Healing Hospital VBAC After Traumatic Cesarean

by mamabearbri on August 13, 2013

The stories of my children’s births are both my worst and best day.

Jackson was born February 26, 2011.  I had wanted a natural childbirth, unfortunately that did not happen.   I was called by my midwife on the 23rd, stating that she had concerns regarding some of my blood work and said that I would need to be induced that day.  This is a moment I think of often and wish so much I could go back to.  I was close to 42 weeks and was ready to be done, and so I consented to the induction without question.  I knew I should have asked what other options were available, but I didn’t.

When we got to hospital my birth plan fell apart immediately.  My midwife told me that my platelets were low, a condition called thrombocytopenia, and due to this I would be unable to have an epidural.  It’s hard to believe now, but at the time that sounded like good news, a way to ensure I received no pain medication in a moment of weakness.  I was dilated to a one and nothing seemed to help, my body and my baby were not ready.

The first day they administered cervidil which did nothing.  We waited and had countless cervical checks that always ended in disappointment. The second day they tried cytotec which gave me some mild contractions the entire day.  I was still excited at this point and couldn’t wait to meet my baby.  I was not scared of birth; I couldn’t wait to take part in this amazing journey.  Even though I was contracting, I wasn’t dilating.  The next morning they gave my Pitocin.

This is when my world fell around me.  Two hours after receiving the drug I was in agony.  I was unable to get through a contraction without vocalizing and I felt completely lost.  Leaning over the bed on my knees roaring through contractions that felt never-ending I finally asked how long they were lasting.  The nurse replied that my last one was almost five minutes long.  Following each contraction was panic; I knew they would not stop.  Fear led my body and my breath to hyperventilation.  I have never in my life experienced such raw and honest emotion.  An oxygen mask was placed on my face because there was concern I would pass out due to my struggle to slow my breathing.

They told me that Jackson’s heart rate was of concern and they needed to monitor it more closely.  I agreed without really listening, let alone understanding, to allow internal monitoring.  I had taken a labor class through the hospital several weeks before Jackson’s birth and I remember the instructor passing around a device which is screwed into the top of a baby’s head.  I held it in my hand and thought, not my baby, but that is exactly what happened.  Not only did this cause my son pain, but it also prevented me from getting out of bed.  I begged to get back into the shower or tub, but I could not with the internal monitoring.  I was trapped in bed with no coping strategies and no ability to move.

I was not prepared for this.  After hours of intense contractions with no relief my pain transitioned into suffering.  I begged for help, but no one could do anything.  At one point I looked around the room and saw our midwife, Faith, our nurse and my husband simply staring at me totally helpless.  No one could help me; I was entirely alone in this room full of people.  I continued this way for almost an entire day.  I got to nine centimeters dilated and stayed there for hours.  My hope was gone, I had done enough and I was ready.  I told my nurse I wanted to talk to my midwife.  With every bit of strength I had left I told her that I needed this to be over and that I had done enough and could take no more.

I agreed to wait one more hour to give my body a chance to fully dilate, but I knew it would not.  I wish so much that I would have been told that I had to have a cesarean, but I wasn’t.  I asked for it.  I asked for it.  I begged for it.  There is no part of Jackson’s birth that does not fill my heart with shame.  Women throughout the history of the world, my friends, my mother, had given birth and I could not.  I was so weak and so incapable and inadequate.

Faith told me that I would not be able to be awake due to my low platelets but instead under general anesthesia.  I cried, actually sobbed, but still I needed the suffering to end.

Leaving for the surgery room was a moment of exhaustion and shame.  Kevin remained seated with his head in his hands in the same rocking chair he had been in for hours.  We did not say goodbye, did not kiss, no words were exchanged between us.  Nothing was left of me, pain was all there was.  I did not even consider my son once pitocin started.  I did not think of his health or his safety.  And while many would be disgusted at the admittance of this, before an agreement was reached for a cesarean, I had hoped that something would go wrong in some way, even if it was with my baby. Pain is manageable; suffering takes all of your being away.

Out of desperation I searched for anyway to escape the never ending physical brutality I was in the throes of.  While I did not want him hurt, I wanted Faith to look at his heart strip with concern and say that it was time.  I wanted someone to find something that required immediate response.  My son was not even of this earth yet, and I had let him down so hurtfully and so selfishly.  Every mother wants the health of their baby before anything else, and yet I had hoped for something to go wrong to end my suffering.  I will forever atone for those thoughts.

I was asked several months following Jackson’s birth what was most surprising about motherhood, and my answer was guilt.  I had lived the first bit of Jackson’s life consumed with guilt for the ways I had already failed him.  I had always expected that motherhood would come naturally to me and that I would simply fall into the role of a near perfect parent.  I never thought that even before my son was born that I would hope for his health to be compromised to make my life easier.

The surgery room was cold and sterile.  I was naked and strapped to a table with my arms outward.  My panic continued as I begged for them to give me the medication to fall asleep.  With each contraction I had folded my body into itself and rocked and swayed back and forth.  This was no longer possible.  “Please, hurry; I can’t have a contraction like this.”  The thought of a natural, beautiful, vaginal birth was gone; it had not entered my mind for several hours.  I only wanted it all over.  Finally the pain was gone.

After some discussion with hospital staff they agreed to allow our midwife to video tape my son immediately following his birth.  I thought if I could at least see video footage of his first cry it would alleviate some of my sorrow, it did not.  The video is one that I have watched twice.  Jackson comes on film bloody and screaming.  The nurses move him in such an unloving and uncaring manner.  He is obviously of no importance to them, simply another task they need to complete before they can go home.  They forcefully rub his body clean leaving no evidence of me on him. It was as if they were hurriedly washing dirty dishes.  His screams continue for several minutes and not one person rushing around the room pauses to hold him affectionately, talk gently to him, or attempts to soothe him in any way.  His first introduction to the world was one of utter coldness.

When I woke from surgery the full impact of what just happened hit me.  I was stuck on the table and could not get up.  I did not know one person in the room.  Tears instantly began streaming down my face.  I felt like I couldn’t breathe.  I had failed.  All of my physical pain had turned into emotional trauma.  One of the nurses came over when she saw I was crying and asked what hurt.

That was such a strange question to me, didn’t she know?  How could she not know how I felt?  I told her I wanted my baby.  “In just a few minutes,” I heard them tell me that for almost an hour while I waited to meet my son.  I asked what color eyes he had, “I don’t know,” what color was his hair, “I don’t know,” how much does he weigh “I don’t know,” What time was he born “I don’t know.”  It was the worst time of my life, waiting and searching for my baby while I knew he was doing the same for me.

Finally they took me into our recovery room where my husband and my son were waiting for me.  I remember them wheeling me down the hall, still lying in a bed.  I could not stop crying.  I saw family of other women who were likely having beautiful births waiting to meet their newest family member.  They saw me roll by lying on a bed with sorrow on my face and they no doubt knew that child birth was not always a beautiful experience.

Once I was in the room I hurriedly looked from side to side asking where he was.  My husband pointed to the bassinet in front of the bed.  It was strange, but I felt like I could not have him, like he wasn’t mine, as if it would be inappropriate to ask them to give him to me.  It was as if the hospital had more rights to him than I did at that moment.  My husband went over and picked him up and put him in my arms.  While many women who have cesareans experience difficulty bonding with their baby, I did not feel this way.

I felt instantly and profoundly connected to him, and did not let him go.  I felt that I needed to protect him and make amends to him for what we had just experienced and what I had just put him through.  One of the nurses had told me not to fall asleep with my son in my arms because it would be dangerous.  I was also told not to kiss my son on his face because I had a cold and they did not want him infected.  I disregarded their well-intended advice and held my son with his naked skin tight against mine, kissing his head over and over until we finally went home the next day.

I can’t tell you how painful Jackson’s birth was.  He was our first child and I missed everything.  I missed his first breath, his first cry.  I missed my husband meeting his son for the first time.  I didn’t know if someone had bathed Jackson or not.  I couldn’t answer simple questions in our baby book such as “Dad’s first words to his son.”  Family members received pictures of Jackson on their phones before I ever saw his beautiful face.  Jackson was introduced to me by others, others who knew my son first.  I should have been the first.

He was forcefully introduced to the world with people who had no attachment to him, when he should have been in my arms the second he was born.  I should have rocked and nursed him until his crying calmed.  He should have known my love as soon as he was born.  This was never going to happen to me or another child of mine again.

The days following Jackson’s birth were happy ones when I could avoid thoughts of his birth.  When the thoughts did creep in I felt a physical reaction.  My stomach dropped and tears filled my eyes.  It was hard for me to process that I had had a cesarean, let alone missed the birth of my child.  The few times I attempted to talk with friends about my grief, I was instantly dismissed and heard the all so familiar phrase, “You and the baby are healthy and that’s what matters.”  Add that to all the reasons why I hold blame and guilt, because his health wasn’t enough for me.

When Jackson was 15 months old we learned I was pregnant with Audrey.  A dark shadow hung over my pregnancy as I was told that my platelets would likely drop again.  I went back to my midwife and she told me not to worry, that this birth would be different.  I wouldn’t have to labor; I would come in for a scheduled cesarean.  She gave me a concerned look when I said that I was going to VBAC.  Given my birth with Jackson I think she expected me to be relieved that I would never have to experience labor again, but I knew I could do better.

There was a primal need in me to deliver my baby as nature intended.  I could never let another child down the way I had done to Jackson.  And if thrombocytopenia was likely going to be an issue again, how could I ever elect to birth my baby while I slept?  I would never experience the guilt again, perhaps the pain, but not the guilt.

My platelets were indeed dropping.  I did everything I could to keep them up.  Took an array of vitamins, ate huge amounts of organic fruits and vegetables.  I spoke with doctors and scoured the internet for anything I could find on lifting platelet levels.  I had to be awake for this birth.  But I knew that my success did not just depend on me, it also depended on the people I chose to support me.  My husband and I chose to birth in a hospital, which meant I would need to find an OB, which was a little concerning to me.  I wanted to find someone who would understand what I went through with Jackson and have a genuine desire to work to ensure it didn’t happen again.  I wanted a doctor that not only felt compassion and empathy, but also had a good VBAC success rate.   I needed someone who would take time with me during appointments and would truly understand the importance of this birth when the time came.

It was at this point that I slowly discovered a network of midwives, doulas, and women who understood the importance of birth that helped guide me on my search.   Over and over the same names came up, doctors to definitely check out and doctors to definitely avoid.  I began interviewing those doctors and felt exhausted.  I tell you, this search was almost as difficult as choosing a husband!  I would end consults feeling unheard or brushed to the side.  Then I finally found a doctor that I intuitively felt I could trust.  Dr. Nathan Meltzer listened to me and seemed to understand in a way you would not think a man could, how much Jackson’s birth hurt.  He promised to help me and provided me with a good statistical chance of a successful VBAC.

I was almost 20 weeks pregnant when I chose a doctor but was so glad that I took the time and energy to ensure that the person I chose to stand by my side during labor was one that I knew would support me and my baby.   I also hired a wonderful doula, Reannan Keene, who was the first person who provided me the opportunity to tell the story of Jackson’s birth and allowed me to cry free of judgment.  She knew my desire to birth my child on my own terms.  Reannan helped me establish a birth plan for every possibility and stood beside me throughout my pregnancy and birth.

My husband and I took a hypnobirthing course during Audrey’s pregnancy.  I knew if I still carried the fear of Jackson’s labor and birth with me into Audrey’s it would likely interrupt everything I was working so hard for.  Everything I read and learned I implemented into my life.  If someone I trusted told me to stand on my head to ensure a vaginal birth I would have done it.

I went into labor with Audrey the night before her due date.  My contractions began at just under four minutes apart and were mild.  After about two hours of labor I woke my husband up to let him know.  He urged me to call the doctor’s office.  I got the doctor on call, not my doctor.  She said that I needed to come in and that I shouldn’t worry, if I’m not dilating she’ll just start me on Pitocin.

I got off the phone with her and felt like all of my plans were being thrown out the window.  The doctor that I had worked so hard to avoid was the one that was on the phone and would be at the hospital awaiting my arrival.  I couldn’t understand how a doctor could so quickly turn to a drug like Pitocin without any information other than my name.  I called my doula.  I felt grounded when I heard her voice.  I remembered that I have the right to refuse any procedure, but that I would need to be strong.

We drove the hour drive on ice covered roads.  When I got into the hospital room the doctor came to check on me.  She immediately said that she wanted to feel my stomach so she could measure the baby.  She said that if the baby was too big she would know later not to use a vacuum.  Fear was creeping in.  Why were we already discussing vacuums and babies that are too big?  I knew we needed to tell the doctor no.  Reannan stood next to me with her hands on me.  I paused and waited for her to speak to the doctor for me.  I expected that at any moment I would hear Reannan explain to the doctor that I don’t want the measurement done and maybe even ask her to leave the room.  There was no doubt in my mind that Reannan knew how I felt about the procedure and knew I would not want it done.

Silence was all I heard as the doctor waited and pressed for my response obviously expecting me to comply.  It was then I realized that Reannan was giving me a precious gift that I missed with Jackson’s birth; it was time for me to protect my baby and my birth.  It was not Reannan’s role to speak for me, it was however her role to empower me.  With my body slumped over a table and hips swaying through an intense contraction I decided that I was a strong woman and a good mother and that I will not be overtaken again.  I thought to myself, if I’m strong enough to get through this contraction then I can tell a doctor no, and I did.  She accepted my answer and knelt beside me while I continued to experience contractions.  She told me that I could trust her, that she had had a VBAC herself.  I appreciated this information, and she became more human to me, but I could not give her my trust.  I was glad when she left the room and I was told my doctor would be there in a few hours.

I asked about my platelet levels right away, they were high enough that no matter cesarean or vaginal, I was going to be awake!  I heard the information, but it didn’t really sink in.  My concentration was solely for the contractions I was experiencing, nothing else.  I began vocalizing like I did when Jackson was born and I was ready for relief.  I opted for an epidural.  Once it began to work Reannan looked at me and said “You’re going to be awake”.  Tears fell, happy tears.  Since the day of Jackson’s birth I had prayed for this to come true, and it finally was.

Dr. Meltzer arrived a short time later.  His first words to me I’ll never forget, “Goal one met, you’re going to be awake”.  Dr. Meltzer knew that while I desperately wanted a vaginal birth, more than that I wanted to be awake to witness my child entering the world, whether cesarean or vaginal.

He checked my progress about an hour after he came on and I was fully dilated!  I began to push but wasn’t making a lot of progress.  The epidural was mild and I was able to get onto my knees to push.   I felt each contractions and still felt as if I was a part of the process.  Audrey was sunny side up and my pushing was not making great progress.  I worked and worked, and the pain was excruciating.  Even though I had an epidural, I could feel my doctor attempting to make room for Audrey to move into the correct position.

I vocalized through many of the contractions.  I remember saying repeatedly that I was done and that I wanted to go home.  While Audrey’s birth was not “calm”, it was beautiful.  Even in my screams of pain, I still knew I would have a vaginal birth.  When I told everyone I was done, even then I knew I wasn’t and that she would be born vaginally.  I never asked for a cesarean, I didn’t beg for Dr. Meltzer to cut me open to end the pain.  I did not fail Audrey the way I had Jackson.  I worked for over three hours and finally consented to allow a vacuum to help her out.

An intense and indescribable pain, the hardest push I could muster, and then I heard the words, “Meghann, reach down and grab your baby”, and I did.  I pulled her onto my chest.  I heard her cry, saw her first breath.  I was the first to hold her.  I kissed her and told her I loved her.  I saw my husband meet her.  I nursed her almost immediately.  Nothing happened to her without my consent.  She did not leave my arms unless it was to go into my husband’s.  There was no brutality in Audrey’s birth, only love.

Audrey’s birth was not simply any other child’s birth; it was a moment I knew I could miss.  It was a moment I missed with her brother.  It was the most precious moment of my life.  It was something that is entirely indescribable.  Since her birth I still feel as though oxytocin is cursing through my body.  I feel so empowered, so strong.  I am capable of anything!  To be a woman is truly an unbelievable gift.  Now I understand more than ever what I lost with Jackson.  Not just the ability to comfort and care for him in those first moments of life, but also the feeling that accompanies birthing your child.  There is nothing I have experienced in my life that is similar to it.

After Jackson was born I felt weak, shameful, powerless and defeated.  I took that all back when Audrey was born.  I was empowered, knowledgeable and succeeded in caring for my daughter the way I knew I could.  It would have been easy to opt for a cesarean, but I stood up and protected my body and my baby.  I didn’t feel guilt, I felt proud of my choices and that I had served her well.  I hope that when the time comes for her to birth her children she will think of the tasks I took on for her and carry out her births with strength and confidence.

The first time I saw our midwife after delivering Jackson I expected her to treat me the way she would any patient, kindly and warmly, but without a personal connection.  Instead Faith came in the room and hugged me.  I was shocked that she obviously remembered my son’s birth for what it was.  She sat with me for over an hour and confirmed that I was not crazy or dramatic; Jackson’s birth was nothing she had experienced before.  She told me she would never forget his birth.  Fifteen months later when I went for my first check up for Audrey’s pregnancy I saw Faith again.  I didn’t expect her to remember me, but I was greeted the same way.

She walked into the room with a smile on her face and hugged me.  Two weeks after Audrey was born I got a telephone call from her.  She said she knew that I was due in January and she wanted to check in and see how her birth went.  She genuinely cared and remembered what I went through.  She asked detailed questions and I was so happy to tell her how beautifully Audrey was brought into the world.  It is strange to me when friends tell me they had to re-introduce themselves to the OB that had delivered their first child, but perhaps that is the way it should be.  It was so healing to hear Faith confirm my thoughts that Jackson’s birth was not typical, but it was for this reason that she would “never forget”.

Dr. Meltzer may still remember some of Audrey’s birth and his experience with me, but in the next year or so, I’m willing to bet we will be a faint memory and perhaps only a familiar face passing by he can’t quite place.  A part of me wants to keep a connection with someone who played such a role in bringing my daughter into my arms, and who I am so thankful for his support, but the other is glad that we are not a patient who needs to be remembered.  Audrey’s birth was not traumatic, and to him, was likely a typical and regular occurrence.  I am thankful for Faith’s words and that we hold a special place in her, because she does for us as well, but wish that Jackson’s birth had been “normal” and that she could forget.

During my pregnancy with Audrey, Reannan asked me if I had ever written Jackson’s birth story.  I had not of course, although I wasn’t sure why.  I work as a therapist and often ask clients to journal as I know how powerfully healing it can be and yet I never utilized this skill for myself.  I know now that I could not have written Jackson’s story because it wasn’t over.  I have two children, but one birth story.  The pain of my son’s birth and the many failings I did to him that day were healed with the arrival of his sister.

 

Meaggan

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