Posts Tagged ‘VBAC’

29 Ways to Have a Natural Birth

Monday, September 5th, 2011

I’m really torn on the idea that a natural birth “just happens.” In some respects, a natural birth does just happen… in cultures where natural is the norm. But in our culture where the vast majority of moms have some sort of pain medication during labor, and 32% of babies are being born by cesarean(1), does it sound like a natural birth “just happens?”

So as an independent (read: out-of-hospital) certified childbirth educator and birth doula, here are my top 29 ways to have  a natural birth. Why 29? Because that’s how many I came up with! Sorry I didn’t pick a “rounder” number.

1. Take a good class.
What qualifies as a “good” class? For starters, make sure the person teaching the class is not being paid by a hospital. I hate to sound all conspiracy-theorist this early on in the post, but unfortunately hospital childbirth educators are often given guidelines regarding what they can (and can not) teach. Whether those “guidelines” are actually written, or just implied is another matter. In the hospital class offered where I had my first baby (before I had a clue), the instructor spouted off crap like “Pushing on your back is probably the worst position to push in, since it makes your pelvis so small the baby pretty much can’t come out on its own. But it’s what the doctors want you to do, so it’s what you have to do.” Present-day Mandi would stand up and say “Ex-squeeze me? Did you just say that’s the worst thing for us to do, but we have to do it anyway? What the hell you been smokin’, hospital educator lady?” But unfortunately past-tense Mandi had no clue, so past-tense Mandi wound up with a slew of unnecessary interventions and a cesarean. An out-of-hospital class will generally equip you with the knowledge and skills that enable you to ask the pertinent questions to ensure that any procedures proposed are for a true medical need, and to know the drawbacks of the routine use of interventions.

2. Hire a doula.
I can’t even begin to stress the importance of this! According to DONA.org:
“Numerous clinical studies(2) have found that a doula’s presence at birth
•    tends to result in shorter labors with fewer complications
•    reduces negative feelings about one’s childbirth experience
•    reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
•    reduces the mother’s request for pain medication and/or epidurals
Research shows parents who receive support can:
•    Feel more secure and cared for
•    Are more successful in adapting to new family dynamics
•    Have greater success with breastfeeding
•    Have greater self-confidence
•    Have less postpartum depression
•    Have lower incidence of abuse”

3. Have a grandma who gave birth naturally.
So, do you have any control over this one? Nope. But it does help to have a family member of very close friend who gave birth to her baby(ies) naturally. Why? For the sheer “if she did it so can I” factor. After my first birth went so lame, this was one of my main driving factors while I planned my second. My grandma had all three of her babies naturally in the knock-em-out, drag-em-out era. My mom had both of her babies naturally in the 80’s. Knowing that they did it five times between the two of them helped to convince me that I could do this, too. And I did. Good birthing genetics isn’t so much the goal here (although it sure doesn’t hurt) as is knowing that countless other women have done this, and so can you!

4. Eat your protein.
Your body needs protein on so many levels. The basic functioning of your own systems. The building blocks for your baby’s body. But also for your own body to be able to produce albumin, which helps facilitate the massive increase in blood volume that a pregnant woman experiences by the third trimester. 80 grams a day is a well-agreed upon base for pregnant women. How do you do it? There’s no other way but to track it! It will take several weeks of tracking, but you will eventually get the hang of incorporating 80+ grams of protein into your diet each day. How do you know? Check the label on packaged foods, or visit http://www.calorieking.com/ for protein counts of unprocessed foods.

5. Choose wisely.
Does your provider support your desire for a natural birth? Or does he/she say helpful things like “It’s fine if you want to try, but don’t get your hopes up. Hardly anyone ever actually does it!” Just FYI, that’s not supportive. Nor is “I only do episiotomies when they’re absolutely necessary, and they are only necessary on 80% of first-time moms.” Just sayin’. That crazy old knight in Indiana Jones and the Last Crusade knows what’s up – “choose wisely.” If your doc has a 50% cesarean rate (like my first did before I had a clue), what do you think your chance of cesarean is?

6. Where are you going to give birth?
Are you going to a hospital/birth center with a reasonable intervention rate? Or are you going to Los Angeles Community Hospital(3) with their lovely 67.5% cesarean rate? What are your odds of having a cesarean at L.A. Community? Think that one over. Where does your birth place rank?

7. Do the friggin’ exercises.
Yes, I know you work 50 hours a week and it’s a million degrees outside. So just hypothetically, let’s say you knew your ass was getting dropped off at the starting line of a marathon in a few months. You had no say – you were most definitely going to be forced to run in this marathon. But even though you were being forced to participate in this marathon, there was a prize. You wouldn’t have to come in first, you’d just have to make it to the finish line. And the prize is a million dollars. Tax-free. How hard would you train for this mandatory million-dollar marathon? Pretty dang hard, right? Well, your baby is worth more than a million dollars, and like it or not, you are signed up for this marathon. Better get to training.

8. F*** negative friends.
Which is ironic, since that’s incredibly negative of me to phrase it that way, am I right? But why the hell does common courtesy get thrown out the window just because someone’s pregnant? If you wore a tee-shirt that said “I’m going for my doctorate in electrical engineering,” everyone would congratulate you and wish you the best of luck. Yet somehow, the big belly gives everyone permission to tell you how excruciating their own (medicalized, pitocin-laden) birth was, and how horribly you are going to fail at your planned natural birth. WTF?!?!? If people don’t have the common courtesy to give you a high-five and keep their negative shit to themselves, then F ‘em! Maybe they can be a friend again after you have your kick-ass natural birth.

9. Smile and nod.
Okay, so you can give negative friends a swift kick to the ass, but what about strange old ladies in the grocery store? The ones talking about how they “slept” (read: were drugged to the point of unconsciousness) through their birth and wonder why anyone would want to feel it? Just smile and nod. In one ear and out the other. Obviously you can’t kick a random old lady in the ass, so just smile, nod, and ignore.

10. Relax.
…don’t do it
When you want to go to it…
Okay, now that we’ve all had that Fankie Goes To Hollywood interlude, seriously, relax.
Tensing your muscles during contractions will make what would feel like a period cramp suddenly feel like a stabbing pain. Relax. How? A comprehensive childbirth class (see item 1) will show you how. The key – actually doing the relaxation homework every day during pregnancy, instead of hoping it will all magically just come together the day you go into labor.

11. Never fear…
Your uterus is here! Okay, it rhymed. I had to use it. But seriously, fear is the first step in tensing those muscles, which is the exact thing we want to avoid in labor. How do you abolish fear? Take a comprehensive childbirth class so you understand everything that’s happening (see item 1).

12. Understand the process.
This is a continuation from above. When you understand the process of labor and birth, you are not going to tense up at each contraction. So how do we come to understand the process? Take a good childbirth class (see item 1). I’m sensing a recurring theme here.

13. Have birthy friends.
Whether IRL (in real life) or online, having the support of other natural birth mamas can make a huge difference in how you view (and thus handle) the idea of natural birth. If you are the only person that you have ever known who has considered natural birth, how do you think you will do? How about if you are in an online community with hundreds of natural birthers cheering you on? It makes a huge difference. Ideally a local natural birth group would be the best, but even a national one will have a huge impact in the level of support you feel.

14. Have a supportive partner.
Again, this might be one of those things that, depending on circumstances, you may not have much control over. Or do you? I’m not gonna pretend that everything is all sunshine, farts, and roses for all expectant moms. Unfortunately, some bio fathers are douchebags. But mom can choose someone else to be her “partner” during the birth if dad is a dip-shit. Mama’s mom, aunt, sister, friend or doula can be her constant support during pregnancy and birth. It is so important to have a reliable, loving person to support you during this time. If you have no support and can’t afford to hire someone, consider a doula in training. She can offer an immense amount of skills and support for often little or no fee as she gains experience.

15. Eat the rainbow.
Not Skittles. I’m talkin’ veggies, fruits, whole grains, and (if you eat them) eggs, dairy, and lean protein! A healthy diet is the single most important thing you can do to stay healthy and low risk. The Brewer Pregnancy Diet(4) is a great, common-sense way to make sure you are getting all of the needed nutrients for you and your baby every day.

16. No more crack sandwiches.
In my very first class, way back when, I was covering harmful substances during pregnancy and my very funny student quipped “Damn! No more crack sandwiches!” I still crack this joke in every class where I cover harmful substances, and it always gets a good laugh. We all know that crack sandwiches are not cool, but there are lots of other “social” drugs that are probably best avoided during pregnancy. Namely, caffeine(5), alcohol(6), and food additives(7).

17. Have a birth plan.
This is not a magic wish list that guarantees a perfect birth. However, it is a wonderful tool for solidifying your preferences that you wish to discuss with your provider. I understand why it may be tempting to keep your fingers crossed and just hope that everyone is on-board when you go into labor, but that’s not reality. It is so much wiser to discuss your desires well beforehand and work out any kinks that may exist. What if it’s more like the Grand Canyon than a kink? If it’s early enough you can switch providers to one that’s more in-line with your hopes. Hence the importance of completing the birth plan as soon as possible. My tips:
•    Keep it to one page
•    No 8-point font to fit more into one page. That’s cheating. 12 is fine
•    Phrase things in a positive way. “I would prefer to have a hep-lock” vs “I hereby REFUSE IV fluids! May God help your wretched soul if you dare ask to administer IV fluids!” You still have the final say either way, but you catch more flies with honey.
•    Include a brief few sentences at the top introducing yourself and conveying that this is your plan for a normal low-risk birth, and that you are flexible and open to discussion if medical complications arise.

18. Let that belly go!
I already covered relaxation, but I think special attention needs to be paid to the abdomen. It is utterly crucial that the abdominal muscles remain limp and loose, especially during contractions. No matter what position you are in, you should be able to just let your belly go. This is where good classes (item 1) and a supportive partner (item 14) come in handy.

19. Water, water everywhere… and you must have a drink.
I’m just gonna say it – ice chips turn into friggin’ water about a nano-second after you eat them, so what’s the big deal? Water is off limits, but ice chips that turn into water in the esophagus are somehow okay? WTF gives? In a case where mom is vomiting and can not keep down fluids, IV fluids can be a wonderful thing. But what about the other 98% of moms who are fine, yet are still told NPO (nil per os – nothing by mouth… yet somehow ice chips are okay… figure that one out…)? The alleged “concern” is that if mom ended up needing general anesthesia (which is rare), she might aspirate stomach contents. In the rare event of general anesthesia, when proper anesthesia protocol is followed aspiration is unlikely to happen. Although I have yet to find an “official” source, I have seen it quoted as less than 5% of cesareans (1.6% of all moms) who will need general anesthesia. So because of 1% (the vast majority of which would have no aspiration complications), we are denying the other 99% the right to water, the most basic of human needs? This makes no sense. The drawbacks of IV:
•    Being tethered to a pole
•    Fluid being pumped directly into your veins can dilute labor hormones, thus slowing labor
•    Makes mom and baby swell. For mom, this may cause breastfeeding difficulties from swollen breasts. For baby, this may lead to an artificially inflated birth weight. When baby begins losing said “water weight,” to the untrained eye it seems that baby is loosing too much weight, leading to formula supplementation. All because mom had an IV instead of sipping water.

20. Snacks are your friend.
You will most likely still feel like eating during early first stage. Not so much during late first stage. Carb (and protein) up during early first stage. If you are getting fatigued during late first stage, it may be worth it to snack. Low blood sugar will only fatigue you and make your labor unproductive and more painful. Try light things, like a honey stick, plain yogurt, toast, or applesauce. Many women are told NPO at this point (see item 19). There is no scientifically justified basis for a blanket NPO order, so this is yet another reason to choose wisely (see item 5) and discuss your wishes ahead of time (see item 17).

21. “I’d prefer not to.”
This is a concept I didn’t grasp with my first birth. If there is a procedure proposed, and you are not given a valid medical reason, you always have the option of politely declining. Now I’m certainly not saying forgo interventions when there is a medical indication. But if something is just routine and not based in science (routine IV, anyone?), and if the staff can’t give you a medical reason pertinent to your personal situation, then you always have to option to politely decline. Calm and mature is the best way to handle these instances, as opposed to being the crazy screaming pregnant chick that no one is taking seriously. Just FYI.

22. The anti-Kegel.
I can’t stress this enough. We Kegel during pregnancy to tighten the muscle. This helps position the baby, encourages flexion, and helps to avoid injuries to the PC muscle during delivery. However, it is just as important to do the ANTI-Kegel during delivery. As the baby descends, you must be able to relax the Kegel area. I have seen moms holding their babies in (literally) by clenching the Kegel as they pushed, and as soon as I whispered “do the anti-Kegel,” baby starts descending like you wouldn’t believe. So, Kegel during pregnancy = YES. Kegel during 2nd stage = NO!

23. Breastfeed
Immediate breastfeeding helps with bonding and provides the baby with immunities, but it also helps the uterus to contract, reducing the need for postpartum Pitocin, which may interfere with the intricate hormone balance needed for breastfeeding. Can’t breastfeed immediately? First off, I feel ya! My third baby was in the NICU for 10 days and couldn’t even eat per os for 5 days. I pumped like mad, and she had only my colostrum from the time when she could finally have a feeding tube, and eventually nursed (and by eventually, I mean that she is 26 months and still demanding “buboo!” So it all worked out okay.).

24. Complications, schmomplications.
Sometimes shit happens. I know that’s not very “positive” of me, but it’s reality. Sometimes you do everything right and something happens where it’s just not a good idea to have a natural birth anymore. Knowledge can have such a huge part in how you end up feeling after your “natural” birth ended up legitimately needing to be not-so-natural. If you had a sucky doctor and got steamrolled into a bunch of unnecessary interventions and a cesarean and perpetual self-doubt (past-tense Mandi with 1st baby), it is likely that you will be pissed after your birth. If you were knowledgeable and did everything right (present-day Mandi with 3rd baby), but your baby just really needed to be born by cesarean, then you will likely feel much more satisfied. I know I did! After my third birth, I was slightly bummed because I would not have necessarily picked a cesarean, but it was only a minor bummer because that was just how she had to be born. There wasn’t a single thing I could have done differently. Thank God we have cesareans, because she was just not doing anywhere near well during labor. Although I didn’t hope for a cesarean, I still felt like this was a great birth. It was the best possible decision with the hand I was dealt. And I honestly feel great about that. Damned empowered, in fact, because I understood what complications were happening and I was in on the decision process.

25. Cesarean can be our friend.
Again, this isn’t what you would normally read in a fluffy, feel-good natural birth post, but it’s reality. Sometimes cesarean is the only way to a healthy baby and healthy mom. My first birth was most certainly an unnecessary cesarean, and I was pissed. My 2nd was an all-natural VBAC (go me!), and my 3rd was a truly necessary cesarean. It happens, and it’s okay. Sometimes, no matter how “right” your choices are, cesarean is the safest bet. And although it sucks, it’s still okay. And it’s okay that it’s both sucky and okay.

26. A healthy baby is not all that matters.
It is the most important thing, closely tied with a healthy mom, of course. But it is not the only thing that matters. It’s okay for you to feel sad that your birth didn’t go as planned, for whatever reason, whether medically justified or not. There is nothing inherently wrong with being sad that your birth did not go as you had hoped. It can be beneficial to seek help if your feelings are impacting your life negatively.

27. It’s okay if it’s not natural.
Especially if you made educated decisions. Sometimes natural is not the best option in a particular case, and it’s okay. One of the most important factors is how you feel about your birth. If you made wise choices, but just happened to be dealt a lame hand, it’s much more likely that you will feel proud of your birth!

28. Know you did good.
So far, 86% of my clients have had a natural labor. Yet, as a doula, I have also been at births where an epidural was a great idea. Not often. Most births go natural. But natural is not the best for everyone. And I truly feel like my clients and students who have needed an epidural made a wise decision for their particular situation. I only urge you to look at the percentages. My clients go unmedicated 86% of the time. So when local hospitals have a 95% epidural rate, doesn’t that show the gap? Most women don’t have a need for an epidural. But a few do truly need it, and that’s okay if they were educated about the benefits vs drawbacks.

29. The family unit is key.
Bond! Bond immediately, bond often and bond well! Certified baby-friendly hospitals have rules about leaving the new family alone during the first couple of hours, but luckily even most non-certified hospitals have similar policies as they work toward certification. Skin-to-skin is the best option for warming the baby, as well as for comforting and breastfeeding. Baby knows mama and daddy’s voice at this point, so get to chatting! Even in a less than ideal birth situation, skin-to-skin and verbal bonding can be extremely beneficial to not only baby, but mom and dad as well.

Unfortunately, there is never a guarantee that you will have a 100% natural birth. But by following the rules above, most of my students do have a natural birth, and those that need interventions are confident in their choices. My students are overwhelmingly having satisfying experiences and entering into healthy loving relationships with their little ones.

Your choices in pregnancy make a huge difference… choose wisely!

Peachy Keen Birth ServicesMandi Woolery
Peachy Keen Birth Services

Citations:
1 – http://www.cdc.gov/nchs/data/databriefs/db35.htm
2 – http://www.dona.org/resources/research.php
3 – http://www.theunnecesarean.com/blog/2011/7/19/california-cesarean-rates-by-hospital-2009.html
4 – http://www.drbrewerpregnancydiet.com/id96.html
5 – http://www.marchofdimes.com/pregnancy/nutrition_caffeine.html
6 – http://www.marchofdimes.com/pregnancy/alcohol_indepth.html
7 – http://www.livestrong.com/article/117114-additives-avoid-during-pregnancy/

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Quote: Billie Holiday

Sunday, July 24th, 2011

“Singing songs like ‘The Man I Love’ or ‘Porgy’ is no more work than sitting down and eating Chinese roast duck, and I love roast duck.” – Billie Holiday

Anyone who loves Billie Holiday’s music knows that she was troubled. That’s what makes her Billie. Can you imagine a Lady Day without personal strife? She would have been… well, infinitely less interesting.

As I was “far” past my arbitray cut-off date with my VBAC baby (41 weeks was the hospital “cut-off” and I was already at 9:00 PM on 41 weeks and 2 days), I knew that I needed to relax. Our 19-month-old was asleep, so my husband drew a bath for me, lit some candles, and put on my favorite Billie Holiday CD. I relaxed in the tub for an hour, and within minutes of getting out, I was in labor, destined to have my VBAC baby in less than 4 hours, completely naturally.

So when I came across this Billie Holiday quote tonight, I felt moved. Not only because this was the woman I had adored since I was 15, and who had sent me into labor… but because her words fit in so well with what I am trying to do now as a birth worker.

“Singing songs like ‘The Man I Love’ or ‘Porgy’ is no more work than sitting down and eating Chinese roast duck, and I love roast duck.” – Billie Holiday

These are not happy songs. At best, “The Man I Love” is hopeful, and “Porgy” is just desperation. Yet she loved singing these songs. It came naturally to the great Billie Holiday.

I find myself in much the same place these days. I am singing a hopeful tune in my classes. Mom is in control, deserving (ideally demanding) respect, birthing on her terms. Yet it’s sad… In reality I see doctors disregarding wishes, women without choices (other than direct defiance, which is fun for us 1% of the population who actually DO get a kick out of fighting while in labor, and trust me, I was in that minority!), and those whose doctors cut them off mid-sentence… repeatedly. Nothing is more frustrating than hearing a pregnant woman trying to form a sentence and being rudely cut-off by her doctor. As if the edicts of basic courtesy, those that you would expect from even a stranger, don’t apply. This is a state of desperation.

Yet I am happy to sing the song. I will continue to teach about options, priorities and informed consent. It is like eating “roast duck.”

I have been told by many students that I was THE key factor in why their birth went so well. In reality, it was the preparation and education that mom and dad took so seriously beforehand. And mind you, not all of these births have gone the way the mom had initially hoped. But in all cases, the moms were confident, strong, and an active decision-maker in their birth. And now I’m starting to have a trickling-in of past students and doula clients who want to get into the birth business – who also want to work towards a positive change.

So I can see that my song will have an exponential impact. And I will continue to sing my song, as easily as eating “roast duck.”

Mandi Woolery
Peachy Keen Birth Services

*DISCLAIMER* – I really don’t even care for duck. I mean, I like just about everything, and duck is one of the very few items I don’t like. But dang it, this was a perfect quote, am I right?

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Why I’m Thankful That My First Birth Experience Sucked Royally

Friday, June 24th, 2011

This post was originally posted in November of 2010, but it seems to have been randomly deleted. Thank you, WordPress. You suck.

With Thanksgiving being one of my absolute favorite times of the year, I’ve been thinking a lot lately about all that I have to be thankful for. I have the most amazing husband on the planet – so kind, so supportive, and damned good lookin’! I have three healthy, beautiful children who never cease to amaze me with their wit and intelligence (even when said intelligence is enabling them to find new and creative ways to irk me). I have a close-knit extended family, most of whom I am lucky enough to see daily or weekly, rather than just at holidays. I have a place to live. My husband’s job is secure even in this economy. I’m able to work in a field that I’m passionate about, and which also allows me to be home with my kids. The list of things which I am thankful for could go on to fill a book.

But there’s one more thing that I’m eternally grateful for, and it’s not what most people would expect:

I’m thankful that my first birth experience sucked… and sucked royally at that.

When I was pregnant with my first baby, I wanted a natural birth. My grandma had quick and easy natural labors, my mom had the same, and so I figured that it was a given that I would experience an easy natural labor. The problem, however, was that while I had the genetic potential for an easy birth, I lacked the resources. I’m ashamed to admit this, but it was 2004-2005 during my first pregnancy and I really wasn’t that into the Internet yet. I knew how to check my email, but I honestly didn’t even know what Google was at that point. So to say that my resource base was limited to only mainstream thinking… well that would be a major understatement.

So, I read What to Expect, and I took a hospital “prepared childbirth” class (lots of focus on policies and procedures, a little “hee hee hooooo” breathing, and that was about it)… and that, my friends, was the extent of my preparation for what I was certain would be a natural birth. The sad part is, I really and truly thought that was the way you prepared for a birth. It literally had never crossed my mind that there might be an alternative, so I thought I was kickin’ some ass.

At six days past my due date (which had actually been arbitrarily moved up an entire week sooner during the third trimester), my OB told me “It’s very dangerous to be this far past your due date.” In retrospect, I have to assume he said this to all of his patients, as there was no indication that there was any problem with me or my baby. But this guy was the head of obstetrics at the hospital where I planned to deliver, so I thought that meant he was the best obstetrician, and therefore knew what he was talking about. I was more than happy to induce since my uterus didn’t get the EDD memo and apparently I was putting my baby at increased risk every extra minute he gestated. To start the induction, I was given an enema and then an unholy amount of Pitocin. How do I know it was an unholy amount? Because even though I was clueless, I remember the nurse shaking her head in pity and muttering “I can’t believe he’s starting you out on this much Pit” as she began the drip. Shortly thereafter Dr. Douchebag (that’s what I call him now) came in and broke my water to “speed things up” and I was told to stay in bed. I endured the horrific Pitocin contractions while laying in bed for about six hours. Dr. D then checked me and announced that I was only a 3. I caved and begged for the epidural at that point.

After 22 hours of labor, I was complete and began to push. I was totally numb from the epidural, to the point where I couldn’t even move my legs. The nurse had to let me know when I was having a contraction, because I had no clue. I couldn’t tell if I was even pushing or not, but after about two hours my husband said that he could just see the baby’s head. In strolled Dr. Douchebag and told me “It’s very dangerous for the baby if you push any longer than 2 hours. We need to do a cesarean.” I obliged because, again, even though there were no signs of distress from the baby, this guy was the head OB, so he must have known what’s what. I certainly didn’t want to risk my baby’s life with what would have probably been another 30 whopping minutes of pushing. During the cesarean, the OB mentioned that it was a good thing we did a cesarean, because the baby would have never fit through my pelvis. A couple of months later, when I finally did discover Google, I realized that he was talking about CPD.  The baby was 7 lb. 5 oz. at the time of delivery, and was doing great. I was lucky enough that he nursed well, even though I didn’t get to see him for the first few hours while I was in recovery.

This was the first time I saw my son. I didn’t see him again for 3 hours.

Right after the birth, I still had no clue. I was so thankful that my doctor had “saved” my baby. I figured our second baby would be a scheduled cesarean, because the hospital “prepared childbirth” class had taught us that there was a 5% chance your baby could die during a VBAC attempt, and I certainly didn’t want to take that risk.

It was only after I began to embrace the Internet that I realized that I got screwed. That I had been lied to. That I had been led right into a cesarean, oblivious to the reality of the situation the entire way. I stumbled upon a natural childbirth message board, and that’s where I discovered that there were truths to be learned that weren’t in What to Expect, and certainly weren’t taught in that hospital class. I learned the truth about using interventions without a medical indication. I learned the accurate statistics about VBAC, not the completely imaginary number given in the hospital class. I learned that if there are no complications, the natural process of labor can usually be left alone, and will usually progress just fine. I learned that it is not, in fact, inherently dangerous to be six days past your EDD… especially when your due date has been moved up a week for no reason at all. And I learned that it’s a-okay to push longer than 2 hours as long as mom and baby are fine… especially when you’re starting to see the freakin’ head!

I learned all of this and I was PISSED. Absolutely livid.

So if this birth experience sucked royally, and if learning the truth enraged me, why is this something that I’m thankful for?

Because it lit a fire under me. I now had a mission in life. A purpose. To make sure that I would be an informed decision maker for my next birth – and for any type of future medical care I might receive, for that matter. And someday I would help even one woman learn these truths before she had this same crappy experience.

So although my first birth sucked, it was the catalyst for everything that I have come to believe, and everything that I have come to be…

  • a Mom – even though it sucked, it still was the way my first son came into the world, and I am perpetually thankful for him.
  • a VBAC Mom – after discovering the world beyond What to Expect, I became pregnant with our second son. I read every book I could get my hands on. I took independent childbirth classes. I hired a doula. I switched to a VBAC-friendly hospital where I was able to see a midwife. At 10 days past my EDD, I gave birth to my second son via all-natural VBAC. My labor was only 4 hours from start to finish. It was so easy compared to the horrors of Pitocin. Oh, and he was 8 lbs. 14 oz, a full pound and half bigger than my first… so there goes the CPD theory.
  • a Childbirth Educator – I am now a certified childbirth educator. I thoroughly enjoy teaching independently (as in not receiving payment from a hospital) so that I can feel free to give evidence-based, rather than policy-based, information. Watching my students’ horizons expand as they educate themselves about their different options has been such a fulfilling reward!
  • a Birth Doula – I feel immensely grateful, and humbled beyond belief, every time a family invites me to be a participant in what is most certainly one of the most important days in their lives. It’s the most amazing job ever.

Until I had that moment of awakening, I had never known what I wanted to do with my life (other than being a mom, which is a calling in itself, am I right?). As soon as I became royally pissed about my first birth, I instantly knew what I wanted to do… how I wanted to make a small difference in the world.

So, my first birth experience sucked. But if it had not happened exactly the way it did – if I had been induced and had the epidural, but still birthed vaginally – I would have probably felt like that was a “good enough” experience. I can pretty much guarantee that I would have had the same exact experience the second time around. I doubt that I would have ever known there was anything beyond that experience. I never would have known the satisfaction that comes with making informed decisions, rather than obliviously following the directions of someone giving you flat-out false information.

Yes, I am thankful that my first birth sucked. I am grateful that it was the exact opposite of everything I had envisioned. And now I smile when I think of how pissed off I was when I realized that I had been duped.

Because that birth sucked, I am exactly who I am supposed to be now: a childbirth educator… a birth doula… a mom who made smarter choices the second time around.

Mandi
Peachy Keen Birth Services

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And Now For Something Completely Different… My VBAC

Saturday, May 7th, 2011

Since I’ve already written about why I’m thankful that my first birth experience sucked royally, I thought it would be nice to follow up with how insanely amazing my VBAC was.

By the time, I became pregnant with my second son, I was certain of two things: unnecessary interventions in my first birth had caused my cesarean, and I wanted to have a VBAC this time.

I began to join message boards devoted to natural birth, and I noticed that a very high percentage of the successes were those who were tuning into their bodies, and letting the natural process take it’s course. I read every positive birth story I could get my hands on.

I signed up for out-of-hospital childbirth classes. At this point, my husband was still skeptical and was gently and subtly hinting that I could just have a repeat cesarean. But being a very smart man, he humored me and joined me for the classes. One night, a few weeks into the classes, on the drive home, my husband turned to me and said (quite outraged!) “That doctor set you up! He led you right into a cesarean! There was no reason for any of those interventions!” I was so happy that he finally understood what I was so pissed off about. From that point on, he was fully on board with a natural birth.

Financially, a birth center was not an option, but I had since switched to a hospital which was much friendlier toward natural birth. This hospital encouraged VBACs. I was able to see a Midwife, and in general, I was never made to feel that I was “high risk” because of my prior cesarean. The one time I met with an OB, she mentioned that their “policy” is to not let any mom go past 41 weeks, so I would need to schedule a cesarean for that date, because they don’t induce VBACs. I took it in stride and politely told her that I wouldn’t be scheduling a cesarean without a medical indication. She laughed, gave me a knowing look, and said “Hey, I did my part and told you what our ‘policy’ is. You have every right to decline.”

I’m glad we had that conversation well ahead of time, because at 9 days past my due date, there was still no labor! I was much more at ease knowing that we had already come to an understanding about not intervening without a reason. I asked my midwife to check me at my appointment, and was pleased to find that I was 3½ centimeters. I left my appointment excited, and feeling certain that my body knew what to do.

After the appointment, my husband and I went to lunch. The waitress congratulated me on my pregnancy and asked when I was due. I told her “Nine days ago.” Her jaw dropped, and she said “Oh, my GOD! Is it safe to still be out and about? Shouldn’t you be on bed-rest or something? I thought women weren’t allowed to go past their due dates.” I let her know that I was planning on doing things naturally and there wasn’t any reason to evict the baby just yet.

Being a tightly wound person by nature, I thought that maybe I just needed to deeply relax for labor to start. That night, after my 19-month-old was in bed, I made it my mission to relax. My husband filled the bath, lit some candles, and put on my favorite Billie Holliday CD. He sat next to the tub and kept me company. We talked about our toddler, the new baby, the upcoming birth and our hopes for our family. I relaxed in the tub for what must have been an hour. I got out around 9:30 p.m. completely loose and at ease.

I sat down on the couch to watch TV with my husband. I noticed a very slight cramp, much easier than a menstrual cramp, but I definitely felt a distinct tightening. Three minutes later I felt another tightening, then another three minutes after that, then another. They didn’t hurt at all, which had me confused, but knowing that the contractions were already 3 minutes apart and lasting over 60 seconds each, and considering that I had already been dilated to 3½ cm that morning, and knowing that we had about an hour drive in the pouring rain, we decided to call my mom to make the half hour journey to come stay with our son. I figured we could always send her home if it turned out to be a false alarm. I just had this instinct that this was the real deal and that it would go fast, so I wanted to save as much time as possible.

As my husband packed the truck, I relaxed in the shower, then picked out my favorite pajamas and fixed my hair. By this point, the contractions felt like stronger period cramps. Even though they were still 3 minutes apart, I wasn’t sure if it was labor, because they just weren’t anywhere near the level of pain I had experienced on Pitocin with my first birth. I called my doula, Kym (PS – if you learn one thing from this story, it’s HIRE A DOULA!), to have her meet us at the hospital. As we began the drive, I fully expected that I would find out that I wasn’t really in labor… it just seemed way too easy. I secretly began to fear that this was just the beginning and I would have much more pain ahead of me. In retrospect, this self-doubt was classic transition.

When I arrived at the hospital, the nurses told me that I was way too calm – there was no way I was in “real” labor and I would be going home, but that they would have my Midwife check me anyway. When she checked me, to everyone’s surprise, I was already fully dilated. “SWEET!” I thought. My midwife asked my husband if he’d like to see the nurses faces when she told them that the woman they thought was too calm to be in “real” labor was already 10 centimeters. Of course he stayed with me, but I’m sure it was tempting. My midwife told me to let her know when I felt an urge to push.

A nurse came in and tried to give me an IV, but I declined, and told her that my midwife had already agreed to a heplock. She insisted that it was hospital policy to run IV fluids, and I politely declined a second time, at which time she gave up.

The position that was most comfortable for me was sitting completely upright in the bed, my back supported by the back of the bed, with the foot of the bed lowered so my legs could dangle. My doula called this the beach chair position. She rubbed my feet which felt divine, and my husband held my hand. I sat perfectly still and completely relaxed during contractions.

I had a contraction that suddenly felt more uncomfortable than the rest. My doula noticed, and after the contraction was over she encouraged me to listen to my body and get into a different position. I flipped over onto my knees and rested my arms and head over the back of the bed.

With the very next contraction, I was PUSHING! I was in awe of the power of it all. My body was pushing all on its own! My doula paged the midwife, and she quickly came in. As the baby began to crown, I wanted to flip over. I gave those last couple of pushes in the classic position, and out he came! I remember shouting with joy “I’m DONE!” The nurse exclaimed “Wow! He’s a big one!!!” I remember being confused and saying “No he’s not. Look how tiny he is!” After having a toddler at home, this new baby looked so teeny tiny. I thought there was no way he could be over 6 lbs. My perception was off, because he was 8 lbs. 14 oz.  It’s worth it to note that during the cesarean with my first (7lb 5oz) baby, the doctor told me “He wouldn’t have fit through your pelvis anyway.”

VBAC Birth - Peachy Keen Birth Services

"I DID IT!"

My entire labor was only 4 hours from the first contraction until birth. I only pushed for 15 minutes. I was elated that I had just given birth to my baby completely without intervention. I felt like I could climb Mt. Everest!

Everyone cleared the room and gave us that golden alert time to bond. Seth went right to the breast and nursed like a champ.

I was in utter bliss with this new little man, and thrilled that thanks in large part to my planning, learning, practicing and preparation, I had now become a VBAC mom.

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