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My CBAVBAC – Cesarean Birth After VBAC

My CBAVBAC – Cesarean Birth After VBAC

The birth of my second child was shared on your blog several years ago: Long Labor Ends with Beautiful HBAC. With my home birth I really wanted to inspire other women. I wanted to show them that they are capable of having the birth that they want. This time around, I think it’s important to share that sometimes the birth you want ISN’T the birth you get – and that’s okay too. Here’s my story that talks about when VBAC doesn’t happen…

The birth of my sweet Kelsie.

Every labor is different.

How many times have I heard that sentence? How many times have I said that sentence? I thought that I understood that as well as anybody. My first two children had completely opposite births. My son was born at 36 weeks via emergency C-section and my daughter was born at almost 42 weeks, at home, after 35 hours of drug-free labor. Because of these completely different experiences, I really thought that no matter how Kelsie’s labor and birth went I would be pretty prepared.

I wasn’t.

My water broke at 4:30am on June 15th, 2015. I was 41+1 weeks pregnant. I woke up to a small gush and quickly ran to the restroom. Broken water – Check. Bloody show – Check. YES!!! It’s baby time! My water has never broken at the start of labor before, but I had dozens of dreams that it would this time around, so I really wasn’t too surprised. I went and woke up Eric and let him know that my water broke and we would be having a baby either that day or the next. I knew that it could be several hours before contractions kicked in, so I kissed my hubby, told him to let his work know that he wouldn’t be in that day and advised him that we should both try and get a bit more rest since we would probably need our energy later that day.

About a half hour later I gave up on sleep and went downstairs to make some coffee. Eric joined me and we had a light breakfast, played some cribbage, and talked about what we thought our labor would be like and how excited we were to finally meet our newest daughter. A couple hours later my two kiddos and my parents (who flew out to stay with the big kids while we were in the hospital) got up and I told everyone that I was officially in early labor. We decided to try and get the contractions started by going to Ikea to eat some breakfast and to walk the entire store. We spent over an hour and a half walking around. We left Ikea and decided to take a drive by the hospital to show my parents how to get there later. We also wanted to show them how close the hospital was to the beach, an awesome park where they could play with the kids if they needed to burn some energy, and most importantly, the closest coffee shop.

We went back to the house after and I decided to rest. A little bit later I decided to try the breast pump to see if I could get contractions going. Afterwards, my hubby and I went to a park and walked close to a mile as quickly as I was able to (which isn’t saying much). My water had now been broken for almost 12 hours. I started to get really emotional and frustrated. I decided that I must have been imagining what had happened that morning. I called my doctor, Dr. C, to give him an update and after going over our options in lengthy detail Eric and I decided to go in to the hospital to get confirmation that my water had broken.

We took our time getting our bags together and made sure to give the big kids extra hugs and kisses. I cried off and on the entire way to the hospital. I told Eric that my two best case outcomes would be that either my water had in fact broken and I wasn’t losing my mind, and even though the contractions I was having weren’t super uncomfortable I would somehow still be dilated to 6cm OR that I had completely misread the situation and my water had NOT broken.

Then we could just go home and come back a few days later to have a baby. We got checked into the hospital and were taken to our room. I got changed into the hospital gown and went and sat on the bed; my husband said I looked so scared and anxious that he decided to build my confidence by dancing for me like Ray Lewis (you can see it here…). My goofy husband was able to make me smile but I was definitely not feeling any more relaxed.

Not long after we arrived it was confirmed that my water had broken. A bit later Dr. C came in and checked me. I was dilated to 2 to 3cm on the bottom, but my cervix was still very posterior and almost cone shaped, meaning it was still closed pretty tight at the top – not at all what I had hoped for. Because I am a VBAC, we were told that we would be staying put, but that we would not be on any clock – meaning that even if my water was broken for over 24 hours as long as the baby and I were doing well we would be able to continue labor as long as we needed to. This was not at all our original plan, as we had hoped to labor at home as long as possible and only go in to the hospital once, in my doctor’s words, there was a “baby coming out of my vagina.” However, I knew there was nothing I could do about that now. Dr. C told me I needed to have a good cry about it and then I needed to get out of bed and see what I could do to get this baby coming.

So I did. I sat there and cried, trying to understand why my body didn’t want to start the process that would bring my baby into my arms. I sent Eric out to the car to grab our bags and tried to focus on the few positive things that came with being at the hospital so early. We had plenty of time to set up our music and oil diffuser and for me to spend a few minutes playing birth photographer for my own labor. I changed into the labor gown that I made and called my parents to bring my kids over for a visit. I really just wanted to hug and kiss them and needed a bit of a distraction. My family showed up soon after and I snuggled my babies and my oldest read me a bed time story.

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After they left, we called in my doula. I paced the room back and forth as far as the monitors I was hooked on to would allow. I paced and paced and paced and began to feel increasingly like a caged animal. I was so frustrated having to be attached to those stupid monitors and not feeling like I was really being given a chance to get things going. My wonderful nurse Lisa came in around this time and reminded me that no one could make me do anything that I didn’t want to do. She had to have some record of monitoring, but that if I refused there was nothing they could do. So I did. I said I needed to use the restroom for a long time and removed the monitors so that I could have at least a half hour of freedom to move about the room. I walked some more and spent some time on the birth ball. A little after 10, I got back on the monitors to try and give my poor nurse some more readings. She had been so kind to me and I didn’t want to put her in a bad position.

A few minutes later my wonderful doula Crystal arrived. She was quick to offer help in any way that I needed. She rubbed my back and shoulders and feet and prayed for me. She whispered words of encouragement and when I wanted to try and sleep she sat beside me and held that stupid monitor in place since my little lady inside insisted on kicking it off.

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Now I know that during the next several hours I had another visit from Dr. C, I cried and felt like I was on an emotional roller coaster going from completely defeated, to motivated, to crushed, to relaxed. I was emotionally and physically exhausted. We were coming up on 22 hours since my water had broken and I had slept less than ten minutes. Around 2:30 in the morning, the nurses moved me and my crew into a different room with wireless monitors. YES! But they didn’t work. NO! So we continued pacing as far as they would allow me and bouncing on the birth ball. And many times I crawled into bed hoping that rest would bring something on. My doula kept offering things that we could try. Some of them I did, others I looked at her like she was crazy.

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This pattern continued for the rest of the night and well into the morning. My big fears at this point weren’t only what would happen if my body never went into labor, but also what would happen if it did? I had been awake for going on 30 hours and I could barely put together full sentences. How was I going to push through a labor?

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I was anxious for Dr. C to come in for a visit. I really wanted a check to see if anything we had tried throughout the night had helped. He arrived a bit after 9:00am. It had been 15 hours since my last check. I tried so hard to remain hopeful, but as soon as the check started I knew.

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Before he even had the chance to say anything I looked at Eric and Crystal, shook my head no and let the tears fall. There was no change.

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No. Change. At. All.

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My heart broke. Off and on throughout the night I had thought, talked, and prayed about what to do if there was still no change the next day. I didn’t feel like I had it in me to keep going. Dr. C sat down and we started to talk about options. As far as he was concerned I had several. First, everyone looked good so I was free to continue laboring as long as I wanted. Second, we could start to talk about other ways to get this baby out. Third, I could take off the monitors, go to sleep and not decide anything at all. I had already shared with Eric and Crystal what I was thinking. I feel so strongly that babies know how to be born and I know for a fact that my body is strong and capable of birthing a baby – so in my heart I felt that if Kelsie wasn’t coming there was a reason for it. I didn’t want to make this decision based solely on exhaustion or fear so Eric and I asked Dr. C a bunch of questions and then agreed that we would all just take a break before we made any decisions.

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Dr. C left, saying that he was hoping that rest was all I needed and he hoped I woke up in active labor. I no longer felt as hopeful. Crystal left shortly after to get some rest and to allow Eric and I some time together. While Eric and I were alone I was able to be completely vulnerable and vent out everything that I was thinking and feeling. I told him that I was leaning towards a gentle cesarean, but I needed to know that he wouldn’t be disappointed in me. He hugged me close, kissed me lots and told me that no matter what choice I made he knew I was making it for the right reasons. He reminded me that I was strong and that I was a wonderful Mom just trying to take care of our baby. He told me that he was proud of me.

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He laid down to get a much deserved nap, while I laid in bed, finally free from the dreaded monitors. I tried to sleep, but wasn’t able to. I don’t think I could possibly put into words how much I battled with myself during this time. I tried to rest, but when I wasn’t able to I decided to call my munchkins and make sure that they each knew how much I loved them. Hearing their sweet voices calmed me.

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A while later Crystal returned and Eric woke up. I didn’t tell either of them what I had decided. Our nurse walked in to check on me, “What do we think?”

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My eyes filled with tears and I looked at her and answered, “I think it’s time to meet my baby.”

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Even the nurses knew that Kelsie was in charge.

At this time things started to move pretty fast. Despite the speedy pace though, I felt in control and respected, which is so different then my first cesarean. Everyone was kind and went out of their way to try and keep things as calm as possible. Eric was given his awesome new duds, Kelsie’s blanket and hat were brought into the operating room and I was introduced to the anesthesiologist that would be working with my doctor. I sat on the bed in our hospital room, trying to just remain calm and cling to the small moments of peace that I felt. As I was sitting on the bed, letting Eric put some cozy socks on my feet, I heard my phone vibrate next to me, indicating that a text message had arrived. I had mostly been ignoring all messages since we had kept the news that my water had broken very quiet. But for some reason I decided to read this message before I walked into the operating room. It was from my best friend Lisa:

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“I love you so much. You are an amazing mom and will see that sweetie soon! Enjoy as her story happens knowing that God wrote it just for her!”

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Wow. The exact words I needed to hear in the exact moment that I needed to hear them. Eric helped me out of the bed, we walked to the operating room and I kissed him and let him know I’d see him soon.

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This cesarean was so different than my first. The operating room, while busy, was not at all chaotic. Everyone let me know what was going on and what to expect next. I was treated with respect the entire time and even felt comfortable enough to make jokes. For instance, when the nurse asked someone to let Justin know that he’d be able to come in just a few minutes I calmly replied, “Actually if you don’t mind I’d rather Justin just wait outside, but if you see my husband, Eric, he’s welcome to join us.” Prep went quickly and easily and before I knew it the drape was up and Eric was sitting next to me holding my hand and waiting on our girl. Before we knew it the drape was being lowered and the anesthesiologist was lifting my back up a bit so that Eric and I could watch our daughter being born. I cried and cried. She was here. 32+ hours after my water broke – and born at the exact same minute that I was: 12:31 p.m. She was perfect and pink and loud and tiny and COVERED in meconium. I mean head to toe covered in poop. And I had only ever seen anything that beautiful two other times in my life. She was quickly looked over while Dr. C did his best to get her as much cord blood as possible, while still keeping me safe. And less than two minutes later she was in our arms. As requested she hadn’t been bathed or weighed or measured. None of that mattered.

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One of the nurses came over and helped pull my pajamas down and slide Kelsie in so that we could lay skin to skin while the surgery was completed. Eric also held her during this time and we all laughed at how much she was rooting. The anesthesiologist mentioned that he had never seen a baby with such an immediate and enthusiastic root instinct. While she was laying on me and trying so hard to find what she was looking for I said, “I’m so sorry baby. You have to wait just a few more minutes.” Her response was the most perfect, most dramatic pouty lip that you can imagine. She had Eric and I and several others in the room laughing. Before I knew it everything was done. Eric held Kelsie while I was moved from the operating table to a bed. Kelsie was again tucked in with me skin to skin and we were rolled back to our room together.

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Eric, Kelsie and I were left mostly alone for more than an hour after she was born. Everything else that needed to be done was done with her in my arms. She wasn’t measured or weighed until we requested and when I did decide to have them rinse some of the poop out of her hair, they were quick to honor my request that they only use water.

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We stayed in the hospital for two days and were blessed to be taken care of by so many wonderful nurses and one exceptional CNA. I have had a few moments where I have felt sad about the way everything went down – like when I had to sign my consent to have cesarean, because of a “failed trial of labor” (I don’t think that’s the right reason – I never went into labor and I certainly didn’t fail). But the fact is I made the best choice that I could make with the information that I had at that time. I was supported and respected in all of my choices and I felt like I was in control. I never felt bullied or pushed into anything I wasn’t comfortable with. I wanted Kelsie’s birth to be joyful. I prayed for that for the entire 10+ months that I carried her. And when I look back at her birth, I will remember laughing at her silly faces right after birth and joking with my doctor about a dream I had where I had a C-section, but in the dream he had bleached blonde backstreet boy hair and him asking someone to bring him a wig. I will remember the jokes and fun that I had with my husband and doula in the middle of the night when we were all so exhausted that we were borderline giddy.

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I will own the choices that I made during this labor and I choose not to regret any of them.

This is Kelsie’s story and I will tell it to her proudly and remember it with joy.

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Welcome to the world, Kelsie.
You are loved.
You are wanted.
You are precious.

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*** I wrote Kelsie’s birth story the week that she was born. That was over 6 months ago. One thing that I wasn’t prepared for after her birth was how hard it would be to process everything. How much I would doubt my choices. How often I would ask myself, “What if…” Not having a VBAC when you prepare for one and want one so badly is HARD. With my first child’s birth his emergency C-section was out of my hands. It was easy to be frustrated with everyone else, because I had zero control in that situation. But this time around the decision to have a cesarean was mine alone. Processing Kelsie’s birth has been hard. For over four months I obsessed over everything that had happened. What could I have done differently? How much better would it have been if I had just planned a home birth? What if I had just given myself more time? Did I give up too easily?

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The self-doubt that comes in can suffocate you and it felt like nobody really understood WHY I was upset. My baby was healthy after all and my recovery had been as easy as it could have been. Yet still, I felt like I had let myself and my daughter down. For months (and sometimes even now) I couldn’t read birth stories without feeling sad, disappointed, and even jealous of these other women achieving their drug-free vaginal births and VBACs. My sweet doula sat me down and told me, “You’re only thinking of this one way. But what about these ‘what ifs?’ What if you HADN’T had a cesarean? What if you HADN’T followed your instinct? You birthed a beautiful baby. Be kind to yourself.”

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And you know what? She was right. The decisions made that day were mine alone. I chose the decision I could live with and now, over half a year later, I truly can accept that. Her birth story is unique to her. I did the best I could do and I am so grateful that the choices I made led to a beautiful, healthy, joyful baby girl. I think that I will probably always have moments when I wonder “what if,” but I no longer feel like I failed. Kelsie’s birth story is her own. I hope that other women reading this, possibly in the same situation, will know that they aren’t alone. It’s hard when VBAC doesn’t happen. Those feelings of disappointment, sadness, and anger are real. But in the words of my favorite doula, “You birthed a beautiful baby, be kind to yourself.” ***

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Not Quite the Plan or 100% the Plan? A Hospital Birth

Not Quite the Plan or 100% the Plan? A Hospital Birth

My due date was January 22, 2017.  We had planned so much more with this baby than we did our son.  We prepared our son the best we could, I switched my doctor to midwives, we wrote a detailed birth plan, we hired a wonderful doula and toured a wing of the hospital called “The Birth Place” that is designated specifically for low risk pregnancies. They have a queen size bed, rocking chair, and private bathroom.  Mother’s labor, deliver, and recover in the same room. They do not administer Pitocin there or epidurals. I had such a horrible experience with my first with both of those that I was immediately drawn to that aspect. Sign us up…

My due date came and went on a Sunday.  I had an appointment the next day at 40 weeks and 1 day for an ultrasound to check my fluid level with a follow up appointment with my midwife.  I got into the follow up appointment to start a non stress test around 1:30 pm. My midwife came in and had a look that I recognized as a not fun one.  I had much too much fluid left for being that late in the game and she wanted me to head in to the hospital around 4 pm: not quite the plan. I immediately started crying as the words she spoke shot through my brain: break your water, cord before baby, placenta could tear from wall, possible Pitocin, minutes to get a c-section if cord comes first…

So in we went armed with prepped-for-a-week bag, specific pillow for comfort, new, fuzzy, purple socks a friend bought so I wouldn’t be stuck with hospital ones, and anxiety. So. Much. Anxiety.  

Unfortunately, because they had to do some slight induction actions, I was not able to go to the Birth Place as I wanted: not quite the plan. The midwife there at the hospital started a little pill to get my cervix to start thinning and dilate a little more.  She had planned on doing three rounds of it. After the first, I had some bloody show which I was waiting for so that gave me hope. Braxton hicks had picked up a little after the first dose. Then again with the second one. I had made enough progress after the second one that she did not do the third dose.  She said my body was starting to do things a little on its own so she didn’t want to do the third and stress the baby, which was good.

So come the next morning, January 24, the midwife that sent me in from the office was on her shift.  I met her in the hall walking laps as contractions were starting to pick up a little. I excitedly caught her up on what was happening: I was a solid 2 or 3 cm, contractions were coming on their own, I was walking laps to keep them going.  I went back to my room about 930/1000 am. The midwife came in and broke my water which was way less scary than I expected. Let me tell you… it’s a very gross feeling having your water broken. I sat up in bed to make sure the water kept draining.  She kept her fingers up near my cervix to make sure baby’s head was coming down first. She fell right into place as we were hoping. I sat in bed for about another hour. Contractions got just a little more intense so we decided to call in our doula. Our wonderful doula walked laps with us and brought me to some stairs so I could go up and down a few times.  The goal was just to keep contractions going. We did this for just about most of the day.

We went back to my room about 330 pm.  The midwife came in and said basically that we were running out of time: not quite the plan.  She said she wanted to postpone Pitocin as long as she could but we were running out of options and I was not progressing fast enough.  Because I had so much fluid, my uterus had been overstretched for so long that the contractions it was doing were not really doing anything.  My uterus was tired: I feel ya sister. So the midwife said as a last ditch effort to try nipple stimulation for an hour. They brought in a pump and I was to pump until I felt a contraction, wait five minutes and if a contraction did not start on it’s own, then to pump for another five minutes until a contraction started, and keep the pattern going for an hour.  We were looking for contractions to go on their own between 3-5 minutes and last a minute long. At first, they did not come unless I was pumping but then they started coming between 3 and 4 minutes, and only lasted about 45 seconds. The midwife came in after about 45 minutes and recommended going on Pitocin: not quite the plan. The saving grace was that they did not push Pitocin the way the hospital we had our first baby at did.  They start off at 2, and then go up by just one unit in cases like mine. Since my body was showing obvious signs of trying desperately to do something on it’s own, it just needed a little push.

Pitocin definitely got contractions going more.  At about 600, they bumped the Pitocin from 2 to 3 units.  My doula put counter pressure on my back during contractions while my husband played specially requested songs on youtube through his phone for me.  

At about 6:30 pm, the midwife came in to check me and I was 7 cm. Thank goodness. Only 3 cm to go.

I said “really? Seven centimeters already?”

She smiled and said, “ yeah, I told you your body just needed a little push from Pitocin.”

I was shocked because the contractions I was having did not feel like what I imagined 7 cm contractions would feel like. She recommended I get in the labor tub to sort of catch up with myself for a minute and relax before things got even more intense.  So at about 6:45 pm I was in the tub. It felt amazing. My doula spread the scent of lavender and her and the midwife helped me breath through contractions in the water. Before I left my room for the tub, my midwife told me to let her know if I felt any pressure or need to push when I was in there. That most likely meant baby was coming down and I would have to get out and get back to my room as quickly as possible. So I had one contraction and was fine. I had another and felt the pressure.  

I let her know and she said, “okay, let’s do another one and see if the feeling remains and if it does, we’ll get you out and back to the room.”

I felt it more with the third contraction in the water. I immediately stood up in the tub when it was done and said “yep, feeling is still there.”

So we headed back to my room. I had a contraction right as I got to my bed and said to my doula, “I can’t do this.”

She said, “you’re already doing it, it won’t be long now.” I knew as soon as she said it, from my research, that she was right. I got up on the bed and set the back straight up so I could lean over it during contractions which quickly became more serious. I asked for the music to be turned off and my doula rubbed a cold washcloth over my forehead which was one of the most amazing feelings at that moment.

The midwife checked me and said there was a little bit of cervix left to go but I was almost there. I knew from the experience of my son that it would not be long.  The same thing happened with him and 10 minutes after my doctor said that to me, I was ready to push. The midwife was having me sit back on my knees with each contraction and really let gravity do its work.  I became very quiet and internal during the contractions and had the sensation that I was having a bowel movement. In the next second I thought, that’s the baby coming down. I said to the midwife “my body is pushing on its own, she’s coming on her own.”

She said “okay, well try not to, because I don’t know what your cervix is doing yet.”

I thought to myself I don’t know how to stop it from happening, it just is.  The midwife asked for me to turn at least on my side so she could check again to make sure I was good to push. The only problem with that was during my pregnancy I had horrible pelvic pain from everything loosening and stretching like it was supposed to. Adding the extra pressure of baby coming down and moving in any other way other than upright was excruciating. I managed to slither, for lack of a better word, onto my side.  She checked me and I was ready to go.

I had a sudden rush of fear.  I went to push with the next contraction and I felt just the beginning of the ring of fire. That was the only time I let out a scream. I instantly thought, “oh no, I don’t want to do this anymore, no way.” But I knew, it would be over soon and the head was the hardest part. I had to 5-second pep talk myself and just go for it.  That’s what I did. Let me tell you one more time, that ring of fire is nothing to mess around with. But it was the most amazing feeling to be able to feel her head coming. I reached down and felt her as she was crowning. I will never forget how slimy and wonderful her head felt to me and how I’m 90% sure I said the actual word “ick” as I wiped the slime off on my thigh.  Her head was almost out, probably to her nose, when I stopped the push I was doing and I thought, “nope, I don’t want to sit here in this much pain with her head just sitting there, just a little more of her head to go.” I gave half of  another push and I felt her head come the rest of the way.

One of the best parts was looking down at her and watching her turn herself like they are supposed to. I saw her face and she was already screaming. I was thinking “okay, just her body now, one more push and you’re done,” when the midwife said “do you want to pull her the rest of the way? Grab under her arms.”  

I didn’t even respond. I instinctively reached down while I was pushing, scooped her under her arms and pulled her up onto my chest. She slid right out, I laughed and said, “I am woman, hear me roar!”

The things you say in a baby induced oxytocin high.

We did delayed cord clamping, the midwife let me feel her cord pulse. The placenta was delivered and she brought it over to me to explain all the parts of it which was amazing to me.  My mom was even looking at me in awe. My husband cut the cord and she was weighed and measured. Adeline Rebecca was 7 pounds 9.5 ounces and 21 inches long. I was able to nurse her immediately and she was a champion from the beginning. The nice thing is that even though I was not able to deliver in the Birth Place, I was able to recover there. They wheeled me and baby to the new room with a queen size bed, rocking chair, and private bathroom.  My husband and I curled up in the bed with Adeline so he could do some skin to skin contact with her. She was awake, alert, and making eye contact with us as if she was as amazed by us as we were by her: 100% the plan.

Birth experience and photographs submitted by Kathryn Garceau. 

Never Underestimate the Power of YOURSELF!

Never Underestimate the Power of YOURSELF!

These will never get old. Because women feeling supported and empowered should be the damn norm, no matter how we birth. 🌟 “Never Underestimate the POWER of a Woman. Never underestimate the power of YOURSELF. Sometimes it means digging deep, but I can tell you…you come out the other side feeling on top of the whole entire world. 💙 It felt SO dang good to celebrate birthing Trey and I really cannot wait to tell you guys the full story! Let’s just say it’s a good one: the OB had to deliver him with her fleece on, barely had time to catch him, and it is official that the only way I give birth is standing up. 🙃💙 • I’m also over the moon to raise TWO little gentlemen, because if there is one thing this mama can teach them…it’s that women are every bit as strong and capable as ANY man. They will give women the respect that we DESERVE, that is my #goals.” 🙌🏽 @ameskiefer #birthwithoutfear #optionssupportrespect

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Cholestasis, a Change of Plans, and a Respectful Induction

Cholestasis, a Change of Plans, and a Respectful Induction

I’d planned a natural birth in a birth center from the second I found out I was pregnant with my third child. I’d had a dehumanizing induction with my oldest; my second baby’s birth was far better than my first but still not exactly what I wanted so I made huge changes during my third pregnancy in order to finally have the experience I desired. My pregnancy was wonderful and healthy and everything was perfect every step of the way, I received care from a wonderful practice of naturally-minded obstetricians and midwives and truly enjoyed every prenatal visit. Everything was going great and my husband and I were happily anticipating our impending daughter’s birth.

When I hit 37 weeks I started noticing that my skin was very itchy. I used a lot of lotion and didn’t think much of it at first but I quickly realized it was getting worse by the day. I was soon so miserable I was even willing to try anti-histamines despite being reluctant to take any medications while pregnant. Unfortunately neither anti-histamines or any lotion or cream helped at all. After six days it was so horrible I was becoming concerned, this just didn’t feel normal. I called my doctor’s office on a Sunday morning and asked for advice. The midwife I spoke to thought it would be a good idea to come into labor and delivery and have blood drawn to be tested for obstetric cholestasis. After examining me she was hopeful that it was just a miserable case of PUPPPS but felt that the tests were a good idea.

Unfortunately the tests took about a week to come back so we wouldn’t know for sure anytime soon.

The next day I noticed baby was moving a bit less than normal. By that evening movement was significantly less but I was still feeling her enough that I wasn’t panicking. I was up all night trying everything I could think of to get her to resume normal movement but had no luck. I got up in the morning, took our big kids to school and called my doctor’s office. They had me come in immediately for a non-stress test. After a few minutes on the monitors baby wasn’t moving so they brought me apple juice… and more apple juice… and cups of ice water. Attempts to buzz my stomach yielded no results. Baby’s heart rate was perfect but for some reason she was clearly not moving.

A few minutes later one of the doctors came to talk to me. My hands and feet were where the itching was the worst, he examined them carefully and found there was no rash or apparent cause to the itching and said that this was concerning. The timeline of my symptoms and the appearance of my skin were textbook signs of cholestasis, a condition where a build up of bile acids in the blood stream cause intense itching. Still birth is a potential risk of cholestasis and given my baby’s major decrease in movement he felt it would be best to induce labor. He could tell I was extremely upset and was willing to support me even if I disagreed with his recommendation. He told me to call my husband and discuss it with him but that if we decided it would be best to induce labor that he was going to schedule my induction immediately. It didn’t take my husband and I long to agree that this was the best option. Several months before I had attended a Birth Without Fear Meet Up where January described the birth of “Beard Baby”. Prior to her birth she had had decreased movement and January described this as feeling that her baby had “nudged” her. I had a brief moment of peace realizing that my baby was nudging me as well and that this was all a sign that it was time for her to be born.

My mother picked up our children, we packed our bags and in what seemed like seconds we were at the hospital starting the induction. I had a very hard time processing what was happening to me and barely spoke a word for hours. I couldn’t believe that in such a short time my plans for this birth were completely shattered. How could a pregnancy go from complication-free to this in a matter of minutes? I was three centimeters dilated and 50% effaced but I truly did not feel my body or baby were ready to be in labor and I was absolutely terrified to start down this road of interventions.

After getting settled into our hospital room, the midwife from my practice who was there that evening came in to talk. She had a student midwife with her and they were both extremely compassionate and willing to do whatever they could to try to give me as much of the birth center experience as they could. The induction plan was to use Pitocin very slowly and to bring in a portable birth pool for me to labor and birth in. After talking to them I felt a million times better, this wasn’t exactly the birth I wanted but it was going to be okay.

Pitocin was started and I quickly began having regular contractions. I tried to rest through the night but the itching was worse than ever and prevented me from resting at all. One thing I’d found that helped the tiniest bit was Earth Mama Angel Baby nipple cream and luckily the hospital used this brand. My midwife’s student brought me tons of packets of it and I passed the night applying nipple cream to my entire body. By morning I’d had little progress and was feeling discouraged. I felt sick to my stomach I was so worried that this was going to turn out badly. As the morning went by however, things finally started to pick up a bit and contractions became much more intense. I began having to actually breathe through them and was only comfortable standing up, rocking through them. My midwife Missy and her student Lila Rose thought it would be a good idea to check me and see if they could break my water. They thought that since this was my third baby that if they broke my water things would progress very quickly but I was absolutely convinced there was no way that would work. Regardless I agreed that it was worth a shot. They checked my cervix and found that I was five centimeters. They broke my water and left the room for a bit to be with another patient.

In a matter of minutes my contractions intensified. They went from very uncomfortable to actually painful and I continued standing up, rocking and swaying through them. I suddenly realized I’d been too upset to eat anything for almost twenty hours and became very worried that this would effect my ability to get through labor. My husband offered me several healthy snack options but the only thing that sounded good was a Kit Kat bar that he helped me eat in between contractions. I don’t remember Missy and Lila Rose coming back in the room but when they saw me they realized I was getting close. I didn’t realize this myself though and still truly felt that I was half a day away from giving birth.

I was in a lot of pain at this point and asked to get in the tub. Lila Rose got it ready for me and helped me get in. The warm water was an immediate relief in between contractions but during contractions I was in extreme pain. I remained sure that I was no where near giving birth and this began to alter my state of mind. I was so sure I was going to be in labor for hours upon hours and didn’t know if I could handle this pain for the rest of the day. Lila Rose helped me breathe and focus more during contractions, despite my being a total wreck her words of encouragement were extremely helpful. She was using a Doppler to check baby’s heartbeat frequently and realized her heart rate was going up and staying up and she asked me to get out of the tub. She and my husband helped me get out. As soon as I stepped out I felt like I needed to go to the bathroom. Lila Rose told me that that was just the baby and I didn’t really need to use the bathroom. I remember thinking “I’m not an idiot! I know that feeling like you need to use the bathroom is actually the baby when you’re close to giving birth but I am NOT even close to giving birth so I must actually have to go.”

I labored on the toilet for a minute and Lila Rose draped a warm blanket over me. Baby’s heart rate was still high so Missy asked me to try to get on my hands and needs on the bed. I moved into this position pretty easily and the contractions suddenly became absolutely unbearable. Contractions were maybe 20 seconds apart so I wasn’t getting a break between them at all. I started saying there was no way I could do this and that I needed an epidural. Missy tried to calm me down and reminded me that I didn’t want an epidural and that I would most likely regret it. She and Lila Rose tried to get me to focus more on what my body was doing and how each contraction was getting me closer to meeting my baby. I was still sure that I wasn’t actually close to meeting my baby though and asked again for an epidural. They explained that this baby was going to be born before they would even have a chance to request an epidural and I was perplexed. I didn’t understand why they were so sure that I was very close to having a baby when I was beyond certain that I wasn’t close.

Suddenly I felt the urge to push. I slid down on my side and started pushing and instantly my entire mood and mindset changed. I could feel my baby descending and the urge to push made me realize that I really was very close to giving birth. The urge to push was such an immense relief compared to the contractions that I’d been feeling that they actually almost felt good. I could tell each push was extremely productive and she was coming fast. My midwives started telling me that they could see her hair. I could feel intense burning and felt like I was pushing too hard and too fast and I tried to slow down and breathe her out but my body was on auto pilot and I didn’t feel lik&e I had much control over pushing. Before I knew it I could feel her body sliding out and I reached down to touch her, suddenly she was on my chest, screaming, and I was in disbelief. I immediately asked my husband what time it was and found that it had only been about 40 minutes since my water broke.

I birthed the placenta painlessly but my midwives said there were still a lot of large clots in my uterus and working them out was extremely painful. I was bleeding more than they liked though and they wanted to make sure everything was okay. Once they were sure, they checked me for tears and found two very small tears and asked if I would like them to stitch them. They thought they would probably be fine either way but that they would heal a little faster if they were stitched and I agreed. As soon as they were finished they covered my naked baby and I with warm blankets, dimmed the lights and left my husband and I to bond with our baby girl. We were left completely alone for hours and it was absolutely wonderful. No one bothered us or tried to bathe our baby or mess with her at all. A pediatrician stopped in just as I was actually feeling ready to try to get up and use the bathroom and clean myself up a bit anyway so the timing worked out perfectly.

I felt immense relief knowing that our baby girl was earth side, safe and healthy. I had salvaged a pretty awesome birth out of a situation that terrified me. I had been induced with my first baby and had absolutely no control. Every decision was made for me, without me. Not only was I never consulted but I was so disconnected from how birth should be that I didn’t even realize that I had a right to be consulted. I remember feeling as though I was in the way during my own birth. I remember thinking everyone would have an easier time delivering this baby if I wasn’t there. This induction was a completely different and wonderful experience. My health and the health of my baby were the priorities of my doctor but they were not used against me. My choices were respected every step of the way. I received guidance from my health care providers and was allowed to make my own choices. This wasn’t the birth I had planned but it was exactly the birth my baby needed.

Submitted by Kate S. 

Dancing Doctor & Mama

Dancing Doctor & Mama

“Who you choose as a provider will play the biggest role in the options, support, and respect you receive through your pregnancy, labor, birth, and postpartum journey. Choose carefully, be picky as hell, and don’t hesitate changing if needed. Love yourself enough to get the care you deserve. As much as you would for someone else you love. Yes, love yourself that much, darling, because you’re worth it!” – January Harshe

We love seeing providers like @drfernandoguedescunha who is dancing with mama to get baby down and earthside!

VBAC Despite Thrombocytopenia: The Birth of Elodie

VBAC Despite Thrombocytopenia: The Birth of Elodie

The birth of sweet little Elodie really begins with the birth of our son Huck. I had a normal and, dare I say, easy pregnancy with our first. Nothing was out of normal and I had no doubt I would be able to deliver this baby naturally until about 32 weeks when I was diagnosed with severe gestational thrombocytopenia. Basically my blood platelet levels were dropping rapidly, putting both me and the baby at risk for hemorrhaging during the delivery. At this time, we were living in Africa in a city where health care was limited and our doctor became so worried about my severe thrombocytopenia that she demanded a C-section at 36 weeks and 2 days. I ended up having a C-section under general anesthesia and didn’t even get to see my son until he was 3 hours old which left me feeling so removed from the whole birthing process. The whole experience was very traumatic for me and recovery from this C-section, which I never thought would happen, was harder than I ever thought possible. I almost didn’t want another baby until I started reading about VBACs.

When we found out we were pregnant with our second, I knew without a doubt that I wanted the opportunity to try for a VBAC. During this pregnancy we were living in another country overseas which was not the best place to try for a VBAC. After many conversations with my husband, we agreed we would temporarily move back to the States at the end of the pregnancy so I would have the best chance possible of delivering naturally. We emailed an OB/GYN who was a family friend and he was immediately on board and excited about helping me go for a VBAC.

Our pregnancy was pretty routine and easy like my first one but the whole time we questioned whether the thrombocytopenia would come back and what it would mean for my chances of a VBAC. Around my 30th week of pregnancy, we flew the long transatlantic flight back to America and settled into my in-laws’ house with our almost two year old to wait for baby girl’s arrival.

About the same time that we got to America, my platelets started dropping again which meant the thrombocytopenia of my first pregnancy had returned. Our OB/GYN was amazing and had many a long conversation with us about how my low platelets could lead to different outcomes including steroids, induction, and the inability to get an epidural in case of an emergency C-section. The whole time he never mentioned a repeat caesarian as an option for me and made us feel in control of our decisions which was such a different experience from our first pregnancy.

We were fortunate enough to be able to transfer our care to the midwives of his office while he still helped us navigate the thrombocytopenia. Still we were forced to wait to see what my platelets would do. Every week I had blood draws to check my platelet count and each week, from 30-35 weeks, they dropped more and more until they were around 90,000. At this number they are considered too low for epidural and were coming closer and closer to the number our doctor wanted to induce me at. I had many good cries about my platelets and about the idea of having to go on steroids and then have an induction as I had really wanted an intervention-free birth where I could labor at home as much as possible. There were moments I was convinced my dream of a VBAC was slipping away. I wanted so badly to avoid interventions or an induction. I had this overriding desire to see what my body could do because I felt like I was robbed of the chance of experiencing labor with my first. I knew my body could do it if only it was giving the chance but with the thrombocytopenia I was so scared I would not be given the opportunity to naturally labor. All this time, my husband was always there to encourage me to trust my body and believe that we could have the birth I wanted.

We asked all our friends to start praying for my platelets to miraculously go up, even though we were prepared for them to start drastically dropping as they did in my first pregnancy. We went in for my 36 week blood draw full of trepidation to see where my platelets had fallen to. My husband called for the results a few hours later and found out they had gone up to 105,000. That was the first time ever in either of my pregnancies that my platelets had gone up! Over the next two weeks they kept going up until they were at a really good level (121,000) when I entered my 38th week.

At this point I started knowing in my heart that this was the ideal time for baby girl to come as we didn’t know if and when my platelets would drop again. On Thursday we went to our chiropractor for an adjustment and then spent Friday, Saturday and Sunday walking a ton. Each night I told baby girl that then was a good time for her to come. Sunday night I went to bed asking God to bring baby girl in his timing but asking Him to allow me the natural VBAC we had worked so hard for.

Around 1:00am Monday morning (I was 38 weeks 4 days), I woke up for my nightly pee and noticed bloody show in the toilet. I got really excited and knew that this at least meant my body was getting ready. Almost immediately after that I started getting my first ever contractions (I never had one with my first pregnancy). My husband was sleeping in our two year old’s room because our son was sick with a cold and ear infection so I laid in bed timing my contractions. I ended up having contractions all night long every 5-7 minutes apart. In the morning they spread way out and my husband and I were both disappointed. I had contractions off and on all Monday then throughout the night again which left me exhausted by Tuesday. Tuesday we spent the day relaxing and napping as contractions came and went. I eventually told my husband I did not think I could do another night of these contractions and I really hoped active labor would start soon. My husband ran out Tuesday evening to get me some of my favorite soup for dinner while I bounced on my birthing ball and watched our two-year-old.

It was at this point that the contractions changed from being mildly annoying to being painful. I started having to concentrate on breathing more and really focus during them. My husband at this point didn’t realize that things were changing so he was going about doing dishes and laundry…at some point I snapped at him to stop leaving me alone because I needed him. He said it was at this moment he realized things were picking up. We sat together and watched Wheel of Fortune and Jeopardy as contractions came every 7-10 minutes or so. It wasn’t until around 9pm that I think I really entered active labor. I moved into the shower and labored there as contractions started coming every 5 minutes or so. Eventually we ran out of hot water for the shower so I went into the bedroom. It was at this point the contractions became really intensely painful. My husband called our doula and she came by the house to check on us. It was about 11:15pm and she guessed I was probably 4.5-6 centimeters and said I should try to sleep between contractions as I was now on my third night without much sleep. She left around 11:45pm asking us to call her when we headed to the hospital, which she thought would be in about 2 or 3 hours. As soon as she left contractions picked up in both intensity and frequency. They started coming almost every 2 to 3 minutes and lasting almost a minute. I was a little shocked by how intense they got in such a short amount of time. I told my husband that we needed to head to the hospital then. He was hesitant to go to the hospital as the contractions had not been that consistent for a whole hour yet. After a few more minutes of me yelling about going to the hospital, he decided it was indeed time to go and we headed out. The drive to the hospital was only about 10 minutes but I was contracting every 2 to 3 minutes so it seemed much longer.

We got to the hospital around 12:20am and were checked around 12:30. The nurse said I was a stretchy 6.5 centimeters so I was immediately brought to a labor and delivery room. At this point I was exhausted and demanded some IV pain killers. I knew I didn’t want an epidural but I was beginning to panic between contractions and knew I needed something to calm down. The painkillers helped me relax and sleep a bit between contractions with me still waking up every 3 to 4 minutes to breathe, scream, and occasionally cuss through so wildly intense and painful contractions. All this time the nurses were struggling with monitors for fetal heart beat and contractions. I did not know what they were talking about but I kept hearing them say “the contractions aren’t being read on the monitor” which in my tired mind meant that they weren’t strong enough to be picked up yet. That totally freaked me out as I thought I must just be at the beginning of labor. I kept asking our doula and husband if all of this was just false labor, to which they kept assuring me that this was really labor and a baby was coming soon.

By around 1:45am the painkillers had worn off and I started asking (demanding) for an epidural during every contraction. Our doula knew in that moment that I would really regret that decision so she lovingly but strongly told me no. Our nurses were awesome in honoring our request that they not suggest or bring up epidural either. Our doula did suggest I get checked at 2:00am as a way to give me a goal. At 2:00am our midwife checked me and I was at 9cm and the baby was at a 0 station. It was then suggested by our doula, that our midwife should break my water to help speed things along. At 2:15am she broke my water and I immediately began to feel the baby moving down. After about 2 contractions where I felt baby moving down, I told everyone in the room that I was going to start pushing. Our midwife, thinking I was still at 9cm, told me to try not to push. I told her again I was pushing and pushed with the next contraction. She had me flip over onto my back (I had been on my knees up over the top of the bed the whole time) to check and saw that the baby was close. At that point she called the nurses in and told me that since pushing was working I should just keep going. At that point all I wanted in the world was to get that baby out. I started pushing at around 2:25am and baby was crowning after only 2 or 3 contractions. Even as the baby was crowning I was scared of messing up somehow and needing a repeat C-section. I think almost everyone in the room laughed as baby was crowning and I was asking if there was any way that I was still going to have a C-section and if I was really in labor. It all just happened so fast that I was in shock!

The moment I pushed my baby girl out was literally one of the best and most empowering moments of my life. Her head came out and the rest of her body followed immediately. Our midwife placed her right on my chest and that is where she stayed for over an hour. After having a general anesthesia C-section with our son, getting to spend the first hour of my daughter’s life just holding her was a gift that I could not possibly be more thankful for. It was only after my daughter’s arrival that our midwife told me that my platelets had indeed dropped again and were under the threshold for an epidural. My husband and I are both so thankful we did not know that going into the hospital as the fear of a general anesthesia C-section would have caused me to panic. We are just so thankful baby girl came right when she needed to and exactly how she needed to.

Overall, I felt like my husband and I really fought for this VBAC and it was so worth it. We felt educated, informed, and empowered during the whole pregnancy. Even when dealing with thrombocytopenia and the complications that came with that, we felt like all our providers were fighting alongside us for our VBAC. All I wanted was to give my body a chance to do what I knew it could do and what it was made for. Our amazing team never pushed any interventions on me and allowed me to labor how I wanted. Our midwife was absolutely amazing in completely following my lead and allowing me and my body to control the pace and feel of labor. One of my recovery nurses, while reading the notes on my labor and how fast it went, said, “It is just sad you ever had to have a C-section in the first place. It’s clear that your body was just made for this.” It was such a redemptive moment for me to once again believe in my body’s ability to birth.

Overall, God gifted us with a birth we only could have dreamed about with only 2 hours in the hospital from check-in to baby. We now are thrilled to have a beautiful, healthy baby girl that came into this world naturally, surrounded by a loving and supportive team.

Story and photographs submitted by Julia Van Scott. 

The Harshe Podcast – Episode #8: BeardBaby’s Birth & Closed For Business!

The Harshe Podcast – Episode #8: BeardBaby’s Birth & Closed For Business!

January and Brandon tell the birth story of baby #6 aka BeardBaby! They reveal how Brandon’s newly grown beard in 2014 magically led to another pregnancy, how January received prenatal care from both midwives and an OB/GYN, and how a newborn baby can temporarily cure the flu!

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Click here to download Episode #8: BeardBaby’s Birth & Closed For Business!

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We are having a 30% sale on all “Team No Sleep” raglan shirts at Self Love Generation! We also have our classic Birth Without Fear logo T-shirts and “You Do You Boo” rainbow unicorn lanyard that Brandon loves! 

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Join January in 2017 at a Find Your Village event near you! January will be in Nashville, TN on September 23rd! Make sure to get your tickets because this is the last year January will be holding Find Your Village events!

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