My Thoughts as a Pregnant Woman about Forgiving Myself

This is a post I wrote on the blog I was keeping throughout my pregnancy...little did I know that less 24 hours later, I would be admitted to the hospital and induced into labor...another story for another day. But this post is an example of how sometimes in pregnancy, like in any other aspect of life, things may not go how you plan and you have to accept that it's not always your fault, especially if you know and do your best.

 

Maybe not an epiphany, but…

…definitely a tough realization. I had “it” last night while talking to my sister…it was one of those things where you talk and talk so much that eventually something profound pops out of your mouth without even thinking about it.

I was explaining to my sister all the reasons why I want a completely unmedicated birth (in no particular order):
1) I want to avoid the slippery slope of unnecessary interventions. For example, if you are induced and they start you on Pitocin, your body is forced to labor before it is ready, which leads to much stronger and more painful contractions than you might have actually had if you had avoided the drugs. Now that the pain is SO strong, you feel like you need an Epidural, so you get one. the thing about an epidural (or any pain medication) is that it slows down your contractions, and before you know it, you’re being given MORE pitocin because you’ve plateaued or slowed down more than the hospital would like. The pain is back full force, so you get more pain medication. Lo and behold, the doctor walks in and tells you that the baby’s heartbeat has slowed/risen/become erratic, etc. and now you need an emergency c-section. What they won’t tell you is that the heartbeat got like that because the baby couldn’t handle the constant changes in the uterus due to the medications.  Now your baby is in danger and you need emergency surgery just because of one intervention that didn’t even need to happen.
2) It’s safer for the baby to labor naturally, not just because of the reasons I listed above, but because every medication you could be given (and there are LOTS of kinds, not just pitocin or an epidural) can leave your baby in a stupor for hours, even days after birth. I would rather bond with a baby that is more alert than know he has no clue who I am because I made sure he was born zonked out.
3) the most important reason in my gut is that I VALUE the hard work and dedication it takes to give birth naturally. I don’t know if it’s this city and it’s “get in, get out, get on with life” superficiality, or what…but there is ZERO support here for mothers that want to go natural. You’re likelier to be told you’re insane for trying (even by other moms) than receive any sort of support. There’s no natural-method birthing classes in the entire county, insurance doesn’t cover midwives (if you can FIND one), there’s no resources on cloth diapering or baby wearing…even breast-feeding past 3 months is weird and taboo here. I’ve spoken to two OBs and even hospital staff regarding my wishes for a natural birth, and every SINGLE time, I was answered that all my requests would depend on what drug(s) I was on at that particular stage of labor. So literally EVERY person I spoke to regarding my birth assumed that I would have some sort of drugs at some point of the labor, even when I had prefaced the conversation with “I want a natural birth, so…”

 I mentioned that earlier this week, I had a breakdown because I was so frustrated with the anxiety of the upcoming birth and not being able to plan for everything because every time I spoke to someone else about my birth plan, I was told at least a couple more things I could not count on having. While I was talking to my sister, I realized that my problem was the planning. I desperately want a natural, drug-free birth, but the fact is that all the books I’ve read on the topic and all the videos I’ve watched to prepare all assume that I will be among supportive people in an environment suitable for natural labor and delivery.

I am not. And I will not. And as much as I blame myself for that, it is unreasonable to because there’s nothing I can do about it.

The hospital requires continuous fetal monitoring. They don’t have wireless OR waterproof monitors. This means that once I am admitted to the hospital, I will literally be strapped to a bed in one position until I have the baby. In my original birth plan, I wanted to labor in a tub, or at least in a shower because I’ve found throughout the pregnancy that all my pains can be eased substantially with warm water. Well, there ARE no tubs, and I am not ALLOWED to shower until after the baby is out, “considering whatever drugs you’re on have worn off at that point”. Why? “Hospital rules.” That’s it. I’ve not once been given a legit medical reason why I can’t do X, Y, Z…all I get is “it’s hospital policy and they’re not flexible” which is basically they’re way of saying “don’t try to fight us on this, you’re going to lose.” In fact, I was even told by one of the doctors that if I want to labor in the shower, I better “stay at home as long as possible”. Hmm.

Because the hospital requires continuous monitoring, I am also not allowed to walk, squat, or otherwise change position at all because I cannot take the monitor off. Every resource I’ve come across says that changing positions can be the difference between tolerable and intolerable contractions, and that laying on your back is the absolute WORST and most PAINFUL way to labor. Well, that’s apparently the only choice I have.

I’ve been mentally preparing for the fact that labor is going to be hard and painful and will require a LOT of determination on my part, but that’s considering that I’d have the ability to labor in a way that would encourage or facilitate what I want/need. In my current situation, I’m fighting an uphill battle because I’m putting pressure on myself to do something that’s ALREADY so difficult, PLUS I have the hospital policy pushing back at me. It’s an uphill battle at best.

So what conclusion did I come to?

I cannot plan. I should not worry. I am as prepared as I can be, but I do not know what to expect, and I shouldn’t expect anything because it will only lead to disappointment if/when things don’t go the way I thought they would.

So I am still going to do my best to cope with the pain naturally using the techniques that I have been focusing on for months. But I am also trying to come to peace with the fact that I might feel I need pain medication, and that I shouldn’t hate myself or feel disappointed if I go that path. As it is right now, I know I will feel like an absolute failure if I opt for pain medication, but I realize I need to cut myself some slack because the hospital is literally making everything as backwards to what I need as they can, and there’s nothing I can do about that.

As soon as I said out loud to my sister that I should try to forgive myself in advance in case I DO opt for pain medications, a calm came over me. As long as Bu gets here healthy, I should focus on that and not HOW he got here, though I do still feel it’s so important to do my best and go natural for the both of us. I’m not 100% ok with being this flexible yet, but I can’t  regret something I haven’t even done yet, and if I DO do it, I can only use it as a learning experience for next time.

And by next time, I mean I am NEVER setting foot in an OB or hospital again when it comes to having children. I must find support for a more natural path here, otherwise I foresee all of Bu’s future siblings being born outside this city. This pregnancy has made so many beautiful things in my life, but it has also made me deeply dislike this city and it’s attitude, and I’d love nothing more than to give my children a chance to live AWAY from it and it’s influence.

Factors for VBAC success, Part 1/2

In this post, I will discuss why each of the following factors are important in VBAC success:

*reasons for previous c-sections
*arriving at the hospital as late into labor as possible
*not having continuous fetal monitoring
*epidural as late as possible into the labor, if at all
*no induction or acceleration
*previous vaginal birth

*Reasons for previous cesareans
If previous cesareans happened because of something unlikely to reoccur, like the baby being breech (which is a whole other topic, and I will be featuring both facts on breech babies and a couple of guest post on the topic next month), you have a pretty good chance of a successful VBAC. Something like CPD (a medical condition where one's pelvis is actually too small to allow a baby to pass) can make a VBAC more difficult, but it is still not impossible. According to The VBAC Handbook, as many as 2/3 of women with CPD that attempt VBACs are successful!

*Arriving at the hospital as late into labor as possible
The reason for this is simple. The longer you labor at home, the less opportunity the hospital/doctors/nurses have to "help" you with a cascade of interventions that could just lead to a RCS.

*Not having continuous fetal monitoring
Continuous monitoring restricts your mobility, which is a huge problem because being able to move around in labor is a necessity to help labor progress. You might also experience more pain/discomfort constantly laying on your back because you're stuck in bed, hooked up to a monitor. 15 minutes an hour is more than sufficient to give care providers an idea of how baby is doing, and then momma can focus the other 45 minutes of the hour on LABORING how she's most comfortable. Another reason to avoid monitoring if you can help it is that results are often misread, which leads to more cesareans unnecessarily.

*Epidural as late as possible into the labor, if at all
Epidurals usually require continuous fetal monitoring so that the laboring moms lowered blood pressure (a side effect of the epidural) can be checked regularly, along with it's effect on the baby. Because you don't want CFM (see above), you should wait as late as you can to get the epidural, if you get one at all. Epidurals have also been shown to stall labor.

*No induction or acceleration
Any sort of induction or acceleration of labor, including artificial rupture of membranes (AROM, or having your water broken) can raise the risk of the previous cesarean scar "unzipping". Some doctors might want to administer pitocin once a labor really gets going to speed things up, but be aware of the risks before you consent to ANY sort of augmentation!!!

*Previous vaginal birth
If you have had a vaginal birth before your cesarean, you are likelier to have a successful VBAC. You are also likelier to have a successful VBAC if you've already had a VBAC! Crazy, huh? ;) Not much help for mommas like me, that had an unnecesarean right out of the gate, but perhaps good news for other mommas out there!


The next post will finish up the list of factors and the reasons behind them. I'd love to hear your thoughts on the list so far!

My Birth Plan Revisited

 Originally posted in 2011 at Plus Size Preggo

 Spoke to an OB at my practice yesterday (they rotate so you get to know everyone), and I was pretty disappointed with what I was told about my birth plan, even PO’ed at one point…As I told my sister, who came to the appointment with me: “Unless something magical happens during birth that makes me want to blow everyone in that hospital, I am NOT going to do a hospital birth with the next baby!” (Blunt but true story LOL)



* I’d like the following people to be present during labor and/or birth: My husband, my sister, and my mother. “OK”

* I’d like to wear my own clothes during labor and delivery. "OK, but you probably won’t want to"

* I’d like to take pictures and/or video during labor and delivery. “Only allowed BEFORE labor, AFTER birth and NOT during newborn tests”

* I’d like the option of returning home if I’m not in active labor. "OK"
* Once I’m admitted, I’d like my partner to be allowed to stay with me at all times. "OK"

* Once I’m admitted, I’d like to eat if I wish to. "Not going to happen"

* Once I’m admitted, I’d like to try to stay hydrated by drinking clear fluids instead of having an IV. "Not going to happen, either"

* Once I’m admitted, I’d like to walk and move around as I choose. “You’ll be strapped to a monitor so you can walk as long as you’re not far from the edge of the bed” read: NO.

* As long as the baby and I are doing fine, I’d like to have intermittent rather than continuous electronic fetal monitoring. "We can do it, but it’d be a nuisance." read: "Not going to happen"

* As long as the baby and I are doing fine, I’d like to be allowed to progress free of stringent time limits and have my labor augmented only if necessary. "OK"

* If available, I’d like to try a birthing ball, birthing stool, squatting bar, and/or a birthing tub/pool. “What are these things?” I WISH I was kidding.

* I’d like to try the following pain-management techniques: bath/shower, hot/cold therapy, massage. "No bathing or showering, stay home and do that until you MUST come to the hospital"
* Please don’t offer me pain medication. I’ll request it if I need it. "Make sure you tell them that at the hospital" I thought that’s what the point of THIS was?

* If I decide I want medicinal pain relief, I’d prefer regional analgesia (an epidural and/or spinal block). "OK"

* When it’s time to push, I’d like to be coached on when to push and for how long. "OK"

* I’d like to try the following positions for pushing (and birth): semi-reclining, squatting, hands and knees, whatever feels right at the time… "We’re not equipped for that" read: "Not going to happen"

* During delivery, I’d like to give birth without an episiotomy. Again, “Make sure you tell them that”. Um, will do.

* After birth, I’d like to hold my baby right away, putting off any procedures that aren’t urgent. "OK"

* After birth, I’d like to breastfeed as soon as possible. "OK"

* After birth, I’d like not to get oxytocin (Pitocin) after I deliver the placenta unless it’s necessary. This is where I got pissed. "Well, we will do that so you don’t bleed. I mean, you’re going to bleed anyway…but we’re physicians. This is what we do." Uh-huh. So basically, fuck yourself. We’re medicating you one way or the other.

* After birth, I’d like my partner to cut the umbilical cord. "OK"

* If I have a c-section, I’d like my partner present at all times during the operation. "OK"
 
* If I have a c-section, I’d like the baby to be given to my partner as soon as he’s dried, if appropriate. "OK"

* If I have a c-section, I’d like to breastfeed my baby in the recovery room. "OK"

* I’m planning to bank cord blood privately. "OK"

* After delivery, I’d like all newborn procedures to take place in my presence. "OK"

* After delivery, I’d like my partner to stay with the baby at all times if I can’t be there. "OK"

* I’d like 24-hour rooming-in with my baby. "After the birth, ALL babies go to the nursery for a bit, but then he’s all yours" I almost clawed at her face when she said that. I’m going to fight this one.

* I plan to breastfeed EXCLUSIVELY. "OK"

* Do not offer my baby: formula, sugar water, a pacifier. "OK"

* I do NOT want my baby circumcised. "OK"

* I’d like to wait and see how I feel before deciding about the timing of hospital discharge. "OK"



So I reiterate…I knew I’d be disappointed because I was expecting too much from a hospital, but for the most part, I expected this. Next go round, once I know I can successfully have a birth without complications, it’s birthing center all the way!!!

My Birth Plan

 Originally posted in 2011 at Plus Size Preggo


* I’d like the following people to be present during labor and/or birth: My husband, my sister, and my mother.

* I’d like to wear my own clothes during labor and delivery.

* I’d like to take pictures and/or video during labor and delivery.

* I’d like the option of returning home if I’m not in active labor.

* Once I’m admitted, I’d like my partner to be allowed to stay with me at all times.

* Once I’m admitted, I’d like to eat if I wish to.

* Once I’m admitted, I’d like to try to stay hydrated by drinking clear fluids instead of having an IV.

* Once I’m admitted, I’d like to walk and move around as I choose.

* As long as the baby and I are doing fine, I’d like to have intermittent rather than continuous electronic fetal monitoring.

* As long as the baby and I are doing fine, I’d like to be allowed to progress free of stringent time limits and have my labor augmented only if necessary.

* If available, I’d like to try a birthing ball, birthing stool, squatting bar, and/or a birthing tub/pool.

* I’d like to try the following pain-management techniques: bath/shower, hot/cold therapy, massage.

* Please don’t offer me pain medication. I’ll request it if I need it.

* If I decide I want medicinal pain relief, I’d prefer regional analgesia (an epidural and/or spinal block).

* When it’s time to push, I’d like to be coached on when to push and for how long.

* I’d like to try the following positions for pushing (and birth): semi-reclining, squatting, hands and knees, whatever feels right at the time…

* During delivery, I’d like to give birth without an episiotomy.

* After birth, I’d like to hold my baby right away, putting off any procedures that aren’t urgent.

* After birth, I’d like to breastfeed as soon as possible.

* After birth, I’d like not to get oxytocin (Pitocin) after I deliver the placenta unless it’s necessary.

* After birth, I’d like my partner to cut the umbilical cord.

* If I have a c-section, I’d like my partner present at all times during the operation.

* If I have a c-section, I’d like the baby to be given to my partner as soon as he’s dried, if appropriate.

* If I have a c-section, I’d like to breastfeed my baby in the recovery room.

* I’m planning to bank cord blood privately.

* After delivery, I’d like all newborn procedures to take place in my presence.

* After delivery, I’d like my partner to stay with the baby at all times if I can’t be there.

* I’d like 24-hour rooming-in with my baby.

* I plan to breastfeed EXCLUSIVELY.

* Do not offer my baby: formula, sugar water, a pacifier.

* I do NOT want my baby circumcised.

* I’d like to wait and see how I feel before deciding about the timing of hospital discharge.


I’ m sure a lot of these won’t be do-able (I’m looking at YOU, eating during labor and no IV!) but I’m going to take this to my OB appointment tomorrow and talk everything over with my doctor to see what I am willing to compromise and what MUST be.


(This nifty PDF was a big help in articulating just what I wanted during my labor and delivery.)

Guest Post: "Henry Louis' Birth"

I was told on Monday that my OB does not "allow" pregnancies to go beyond 42 weeks, and while this wasn't news to me it made me antsy because my first son was so eager to be here he came rushing out the day after his due date. This one was more than content on staying put.

Induction was set for 730am Friday. My waters broken at 9:18am and I was told there was meconium in the fluids. This altered my plans for intermittent monitoring. I would now be hooked up to wireless fetal heart rate monitors that would dictate the remainder of my labor. My contractions came on strong and hard, piggy-backing 2 and sometimes 3 without a break in between.  I was checked at 11am and found to be at only 5cm, they began talks of pitocin and augmentation of labor. This jumped my BP up and I began to panic. I remembered from all my readings, especially Ina May's words, fear and panic are the worst enemies of progression in labor. So I dug down, and found my mantra, "OOOOOPENNNNN".

After being checked again at 1:45 I was found at 7+ fully effaced and baby was at 0 station - here's what I had been dreading - transition. I knew it would be painful, but I didn't know it would be so short this time!! At 2:22pm I brought my son Henry Earthside in two pushes with the guidance of my midwife, husband and mother. He was born perfectly healthy, APGAR of 9, 7lbs even 21.5 inches long. And every once a little gentleman.

It may not have been my ideal way to go into birth, and the start of labor shocked my body so that my contractions were honestly way more painful than that of a naturally progressing labor, but it was short sweet and to the point! I labored for 5 hours 4 mins with no augmentation (other than AROM) no tearing, no medical interventions or drugs. I'm a birth Amazon 😁



This post was written by Megan from CT. She previously worked in healthcare but is now a SAHM to her two little boys. She plans to be a certified doula by the end of 2014 and her life goal is to become an independent midwife and attend home births. You can find out more about Megan at her blog.