1 Month Later.... Miss Moira's Birth Story

(Sorry this is so late folks.... babies don't leave a lot of time for blogging!)


Even though I had planned on VBACing with this baby it turns out that she just wasn't engaged in my pelvis so my OB and I decided to go ahead with a c-section. This was both an easy decision and a really tough decision, if that makes any sense. I felt relieved that there was an end in sight, that my OB had done everything in his power to get this little girl to engage my pelvis, and that this time I was making a very informed decision. But at the same time I was really disappointed because I was so informed and was still ending up in the OR. I had switched from an OB who was so anti-VBAC that she resorted to lying to me, to an OB who was everything a pregnant woman could hope for. I got a doula, read the right books, and worked super hard to encourage the baby to come down. And yet, there I was, looking at yet another surgery.... 
Still, in the end I was ok with the decision because I felt like it was 100% my choice and that I was still giving the baby time to come on her own by waiting a few more days. 


So on Tuesday morning, at 6am, Klint and I arrived at the hospital to get the ball rolling and meet our baby. The surgery was scheduled for 7:30am and everything looked like it was going to go as planned. I got my IV, the appropriate paperwork was signed, and I had been fasting since 10pm the previous evening. All that we needed to do was meet with the anesthesiologist.  But then a hiccup in the plans occurred.... apparently another expecting mommy needed an emergency c-section and they were going to have to bump my delivery to the early afternoon.... not good news for a hungry and anxious pregnant woman!

So Klint and I hung out in a room until the afternoon came and we were given the green light that at 1pm I was going to be rolled into the OR. Ahhhh! Crazy!! After the news came that everyone was all set to go things are a little blurry because of all the emotions going through me at the time.... I was scared of the spinal (I react REALLY badly to any kind of anesthesia), I was excited to finally meet the baby, and I was a little nervous about yet another surgery.

All in all, the surgery started at about 1pm and at exactly 1:30pm Miss Moira Marie Krebs was born into the world! I remember a LOT of pressure around my ribcage to pop her out... not the most pleasant feeling in the world, hearing her cry for the first time, and then the whole unpleasantness of the doc putting me back together. There were some moments where I thought I was going to be sick from all the pulling and tugging sensations, but thankfully Klint helped me stay calm and not pass out from everything. I don't know if I would have made it without his strength by my side. It was so nice knowing that as soon as Moira was weighed that Klint had her and she was with her daddy.

About 30 mins after they got Moira out I was stitched back up and was given the baby to hold while we went to the recovery room for a couple of hours. From there on I was taken to my post postpartum room where I stayed until I was discharged. There is absolutely nothing negative that I can say about any part of my hospital stay, from the nurses who took care of me to the supporting staff. Everyone was kind, compassionate, very skilled, and at no time did I ever feel like a burden or a pain. I was actually so happy with my care that I spoke with the head of nursing to tell her how much I enjoyed my stay and that every single nurse there had my complete gratitude.

So that is Moira Marie Kreb's birth story. A very happy ending to a very eventful pregnancy!! 

 

Those Pesky Doubts...

I think that one of the hardest things about this journey is dealing with all the unknown factors in labor and delivery. Up until this point I was a cool confidant mama who just assumed that my body would fall in line with the whole going into labor bit. In the last week though I am starting to have doubts about whether my body will actually be able to work right and get this little one into the world without seeing the inside of an OR.

At my appointment about a week and a half ago my OB asked if I had had any surgery on my cervix, which I had not. Apparently I have a "funky" cervix that feels more like a ring of scar tissue and makes it really hard for others to check me and know that I am dilated. A week ago, when I thought that this was it, I went into L&D with contractions 2.5 mins apart and coming strong, yet wasn't dilated enough to be called real labor.... and the contractions have continued on and off but never strong enough to progress into labor.

Now I am worried that this funky cervix of mine can't dilate because if it feels like scar tissue will it be able to stretch like it needs to? I worry that I am having all this prodromal labor for nothing and even though my body is working hard, it just can't do what it needs to do... sigh.... I hate worrying!

I am anxious to see if I make it to my usual Weds appointment and if I have made any progress.... I just hope that I have and that my anatomy works with me and this baby girl (who is having a grand ole time propelling herself off of my ribs and headbutting my girlie parts!)

I am sure that lots of VBACing women have these doubts, especially at the end.... I just never expected anything  to do with my anatomy to be the issue. And I know that my OB is doing his best to help things along in the most natural way possible, he won't even use a Foley Catheter to get things moving.... so it is all up to me to avoid the knife!

Say a prayer, light a candle, whatever you do.... here's to my funky cervix, lol!

 

Homestretch is in Sight

It is hard to believe that these months have passed by so fast.... From that shocking first moment, holding the pregnancy test in my hand  and yelling "Shit, shit, OH MY GOD SHIT" (lol) to now when I am seeing my OB every week, talking to my Doula, and feeling this little girl gear up for her big debut.

Last night I had a great conversation with my friend Tara, who is a certified Doula in the WNY area. She is a HUGE birth advocate and called to tell me about her latest birth that she attended- a VBAC that almost didn't happen. It was a great story with a lot of important information such as the usefulness of certain interventions like epidurals and Pitocin. What struck me about our conversation though is that Tara pointed out how different my views on birth are now compared to when I first found out I was expecting again.

I used to think that my OB was always looking out for my best interests and the health of the baby. I used to think that c-sections were the only way for me since I had 2 previously. I used to think that c-sections were easier for everyone and that there was NO WAY in heck I was going to birth naturally. (I used to tell people that unless I was getting a free car at the end of my hospital stay, why put myself through all that pain?) I used to think that women who birthed naturally were gluttons for pain, hippies, or trying to prove something. And I used to think that I didn't have the option to say No to an intervention that I didn't want to happen without good reason.

What a difference a movie, some books, a network of devoted women, a web board that offers information, and some cojones can do in a mere 4 months!

 

I Found My Nurse!

So I don't know if I have mentioned it before, but starting at 31 weeks I have had to go for Non Stress Tests as a "precaution", Usually you only hear about high risk preggos having to go for these, but since my OB is really cautious, apparently having 2 previous c-sections puts me in the high risk category in his book. I complied because the tests are non-invasive and I see it as a chance to develop a relationship with the nurses in L&D.

Well, today that plan worked! There is one nurse in particular that is really nice and was actually offered a job as a doula by a mutual contact of ours, so I know that she is very supportive to a laboring woman. This nurse offered today to come attend my birth, even if she is off, and talked to my OB about it to let him know that she is who I wanted with me at delivery time. All in all, I LOVE her! She is really supportive of my VBA2C and knows that I am planning to go all natural. I am relieved because that takes away my worry of having a nurse that is not supportive and will try to push interventions on me that I don't want.

Even though I hate going to these NSTs because I think that my pregnancy does not warrant them, at least now I can visit with Annie!

 

What's The Difference?

This is the difference between a "hospital managed" birth and a VBAC where the woman is in control of labor and naturally lets birth happen, rather than be given orders. How inspiring!




 

A Beautiful All Natural Hospital VBAC

This wonderful photo slide show of a VBAC that was all natural AND took place in the hospital has taken my breathe away. Especially since I am nearing the end of this journey and have periods of doubt and such, this is just the inspiration that I needed to keep my resolve. I know in my head that this VBA2C is the best for me and the baby... it is just the unknown that is a bit scary.
But, just look at the resolve in her eyes.... it is wonderful, beautiful, and sooooo inspiring! Check out the whole thing here!!

 

It's All Relative

When you talk about a VBAC two words that get quickly ingrained in your head is uterine rupture. The risks of, that dangers of, the possibility of.... it is the first thing my former OB brought up and purposely inflated all details about it to scare me out of even researching a VBA2C for this baby. When I called, and called, and called other OB offices and they promptly denied me, uterine rupture was the reason for them saying a very quick NO!
But really, when you think about it... yes, there is a risk. But isn't there a risk in everything we do? When we choose to drive, fly, eat at a restaurant, have sex, park downtown, etc.... there are all risks associated with these actions. Rarely though are you in a hospital where if the unthinkable does happen you are in good hands.
Here are some statistics to put it all in perspective: (from here)

Your risk of dying in a car accident, over the course of a lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.

You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.

Your odds of being murdered are 1 in 140 over the course of you lifetime. That's 2 times more likely than the risk of rupture.

The annual risk of having a heart attack in 1 in 160, 2 times more likely than rupture.

If you're a smoker, your risk of dying from lung cancer is 1 and a half times more likely than a VBAC mom having a uterine rupture during her labor.

You're about 17 times more likely to contact an STD this year than having a uterine rupture, more likely to contract gonorrhea as well.

You're 13 times more likely to get food poisoning than to rupture.

You're more likely to have twins than to rupture. Odds of twins: 1 in 90. That's about 3 1/2 times the likelihood of uterine rupture.

If you ride horseback, you're 3 times more likely to die in a riding accident than you are to experience uterine rupture.

If you ride a bike on the street, you are 4 times more likely to die (annual risk) than to suffer a uterine rupture.

Having a serious fire in your home during the next year is twice as likely as experiencing a uterine rupture.

You're 10 times more likely to win at roulette than you are to have a uterine rupture.

If you flip a coin, you're more likely to get heads (or tails) 8 times in a row than you are to rupture.

The risk of cord prolapse is 1 in 37 (2.7%) or nearly 10 times more likely than that of uterine rupture.

And a final irony (heads up those of you who want a doctor to give his/her opinion on the likelihood of rupture next pregnancy!):

You're 6 times more likely to have a doctor who is animpostor than you are to suffer a rupture. 2% of docs are phonies (1 in 50), according to several sources I found.

So, instead of worrying about rupture, why not take a few minutes to check up on your doctor's credentials? :) It'd be a more profitable use of your time, and a substantially more likely cause for alarm.

Here's a few more I came across on my own (keep in mind the odds of uterine rupture are roughly 1 in 200 or .5% (though I have seen it as low as .3% or 4%)):

Your odds of dying from cancer is 1 in 7

Your odds of dying as a result from a stroke, 1 in 23

You're odds of dying from committing suicide, 1 in 121.

 

An Interesting Read... from 2006!

In September 2006 I was trying to convince my husband that another child would be good for our little family and a year later that is exactly what happened. However, when I got pregnant with Amelia, my OB had already decided that another c-section was my only option and refused to discuss the possibility of a VBAC. I had never thought to question her or research my options because I didn't think I had any. (This is all moot point of course because AJ was born via emergency c-section due to distress at 37 weeks- her heart rate was in the 200's!)

But, had I done any research hopefully I would have come across this wonderfully written article by Dr. Mark Landon that was posted in the Ohio State University Medical Center.

"In his most recent analysis of multicenter data collected over four years, Dr. Mark Landon evaluated the risk of complication and success of VBAC in women who had undergone more than one prior cesarean delivery. 

The 19-academic center study was led by Landon and conducted through the National Institutes of Health, Maternal Fetal Medicine Units Network. Its data included more than 45,000 patients with previous cesarean section, which included almost 18,000 women undergoing a trial of labor or an attempt at VBAC.  

Landon found that the risk of uterine rupture was 0.9 percent in cases of women with a history of multiple prior cesarean deliveries undergoing a trial of labor, compared with 0.7 percent in the cases of patients who had experienced only one previous cesarean delivery. These data challenge the notion that women with more than one prior cesarean are at dramatically increased risk for uterine rupture with a VBAC attempt."

Huh.... interesting that not only does this state the risks of VBACing with 1 c-section but multiple, AND states that the risk increases only minimally with multiple surgeries. And this was back in 2006! Before ACOG released the new guidelines stating basically the same thing- that women with multiple c-sections CAN benefit from trying for a vaginal birth.  

This study is really good because it is a huge pool of women and shows what the true risk of rupture is plus how small the risk of a catastrophic rupture (fetal death or brain damage) is. It is just too bad that it took ACOG 4 years to take notice and change its views on VBAMC.

 

It CAN be Done!

I have discovered that if you yell loud enough people take notice, whether they agree or disagree. And if you not only stand your ground but use intelligence to wage your wars, your chances of success are that much higher.... but sometimes it is purely luck that is on you side!

Yesterday, I went to my 3rd OB consult in the hopes of finding a supportive OB so that I could have this baby in a hospital but still have the natural VBAC I am hoping for. I had made the decision to have Klint stay at home because I don't know if I could have undone yet another OB's lies and inflated "your baby and you are going to die for sure" statistics. I had tried to talk myself into a mindset of calm, peace, and non-defensive which was hard considering what I have been through thus far... it helped that I was seriously running through the hospital to find this OB's office... I was too out of breathe to be defensive!


After all the phone calls, all the stress, research, worrying, and distrust of the medical community I have finally found an OB. One who not only did not mention a single uterine rupture statistic, (actually that was not even talked about), he did not tell me my chances of failing were high, or that this is a bad decision. What we did talk about are things that pertained specifically to me and my personal birth history- I am short (4'10'') so that may not help BUT he delivered a woman vaginally who was only 4'8'', it was not noted if my previous OB thought that my pelvic bones were too small- bad because he would like to know BUT good thing because it is purely an OB's opinion and opinions like that vary from doc to doc. He looked at my scar- was completely amazed at how "beautifully" it healed, was confidant that my body can progress when it is ready to deliver, refuses to induce births before 42 weeks, AND has witnessed all-natural VBAC's. OMG!!!!!!!

So here is the lesson learned from this experience- DO NOT settle for anything other than what is BEST for you and your baby. There are good OB's out there who will not make you jump through hoops to have a VBAC (aka the 3 Ring Circus VBAC), who are supportive of natural VBACs, and who are confidant in their abilities to keep you and your baby safe. This OB was referred to me by both the local ICAN chapter, a great resource! And even though his name isn't mentioned, this is his patient mentioned who had 3 c-sections prior to finding him and having successful VBACs!

My new OB blew my mind when he said "I am open-minded and flexible as long as you and your baby are safe and well". Isn't that how ALL OB's should be?



 

Informed Consent vs. Medical Bullying

One of the biggest things that I have learned thus far is that women have the right to say no to interventions and procedures that they feel are not in their best interests. Before I got "that feeling" that something was not right with what my former OB was saying, I honestly thought that the professionals entrusted with my care had my best interests at heart. I did not realize that some OB's choose to lie and manipulate their patients to back up their "facts" and that I had to be the one to do my homework about everything involved in having a baby in modern America. Every childbearing woman in America has rights, which you can read here.

Most providers, I want to believe, will be open and honest regarding the risks and benefits to all the interventions pushed on birthing mothers today. However, there are some who choose to use their "professional" status to bully the patient. This includes brushing off whole topics, inflating statistics to support their opinion, graphic imagery to make a statement, and threats that are meant to stop the patient from questioning further.  Unfortunately, for women who are trying for a VBAC and even more so, a VBAMC (vaginal birth after multiple cesareans), these "scare tactics" are pretty common. Here is a great list of the tactics OB's and yes, even some midwives, will use to get a woman to "choose" a repeat c-section.

So what can you do if you are being bullied into interventions that you don't believe are medically necessary? The OB wants to induce you at 38 weeks, you are told you HAVE to have an epidural, the nurses won't let you move around, or you are told that you have no choice but to have a repeat cesarean....

1. Do your homework- there are great websites here that will inform you honestly about the risks and benefits to most of the common interventions such as Pitocin, artificially breaking the water, laboring on your back, etc. 

2. Make sure that your partner, doula, midwife, and labor coach know what you want for your birth and even more importantly WHY. When you are concentrating on labor the last thing you need is someone from your labor team pressuring you to go along with whatever suggestions the nurses and such are making! 

3. Ask questions- ask what other options there are, ask for a second opinion, ask for time to decide.

4. Go with your gut and listen to your body- if your body is telling you that you need to move then do it, if there is no medical reason for the intervention then decline.

5. Remember that even if you do decline and give your informed refusal to something, you have the right to change your mind. 

I know from recent experience that the more informed you are prior to giving birth the more prepared you will be to deal with various situations. I have no clue how this birth will go, what kind of support the hospital staff will give me or if I will have to constantly fight to remain in control of what is happening. But I truly feel that the more knowledge I have about the whole process, the better off me and Miss M will be!


 

Catching Up

Obviously a lot has happened in the past few weeks to send me from just going along with what my OB told me to do without question to considering a homebirth or laboring at home until the hospital couldn't section me. I have been blogging about it on my other blog- Creative Bubbles- up until this point.

** The first post, here, is really the smoking gun for this whole thing. I saw the movie The Business of Being Born. I sat there, mouth open, watching my first birth experience happening on TV and realizing that none of it should have happened as it did. I saw women in hospitals, scared out of their minds and drugged up. But I also saw powerful, brave, serene women giving birth so peacefully and confidently.**

I had no idea that birth could be like that. And then my head started going over conversations, or lack there of, that I had with my OB regarding the possibility of a VBAC with AJ and now a VBA2C with this little one. I reeled from the fact that this professional that I trusted and hired had sorely misled me and I had almost let myself be operated on AGAIN for no good reason!

** At my 20 week appointment I tried to talk about my new found knowledge with my OB, posted about here. Needless to say that no matter what, I will never see that doctor again regarding my health. In researching I realized that I had been fed a bunch of scare tactics, as read here, and that they partially worked on my husband and myself.**

So now I have been searching for a new OB, one who will support my decision to VBA2C and will tell me the real risks of both a repeat c-section and a trial of labor. I blogged about it yesterday, here, and today I *think* that I may have found a place for me to have this baby that is safe and supportive... *think*... I am trying not to get my hopes up too high because I have been lied to enough and misled enough. But me, being me, will keep a positive outlook and just know that karma will lead me where I am needed.

UPDATE: I found an OB who clearly states that he supports VBAMC and has patients travel as far as 2 hours away to deliver! I have an appointment on Monday where he will look at my surgery records, look at my scar, and really be honest with me in regards to the risks of me birthing vaginally, which is all I am asking. I am both excited and scared to be excited because I don't want to go in with high hopes that this OB is going to "let" me birth naturally and with as little medical intervention as possible. But at least it is a start!