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The Harshe Podcast – Episode #57: FYI: Cesarean Birth is Birth!

The Harshe Podcast – Episode #57: FYI: Cesarean Birth is Birth!

It’s 19 days until the release of Birth Without Fear: The Judgement-Free Guide to Taking Charge of Your Pregnancy, Birth, and Postpartum(Hachette Books, March 5, 2019)! 

January reads a snippet out of Chapter 5 of Birth Without Fear, and she discusses the idea of writing out a cesarean birth plan philosophy!

Subscribe to the Harshe Podcast on iTunes!

Subscribe to the Harshe Podcast on Google Play!

Subscribe to the Harshe Podcast on Stitcher!

Click here to download Episode #57: FYI: Cesarean Birth is Birth!

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Considering certification as a childbirth educator but haven’t quite found the right fit yet? Interested in creating inclusive classes where birthing people can become educated about their options and patient rights?

If you’re eagerly nodding your head along to one or all of these questions, we got ya! Become a childbirth educator with Doula Trainings International‘s Childbirth Edu Training program. 

https://www.doulatrainingsinternational.com/dtis-childbirth-edu-training-program/ 

The online platform will take you through certification requirements, tracking your participation progress for your own review of the curriculum and corresponding teaching guide, required scholarly reads and required videos.

https://www.doulatrainingsinternational.com/dtis-edu-childbirth-education-different/

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Pre-order your copy of Birth Without Fear: The Judgement-Free Guide to Taking Charge of Your Pregnancy, Birth, and Postpartum today! If we want to see real change in our society where pregnancy and birth are concerned, let’s use our collective voice to change the narrative by getting a copy of this book into every birthing person’s hand! Pre-order a copy for yourself, or pre-order a few copies to hand out to friends and/or family!

The Harshe Podcast – Episode #56: Cesarean Birth Without Fear

The Harshe Podcast – Episode #56: Cesarean Birth Without Fear

It’s 20 days until the release of Birth Without Fear: The Judgement-Free Guide to Taking Charge of Your Pregnancy, Birth, and Postpartum(Hachette Books, March 5, 2019)! 

January reads a snippet out of Chapter 5 of Birth Without Fear, and she and Brandon discuss cesarean birth!

Subscribe to the Harshe Podcast on iTunes!

Subscribe to the Harshe Podcast on Google Play!

Subscribe to the Harshe Podcast on Stitcher!

Click here to download Episode #56: Cesarean Birth Without Fear

=================

Pre-order your copy of Birth Without Fear: The Judgement-Free Guide to Taking Charge of Your Pregnancy, Birth, and Postpartum today! If we want to see real change in our society where pregnancy and birth are concerned, let’s use our collective voice to change the narrative by getting a copy of this book into every birthing person’s hand! Pre-order a copy for yourself, or pre-order a few copies to hand out to friends and/or family!

Two Out Of Three Babies Born En Caul During Triplet Birth!

Two Out Of Three Babies Born En Caul During Triplet Birth!

“Awesome! Yesterday we birthed the triplets! And Joaquim was born veiled (when the waters/sac does not break). We were delighted. But then came Adeline… she was also born en caul, and left us all admiring her as she slept soundly. We stayed (that way) for 7 minutes observing her behavior as if it were still inside her belly. It’s the magic of life. The perfection of God!!” —@dr.rodrigorosa

Incrível! Ontem fizemos o parto dos trigêmeos! E o Joaquim nasceu empelicado (quando a bolsa não rompe). Ficamos encantados. Mas aí veio a Adeline ( as mulheres sempre superam os homens) e arrasou! Também nasceu empelicada e deixou todos nós a admirando enquanto dormia tranquilamente. Ficamos por 7 minutos observando o comportamento dela como se estivesse dentro da barriga ainda. É a magia da vida. A perfeição de Deus!

Sortudos por presenciarem:
@dra.julianahalleyhatty @ornellaminelli@gicassavia @katiarochafotografa@marianacaniato
#partoempelicado #triplets #trigemeos#lindodemais #obstetrafeliz#birthwithoutfear #cesareanwithoutfear#cesareanbirthisbirth#optionssupportrespect

CBAC: The Birth of Ingrid Alexandra

CBAC: The Birth of Ingrid Alexandra

In the “birthy world”, CBAC or “Cesarean Birth After Cesarean” refers to a belly birth that was initially planned to be a VBAC (Vaginal Birth After Cesarean). In cases like this, sometimes simply saying “repeat cesarean” negates the significance of the decision to birth again via cesarean. As someone who has personally travelled this road, I share the story of my second child’s birth, a family-centered, gentle cesarean, in the hopes that it can bring healing and comfort to others whose birth stories may not have gone *quite* as planned.

The dense heat of the Florida summer air hit my face as I opened the car door. I was parched, despite sneaking a few sips of water to keep that nasty, constant companion of heartburn at bay. At 41 weeks 1 day, I was tired. Weeks of nightly (and daily) prodromal labor had left me exhausted, depleted. My whole body ached to finally hold my little girl.

“It’s your birthday, Ingrid!”, I whispered to my swollen belly, feeling its tightness once more and pushing that obstinate little foot, always stuck in my ribs, to a more comfortable position. I grabbed my favorite pillow and reached for my husband’s steady hand before heading towards the fluorescent-lit entrance of the Family Birth Center.

She wiggled in response to my voice and moved her foot right back.

As I completed the hospital admission forms and surgical consents, my birth playlist cycled through the carefully chosen songs that I’d accumulated over the last three years. The room was filled with laughter and love, as it should be when a child is about to be born, and I was calm and content. As my dreams of having a VBAC faded into the distance, I eagerly anticipated meeting my daughter.

The nurse unhooked me from the monitors, and I maneuvered my way to the edge of the bed, dangling my legs off the side for a second before I stood. I nervously fiddled with the ties of the gown that I’d brought with me, the one that I’d purchased for her birth before she was even conceived.

It was time.

My doula and birth photographer faded into the background, as my husband and I shared one last moment together before her arrival. Always my rock, he whispered tenderly in my ear, “You’re so brave. We’re gonna meet her soon, babe.” He kissed my neck, my cheek, my lips, and I smiled at him with tears in my eyes.

I, myself, walked to the OR.

It was cold.

I awkwardly climbed onto the slim surgical table, trying to center my very pregnant self on its tiny surface while shimmying my gown up to expose my belly.

I remembered the uncontrollable shaking from last time and tried to fight it as I felt the anesthesia taking hold, moving up my lead legs and climbing towards my chest. I’d forgotten that feeling, but it came rushing back as I gasped, “I can’t breathe; I can’t breathe”, knowing full well that I could if I was saying those words.

The nurse anesthetist put her hands gently on my shoulders, and said, “Bethany, I want you to think about your baby. What’s her name? What do you think she’ll look like? Does she have any siblings?”

I inhaled deeply and intentionally, blinking furiously as tears trembled on my eyelashes. As I answered her questions, my mind began to calm once again.

Seconds later, my husband was there, stroking my shoulders, kissing my forehead, whispering words of encouragement in my ear as he sat beside me.

“Everyone’s in here,” he said, “Samantha, Cassie…just how you wanted…”

I smiled, still shaking, thankful for his presence and the stability that he brought to my soul in that moment.

I heard the door of the OR open and the chatter of familiar voices as the remnants of the surgical team assembled.

“All right, Bethany,” I heard from the other side of the drape, “You ready to meet this baby?”

I nodded: “Let’s do this.”

I grasped Doug’s hand and held tight.

I visualized the whole process in my mind as the familiar smells of surgery filled the suite. I felt the pressure of my abdomen being stretched and pulled to accommodate her entrance. It felt like an eternity. Then, finally:

“Here she comes!”

“Drop the drape! Drop the drape!”

Doug ceremoniously stood to greet her, still holding my hand.

The blue curtain was yanked down, and I strained to catch a glimpse of her as she was lifted from my belly. She cried immediately, justifiably appalled at being forced to leave the warmth and dark of my womb. Dr. Graham held her wriggling body over the limp blue curtain.

Ingrid glared at me in all her newborn glory.

“You can touch her if you want…just don’t touch me because I’m all cleaned up for surgery.”

It was surreal.

My hand trembled as I reached out to grasp her tiny, wet fingers as she enthusiastically announced her presence.

“We’re gonna take her to the warmer, dry her off so she doesn’t get too cold in here, listen to her heart real quick, and bring her right back.”

My husband followed her.

I could see her the whole time.

My doula stayed with me, stroking my hair, talking to me, telling me how beautiful Ingrid was.

Barely a minute later, I watched as Douglas carried our daughter back to me, cradling her gently in his strong, capable arms. His brilliant blue eyes, accentuated by the surgical cap and mask, sparkled with tears of joy. He helped me open my gown, snuggling her onto my chest, skin-to-skin, just minutes after her arrival.

She melted into my warmth, half-heartedly rooting, alternating between protesting her arrival and staring at me and her daddy with her dark, wise newborn eyes. I kissed her – kissed her dark hair, her perfect button nose, the sweet curve of her cupid’s bow. I felt her soft, warm skin against mine. I breathed in her smell and marveled at her tiny fingers.

I smiled.

I cried.

Douglas wiped away my tears, as we laughed together, rejoicing in our daughter’s birth.

It was perfect.

Ingrid Alexandra, our sweet girl, our strong baby, born on July 12, 2016 at 07:53.

Birth experience submitted by Bethany B. 

Photographs by Cassie Ringl of New Light Birth Photography. 

 

Birth and Children Are Not All Balloons and Roses

Birth and Children Are Not All Balloons and Roses

My twin girls were born early at 30 weeks and five days. Yesterday I saw a friend posted on Instagram, the birth of his beautiful baby girl. The pictures were incredible. His wife delivered naturally, he got to help in the delivery of his baby, and immediately after, they put their first child on her chest. Both parents were able to cherish that moment, in what seemed like a magazine article on the picture perfect child birth.

I burst out crying.

Selfishly, I was NOT crying out of happiness for them, I was crying out of sadness for myself. I had an unplanned C-section, and upon delivery my babies were immediately taken to the NICU after I had just barely had a glimpse of them. As I looked at these pictures on Instagram of my friend’s perfect birth, I realized I would never have that experience. No vaginal birth, no holding my baby and I didn’t have that immediate feeling of “LOVE like you’ve never felt before,” you know the thing that all parents talk about when they first have their child.

Instead, I spent the first 24 hours after my babies were born feeling completely disconnected as if I was watching someone else’s life happen. I didn’t feel like a mom or have an overwhelming love and connection. Instead, I felt the complete opposite. I was scared, filled with anxiety and freaking out that this is not the way I am supposed to feel after the birth of my children.

My parenting comparison had already started. I questioned everything. Asking myself, “is this how I am supposed to feel? I’ve only ever heard about the overwhelming love and joy. What is wrong with me? Is this postpartum? Is it because I didn’t do it the right way, should I have pushed more and stayed the course of a vaginal birth?”

I continued with the self-shame: I will never get the experience of holding my newborn after delivery. Will this affect them and me for the rest of our lives? What does this scar mean and how will it affect my body? How long will they be in the NICU, did I do something to make them come early… Am I going crazy?

How come no one talks about this stuff? The doubt, the unstoppable crying, the night sweats. OMG, the night sweats. After 48 hours of pure anxiety, I woke up and realized something…..

Here are these two girls who were just brought into the world who know nothing but how to wiggle their toes, while they are trying to figure out how to breathe. I am already putting the pressure on them and myself on having the perfect birth. This is how parenting shaming starts, and this is how we create unrealistic expectations for ourselves and our children. Seriously think about it, our kids start out perfectly innocent, knowing nothing. With no standard on how they are supposed to look, dress or how they were meant to be born they are just working on staying alive at this point.

A lot of us are following a program to what our life is supposed to look like and to be honest; it’s a false program. We think if we just do it right, always give 100% and make it look like it’s supposed to look, then we are successful. The fact is, no one can give 100% a 100% of the time, it’s impossible. So why are we trying so damn hard to be perfect, to one-up each other? The expectations we have accepted from what society puts on us are FALSE expectations, and we have to stop.

Birth and children are not all balloons and roses. I don’t even have my girls home, and I’m already feeling the pressure of what’s right and wrong and what feelings I’m supposed to be feeling. What about being present in the moment my girls are alive and thriving. All they need right now is support and love. They don’t care if I cry or second guess myself they care I am here holding them, reading to them, kissing them and everything else is B.S.

I am committing to a platform of raw, open and real honesty. I have done this on all my other blogs about body image, food, and alcohol and I am committing to it as a parent. I will be honest about ALL the stuff. The good, the bad and the worse because I believe as parents and as a society, we need to talk more about the hard stuff, so we know we are not alone. We have to remind each other that the “perfect family” on Facebook is NOT real life.

If we want the best for our children it has to start with us, the parents. We would never want to pass our insecurities onto our children: our body issues, food issues, and low self-esteem issues. It all starts with us leading by example, and working on our comparisons of ourselves to others.

I want to change the message. Here are three things that hit me like a ton of bricks after childbirth:

Not everyone has the initial, “love like you’ve never felt before” immediately after childbirth, and that doesn’t mean something is wrong with you. However your babies came to you and however, you feel is exactly how it is supposed to be for YOU.

Comparisons, guilt, shame, anxiety, and uncertainty all are REAL. We all have negative thoughts. Don’t keep them inside. Find a tribe or one person to talk to, or even this blog to leave a comment on. You are not alone in how you’re feeling, let it out and let’s support one another.

No one and I mean NO ONE has a grip on parenting. The person you think has it all together could be a complete mess and just scared to share the struggle. It’s time we talk about the struggle.

My birth plan was NOTHING that I thought it was going to be and you know what? It’s OK. Every day is a rollercoaster but I’m on it, embracing it and I’m mentally committing to being present in it, ALL OF IT. Even the dark stuff.

To any parent out there struggling, to anyone, anywhere struggling, with or without kids, you are not alone! I am here for you. We NEED to be here for each other. Let’s talk about the REAL stuff, let’s stop judging one another and come together. It’s time we teach the younger generation and each other that self-worth comes from what we think of ourselves, not what society has put on us. It’s time to change the conversation and lead by example.

I love you thank you for letting me continue to be honest, real, raw and open with you. Thank you for allowing me to continue to tell my story. I love each and every one of you, we are in this together!

Birth experience and photographs submitted by Jenny Schatzle

That’s Why It’s Called a Birth “Preference” Instead of a “Plan”

That’s Why It’s Called a Birth “Preference” Instead of a “Plan”

I have long-struggled to like myself. I hated my body and lacked self confidence in many areas, so finding out I was pregnant just triggered a heightened sense of anxiety for me. Finding out I was diabetic at my first OB appointment made things even worse. As the doctor rattled off the list of awful things that could result, I sat there expecting each to all happen to my baby, and they would all be my fault. I wondered if I could live with myself if I caused such pain for my beautiful growing baby – macrosomia, dislocated limbs during birth, heart and spine defects, respiratory problems… One thing I had been told from the beginning – I would be induced at 38 or 39 weeks due to an increased risk of stillbirth for infants of diabetic mothers. I strongly opposed an induction but wanted to do what was best for our baby.

As the pregnancy progressed and my education on the issues increased, I became “a model patient” (the doctors’ words). My confidence grew as quickly as my sugars and A1C decreased, and for the first time in my adult life, I was actually feeling good about myself and my body. This new-found confidence gave me the ability to try new things (like yoga, which has been life-changing!) And maybe it was my “mama bear” instincts forming, but I was blessed with a feisty courage that I had not previously known to speak up for myself. Did that cause some tension between my doctors and me? Yes. Was it worth it? YES.

At that point, if I pictured our baby’s ideal birth, it would be in a peaceful environment outside of a hospital, calm, quiet, in water, with no interventions. My husband and I took a hypnoyoga birth class and hired a doula. I talked to several midwives; however, they couldn’t deliver my baby, due to the fact that I was taking insulin. I started researching natural induction methods to encourage baby out on her own. I drank red raspberry leaf tea, walked every day, faithfully attended yoga, saw my chiropractor once a week, got acupuncture, used essential oils on acupressure points, and visualized her calm, peaceful birth every chance I had. And still, the induction date (Sunday) arrived with no sign that baby Samantha was going to come out on her own.

As we walked the short hallway to the antepartum wing, I debated escaping. But I was with my husband and his mom, and really, pregnant ladies can’t run that fast. So we checked in, got settled in our room, and I was soon disappointed to learn that I wasn’t even ripe! After three doses of Misoprostol throughout the night, Resident S (that I ended up liking the most) tried and failed to insert a Foley bulb. Also throughout the night, our amazing nurse kept coming in and apologetically asking me to shift positions. He was noticing small drops in Samantha’s heart rate during the tiniest of contractions. (I wasn’t so worried, as that was a normal occurrence from the time I started attending my NSTs twice a week for the previous 2 months.) Finally, after one more dose of Misoprostol and lots of waiting, Resident K was able to get the Foley bulb in. I was hopeful that things would start happening that day (Monday), especially since they moved us to labor & delivery.

By Monday evening, the Resident K was somewhat surprised to learn that the Foley hadn’t come out on its own. So she gave it a tug and it came out…it was Pitocin time! My stomach did some flips thinking about all the stories I’d heard about the dreaded P, but at the same time I was so excited to meet Samantha and I was really ready for things to get a move on. After 24 hours in the hospital, I’d slept about 4 hours and had felt zero contractions. Thankfully we were blessed with amazing and fun nurses, which helped to pass the time. My husband put on my favorite Harry Potter movie, a few visitors came by, and we listened in excitement as the OB on call said we’d be meeting our baby by the end of the day tomorrow.

Here’s roughly how Monday night/Tuesday morning went:

Nurse: “Did you feel that contraction?”

Me: “Nope.”

Nurse: “Let me adjust the monitors; they are slipping.”

Me: “Ok.” (Try to sleep! Try to sleep!)

3 minutes later…

Nurse: “Did you feel that contraction?”

Me: “Nope.” (Try to sleep! Try to sleep!)

Nurse: “Sorry, I need you to move onto your side…her heartrate is not quite cooperating.”

(Repeat 5,000 times.)

And so it continued throughout the night. By Tuesday morning, they had adjusted the dosage of Pitocin more times that I could count – first increasing steadily, then backing off when her heartrate would drop significantly (from the 150s to the 60s…a few times it even went down to 20!) So when Resident K came in that morning, she explained that it was time to break my waters, in the hopes that things would pick up. I still hadn’t progressed beyond the 3cm that she had measured when the Foley bulb was pulled out.

After hearing her out, I told her that I wasn’t ready for them to break my waters. I explained that I was aware of the risks and benefits and that I just didn’t think it was time. (I had hoped getting up and about during the day would help things move along and that my water would break on its own. I’d given up trying to sleep by that point.) Then the OB came in and gave an even longer, guilt-laden explanation about why it was time to break my waters. She started talking about a “failed” induction. Truthfully, I wasn’t really listening. My mind was made up. Earlier my doula had prepared me for this moment and I followed her suggestion in saying to the OB, “I understand that there are risks associated with a labor that’s not progressing, but I am not ready for you to break my water. I would like to continue as things are for now, and if my baby does become truly distressed to the point where she needs to come out immediately, I know that you are very capable of performing a successful c-section very quickly.” After looking me up and down, “Um…actually for a woman your size, a c-section isn’t that quick.” If only there were words for how I felt at that moment. The only thing I managed to say was, “No. Not now.” A few tense moments later, the OB suggested that we take a break from it all. I wasn’t discharged, but they took me off all the monitors, stopped the Pitocin, and gave us 4 hours to walk around the hospital. “Just don’t go outside; it’s wet and you might fall.” (So the first thing my husband and I did after a shower was go outside. I didn’t care that it had been snowing earlier and was freezing…the fresh air felt amazing after 2 days of being cooped up in a tiny room.)

My husband and I ate some lunch, climbed (crab-walked, jumped, lunged) 10 flights of stairs, and visited the postpartum clinic to look at cute baby stuff…and not one contraction. I was so discouraged. I’d truly hoped that my body would take over and decide to bring Samantha into the world! I lost my mucous plug, but that was it. I am so thankful for the support my husband gave me during that time – he had my back through all of this and did everything he could to get me laughing and having fun. I’ve never had so much fun climbing stairs.

Defeated, we returned to the room and I told them I was ready for them to break my water. They did, and I was back on the Pitocin. Things finally picked up. OF COURSE there was meconium in the water, so I knew that she would have to come soon! As the contractions became much stronger, I bounced on the ball, walked the halls with my husband, and stayed on my feet as much as possible. Standing was the most comfortable way for me to labor, but I knew I couldn’t keep it up forever. My mom and my husband’s mom stopped by for a visit as they had each day, and it was sometime during their visit that I realized it was getting too hard to talk during the contractions. And that’s when all sense of time left me. Was it minutes before the doula came? Hours? Not sure. My contractions were lasting 40-60 seconds and coming a minute or less apart. Sometimes there was no break between them at all. Things picked up quickly and soon I wasn’t able to stand through the contractions. My doula suggested kneeling over the back of the bed so I could rest between contractions. How long had it been since I’d slept? Probably Sunday night. I was exhausted. And these contractions were no joke! And my back…my lower back started hurting so bad. Counter-pressure on my sacrum did nothing, hip squeezes did very little. But I was able to turn inward as I’d been practicing and breathe, focus. Through the toughest moments, I could also hear Samantha’s heartrate dropping. A few times during those drops, I panicked inside and I’d lose control. I felt myself crying out or breathing too quickly. I started to feel like I couldn’t do it. Finally, I asked to get in the tub, and the hot water felt amazing. My husband faithfully knelt by, feeding me ice and refilling the leaking tub.

At some point, I fell asleep. (My husband said I was even snoring and he was so relieved that I was getting rest.)  Maybe it was only for a second, but I felt so much better. Sure, some of it was the hot water, but mostly it was because my labor had slowed down considerably. Samantha’s heart rate had continued to drop with the big contractions so they were decreasing the Pitocin drip. Meanwhile, I heard some commotion outside the bathroom – my doula was packing up our stuff! The charge nurse had decided that she wanted to close the wing we were on, as there were only 3 other patients on the floor. My husband protested, asking her if she really felt like it was right to move a woman in labor. She relented and told us we could stay. Calmly explaining the situation, my doula told me what was happening and how they had already packed up everything, but we could stay if I wanted. She also suggested that walking to the other wing might help move things along without the help of the Pitocin. That seemed appealing, so they helped me out of the tub. I remember thinking it was funny that they were trying to help me into a gown…at that point I didn’t even care what anyone in the hallway saw.

As we walked through the corridors between the two L&D floors, I stopped to squat through each contraction. By the time we were almost to our new room, I was approached by Resident S.

“Things just really aren’t moving along like we thought they would, and Samantha is in quite a bit of distress during your contractions,” she explained. As I attempted to wrap my sleep-deprived mind around what she was trying to say, I remember sinking onto the bed and asking, “If you can give me advice, what would you do?”

After a long pause, a big sigh, and a bit of a frown, she said, “Well, I think I would have a c-section.” She really knew it wasn’t what I wanted, and I trusted her that at this point it was the best option for Samantha.

It’s shocking how fast you get prepped for a c-section. It seemed like only minutes went by before I’d expressed my “demands” (drop the curtain as soon as she’s coming out, immediate skin-to-skin with me or my husband if I wasn’t able…) and asked questions about the surgery, met the anesthesiologist, and walked to the OR. My doula and husband were both with me the entire time, which was incredibly comforting. The worst part of the surgery was the uncontrollable shaking! I felt a sense of calm going into this surgery, because I knew I was going to meet our dear, sweet baby so soon.

It’s just like they described…it feels like someone’s sitting on your chest. At one point I felt nauseated, several times I felt like I was hyperventilating, and the whole time I was shaking uncontrollably. But then I heard someone say “She’s out!” and I tried to wave my useless arms around and tell the anesthesiologist to move the curtain. I desperately tried to see my baby girl being lifted into the world, but I only saw her once the doctor was carrying her over to the warming table. It felt like an eternity that they were looking her over, and I was calling out “Is she ok? Why isn’t she crying? Stop wiping her down! Just bring her over here!” My doula reassured me that it was only a minute or two, but I was just so ready to hold her! My husband cut the cord and carried her to me. At that moment, I absolutely lost it. I was sobbing, still shaking, and loving my little girl in a way that I’d never thought possible. She was 5 pounds, 14 ounces of pure, seriously adorable perfection

My husband and I had joked throughout the pregnancy that Samantha was a stubborn girl. She just wasn’t ready to come out and wasn’t going to let someone make her! Born on International Women’s Day, Samantha came out literally holding her head up, quietly observing the world around her. My prayer for our sweet girl is that she will grow up a strong woman with the confidence that I only found once I became her mother.

_____

Every time my husband proudly handed off the stunning visual birth plan that I’d designed and he laminated, we’d joke that it was only a birth “preference” because we know that things can’t always go as planned. It still feels like the only thing that went as planned was that our little girl was born, happy and healthy. Today, her 2 month birthday, I’m still struggling with that. And I anticipate that I will continue to struggle for quite awhile. After a bout of high blood pressure and worries of postpartum preeclampsia, extremely low milk production despite 7 weeks of my best efforts and awful-tasting supplements, complications with my incision (two pinky-finger deep holes that aren’t not healing), and postpartum depression and anxiety, I look down at the often smiling face of our sweet Samantha and know it’ll all be ok.


Photo by Tricia Croom – Doula Services.

Photo by Bella Baby Photography.

Birth experience submitted by Melissa Rogers.

Intrahepatic Cholestasis of Pregnancy (ICP) & My Gentle, Family-Centered Preemie C-section

Intrahepatic Cholestasis of Pregnancy (ICP) & My Gentle, Family-Centered Preemie C-section

I had a typical, healthy pregnancy with my daughter, Priya, until I didn’t. Late in my pregnancy, I became very itchy, my urine was dark in color, I was overly tired and frequently nauseous. I had lamented to friends and family about how I was feeling but was typically met with well-meaning encouragement. I heard things like, “You’re pregnant and chasing a toddler around; of course you are tired!” or, “It’s common to experience itchiness and nausea in your third trimester.” Yet, I could not shake this feeling that something was off.

I started to research my symptoms and came across something called Intrahepatic Cholestasis of Pregnancy (ICP). As I quickly scanned the information, I knew in my heart I had this condition. As I read more, my worry began to increase. The treatment for this condition is to be on a medication that keeps your elevated bile acid levels from harming your baby, accompanied by frequent NST and ultrasounds to monitor the baby, and finally a delivery no later then 38 weeks, my worry grew because I was already over 35 weeks, and when left untreated, the complications can be serious and delivering past 38 weeks has a stillborn rate of 15 percent. Thankfully, I have a provider who excels at really listening to their patients, and when I called with my concerns, they saw me immediately. When I brought this up to him, he ordered the blood test and said they would call with results.

At 35w6d I laid down for bed. Anxious thoughts about receiving my test results the next day filled my head when I realized my baby was quiet. Where the usual kicks and tumbles that kept me up for an hour at bed time every single night, I was met with stillness. I did all the tricks to try and provoke some movement…nothing. Because we were waiting on the results of the blood test, and knowing what complications could arise with this condition, I didn’t want to take any chances, so we headed into Labor & Delivery.

Thankfully, our baby was looking great on the monitors, but right before being discharged by a nurse, my OB caught that the test results had come in. He told me what I had already known in my gut. That my bile acid levels were elevated above 10, which indicated a diagnosis of Cholestasis and that he would need to admit me and deliver her within 12 hours. He said waiting another week when we have had no treatment on board was not safe for her any longer and that she needed out very soon. Thankfully, the whole week I was waiting on my test results I had prepared myself for this scenario and even told my husband on the way to L&D that “I think we are having this baby in the next 24 hours.” So the shock I experienced was minimal.

Because of my previous emergency C-sections, her decreased movements, and the fact that my body had been essentially slowly poisoning her, we opted for a gentle cesarean instead of inducing labor to decrease the amount of stress she would experience during birth.

I have to admit, I mourned the birth I had been preparing and longed for. I had chosen a doula and had put in all the leg work to have my VBAC but sometimes birth plans and birthing your baby safely are not the same thing. Once I knew I would not get my VBAC, I was clear about my desire for a gentle cesarean. My provider explained that a cesarean with a preemie is unpredictable, but as long as she was doing well once she was earthside, my requests would be honored.

My birth plan requested the following:

• I did not want any medication that would make me drowsy for my birth.
• I wanted the radio on to help relax me while in the OR.
• I did not want any drape. I wanted to see my daughter being brought into the world. (This request was met with the exception of needing an air-filled warmer for her on top of us.)
• As long as she was breathing well on her own, I wanted skin to skin immediately in the OR.
• I wanted delayed cord clamping so she could receive her own vital stem cells, red blood cells, iron, and regain her full blood volume.
• I requested that she not be bathed at all but that the vernix should be rubbed in to aide in moisturizing her skin and help protect against infection.
• I wanted my catheter and IVs be removed as soon as possible.
• I requested breastfeeding-safe medication.
• I wanted the support of a lactation team to help me with the learning curve of breastfeeding a preemie and that she would also be evaluated for a lip and tongue tie.

My birth with Priya taught me three important things: First, to always trust your gut. When something feels off to you, listen to your body. Trust your God-given mama instincts. NO ONE knows your body and your baby better then you. Second, find a provider that supports you. Having a birth care provider who listens to you and supports you fully, even during less than ideal birth circumstances like this, makes all the difference in the world. Third, even if you have a less than ideal birth (like my four weeks early, emergent C-section), you can still have a birth that is a healing experience if you feel heard, understood, and your wishes have been respected. Though my story did not look the way I thought it would, I walked away from my less than ideal birth feeling at peace because my providers did everything in their power to give me the birthing experience I desired, and for that I am forever thankful.

If you or someone you know is experiencing itchiness while pregnant, please talk to your provider. Cholestasis of pregnancy, when treated correctly, almost always leads to healthy babies; but when left untreated, it can have devastating consequences. If you feel you are not receiving proper care or support or would like to be informed about this condition, please check this group for the most updated evidence-based research. This is a foundation that brings awareness and proper information to women dealing with this.

Experience and photographs submitted by Emily Russo. 

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