This is the first post in a new series about how different birth can look from one mama and baby to the next yet still be empowering and, in some cases, healing. I am starting with an unscheduled surgical birth story. Reading through Ilana’s story brings the memories flooding back for me. I remember well the emotions that still surrounded her 1st birth as I began to support her partway through her 2nd pregnancy. I remember how concerned I was for her when the 3rd trimester became so difficult. I remember being in the labor and delivery room with her as she labored and doubted her ability to make the right decision for herself and her baby. I recall assuring her that the empowered and healing birth experience that she needed did not have to come from a vaginal birth and that she has the power and ability to make the decision to birth her baby on her terms including opting for a repeat surgical birth. Most importantly, I remember seeing her grinning as she held her sweet baby girl when I came into the recovery room. And hearing her first words to me after surgery, “This is SOOO much better than last time. I feel amazing” was like music to my doula heart.
In Ilana’s words:
At the beginning of 2014, I was newly pregnant, living on the west coast, and full of amazement and wonder at the goddess-like creature I had become as I was making a human life, from scratch, inside of my body. After all that excitement wore off, I remembered that the new person I was making would have to exit my body eventually, and that sounded painful, so I read and did all the things you are supposed to do to prepare to have a healthy, beautiful, natural, humane, and peaceful birth. I bought all the books, registered for the class, I made my husband practice labor relaxation techniques with me on the couch in our living room, I read all the books, I bought my husband the partner books, I did prenatal yoga, I bought a yoga ball, I downloaded music, printed out affirmations, and I knew I was going to want an epidural.
At the beginning of my third trimester, my husband and I and our 2 dogs spent a week traveling across the country in our little Corolla, soaking my swollen feet in hotel ice buckets along the way, as we had decided to leave our West coast lifestyle to live closer to our families back in Georgia before our daughter was born. Suddenly, I was seeing all new doctors, touring all new hospitals, and having a hard time figuring out whether or not I was talking the same birth language as these East coast doctors. So I hired a doula.
My intention for birth was never to have a completely natural and intervention free birth, I knew that at some point I would be begging for an epidural. What mattered to me was that I would give birth in a positive and loving space, that I would feel empowered and confident, and I trusted that my body and my baby knew what to do. While in a lot of ways I wanted the natural birth experience, in my mind that included pain killers. The thought never even occurred to me though that I might have a C-section. No way these child-bearing hips I’ve been toting around my whole life aren’t up to the task of delivering a baby. I sat in class and covered my eyes when they showed the pictures of how a c-section would take place if necessary, and I told myself I wouldn’t need to know any of that stuff anyway.
On the evening of my actual long-awaited due date, I was bleeding and having consistent contractions that increased through the night. I think around 8am the next morning I was ready to go to the hospital. Soon after, someone was telling me that I was only 3cm dilated or so and that I could go back home if I wanted to. At that point, I didn’t think I could manage the pain at home for much longer and thought I should stay, so we did. I spent the day walking the halls with my doula, doing lunges, and having my vagina examined by various folks. After many hours of painful labor, I was told I was not really dilating much, maybe 5cm by then, but I so badly wanted a break from the pain, so I asked for a shot of morphine, which I got right in the ass. A few hours later that seemed to have hardly made a difference and doctors and nurses were demanding that my body needed to rest to allow labor to progress. At that point, I was like, “how the hell am I supposed to rest when I am in agonizing pain every couple minutes”. So, I got the epidural.
At some point my water broke. It was a little green, but they said not to worry. My memory of the following night consists mostly of lying on my side in a hospital bed, shivering violently, coming in and out of sleepy consciousness, with a nurse sitting next to me at a machine, putting stuff in my IV every few minutes. My blood pressure dropped way too low and they had to keep giving me some kind of medicine, I don’t even remember what. I’m also pretty sure that I consented to having a small amount of Pitocin added to the IV at some point during all of that, but to be honest, I’m still not sure about that. By the following morning, I was having crazy intense contractions coming one right after the other with no break, and no amount of medicine in the epidural was relieving the pain. So, I got a second epidural.
By now, I’ve been in the hospital about 36 hours, I have absolutely no control over my pain or my body or my experience in any way anymore, and doctors have been coming in and telling me to get a c-section for hours. I was only 8cm dilated and I had been stuck there for hours. Finally, the doctor and the midwife came in to team up on me and tell me that having a c-section was becoming my only option at this point. I remember ignoring the doctor and looking at the midwife, I asked her are you sure I REALLY need that? She said she was sure. So, I started entertaining the idea and talking about it with my husband and doula for the very first time ever. By then, I was so out of it and exhausted and just suffering from the pain, and I remember asking the doctor if I could get another dose in the epidural just to help me manage the pain enough to think for a minute about making this decision. She refused and said that if I consented to the c-section they would have to begin a whole new dosage of medications and it would interfere somehow. So, I got the c-section.
When my daughter was born, it sounded like she was quacking, and I hardly caught a glimpse of her as all the doctors rushed to care for her. Something was wrong with her breathing, but I wasn’t sure what. They brought her near my face for a split second before rushing her off to the NICU. Probably seconds later, I completely passed out.
I woke up in the little recovery room alone behind a closed curtain. My husband and doula got sent elsewhere at some point and nobody was able to get back to me for some reason. I was in so much pain I could hardly speak. I remember looking all over the room for any signs of human life and searching my bed for a call button or something of that nature. A few minutes later, a couple of nurses came in and noticed I was alive. I told them how much pain I was in and they said I shouldn’t be and that they had given me meds. They told me that I needed to be able to move from the bed I was in over to another one before I could leave recovery. I told them I was in too much pain to do that. They huffed off and came back a while later with IV Tylenol, which actually was the first and only thing that really helped with the pain during everything. Once that had kicked in, I moved to the other bed and asked to see my baby. They said she was in the NICU and I couldn’t see her. I was like, “What do you mean I can’t see her? I haven’t seen her yet”. When you get me up to my room can I go find her? They told me I wouldn’t be able to get out of bed for the rest of the day. I don’t remember what I said finally to convince them to let me see my baby, but something along the lines of- “I will make a scene the likes of which this hospital has never seen if you wheel me to a hospital room before bringing me to my baby”. So they wheeled my hospital bed up to the specialty NICU floor where I found my family and my baby behind a window. The NICU nurses brought Georgia to me and let me hold her on my chest for a few minutes right there in the hallway.
The following days were dehumanizing and wrought with disempowerment and terrible medical care. I had to push or be pushed in a wheelchair every 3 hours to different ends of the hospital to various levels of NICU so that I could try to nurse my baby and then go back to my room and pump and get my meds. Half the time I wasn’t allowed to nurse her because her heart rate had to be below a certain number for me to be allowed to do that. She was full of feeding tubes and things and they had started giving her formula without asking me. She had gotten an infection of some kind at some point during birth, and mainly just needed lots of IV antibiotics. After a couple days she was moved into the nursery on my floor and eventually my room, but they were telling me they were going to send me home but keep Georgia for another day because she needed antibiotic shots still. So, I called a friend of the family- a pediatrician, who came down to the hospital and told them to let my baby go. So, some outpatient nurses came and gave her the shots at our house.
I was of course filled with joy to be home with my baby in my arms at this point, but there were many long months of painful and difficult recovery time, along with nursing complications, before I was finally starting to feel whole again.
By 2016, I was expecting baby girl #2. By now I knew a lot more than I did before about c-sections and VBACs, as well as all of the varying benefits and risks and mitigating factors that correspond to each of those options. The ‘diagnosis’ of my prior c-section had been Failure to Dilate. When this is the cause of a past c-section, the internet says that it is likely to happen again. So I learned about VBACs, I saw a good doctor, I hired a doula, I hated that doctor and found a new good doctor, I did yoga, and I told myself I would go in with the intention of a VBAC, but not feel disappointed over the possibility of a second c-section. Around my second trimester I started suffering from terrible sciatica and started seeing a chiropractor, which I continued to do for the duration of my pregnancy in hopes that that would help promote my VBAC dreams.
My biggest struggle when stuck considering my choices, was that I felt like it had somehow been my fault that Georgia had gotten that infection and been so sick. That if only I had been better at labor and managing the pain, maybe I would have dilated further if I tried harder, or if only I hadn’t let my ego or fear get in the way of agreeing to the c-section earlier, maybe she wouldn’t have stayed inside too long which maybe got her sick. How would I know whether or not to trust the doctors if they were telling me I should or shouldn’t opt for surgery at any point during labor? I struggled often with the anxiety of being in the position to have to make that decision again. I wanted to give my body a good shot at labor, but I didn’t want to go through another 2 days of intense pain and end up needing another c-section at the end of all that work. I had an immensely painful recovery from my first c-section and later learned that this was likely related to the length of my labor and how much work my body and uterus had done just prior to being sliced open with a machete and then shoved back together. The one thing I was absolutely sure of was that I would not let myself end up back in a situation like last time, and I would rather have the option of a family centered c-section up my sleeve than go into it with a vaginal birth warrior mindset. I weighed the pros and cons of choosing to have the c-section at an earlier stage in labor, which would still lead to the more difficult surgical birth recovery issues, vs waiting it out and needing the surgery after a long intense labor again (which was a no go), vs my fears of possible VBAC complications and the fact that I hadn’t actually given birth vaginally before and that in itself was still scary and unknown. I am very grateful for my OBGYN, who while avidly advocating for natural birth options, was also extremely skilled at providing a much less invasive c-section leading to a significantly more positive recovery period.
I had the longest 3rd trimester on the planet (and so did my doula) with false labor alarms happening weekly if not daily (or around midnightly) for months. A week after my due date, I was convinced my baby was the size of a small planet and there was no way she was going to make it out of my vagina at this point. Large babies is another one of those notches on the list of unlikely VBAC outcomes. My first was 9.5lb. So, I scheduled a c-section for the following week.
On election night, my little powerhouse decided her presence was needed here to take over the world, and I FINALLY knew I was in real labor. At this point I had already sort of given myself permission to have the C-section, but since my body was at least trying to do its part I felt like I needed to give it a chance. I think I gave myself a few ways out in my head- of the lines I wouldn’t cross or circumstances that I would take as the call to go for surgery. Of course, my focus was whether or not I was actually dilating along with the increasing intensity of contractions. So, there I was back in the hospital bed after hours of Labor with someone’s hands up my vagina, and I was barely 3 centimeters dilated. I started considering my options and trying to make a plan. I hands down already felt way more in control of what was going on at this point then I had before, but once I told the nurses that I had a C-section on the calendar and was thinking about going ahead and just having that, they went ahead and called my doctor to come in to the hospital.
It was still a few more hours before he arrived, and while he walked into the room ready to prepare for surgery, he in no way pressured me to jump into any decisions I wasn’t ready for, even if he might not have been so pleased that I pulled him out of bed at 5 a.m. on a weekend. I made the call that if I was checked again at this point and still under 4 cm, that I was going to give myself permission to call it and go into surgery while I was still calm and comfortable and feeling good. I cannot say that I felt 100% at ease with my choice at the time, and part of me was aching to succeed at that VBAC, but I think in an unconventional way, this was how I was trusting that my body knew what to do and that deep down my gut knew this was the right choice even if my brain wasn’t fully there yet. And so, came C-section and baby girl #2.
The truth is, over 3 years later I can still give you the play by play of each hour of my first daughter’s labor and its aftermath, and it still brings me to tears to write about it. But when I think about giving birth to Maya, all I can remember is lying with her in the recovery room moments after her birth, snuggled up on my chest and beginning to nurse, surrounded by my amazingly supportive doula and husband, and well that brings me to tears also I guess. I remember staring at that little baby’s face and feeling like I had known her forever, an immense moment of bonding that years ago I had grieved and guilted over not having with my first. I was able to care for my baby for the next couple of days in recovery and left the hospital a day early because we were all feeling fine and ready to go reunite our family at home.
I may have drawn a few tears writing out these stories today, but in a very powerful way I would say that Maya’s birth healed some very deep wounds left by Georgia’s birth, and I think that can be attributed in large part to the level of empowerment I felt as a Mama. I will never know what different possible outcomes might have occurred had I made different choices with either of my births, but I no longer feel guilty about that or regret how it all turned out.