back a wrong order at a restaurant was forever changed. Like a light switch my voice was established.
While I was being repaired. I decide to talk to the doctor (at this point I had no idea she broke my water without consent and had falsified my medical records in a few areas), so I tell her I want another baby. I then asked her if my uterus was good for another VBAC. She said sure you can have another VBAC if you want. No problem. My uterus looked beautiful. Wow, I should have felt wonderful that I am such an amazing healer from previous surgery. I didn’t. Sigh. I wanted to die except my baby would want to nurse. Oh yes, my baby J.
Once out of recovery and into my room my husband came and gave me report on J. He was being observed, seemed very well. No they didn’t feed him anything. M had to go home and check on our other children who were just 4 and 23 months. He swapped off with my dear friend who had gone to check on her children. I still hadn’t held my baby. I had no idea what he looked like. I was distraught but no one knew it. I would make a heckuva poker player I think.
Five hours post op and I want my baby. I want him NOW. He must be hungry. He must be wondering where I was. The thoughts ran through my head. I called my nurse and asked her to bring me my son or take me to the nursery to feed him. She said no to both requests stating various reasons. This did not suit the new me at all. I asked her again. She again said no. This did go on for a few minutes where we were actually raising our voices back and forth. Finally I noticed the wheel chair by the door, I looked the nurse in the eye (who by the way was no more than 6 inches from my face), and I said “Fine you want me to get up and walk across the room to the wheel chair then you will take me?” She said, “Yes” in a non-believing tone. HM she didn’t know me at all. THAT my dear readers was a dare in her voice. I called her bluff. I took a deep breath, held my belly, stood up and walked right over to the wheel chair on my own. Needless to say she took me to the nursery to see my son.
My voice was completely in full bloom. Never to go back.
As she wheeled me around my son’s bassinet I grabbed his chart much to everyone’s dismay and horror. Why were they worried, well they had performed several tests, admitted him to the nursery for a minimum of 24 hours, started I.V. antibiotics and put in a central line ALL without consent. All done under implied consent which does not exist once the cord is severed and baby is his own patient. I thoroughly read his chart (no reasons given for the battery of tests), made certain they hadn’t him or given him I.V. fluids to curb his hunger, then I held my precious, sad little boy. Almost 8 pounds. Gorgeous. Very hungry. He nursed beautifully. I was elated and even more stricken. I stayed with him until he fell asleep then instructed them to call me at ANY sign of hunger.
I went back to my room and within another hour I was walking myself back and forth alone to the nursery. They had to ask me to come back for vitals to be taken and implored me to rest. He was MY baby not theirs. Mine to care for, nurse, be with….. Sigh.
When evening rounds took place the I asked the pediatrician to come to my room so we could discuss getting my son out of the nursery and into my room. He went through his whole chart with me and told me exactly what needed to happen for him to be released at 7 a.m. Yes I noted it all. He wrote it in the chart everything he told me.
During one of my evening trips to the nursery, the truly decent and kind night nurse informed me that my son never needed to be admitted to the nursery and she was better equipped to take care of in need babies. My son was fine. She said sure he needed to be observed for an hour or two but never should the tests been done or a central line placed for that matter. She encouraged me to stay as long as I wanted but it was good for me to go and sleep to heal best too.
In the morning I was there before the floor pediatrician was doing rounds. You probably guessed it, my son was in my room by 8 a.m. I can be very persuasive. The funny part about the scenario was that immediately when the doctor walked away the nurse implored me to help her get all the leads off and my son unhooked from everything quickly. Why? Because she had never seen a doctor release a baby like that and feared the doc would change her mind.
I finally had my son with me. Finally. I was hurting physically. I didn’t rest enough. I was his mother after all, that is what we do. Had I not done exactly what I had he would have still been in the nursery and breastfeeding could have been a disaster. More ibuprofen please. I do not even remember my husband bringing the other boys to the hospital. I do not remember anything but advocating for me and my son.
By 48 hours post cesarean I was desperate to go home. As I put it not so delicately to the doctor who didn’t want to release me so early after surgery, “I can sit on my own damn couch and I have better cable than you do here.” Seriously the full throated voice was speaking. Yes, she released me though against medical advice. I assured her I knew what infection looked like and I would be back if I needed to be.
My husband was there shortly thereafter with car seat and our other sons in tow. I was traumatized and shell shocked BUT I had well spoken up for the two of us when all was said and done.
Just like the Grinch who’s heart grew in size, I powerfully came into my own as a woman, as a mother and as an advocate. For this and this alone I am tearfully grateful for my CBAC and though much was lost so very much more was gained.
