I was born on a farm. No seriously, my mom had a home birth attended by a midwife. This was in 1987, when home birth wasn’t progressive or brave. It was something hippies and weirdos did. After a bad first time birth experience with an OB in a hospital, (involving some horribly insensitive comments made by a doctor that could probably earn lawsuits in this day and age), my mom chose the path more traveled over the centuries and hired a midwife, birthing naturally at home for the rest of her 3 live births.
As a teenager I decided that my mother was crazy, and that there would be no home birthing for me. Put me in a hospital, baby. What if something happens??? I need to know that the proper equipment and medications are available in case something horrible happens. But then I worked in the prenatal unit of a clinic on the West Side of Chicago. And what I learned there changed my mind. Don’t misunderstand me. That clinic that served the urban poor had some of the most amazing, gifted, talented, compassionate doctors I have ever met. But the things I learned after hours of reading literature about how a woman’s body works, about the birth process, the things that can happen, the interventions that often take place… I changed my mind.
Midwifery and natural birth are a sort of subculture, especially in places like West Texas, and so when I learned that I was pregnant and finally had to come to a real decision about my prenatal care, I shrugged off the crazy looks and the nervous comments from my friends who were more comfortable with conventional medicine and began praying and trying to figure out where to even begin finding a midwife. God made it happen. I made a new friend who was seeing a midwife, and I was in!
Midwifery care is wonderful, and very different from the care that women typically receive in OB offices. You have an entire hour to spend with your midwife, who is almost always wonderful. (I’ve heard of cases where they aren’t, but mine always were…) They knead around your belly and tell you what your baby is doing in there. As a midwife’s client, you are expected to make yourself aware of risks and benefits, and to be able to competently make decisions about controversial issues involving your care. They don’t assume that you want a sonogram. Or antibiotics to treat GBS. Or antibiotics in your babies eyes after birth to prevent a complication caused by STDs. If you tell them you practiced abstinence prior to marriage, they actually believe you! It is novel. However, they make sure that you have access to all of the information that you need, sometimes even involving libraries of literature that you can borrow from them, so they don’t expect you to go it alone in your research if you aren’t prepared. You are usually asked to keep a food log (which is my least favorite part) for a week to make sure that your nutrition is good. Also, every appointment for me involved an emotional check-in about how I was doing. Not only do midwives care about you and your baby, but it is in their best interest to make sure that you have a great birth outcome, because they need to protect themselves and their practice. So they are far more involved than OBs typically are. It is different from top to bottom, really, and I loved it. All of it. (Except the food log.) Something about the process of birth bonds women, and they often come out great friends with their midwives. I did.
Those were all of the great things. Here are the bad things, not about midwives, but about my birth experiences: both ended up being c-sections in hospitals. I won’t bore you with the nitty-gritty details of both experiences, but I’ll give you the basics. Both births involved 55+ hours of labor. Both labors began at home, then moved to birth centers. Both times I was transported to the hospital at the suggestion of my midwives. Both times I received an epidural at the suggestion, (or at least at the joint conclusion with) my midwife in order that I could rest and have energy to deliver when the time came. Both times I was transported, the midwives’ most trusted OB was attending my birth. Both births ended in elective c-section, (as in, “You can choose to do this now, or we can choose to do it for you if/when _______ happens.”). Neither time was I bitter about not getting the birth experience that I had sought. Neither time did I have any trouble bonding with my newborn. Both times I had a successful latch the first time I tried to nurse, leading to very successful nursing relationships with both babies.
The most emotionally defeating moment of either birth was that first time that I heard the words, “It may be time to go to the hospital.” Most of the crying that took place was in that moment, because that was when I realized that things weren’t just going slowly, they weren’t going how anyone wanted them to go, least of all myself. We were entering into unfamiliar, scary territory. While in the hospital, after I had had the (very welcomed) epidural, things were still just not going. I had a dear friend who was with me for every part of the experience that she was legally allowed to be there for. I tearfully asked her to pray for me, because I was so very discouraged. There was something, (someone) in my mind whispering, “I guess you just can’t do it. I guess you just weren’t made to have babies.”
***Side note: If you have ever heard that voice saying that to you, know this. It was a lie to me, and it’s a lie to you. In Genesis 1:28, God tells the humans He made, “Be fruitful and multiply, and fill the earth, and subdue it…” Woman was designed to have babies. (Whoa there, feminists. Don’t get your panties in a ruffle. Having babies was not the ONLY thing that God designed her to do.) Sin messed everything up, and things just don’t always work the way they were supposed to in the original blueprints. That’s why the world has ugly things in it, like cancer, Crohn’s disease, Alzheimer’s and the like. I do not have the answers to the difficult questions about why God allows babies to be stillborn, etc. But if you have struggled with infertility, an ‘inhospitable womb’, been unable to carry babies to full term, or just not been able to push a baby out, that voice that whispers that you can’t do this and weren’t made to have babies is STILL telling you lies. Don’t let it defeat you into not continuing to fight for your children, no matter how, or through whose bodies they come into the world. Blame sin. Blame Satan. And it’s okay to be angry at God, too. He can handle it, and all the best people have been before. But don’t blame yourself or your body.***
After it was all said and done, I had a healthy, perfect baby, and a stellar, (pretty unbelievable) c-section recovery. As I said, I wasn’t bitter. I didn’t blame myself. I didn’t feel defeated in the end. And while I had some unresolved fears about natural birth, (like the whole push-a-thing-that’s-THIS-size-out-of-a-place-that’s-this-size issue, and holy smokes, that’s gonna hurt!!!) I was pretty resolute about VBAC. I was doin’ this thing.
So when I got pregnant the second time, I found another midwife (we had moved to a different area) and forged ahead. We made plans. We changed things. I took supplements to help my body do what it needed to do around the time of labor. I walked a LOT (up hills with a baby in the stroller, no less…) I saw a chiropractor to make sure that my hips and pelvis were aligned properly to make for a quick escape for the baby. This baby ought to fall out of my uterus, I thought, and on the hour long drive to the birth center (twice) I worried that it might.
But again, I was transferred to the hospital. Things went better this time. I made it to 10 centimeters and actually got to push. But that little head just wouldn’t crown, no matter how hard I tried, and that poor baby girl got tired. When she was eventually born c-section, she didn’t look great. She was greyish, didn’t breathe without a lot of help, and she got a bad APGAR score and spent an hour in the NICU. (You can’t keep a good woman down though, and she perked right up and got released 3 hours earlier than expected.)
When I got home from that ordeal, that is when the defeat and doubt really hit me. Almost every midwife, and even a fair amount of obstetricians will let you attempt VBAC. But VBA2C? That’s when it gets dicey. And why HAD I failed? What had I done wrong? Was it the decision to get an epidural? Maybe if I hadn’t had an epidural and been able to stand up, gravity would have helped me out, and I would have been able to deliver naturally. Maybe I didn’t walk enough. Had I worn my pre-pregnancy pants too long and forced my hips to stay small, when that’s not what they wanted to do? Is it because I didn’t take birth classes?
I knew in my heart that the answers to most of these questions was ‘no’. Lots of women don’t take childbirth class and birth naturally. Lots of women take childbirth classes and have c-sections. The only one I couldn’t resolve was about the epidural. But I decided not to worry about it, because we wouldn’t need to think about it for a long time. Hopefully at least 3 years.
And the six months later I took a pregnancy test and it came out positive. That really threw a wrench into things. The rule is that you aren’t supposed to get pregnant within a year of having a c-section. So this might REALLY mean that vaginal birth wasn’t an option…
After having my prenatal care done through midwives and still having a hospital birth twice, (thus, essentially paying for 4 births with only 2 babies to show for it,) we decided that starting out in the hospital was a must, for insurance reasons, if nothing else. Midwifery care is rarely covered through insurance, or at least it is not fairly covered… (Come on, insurance companies!!!) So I got a recommendation from a semi-crunchy friend who had had care through a clinic that had both a full staff of midwives, and a full staff of OBs. It was covered by our insurance, and after reading every word on their website, I decided that this was my best bet.
My mental state going into all of this was not great. I spent hours in bed at night dissecting my emotions and thoughts, as well as having conversations with a few friends. I felt like a mess. On the one hand, I knew that natural birth is usually best for both moms and babies. Especially with two other children, a c-section recovery sounds difficult, and even dangerous if I don’t have good help in place. I felt like I should pursue natural birth. But in my heart…. I really didn’t want to. And I didn’t know if I could. Contractions were painful. And it was a long, completely exhausting experience.
Things were more rough in that department with my second, because I got farther along dilation-wise. But I only made it to a 7 on my own. And that is only the beginning of transition. So while my husband did not think it could get any worse, (“I was in the room with you. There’s no way it could be worse,”) and I was hoarse from moaning through contractions, I knew it could get worse, and likely would. But I felt sure that there was no way I could do the rest of it unmedicated. (This is a common thought that most modern day laboring women have, regardless of their birth plans. But usually when women start having such thoughts, their bodies forge ahead and do it anyway, whether they want to or not. Mine didn’t. So I stayed in that place of thinking that if it got worse, I couldn’t handle it for about 5-6 hours.) My labors were very long, and by the time I transferred to the hospital, both times I was pretty much spent.
I knew that no woman that I know would ever tell me that I was weak if I didn’t want to go through all of it again. (And if she did, that would be kind of rotten of her…) But I knew the truth. I am a wuss. And so there was this significant part of me that hoped that when I showed up for my first prenatal appointment, the midwife or obstetrician would tell me that I couldn’t VBA2C for some reason. I felt like I should choose one thing, because it would be better. But I wanted something else. And I just didn’t want to have to choose. I had read through the c-section portion of the website that said that they always encourage natural birth when possible. I had also read through the VBAC portion of the site that stated that if a woman wants to VBAC, they have to agree to do things differently in order to get a different outcome, whether that be exercise, weight loss, or some other factor. I felt like I’d been through all of that, and just didn’t know what else we could change. And any time I had to talk about it, I just wanted to cry, and I knew without a doubt I wouldn’t make it through that first appointment without shedding a tear.
The day of our first appointment came, and already I could tell that this OB clinic is a completely different beast from the warm, friendly little midwifery clinics I had been to. (No consultation appointments, mandatory sonogram at first visit, some rigid rules about orientation, and sadly, no bedrooms with beautiful quilts and rocking chairs. They have a seperate birth center, which is where I’m assuming those lovely things live.) I went to the mandatory orientation and got the schpeil on how to be pregnant. “You can have this many cups of coffee. Heat up your lunch meat.” And my personal favorites, “Cook all of your meat well done. NO PINK. Cook all of your eggs hard. NO RUNNY YOLKS.” (Yeah… I’m not doing that.) One pleasant surprise was that at our sonogram, the tech used heated gel. I had already braced myself for the frigid goop that I’ve always been used to. I was mid sentence in conversation with the tech and completely lost my train of thought because I was so surprised. She thought it was pretty hilarious.
Anyway, when I finally had my actual prenatal appointment, I was seen by a midwife, and I was relieved. She asked me all about my previous birth experiences, looked through all of the information that they had collected, and then she asked me what my thoughts and expectations were about this birth. As she listened to me start to dig around in that mess of emotions, she cut me off short and said, “I’m going to tell you now, we’re not going to let you VBAC.” This moment had come, and now that it was here, it took me by surprise. She explained that as they review candidates for VBAC, there are certain situations that that contraindicate VBAC being a good idea. Had I been failure to progress one time, for example, and mandatory c-section the next time with no chance of what is referred to as TOLAC (trial of labor after cesarean), then it would be a different story. But considering the remarkable similarities of both labors, it wasn’t a good sign for my chances. She remarked that especially because I had educated myself well and already tried everything I could, because I had already sought the help of people who are very good at what they do, that I had already done my part in fighting for a natural birth. She said as she heard my birth stories and read my chart, it gave her goosebumps; that every decision made was made at the right time, and that every person involved in my care had advised me well and wisely, and were great caretakers. She explained that she knew I probably wondered if changing things might have resulted in birthing vaginally, but based on the data in front of her, it was unlikely that changing the small things that I could have done differently would have yielded different results.
I felt relief wash over me, because it was like I was being alleviated of the guilt and doubt about my decisions, and being told that it really was not my fault. I wouldn’t have ever said that I thought it was my fault, but that was how I felt, to a certain extent.
I had heard there are different pelvis shapes, and some are not conducive to natural birth at all. She also said that sometimes there can also be a ridge on the sacrum, and that even if baby can get past all of the ropey muscles and possibly the scar tissue from previous operations, that ridge stops them from exiting the birth canal. I can’t be exactly sure what it is about my bone structure that doesn’t want to let babies out at this point, but when they do a c-section, they can investigate it then. But at the moment, it seems that my journey with natural birth is at an end.
On the one hand, I am relieved, like I said. It was tough to go through hours of labor and months of hoping and expecting to be able to deliver naturally, only to end up c-section both times. I wasn’t angry or depressed. But it is a huge shift emotionally. It was easier the second time, but I wasn’t excited about the possibility of having to make that last minute emotional shift a third time. On the other hand, it is hard for me to accept the fact that my body just really doesn’t want to do this. I knew in theory that those women existed, but it isn’t the norm. So it’s hard to find out that I’m one of them, because I still absolutely believe in the benefits of natural labor and birth. I still believe that if you have a normal pregnancy, midwifery care is the best on the planet. (And my pregnancies are normal! But I have to get to know the OBs so I will only be seen by them from this point on, which makes me sad.) I would still recommend a birth center to any woman who isn’t sure about a hospital. They are WONDERFUL. But I have to say goodbye to them.
I am thankful that I was born in the United States in 1987, and that while I’m of childbearing age we have hospitals and doctors and anesthesiologists who know what they’re doing, and that situations like mine don’t have to end like they would have 150 years ago. Back then, at the very least, my babies could have been seriously damaged due to lack of oxygen if I couldn’t have gotten them out. Even worse, I or my husband could have been put in a position where we had to make some really devastating decision about choosing who was going to make it out of this thing alive. But we are all alive, and very healthy.
I am also thankful that I have access to a clinic that practices gentle c-section. This allows me to be a bigger part of my baby’s delivery and the moments after than I have had before. In a normal OR, your baby is born, and then it is pretty much whisked away. Someone asks you if you can see your baby across the room, tells you how beautiful they are, and holds a bag for you to puke in. Or at least that is my experience. You do not normally get options such as delayed cord clamping, immediate skin-to-skin contact, and nursing your baby. I did not get to hold either of my babies for over an hour after they were born. That is nothing compared to moms of babies that end up in the NICU, but it is a far cry from what happens in a birth center, which is the experience I set out to have. I even have the option of seeing the operation through a sheer curtain, if I so desire. While I don’t want to see the bulk of the procedure, there are moments, like when my baby is lifted out, that I would really love to be a part of. And while it grosses most people out, I have never had the chance to see the umbilical cord or my placenta, or any of the messy, natural parts of birth. I missed that, as weird as it is. I just want to know! And I can have that. And it is awesome.
So that is where we stand as we wait expectantly for the arrival of baby #3. Every birth is an adventure. This one is just a different brand for us.