Birth Center vs. Hosptial

There are a lot of debates about a birth center versus a hospital.   I think you know by now that our hospital experience wasn't ideal.  So why would I want to do it again?

First of all, I'm not set on it.  I'm hoping it could work out, but I am very aware that I could go to this nurse-midwife appointment and realize that this isn't for me.  And Daddy B will be there too, it could not be right for him either.

Second, like I said in my previous post, those two other OB's are 50+ miles away.  I've heard from a few different mamas that the driving distance is worth it to get the birth you want.  I'm not sure if we will be looking directly to an OB if the Nurse-Midwife group doesn't work out or if we will start looking in to birth centers closer to our home.

Why am I considering another hospital birth in the first place?  Here's what's on my mind:

1. I was raised by a nurse who taught me to trust our medical system.  Now I know this system failed me last time (for the most part), but I also still have faith in our trained medical personnel. Amiga C is a nurse, my mother is a nurse... I trust nurses and doctors who are like them.   I just don't know if I got the best pick the first time.
2. I feel a little pressure.  Aunt K has told me many times that she wouldn't feel comfortable without a NICU close.  Would I?  I haven't explored how I feel on this completely but I'm afraid that she could have a point.  I think I need to interview a birthing center to be sure.  
3. I don't know if Daddy B would feel comfortable in a birth center.  I haven't directly asked him.  I guess I plan to do that if the Nurse-Midwife group doesn't work.
4. When I visited that first OB, she made a good point about a birth center I was considering.  She said, "The biggest piece of advice I can give you about using a birth center is to make sure they have doctor backing at a hospital in case you end up in a c-section."
5. It scares me to think that I could be laboring in a birth center and realize I need a c-section, only for an ambulance to have to be called and go through a scary ride to an OR.  After the traumatic experience last time... I just couldn't imagine adding that on to it.

I'd welcome advice on this issue.  I don't plan on moving forward with a decision until I explore this Nurse-Midwife group next month.  Know of any good Birthing Centers in DFW? Centrally located?

P.S.  No matter what, we will be using doula.  Just thought you'd like to know.

A Cesarean and Breastfeeding

I had a plan when I was pregnant.  I would be induced, have an epidural, deliver vaginally and start breastfeeding and continue breastfeeding for at least a year.  Funny how we make "plans," right?

To say breastfeeding was hard for me is definitely an understatement.  First of all, breastfeeding is hard for anyone.  Three of the close women in my life all have really great, unique stories about breastfeeding.  I want to tell you a little bit about their experiences, since I'm sure I will be referring to them in this blog.  I'm leaving out their children's names just to be safe and respect their privacy.

Aunt K - She's my sister-in-law and one of my closest friends.  She has two kids, my nephew who is 4 1/2 and my niece who is 10 months. She was induced with both, had epidurals with both and had successful vaginal deliveries.  She had an over supply of milk with her first baby and this led to her decision to exclusively pump for 4 months, with the milk lasting for 6 months.  With her second, she had a great lactation consultant and breastfed for 6 months after overcoming the first challenging few weeks.  So proud of her!

Amiga C - My best friend since high school!  She has one child (planning on more!) and her breastfeeding story is famous!  :)  But really, it was just featured on Mama Birth!  She breastfed for over 6 months after suffering through preeclampsia, which resulted in a 36 week, induced birth with epidural (which she did not like) with her cute-as-a-button daughter.  I remember when she was pregnant she wasn't even sure if she wanted to attempt breastfeeding and has gone on to believe in it so much!  She is one of those women who has just blossomed as a mother! I am also so proud of her!

Cousin M - If you want to talk about a determined mommy, you need to look no further than my cousin M.  She had her daughter about 6 weeks after I had Baby C and had a long early labor at home before heading to the hospital and having a quick, natural birth. Her little girl showed signs quickly of food sensitivities in Cousin M's breastmilk.  I mean folks, she gave up everything to continue breastfeeding: dairy, red meat, certain veggies, all spicy food, went gluten-free, EVERYTHING.  Now this DID help Cousin M to get to a great post-pregnancy weight, but I think she would've rather been able to have a big bowl of mac n' cheese and still breastfeed!  ;)  She is my hero when it comes to breastfeeding and I'm proud to tell you at 17 months old, Mommy and baby are still going strong with nursing!

What do all of these women have in common besides successfully breastfeeding?  A vaginal birth.

I've thought a lot about how my birth with Baby C may have impacted my failure at breastfeeding.  Here's a recap:

• I breastfed in the hospital, but did not have a great lactation consultant.  She kept asking me if it hurt and I would say, "Well it's not comfortable, but I guess it doesn't hurt."  She said that was normal.  I don't think it was.
• The lactation consultant was already having me supplement with formula in a syringe while in the hosptial.  My colostrum should have been enough!
• My milk came in somewhere between 6 and 7 days after giving birth. 
• Baby C had a horrible latch and before my milk really came in, I was already bleeding.
• To attempt to heal and take a break from the VERY painful experience of trying to nurse on bleeding nipples, I pumped for a couple of days and surrendered to giving Baby C pumped milk and formula.  It was then that I noticed I was only making about an ounce on the left and less than 1/2 an ounce on the right per pumping session.  This never increased.
• I was worried about Baby C getting enough so when Aunt K suggested I do exclusive pumping like she did with her first, it sounded like a good idea. We both thought I could maybe be as successful as she was with her first.
• I lasted 6 weeks pumping.  I pumped about 7 times a day and made a maximum of 12 ounces in 24 hours.  I got 3 clogged ducts and started to develop mastitis.
• Funny side note - that pump started saying evil things to me!  In the late hours of the night I swear it would chant "Kill the bitch!"  LOL It's a running joke in the family now that the pump is possessed!  ;)
• When I went to my postpartum vist with the OB who delivered me, told her of all my struggles and showed her the clogged milk ducts, she actually told me to give up. And she was currently a breastfeeding mother!

So I did.  I gave up.  I wish that I knew then what I know now about breastfeeding and I also wish I had Aunt K, Amiga C and Cousin M's and their experiences already with me when I was attempting it with Baby C.  I can't go back though and Baby C is a healthy 19 month old now, so I can't really be too upset.  I feel like I did the best I could at the time with the knowledge I had been given.  I know better for next time.  I can't help but wonder though, did my feelings about being inadequate to the point of not being able to birth my baby the way God intended have an impact on my feelings about being able to breastfeed?  I believe they did.

On to the point of this post...

I feel like a big reason my milk supply was so low was because my body wasn't ready to have a baby (another post, for another day).  I've talked to many VBAC mamas who had a similar experience with their first, but swear it was better after giving a natural birth.  I'm looking forward to that!

Here's a great article on breastfeeding after a cesarean.

Lessons Learned Along the Road

It’s been about 6 months since I put in to words one of the most terrifying experiences of my life. I’ve learned so much since then! I’ve met so many moms through ICAN and other mommy-networks that have been responsible for igniting a passion in me to educate myself and my family on why attempting a VBAC is right for me. Originally, I thought I would just find an OB that would be VBAC friendly and I would move in to having a better hospital birth experience in the same setting I did before. Boy was I wrong. It’s not that easy.

I met with the OB who I originally thought was part of a VBAC friendly practice and hospital, but quickly found out that those were wrong assumptions and you can’t trust everything you find on the ICAN website. The women of the ICAN have been so honest and forth coming with me about their experiences and recommendations and through their wisdom, I have become more empowered than ever to make my own decisions instead of trusting our medical system.

While visiting the original OB, she made a good point that has stuck with me. I want a VBAC, that much is clear, but I have to consider that maybe I was supposed to end up in a c-section, regardless of how I feel about it. I can never know the answer, only God does, and according to His plan, I had the birth with Clint that I was supposed to. Like I’ve said before, I know I can’t guarantee the vaginal birth I want, but I can do everything in my power to make it happen. After much considering, my husband and I decided we’d like to try birthing in a hospital again. Do you know how large the metroplex is? Can you imagine that there are only 2 OBGYNs that have great VBAC rates?! Both of these doctors are 50+ miles from our home. From the beginning of my research, I quickly realized I wanted to work with a midwife mindset more than a physician mindset and our desire to birth in a hospital has lead us to a Nurse-Midwife group that is about 23 miles from our home. They deliver at the third baby friendly hospital named in Texas. I visit the nurse-midwife group on April 26th to have my IUD removed and see if this is the right fit for me, my husband and our next baby. I’ll let you know how it goes.

My REAL Birth Story

Originally written 9/7/2010 - Over one year later

Unfortunately, my birth story isn't unique. While I was pregnant with Baby C, I was told he was a big baby. My doctor never did an ultrasound past 20 weeks, but she said she could tell by how full my belly was. I had an easy pregnancy and was fortunate to be in great health the entire time. My mom had 4 c-sections so I talked with my doctor multiple times about how I really wanted a vaginal birth. My mom is also a nurse of 27 years so I grew up trusting our medical system. When my doctor told me at 38 weeks that she wanted to induce to increase my chances of a vaginal birth, I felt I had no reason not to trust her judgement. She went on to tell me that even with the induction, she felt I still had a 70% chance of having a c-section. So, at 38.5 weeks, I showed up at 5am and started pitocin. Around 12pm I got an epidural and at 5pm I had only dilated to 5cm, was 70% effaced and the baby was still in the -1 position. My doctor then told me that we needed to start thinking about a c-section. I told her I wanted to wait another hour and see what happened. The nurses helped me get on to my hands and knees to labor in a different position. The hour passed and my doctor returned. I hadn't progressed at all. She said it was time to go to the OR. I remember wondering then why it was so urgent. I was fine and the baby was doing great. I asked her what could happen if I decided to keep laboring. She told me that the baby could get stuck in the birth canal and she would either have to break my pelvis or the baby's shoulder in order for him to be born. Obviously, I was scared out of my mind at what she said so I agreed. I asked everyone to leave the room and my husband and I made the decision together. I was very upset.

I'll never forget being wheeled back to the OR by myself. I remember looking up at the lights in the hallway and the chill of the OR as we entered. This was the most scared I had ever been in my life and I kept asking the nurse when Daddy B would come in. I was almost having a panic attack. Daddy B came in, they started the operation at 7pm and at 7:07pm, Baby C was born weighing 8lbs 9oz and was 21.5 inches long. They didn't hold him above the sheet and I was really disappointed. The first time I saw him was when Daddy B brought him over all bundled up. After 20 minutes, they took him to the nursery and I was left with another 45 minutes of them putting me back together. I then went to recovery and went through the most painful process of them trying to get my uterus to contract. By the time I got to my post-partum room, it was 11pm and I finally got to hold my baby.

I'm crying as I type this. I know I still have so much healing to do emotionally. Daddy B and I are going to try for #2 starting around Baby C's 2nd birthday. I am working hard to prepare myself both physically and mentally for a healthy birth and delivery. My hope with our next child is to not be induced, not have any pain medication and deliver a beautiful baby vaginally who will be placed immediately on my chest and we can start trying to nurse.

I know I can end up in another c-section. Baby C was a big boy for 38.5 weeks. But I feel if I don't do everything in my power to try and achieve a different outcome, I will never forgive myself. I think if I have done everything I can and I still end up in a c-section, I will be able to cope with the experience and know that this was simply God's plan for myself and my baby.

My First Birth Story

This is a place to document my journey to a VBAC. I'm hoping that it ends the way I envision it, but there are no guarantees. When looking for support in my quest, I rarely came across a personal story that was brutally honest about the journey to their birth. Here's where it started...

Right after I gave birth to my son, I felt this need to act like I was happy. I didn't have post-partum depression and I wasn't experiencing what some moms sometimes struggle with in not feeling connected to their baby... nope. I was mourning the loss of a birth. Something so personal and an experience every mom has a right to go through THIER way. I typed up the following birth story wanting people to think that I was "just happy to have a healthy baby." That's what everyone says, right? Stay tuned for the real birth story. I think you'll notice the difference.

Originally written 9/1/2009 - 6 Days after Giving Birth

The morning of August 26, 2009 I was up at 2:11am. I could NOT sleep anymore because I was so anxious for my scheduled induction at 5am that morning. I made myself stay in bed until 3am and then went to take a shower. Daddy B (the hubby) , my mom and I left for the hospital at around 4:25am and arrived only 15 minutes later the hospital. I checked in and they had me set up, ready to go and on the pitocin by 5am. I came still dilated to 1cm and 40% effaced, as I had been for about 2 weeks. As the levels of the medicine increased, I started to feel more contractions, but nothing I felt I couldn’t handle. Next, my doctor came in to break my water. This was a lot more painful than I expected! Because I wasn’t dilated very far, my doctor had a harder time breaking the bag of waters and it took her a few tries. I had a lot of fluid! Daddy B’s face was so funny as he saw probably half a gallon of clear fluid come out. Little did he realize, this was only the beginning! Once my water was broken the contractions started to get more intense. I dilated to 3cm after they broke my water and was about a 3 on the pain scale of 1 to 10. I told the nurse I thought I could get to a pain level of 7 before I wanted my epidural. Shortly after, she turned me on to my right side. I quickly progressed to a pain level of 5 and then went straight up to 7! My contractions had a really good pattern and we all thought I definitely had made some progress. At this point I asked for the epidural. I had hurt enough! At about 10:30am, I was to the point where I couldn’t just breathe through the pain, but was having to make some audible sounds to mentally handle what I was experiencing.

The anesthesiologist came in and started to perform the procedure at about 11am. The epidural hurt a lot more than I was expecting. I think it was mainly the unknown that hurt because the anesthesiologist had to feel my lower back and find the space in my spine and he pressed hard on my sides and it made me jump. This didn’t make the anesthesiologist happy because every time I moved, I moved my spine and he had to start over. We agreed that I just need ample warning for him to continue without me moving. The numbing medicine wasn’t bad, but I didn’t like the pressure from the epidural needle. Once the medicine started working, I became more tolerable of the pressure and he finished quickly. The epidural was glorious! I really stopped feeling the pain of the contractions but instead could only feel the pressure of the uterus contracting. My contractions stayed in a really nice pattern, but after my next internal exam, I was still only 5cm dilated and about 70% effaced. They inserted an internal catheter monitor to see how strong my contractions were and the strength turned out to be right on track. Our nurses kept moving my position to try to get the baby to drop down in to the birth canal. After another 6.5 hours, my doctor examined me again. The look on her face wasn’t great. I was still at 5cm and 70% effaced and the baby was still in the -2 station. We had a room full of people and she told me that we needed to start thinking about a c-section. I got really overwhelmed and we asked everyone to leave. The situation was that the baby wasn’t making any progress, and although his heart rate was perfect and he was handling the increasing pitocin very well, my doctor didn’t think he was going to drop any lower and it could be due to the shape of my pelvis, which turns out to be curved and shallow. I was really upset. Daddy B asked the nurses to give us some time alone so we could make a decision. We decided to wait one more hour and have no one else in the room so we could focus on laboring by ourselves. The nurses put me on my elbows and knees to try and see if this would move the baby down. I started to feel a lot more of the contractions in that position but stayed like that for about half an hour. My doctor came in shortly after and examined me. I don’t think I will ever forget the look on her face. She was disappointed as well because I had made absolutely no progress. Daddy B had really calmed me down when we were able to be by ourselves and we told her we were ready for the c-section. It was time for our son to be born!

My mom and dad came in the room to wish me luck, followed by some friends. I was nervous. Daddy B got dressed in his OR outfit and looked really cute and it helped to keep my spirits light. They put cuffs on my lower legs to keep my circulation up and then the anesthesiologist came in to increase the medicine in my epidural. He tested this by poking me with a needle and I had to indicate when I felt it was sharp. The more medicine he put in, the higher up I went numb in my chest. I really couldn’t believe how much I thought I could feel when they said I was ready to go for the surgery. At this point, they wheeled me over to the OR. I kept thinking how surreal it was and I was very nervous. I fought back tears the whole trip across the Labor & Delivery unit and once they took me in to the actual operating room, I sort of lost it. I started crying and just kept asking when Daddy B was going to be able to come in. Once they finished prepping me and they put up the blue sheet, Daddy B finally came in. They started the procedure at exactly 7:00pm. There was a lot of pressure and then even MORE pressure. I was scared. Daddy B was wonderful and kept telling me to look at him and concentrate on him. When Daddy B first sat down he said, “I’m not going to look, is that okay?” I said “Yes.” Well as soon as they said they were about to deliver him, Daddy B stood straight up and watched our son come in to this world. At 7:07pm, Baby C was born! He cried right away and that’s when my tears started to flow as well. They had to use a vacuum on the baby’s head because he was stuck down in my pelvis. Daddy B soon left me to go over and cut the cord and help clean him up. We had great nurses that let him feel really hands on even though it was a c-section. It wasn’t long until Daddy B came over with Baby C and sat with me with him for about 20 minutes. He was so beautiful! I gave him his first kiss and then they had to go to the nursery. I was left alone, and although I was very happy about the birth of my son and listening to the nurses and doctors discussing the pot for the weight everyone was in on (Aunt K won!), I did not like that after he was born it took a total of 45 minutes for me to be finished with the surgery. They wheeled me to recovery and I didn’t get to see Baby C until about 11:00pm. The rest is history and all the pain I experienced after the delivery doesn’t matter. I have a perfect baby boy that I can call my own!