The Right to Know – Cesarean Birth

I fell in love with childbirth the first time I witnessed it with my own eyes.  I had seen kittens and puppies be born before and thought it a glorious thing, but when I helped my sister bring my nephew into the world on that warm summer day in 2000, I knew I had witnessed a miracle.  I knew I had watched a rite of passage like none other possible in life, and while I didn’t think at that time I would be a mother, I was glad to be a woman.

When I prepared for my own daughter’s birth I did everything I thought I should do.  I did prenatal yoga and walked.  I ate a healthful diet and kept my weight gain to a minimum.  I took my vitamins.  I chose a practice with all women (7 of them) obstetricians and never missed an appointment.  I attended every session of the childbirth classes held at the hospital.  I wrote a birth plan that outlined the process that I hoped would be my natural vaginal birth and gave it to the doctors.  I did everything I knew to do to insure that I would experience birth in the most natural form.  The way I felt nature/God intended in most cases.

Then, on the day I turned 38 weeks I was given my 7th ultrasound in my pregnancy to check on the size of my baby.  They estimated her to be upwards of ten pounds.  The doctor I saw that day said that if I had any hope of giving birth vaginally I would need to go in that night to be induced.  I agreed because I wanted a vaginal birth.  I called my family and packed my bags.  We got to the hospital and as soon as the doctor on call (different from the doctor who recommended the induction) read my chart she ordered another ultrasound.  She then explained to us that she believed that my baby being upwards of ten pounds was too large to risk a vaginal birth.  She gave us a list of possible complications if we did indeed choose to attempt a vaginal birth – shoulder dystocia, cerebral palsy, brain damage, death.  The doctor left the room for us to make our decision.  I looked at my husband and sister in uncontrollable tears.  We all thought that there was only one thing to do.  I consented to have a surgical birth.

My daughter was born 8 pounds and 13 ounces 20.5 inches long.  I immediately felt like I had been played.  Then, as complications arose for the both of us from the surgery, including a five night hospital stay, I knew in my heart that I had made the wrong choice.  I now know that surgery was unnecessary and have had it most likely confirmed so by another obstetrician.  At this point, I became passionate about childbirth, and have since set out to educate myself and anyone that was looking for answers on the topic.

While cesarean section is a blessing for many mothers and babies, as it was in the case of my second birth, when it is necessary because of a medical complication, the practice in this country is obviously being abused putting in danger mothers and their babies.

In the United States the cesarean rate is 31.8%.  The World Health Organization (WHO) recommends that to remain within a healthy range no country should exceed 10-15%.  That means that the US has doubled that recommendation.  It has increased 48% since 1996.  Why?

There are many speculations as to why, however there are some things we can be sure of, the first being elective cesarean surgery.  With rumors of celebrities scheduling their surgical births, women wanting to plan ahead to avoid certain days and times to give birth, and others misinformed and afraid of a vaginal delivery, it has become possible for many women to just choose surgery.  I believe convenience for the obstetrician plays into this as well.  They don’t have to be on call or wait on a long labor.  Not only does this seem more convenient for some, but it is also more money in the pockets of the doctors and hospitals.

The other large reason is malpractice lawsuits and insurance companies.  Doctors fear being sued, which I think might play a part in many of the cases of recommended c-sections for a large baby.

Then, there is the cascade of medical interventions most often starting with an induction and leading to a c-section.  A labor brought on by chemical induction is much more intense than regular labor brought on by natural hormones released from both the mother and baby.  This often leads to an epidural and the mother growing tired sooner.  It is also more likely to cause a baby to go into distress.  A natural labor for a first time mother can easily last twelve hours or longer and be completely safe.  Induction brings on hard contractions much sooner.  It is not as gradual a process as natural labor.

Why do we consent to these things?  Some of you may even be wondering why I’m concerned at all with any of this.  It is because we are misinformed and left in the dark by the health care practitioners we are trusting to deliver us safely through our pregnancies and birthing experiences.  It is because for me ignorance was not bliss and has had lasting health complications for both myself and Deladis.  I wish I had known to know better.  I wish what I know now was common information and not something you have to search for.  I wish all women had the means to inform themselves and were respected by their practitioners.

So, you have the right to know this (whatever your choice is)…

1. A c-section is a major abdominal surgery.

2. C-section surgery poses risks to the mother including infection and hemorrhage among others that are 2 to 4 times more than a vaginal birth.

3. C-section surgery can delay mother and infant bonding due to post-op regulations in the hospital and the delay of natural bonding hormones.

4. Babies born via c-section are more likely to have allergies and have issues breathing at birth.  A c-section also runs the risk of babies being cut by a scalpel during surgery.

5. The “big baby” reason is a myth.  Ultrasounds are notoriously wrong the later you are in your pregnancy at determining the size of your baby.  Unless you have had the rickets or your pelvis is knowingly deformed in some way, there is no reason to think that your pelvis would not accommodate the size of your baby.

6. You have the right to refuse cesarean surgery or any other medical intervention you feel is unnecessary.  (Barring any medical emergency, this is your safest option).

7. You have the right to be fully informed of all the pros and cons of any medical intervention before making your decision.

8. You are more likely to experience a c-section if you have private insurance and private doctor.

9. If you become uncomfortable with you health care provider, you have the right to change.  (Check with your private insurance companies as to their date requirements, but in most cases arrangements can be made.)  You also have the right to a second opinion.

10. Homebirth with a midwife is available in most states and is the safest option of vaginal birth.  Midwives generally have better birth outcomes than obstetricians who are trained to look for an emergency not normal vaginal birth.

11. VBAC is safer than repeat c-section.

Please take the time to inform yourself.  Start by visiting some of the links provided in this article and watching this short film.  Then, I recommend you watch Ricki Lake’s, The Business of Being Born.  If you are then inspired to learn more, please feel free to email me and I can recommend more websites and books to help you avoid or prepare for your necessary c-section.  You have been given a glorious gift of pregnancy and the opportunity to give birth.  Take it into your hands.  Make it a peaceful place for you no matter than manner of delivery.

Happy Birthday Ivy Pearl

Today is Ivy Pearl’s birthday.  Actually, 2:12am this morning was.  She is officially 1 year today.  I am officially no longer the mother of an infant.  I approach this day with celebration and trepidation.  I am so happy to have a healthy, rambunctious little girl who is full of fight and fun.  I am excited about her being a toddler.  Even more excited about not having a big birthday bash for her like we tried with Deladis for the last three years.  We are having a simple celebration with just the four of us.  I’m going to make peanut butter balls for an after dinner treat.  We had a chocolate cake that I made at mom’s for them to eat.  Ivy didn’t like cake.

At first she thought it looked like fun!

I am apprehensive about my feelings surrounding her birth.  It was this time last year that my water broke with no labor.  Then, I went through every stage of labor, but didn’t dilate.  It was this time last year that I waited for nearly 2 days to birth triumphantly, and birthed through cesarean a second time.  I am not actively grieving anymore, but I am still full of fire about spreading the word on cesarean births.  I tried a separate blog for that, but it didn’t seem to be working.  I am planning to include a few posts in the next few weeks on the topic here.  I can say that I feel having homebirth as a viable legal option should be a mainstay in every state.  Homebirth midwives are birth heroes in my eyes, and the reason that Ivy’s birth was as good as it was.

I am also sad that I will never have the chance at VBAC again.  It’s not that I want to parent another child, nor is it that I don’t.  I simply don’t believe it is right for me, right now.  I will never know how it feels to birth fully – birth true.  I’ve come to terms with that, but it doesn’t take away the desire to know the feeling.

I look at Ivy today and am happy for her and me.  We came through a year’s journey that was full and fulfilling.  I look at Ivy today and I am glad we are back in our holler, together as a family.  My girls make home a very unlonely place.  I look at Ivy today and I see her potential.  Full of spunk, spark – life.  I wonder what she will be.  I wonder who I will be when I look into a woman’s eyes and see my baby Ivy in there.  Happy Birthday Ivy Pearl.

Ivy Pearl: born 11 pounds – 22 inches (The journey began at 5pm on April 26th and ended at 2:12am April 28th.)

Birthday

Ivy Pearl: Birthday + 1 – 19 pounds and 30 inches

A Week of Lamenting

Today’s post should have been about the beautiful Spring blooms all over the mountains around our house.  There are so many and they are unique.  I’ve really wanted to share them with others.  But, my camera is out of batteries, 2 out of 3 vehicles we have are not running, and John left for Merlefest in Wilkesboro, North Carolina in our only running vehicle yesterday.  No going out for batteries for me.  Instead, we are staying with my mother, and I am posting a blog of laments.

The Merriam Webster Online Dictionary says “lament” as a transitive verb means to regret strongly.  I regret strongly – very strongly – that all of my broccoli and tomato seedlings have perished.  They got too big for my little Jiffy greenhouse and peat pots and when I moved them to plastic egg cartons and free air, they wilted and died.  Apparently, vegetable seedlings are more dainty than flowers.  I’ve planted and grew flowers every year of my mature life with great success.  This is my first time vegetable gardening on my own.  With such a rainy Spring, the ground is too wet to direct seed.  The dirt clumps.  I am beginning to think that our first attempt at a large garden to feed our family might be more of a learning experience than an experience that ends in an abundance of food.

I also believe that my cloth diapering days have come to an end in great sadness.  Yes, I’m saying this the day after Earth Day.  I regret it strongly.  After moving off grid, I have been battling ammonia stinks in my diapers.  I have boiled, boiled, and boiled them.  I have stripped, stripped, and stripped them.  I have tried countless detergents.  I have used baking soda and vinegar together and separately.  I have done multiple rinses.  Multiple hot rinses.  Switched from a pail to a wet bag and back to a pail.  The culprit is our hot water heater combined with untreated well water.  Our hot water heater is old and doesn’t get very hot without shutting itself off.  It does fine for most things like dishwashing and bathing, so we can’t justify purchasing another one just yet.  Our water is tainted with sulfur and/or iron and comes from an untreated well.  I have come to the conclusion that it will be impossible for me to rid us of the stinkies.  I have decided to boil my diapers once more and send my stash of them to a friend due soon.  I suppose I’ll be ordering 7th Generation Diapers from www.diapers.com.  I’ll be doing this despite the fact that UPS doesn’t acknowledge that our address exists, and I’ll have to have them sent to my mother’s house.  It has come to the choice of using bacteria laden diapers on my Ivy, or disposables.  It breaks my heart.  I truly enjoy using cloth.

Ivy’s first birthday is in 5 days.  I will no longer and never again be the mother of an infant.  In a way, I too, regret that strongly.  I so loved being pregnant and anticipating birth.  I so wanted a VBAC (vaginal birth after cesarean) and a homebirth.  I relished holding a newborn.  Nursing an infant is heavenly.  Watching a baby grow from inside your womb to the outside is like watching a miracle.  Now, my baby runs.  My first born sings her ABCs and plays outside all by herself.  Soon, they will have their own pursuits independent of needing me.

Next week will be joyful.  John will be home again.  We will celebrate Ivy’s birthday.  I will get to see my writing in print as I am being published in the upcoming issue of Kudzu Magazine.  I won the 2009 Gurney Norman Prize for Short Fiction to my ultimate delight.  Gurney Norman is a writing hero of mine, and I think his short story “Fat Monroe” is one of the best ever written.  I will get to attend Evening With Poets, and get to workshop with Gurney Norman the next day.  After a week of lamenting, I am looking forward to what is ahead.

My First Blog Give Away

I am hosting a blog give away for the month of April in celebration of both Earth Day and National Cesarean Awareness Month.  A lucky winner drawn at random by my oldest daughter from names in a hat (I’m real tech savvy), will receive a size Large pink wool soaker.  The drawing will be held on the last day of the month.  A wool soaker is a breathable cloth diaper cover that will need to be lanolized.  It is WAHM made by Angel Luvz and is really very beautiful.  I chose the soaker because cloth diapering is a positive thing that parents can do for their babes and the environment.

Also, in celebration of the birth of my two daughters who were both born via c-section.  Deladis was taken early from my womb with no medical reason to do so (I now know).  I was persuaded to have the c-section by a female OB who used scare tactics and made me feel like she knew for certain my baby was too big to fit through my pelvis.  She was 8.13 lbs. and 20.5 inches.  After grieving my inability to birth my child naturally, I researched and talked with other doctors and midwives and found I had been duped.  Ivy was born at 41 weeks 6 days and was an attempted homebirth VBAC (vaginal birth after cesarean).  My water broke on the 26th and she was born via c-section on the morning of the 28th.  This surgery was necessary.  Ivy was posterior, head cocked back, and her cord was wrapped several times around her arm causing pressure knots.  She could not descend into the birth canal.  I had an excellent direct entry midwife and doula with me, who helped me know that the decision to have a c-section was the right one.  I experienced labor to the fullest.  I don’t believe I ever will have another child, but if I did, I would chose homebirth and VBAC.

I want all mothers considering elective c-sections for non-medical reasons to reconsider.  Many babies born via c-section are taken too early from the womb.  C-sections are major surgery with consequences to both the mother and the baby.  It is not something to be considered lightly.  Know that your body was made to birth your baby and you were made to be able to withstand childbirth.  Find your power in that.

I want all mother who have experienced c-sections to know that there is healing emotionally and physically.  You are not alone.

What is Acceptable Human Beauty? – A Mummy Tummy Post

I’ve been part of several conversations lately about the way I look, and I have decided to post at least a few times this week about those conversations.  I have lost quite a bit of weight.  My stomach is flatter than it has ever been in my life.  I wear a size that it literally shocked me to buy when I had to shop for clothes recently.  I had to convince myself to buy the size that fit me and what I was seeing wasn’t a mirage.  I have never before in my life been this size.  Yes, I’ve lost weight before, but never like this.  This has been a different experience.  So, in my recent public appearances I’ve been asked a lot of questions about how I lost it, am I eating, and do I exercise.  There has also been compliments that were followed up by an interesting statement that brought up something I’ve been dealing with for quite sometime – my mummy tummy.

I’ve had women say “oh, you look so good” and follow it up with “you don’t need to lose anymore though”.  They will ask if I am sure I eat enough.  The thing is, if thin is beautiful, why worry about the other.  I am not really trying to lose weight.  It has just happened as the result of my achieving other goals in my life.  The first one was I wanted to exercise at least five days a week.  I like feeling strong and fit no matter how much weight I’m carrying.  I enjoy exercise.  It makes me a happier person.  The second goal was to make my family’s diet as healthy as possible.  I did this first by moving us to a whole foods diet, and have since incorporated much of the ideas set forth by the Traditional Foods way of eating.  That is all I have done.  I never said I’m going to eat this much food, counted calories or fat grams, nor have I had a certain weight I wanted to achieve by a certain date.  I had healthy goals.  It wasn’t a fad diet, some new pill, or an exercise plan that made me miserable.

Since the birth of my second child I’ve been dealing with several scars.  These scars are physically noticeable when I am not clothed and are hard for me to look at.  One of these scars, I cannot even touch.  That is the scar left from my c-sections.  The reminder of the naivety with which I went into my first birth experience.  The betrayed trust of a woman taking care of another woman.  The reminder that I didn’t get my VBAC (vaginal birth after cesearean).  That despite what I did achieve with my second birth, I still needed a doctor to take my baby from my womb.  I have healed so much from the hurt this left in me, but that scar will always make me turn my head.  It isn’t natural.

The other scar is my entire lower stomach.  This scar is natural and one I should easily be able to embrace.  My mummy tummy was left to me after carrying a 22 inch, 11 pound infant for 41 weeks and 6 days.  I was not lucky enough to inherit resilient skin.  I won’t describe it here or post a picture.  My mummy tummy is between me and… uh… me.  I have witnessed on television women getting tummy tucks that I didn’t understand when comparing them with me.  I had never even considered that I would ever say that if I had the money I might consider cosmetic surgery.  Yes, I’m saying I have fancied the thought.  Me… a tomboy naturalist.

So, here I am wearing a size I still can’t believe I can fit into, and I’m hoping one day I will find my belly beautiful the way it is.  It carried my child.  It did exactly what it was supposed to do.  I’ve never been someone to show my naked stomach in public.  I’m not going to miss a bikini.  A close woman to me has a husband who calls her stretchmarks the roadmaps to their babies.  How sweet!  I wish I could see my stomach that way.  I wish I could embrace the beauty that the story behind it holds.  I wish I could not always have that little fear in the back of my head that those who do see it will find it as ugly as I do.

That leaves me with the question – What is acceptable human beauty?  I know my mind has been programmed to see stomachs that are flawless as beautiful when it comes to naked body beauty.  In faces, I look for quirks, uniqueness, not the him or her next door look.  Like… my sister Ariana, Johnny Depp, my hubby, and Oprah Winfrey.  I’ve never been one to obsess about my weight or anyone else’s and didn’t equate thin with beauty in every case.  But, a change in a body part that had before always looked consistent.  It has been hard to accept.  Man, this post is hard to write… I can’t even believe I’m putting this out in cyberspace for whoever to read.  But, it’s truth.  It’s part of it.  I will wonder how many expectant mamas will read this post and hope with all they got that their bellies show no sign of their pregnancy.  I will wonder how many other mamas are commiserating with me.  I will wonder how many mamas have learned to see their changed body as beauty.  I want to find a way to live with what I have, to look at what I have achieved with my health, and see beauty.

Writing Heals?

I’ve been working on a collection of ten short stories themed around birth and early infancy in the Kentucky mountains. All the characters are healing, coping, dealing, grieving, rejoicing, and pondering the situations surrounding the birth of a child. Fiction writing is my passion, and ultimately what I hope will become the permanent gig for the rest of my life. I am nearly finished with the collection and am in the process of submitting the individual stories to literary magazines that I enjoy reading.

What I didn’t consider when I started this collection was the outcome it would have on my emotional health. I know many people look to writing as therapy. Healing through getting it all written out. Writing a letter and burning it and all that jazz. I never did really. I looked to it as more of an escape. Except upon the near completion of this collection, I realized that writing it has brought me to a point of acceptance. Accepting the experiences of my own births.

Ro was born at 38 weeks. I had had a wonderfully healthy pregnancy. I gained only 35 pounds. I exercised throughout the entire pregnancy and worked as a teacher. I had written a birth plan for a natural vaginal birth believing that having chosen a practice of all women that that was very likely for me. I had never been in a hospital as a patient. At 38 weeks and after 7 ultrasounds the doctors convinced me, through scare tactics, that attempting a vaginal birth would endanger the health of my baby in tremendous ways. They told me she was upwards of 10 pounds and my pelvis would not accommodate her. I begged for another option, but they gave me a list of bad outcomes. I, crying reluctantly, signed the waiver and had a c-section without experiencing labor. My baby was 8 lbs. 13 oz. We both experienced health problems after the surgery and stayed in the hospital 5 days.

I began grieving this birth immediately. I felt Ro and I had been betrayed by not even being offered the chance to try. I felt as if we had been reduced to a number and an obstacle in the way of the OB’s chance to go home early. I got angry. I was happy to have my baby, but I felt sorry that she was jerked from me before she was ready.

Even though it was never my intention to have more than one child, I started wanting another. I rationalized about how it would be good for Ro to have a sibling (I still believe it is), but the real reason was I wanted another chance. I struggled with getting pregnant again, but I found myself with child in August 2007. I chose to VBAC and to do that at home with an awesome direct entry midwife. I did everything she told me to do. I immersed myself in the world of VBAC and natural childbirth. I learned the anatomy and physiology. I prayed. I took Bradley classes, got chiropractic care, and hired a wonderful doula. At 41 weeks 6 days (April 26^th) my water broke in a flood in a restaurant before the onset of labor. My baby was posterior with a cocked head. Her cord was wrapped around her arm several times. After finally laboring intensely for many hours, transitioning, but not dilating, I was transferred to the hospital where eventually I had to agree to another c-section (April 28^th) due to health concerns. Plo was 11 pounds. I am so thankful for the experience of natural labor, my midwife and doula who gave me the best possible care I could have received, a healthy baby, being respected and treated like somebody, and for being given a chance. But, I always wondered why the circumstances didn’t line up for the kind achievement I had so longed for.

I could not imagine having another baby at this point. I know if I ever found myself pregnant again, I would chose VBAC and homebirth. I was left a bit jaded, and envious of those who had been able to do what they were created to do – birth without assistance.

When I started my collection, I wanted to visit birth in the mountains throughout history and the present because that is all I could think about. I chose to write about the most triumphant situations, the most devastating, and everything in between. I explored the feelings of both men and women living with their choices, and the outcomes of births that effected them directly. I stayed with them through tears of joy and immense pain. Not running out the door with jealousy, hurt, or anger. I wrote it as real as I could get. As in your face truth of birth. All of the stories, no matter the result, were worthy of words.

Now, that I am coming out on the other side, I am realizing that my births are stories worth sharing as well. That my experience is part of a larger collective of women who have experienced it all. That the experiences were what they were and there is nothing I can do to change it, and that the only way to live with it is to embrace it. Not to say “oh, well”, but to live with the test, the history, the experience that is the reality of birth.

I have found myself in many ways healed. Healed of the constant dwelling. Embracing a new found appreciation for pregnancy, birthing, and the amazing capabilities of a woman’s body. I have found myself more present in the moment. Not revisiting my births, but trying to grow in mothering my beautiful girls. I’m thankful that God put me here with the desire to write, and heal through the process of it.

Wrasslin’ with the Devil

Wrasslin' with the Devil - 2008

My husband titled a painting Wrasslin’ with the Devil (www.haywoodart.com) last year. It depicted a snake handling preacher with snake in hands looking oddly fearful and brave at the same time. I feel like I’m that preacher. Ro is going to have a procedure done to check her urinary tract and bladder and some problems she has been having. It’s gotten bad enough that she doesn’t drink enough to keep herself hydrated as she doesn’t want to go to the bathroom. This was enough to land her in the hospital for four days after she caught a stomach virus that everyone had had and recovered quickly from. The problem is that I am having to trust a doctor to treat her properly. She will be under anesthesia, and more than likely I won’t be in the room.

The devil in this situation is many things – me dealing with past, me dealing with fear, me second guessing. Ro’s birth was an unnecessary c-section that happened because I was too trusting that another woman doctor would treat me ethically. Since, it has been hard for me to trust a doctor even with minor things. So, in turn I second guess whether Ro needs the procedure or not. I think what if some of the behaviors are habits now, left over from a problem now healed, not indicative of a larger problem. I wonder if the procedure is necessary. I wonder all this despite the fact that the symptoms are still around and no better. It is the scar that is in my face everyday that is the problem, and I’m trying to protect my child from being affected by that scar any further.

The thought of a child as young as her being put under anesthesia frightens me. I hate the thought of her feeling that loss of control before you slip under. I’m thankful for it too because she won’t remember anything after – the procedure itself – which is the point. I’m still thinking I might request that I be in the room while it is done. It is in the hospital though, so I’m not sure that will fly.

Ro had her first antibiotics ever just last month. I’m adamant about taking pharmaceuticals only when clearly necessary. Then, I’m told by one doctor that he thinks the type of antibiotic used was overkill. She has had to see three different doctors. So, then, I think, overkill, who can I trust not pull an overkill on my baby. I want to say, “You’re not in the practice of playing let’s see how much of what I know I can actually use, but in the practice of assisting the human body in healing itself.” Why is that so hard?

We live off-grid and unfortunately (though improving) the access to quality healthcare is slim. To see most types of specialists one would have to travel at least three hours. I do believe we have a fairly local urologist with good intentions for my child in my head. Now, it’s time to make my heart believe it and make the best decision for my baby.

The vomiting happened again last night and I soon realized where the bravery in the preacher’s eyes came from.  He felt called to handle snakes.  I am called to protect and nurture my child.  In order for him to handle the poisonous snake he had to let go and let God.  In this instance, I have to look beyond my past experiences, and let go and let God.