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Jen’s Cesarean

From the Beginning

I laugh now when I think of how I felt “ready” to start a family. It’s very similar to saying you are ready to be shot into space. No matter how much you prepare, you will be utterly overwhelmed with the emotional and physical exertion as well as all the things that you didn’t prepare for because you just simply didn’t know. For example, I never knew I would have a c-section, how difficult recovery would be, how that would affect the first few months of my daughter’s life as well as my options in future births. I also couldn’t begin to comprehend how having a child would change my life, the dynamic between my husband and I, or how much love would swell up inside me for this little person. Now, it’s really hard to imagine how I lived almost 30 years without knowing my precious daughter K.

Even before I was pregnant, I was reading and researching. Not all OBs, midwives, or hospitals have the same standard policies and procedures so I wanted to find a midwife and hospital whose birth philosophy matched mine the best. As I read, I learned that every procedure has risks and benefits and that it is important when considering an intervention to assess on an individual basis whether that procedure would provide a particular woman in her specific situation a benefit that outweighed the possible risks of that procedure. I also learned how often interventions are performed due to convenience for the doctor. (One example: many women undergo induction without knowing the risks associated.) Even though I am a lover of technology, when it comes to birth, it is important to use technology when it was truly medically indicated rather than mandating a set of medical interventions as routine and performing them on every woman regardless if her case called for such care.

I was shocked to learn that despite all that Americans spend on health care and all of our technological advances, according to WHO/UNICEF/UNFPA 2000 estimates there are over 25 other countries with lower maternal mortality rates. How can this be? American health care is clearly missing something because we spend all this money and have all the “latest and greatest” technology, techniques and drugs, yet Australia, Austria, Belgium, Canada, Croatia, Czech Republic, Denmark, Finland, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Kuwait, Lithuania, New Zealand, Norway, Poland, Portugal, Qatar, Serbia & Montenegro, Slovakia, Spain, Sweden, Switzerland, and United Kingdom all had lower maternal mortality rates than the US.

Then I learned that according to the Centers for Disease Control and Prevention and the National Center for Health Statistics, in 2000 the US ranked 27th among industrialized nations in infant mortality rates. These facts shook me to the core and further encouraged me to really research and question the standard operating procedure that many OBs and hospitals follow during pregnancy and labor. Clearly, good prenatal care, access to health providers, and birth in a hospital setting was not enough. What was the US missing? (As of 2006, the US was ranked 29th in the world in maternal mortality rates, 42nd in infant mortality rates, and Save the Children found that we have the second worst newborn mortality rate in the developed world! Click here for an excellent commentary.)

I planned on interviewing several midwives (if you are interviewing OBs, here are questions to ask them) and visiting several hospitals. I went to my first hospital maternity tour at Saddleback at my mother’s urging. Little did I know that I would be the onlynon-pregnant woman my age in the room. To add insult to injury, I show up wearing a pair of trim slacks, accenting my pre-baby waist, and a very stylish pair of heels. Wow, where those ready-to-pop moms in their elastic waistbands and sensible flats not happy to see me. I felt horribly foolish. While it was a beautiful facility – was a palace in comparison to UCI where I would tour next – I was a little put off by the several hundred people attending this tour. I wondered if I would even be able to get a room if I came here laboring. I was also concerned about the nurse to patient ratio. In addition, they didn’t address the information I wanted to know: What was their c-section rate? What was their episiotomy rate? Did they routinely give pacifiers or bottles of sugar water or formula to newborns? Did they encourage rooming-in or did they automatically take the baby to the nursery? This was the information I came for and while the tour was nice, I left wondering if I was the only woman in the room who left with the same questions I came with.

I next visited UCI Medical Center and was even more disappointed. Not only did the tour reveal LDR (labor, delivery, and recovery) rooms that looked like former broom closets (very small, crowded, dark and no windows), but the nurse leading the tour had a very condescending tone.  She spoke to us as if we were a bunch of children, which really insulted me. I wondered if she spoke to us in this manner on the tour, what kind of treatment would I receive while in labor? Then the nurse informed us that “all babies would be removed from the mother for two hours after bonding.” No exceptions. I did not want my baby going to the nursery at all. Anything they needed to do to my baby would be done in my room or my husband T would accompany the baby to the nursery. I also did not want erythromycin put in my baby’s eyes. This is a procedure required by law in California in order to combat infection resulting from a vaginal birth in a woman with undiagnosed STDs which you can refuse.  As I did not have any STDs, it was an unnecessary procedure in my situation and the nurse was not happy when I asked about it. If a hospital was not comfortable my wishes, I would not hire them. So UCI Medical Center was off the list.

I finally visited South Coast Medical Center in Laguna Beach and felt like I finally found a hospital that fit me. Their tour wasn’t a cursory cruise through the maternity ward. They actually talked about all the things I was interested in knowing. They didn’t even have a nursery. They encouraged rooming-in, but if you needed a break, a nurse would care for your baby. They were very supportive of breastfeeding and non-intervention during labor unless medically indicated. Did I mention that all the LDR rooms boasted wall-to-wall floor-to-ceiling views of the Pacific Ocean? I envisioned myself peacefully laboring in a warm tub of water overlooking the ocean in a hospital where I would not feel badgered, where our objectives were the same, so I could labor without battling. I was so excited.

While I was interviewing hospitals, I became pregnant, so I started was also interviewing midwives. After speaking to three, I hired a hospital-based midwife. The stage was set! Over the next few months, T and I took Bradley classes (was a better fit for us than Lamaze,) had reserved my midwife’s birthing tub (she didn’t permit delivery in the water, but she would let me labor in the water until my membranes ruptured), and studied various non-drug pain relief techniques. I read a lot, but Ina May’s Guide to Childbirthby Ina May Gaskin was one of the most influential books I studied. (I have heard that Journey into Motherhood is another excellent book featuring non-medicated births.) I gained such confidence reading the various birth stories in the first half of the book. All different women, describing different births, and different non-drug coping skills. It was a refreshing contrast to all the over-medicated, “over-interventioned,” over the top, screaming-all-the-way-to-the-delivery-room births I tortured myself with on “The Baby Story” and other similar shows. Reading Ina May’s book taught me that there was no Right Way to labor and labors can progress very differently. It influenced my expectations for what my labor would be like. I learned so much. I was highly motivated and committed to a unmedicated, vaginal birth.

Breech!

My prenatal appointments were uneventful until 35 weeks when my midwife noticed my baby was laying transverse (sideways). She said it was very likely the baby would turn vertex (head down) on her own. After all, only 3% of babies are breech at term. Surely I would not be in that 3%.

I knew that as the pregnancy progressed, and the baby got bigger, the likelihood that the baby would turn on her own slowly diminished. I asked my midwife, “What if she doesn’t turn” and I was told that I would most likely have a c-section. Goosebumps spread over my body and I felt immediately nauseous. This cannot be happening to me. I wanted my waves, my peaceful waves and contractions rocketing through my body! I did not want surgery.

I went to a chiropractor who was trained in the Webster technique. I did the recommended yoga positions. I sat on hard chairs versus our soft comfortable sofa and when I did indulge in its cozy embrace, I didn’t recline and rarely did I put my feet up. I tried everything I could think of. I was not going to have surgery damn it.

At 37 weeks, the baby was frank breech (bottom down, legs and head up). I could feel my plans for a beautiful birth slipping away. We scheduled an external cephalic version (ECV), where an obstetrician would manually try to turn the baby, for the next week. I started to feel desperate and time was running out.

I borrowed some moxibustion from a midwife friend on April 13th when I was 37 weeks and 6 days pregnant, but never had a chance to use it. Things happened really quickly over the next week.

One last chance

On April 15th (38 weeks, 1 day), we went to the hospital for the ECV. We started off with an ultrasound to access the situation. The baby had moved to a footling breech position, meaning the baby’s head was lodged under my right rib with her bottom down in my pelvis, one leg tucked beneath her bottom and the other leg pointing outward – a pretty complicated position.

The OB said that there were three factors to determine the probability of ECV success – size of the baby (which was in my favor – he estimates the baby to be 6.5 lb plus or minus a pound), amount of amniotic fluid (which was not in my favor since he said I was on the low end of average), and the fact that this was my first pregnancy was not in my favor. He predicted a 50-60% likelihood of success and thus the risks of the procedure were worth the potential success. With that information, my dear husband and I decided to go ahead with the procedure since what did we have to lose? I did not want surgery.

So, in went the IV. They gave me Terbutaline to keep me from going into labor as well as a narcotic called Fentanyl for pain management. A few minutes later the doctor came in. They literally poured a cup, or even more, of mineral oil on my stomach and then the doctor cupped one hand around the baby’s head and the other around the baby’s bottom and turned. It was rather uncomfortable, but never painful, compliments of the Fentanyl. I did my slow deep yoga breathing and that helped me relax. The whole procedure was about 10 minutes. He tried three times to turn the baby and then said that the baby wasn’t going to turn. She was just stuck. Crap.

Due to her position, the OB said that I was not a candidate for a vaginal breech birth. He recommended scheduling a c-section for next week when I will be 39 weeks pregnant. I asked him about waiting until I go into labor and he said that makes c-sections more risky and complicated – more issues with infection. He said that there was a 5% chance that the baby at this stage of the pregnancy could spontaneously turn head down.

He was very warm and understanding of my disappointment. He knew I was planning an unmedicated vaginal birth with my midwife and said at one point, “I know this wasn’t part of the plan.” He was very sensitive to the fact that while I knew the surgery was in my future, I wasn’t happy about it or excited to avoid labor.

I stayed at the hospital for about an hour after the ECV for observation. It was interesting to watch how the drugs affected the baby. The baby was very active, then got quiet once the drugs were administered and then “woke back up” about 45 minutes later.

My c-section was scheduled for April 22nd (39 weeks, 1 day). I was devastated. I remember going to lunch with my mom and mother-in-law, both of whom had all their children vaginally, and just crying. Cesareans are so common in our society that it’s very easy to forget that they are major surgery with real risks. It can be hard to find people who understand the devastation of wanting a vaginal birth and instead laying on a table as you are cut and your baby is lifted out of your body.

Labor Begins!!

We had dinner with my in-laws on April 19th. I devoured a full steak dinner with baked potato and a half glass of red wine. We didn’t get to sleep that night until 11pm. So of course, my water would break three hours later at 2am (38 weeks, 5 days). It felt like a river of warm water. So many things were going through my mind. “Yeah! I went into labor naturally! Yeah! I’m so thankful for the waterproof mattress pad we put on the bed the week prior!” He later told me that he had thought I just peed the bed and didn’t believe that my water had broken, which I found so odd because I do not routinely pee the bed! Really!

I waddled to the bathroom with squirts of water flowing as I moved. I was so excited and the adrenaline running through my body caused my legs to wobble as I walked. I learned in Bradley how you can tell if it’s your water breaking versus urine: if you can stop the flow with your Kegal muscles, it’s urine. Even though a Kegal was harder this far along in my pregnancy, I could tell that my water had definitely broke.

We called the OB who said to come into the hospital immediately and I would be the first c-section of the day at 8am. Of course, my bag wasn’t packed, because my c-section wasn’t for two more days. It was as if when I got my scheduled “due date” I didn’t believe I could actually go into labor on my own. As if that one little piece of paper suddenly overturned all the laws of nature.

So, we quickly packed our bags, I put on a dress, wrapped a towel around my waist, grabbed a bunch of beach towels for my seat, and we hit the road. As we drove the 45 minutes to the hospital, I was having very mild contractions. I could feel my uterus stiffening, which is amazing to feel your belly as hard as a rock, but felt no pain. I called my mom, mother-in-law, and boss and left messages saying that today was the day. I was exhilarated. I was in labor!

Hospital Time

When we got to the hospital, my husband drove up to the Emergency entrance and ran inside. He said, “Wife… baby…I’m going to take this,” grabbed a wheelchair and ran outside. The nurse ultimately caught up with him and wheeled me up to Labor & Delivery as he parked the car. The nurse put me into a four-patient evaluation room, but fortunately, I was the only one there that morning. Could you imagine laboring in a room with three other women with the only thing separating you being thin sheets of fabric hanging from the ceiling? They gave me the fabulous hospital standard blue gown to wear and hooked me up to the external fetal monitor (EFM), limiting my movement to the bed, and put in an IV. They told me to lay on my left side, despite all we know about gravity, balance, and the agility of a pregnant woman in labor.

By this time it was about 3:45am and my contractions were coming on faster – about 2-3 minutes apart. At one point I went to the bathroom so I was able to experience contractions in different positions and quickly saw why it is so important, and can be far more comfortable, not to labor in bed. The contractions I had while sitting on the toilet were easily half the pain. As I walked from the bathroom to the bed, I had a contraction standing with my arms laced around T’s neck. Those contractions were not as comfortable as the ones I had sitting, but were still less painful than lying in the bed. I wanted to labor sitting on the toilet, but the nurses wouldn’t permit it because of the increased risk of cord prolapse with a footling breech baby. I had to be on the EFM.

One of the nurses was a Hypnobabies instructor and was so supportive of my desire to be unmedicated while others continued to offer drugs. Despite the fact that a copy of my birth plan which stated “do not offer pain medications” was deposited at the nurses’ station upon my admission, the nurses offered me pain meds three times that I can remember. Pain management is part of their training and they were simply trying to help, but for me, I wanted to see and feel what labor was like.

I wanted to see my body do all the things and go through all the stages that I had read so much about. One of the reasons why I was so upset about a scheduled c-section is that I wanted to go through labor. I wanted to experience contractions and finally know what everyone was talking about. Through pure luck, my water broke two days before my surgery date. I was actually there experiencing it. I did not want pain meds. I wanted to feel connected to the process, not like a bystander watching from afar.

Contractions felt just like a really bad leg cramp and I wondered if all those early morning charley horses I endured my entire pregnancy was in some way preparing me for this Olympic event called birth. If only baby had been in the right position, I would have been able to see how my body would handle delivery. I was so hopeful that my next child would be in head down/blast off position and I will be able to experience labor and delivery as nature intended.

Labor is so primal and it was an incredible experience to share with T. There is a new dimension to our bond now that we have shared those few hours together. He was amazing. I remember feeling how disgusting I must have looked to him as I walked from the bathroom with blood trickling down my legs. I was a little embarrassed and wondered, knowing how squeamish he was, if he would find me gross. Whether he did or not, he supported me through my contractions and helped me visualize Kauai where we spent our second anniversary. We had such a wonderful time there and thinking of it helped me relax which made the contractions more bearable.

It’s about 4am now and the nurse checks to see how dilated I was – that was more painful than the contractions – and I was 3cm. So they called the OB as I was progressing faster than anticipated and they did not think I could “hold on” until a more decent time of the morning. The OB said he would be right in. At that point, the L&D nurse offered pain meds yet again and I consented. She was so persistent and I began to feel a little defeated as my inevitable cesarean loomed ahead. I knew I was getting a spinal within the hour anyways, so what was the point? Soon I was being wheeled into the OR.

Having a C-Section

The OB, hospital, and staff were very respectful of most of my wishes. I wasn’t shaved or given an enema. My arms were not tied down to the table. I could wear my glasses. Most importantly, T was present the entire time during the surgery. However, the screen was above my breasts, so I wasn’t able to breastfed until I was in the recovery room and they immediately clamped and cut the umbilical cord rather than waiting for it to stop pulsing.

It was hospital policy for husbands to be out of the OR while the anesthesiologist did the spinal (similar to an epidural, but the needle goes in further and pierces the sac containing spinal fluid and spinal cord) but he was running late. So there I was in the OR, waiting. I was in full labor wearing a paper gown with everyone else in the room in scrubs and masks. I felt so disconnected, vulnerable, terrified, and alone. I was exhausted only getting three hours sleep, I was sad because I didn’t want a c-section, I was pain because the narcotics the nurse had given me had worn off, and all I wanted was to be with my husband who was just outside the door waiting to be let in. A nurse said that I could lean on her or hold her hand while I was having a contraction, but it felt so weird to be relying on someone when I couldn’t even see her face. This was such a intimate, private moment for me and here I was with a room full of people with masks on their faces.

After begging for T, they finally let him in and he was present when the anesthesiologist arrived and did the spinal. It was so wonderful to finally know someone else in the room and not feel totally alone. After the spinal was in, they laid me down on the table, put in the catheter, an oxygen mask was placed on my face, the screen was put up, and the music turned on. The anesthesiologist was sitting by my head on the right, T was sitting on the left and with the two OBs plus assistants crowded below the screen, I looked at the reflection in the lights above and saw red blood. They had begun the surgery. I was having a c-section. And all my dreams of a normal, vaginal birth flew out the window.

This is so not how I envisioned the birth of my first child. After planning a peaceful birth, I was devastated to find myself in the operating room. I wanted to labor in the water overlooking the Pacific Ocean and instead here I was, in the early morning hours, physically numb from the epidural and emotionally numb from a combination of drugs and exhaustion.

I remember doing my yoga breathing trying to focus on my breath and not on the tugging I felt below. The whole idea of being cut was terrifying to me. The anesthesiologist was really nice continually asking how I was doing. I started getting a bad headache, so he gave me meds for that and then I got really nauseous so I got more meds.

T completely surprised me. While prepping for the ECV, a little blood squirted out of my IV when they initially placed it. T turned green and had to leave the room, thus I was fully prepared to have T sitting at the “pretty end” during the surgery. So imagine my surprise as I saw my husband rise and peak over the curtain, with the consent of my understanding and kind obstetrician, and videotape the entire surgery!

When I was pregnant, we both strongly expressed that we did not want to video the birth. When I was scheduled with a c-section, that started to change, but even as we grabbed the video camera that morning, I was still undecided. Looking back, I am so glad we recorded the surgery.

I was drugged, totally disconnected from the process and while I could hear everything, I felt nothing. It is wonderful to watch that video – as I have many times – and associate all the noises I remember with everything I didn’t see, especially my daughter’s cry.

Not long after the first cut, my sweet daughter was born at 5:50am, weighing 6 lbs 13 oz and 18 inches long. She was screaming and lovely. Yet when they lift her over the screen, I didn’t feel that legendary joy that new mom’s often report. I felt as much genuine joy as one can have after too many drinks. I was high from all the meds and it was hard to appreciate the profoundness of the moment in that state. The video ends with me seemingly alone and asleep, lying naked on operating table, all sewn up and ready for transfer to the recovery room.

Recovery

I was awake and very hungry, but wouldn’t be permitted to eat for many hours. They did bring my baby into the recovery room so she could breastfeed. I remember her latching on and I was so happy! It was very weird to not feel my legs and it took a while – I can’t remember how long – to finally feel my toes. Family came in and visited us for a little bit, but other than that I don’t remember very much. T said I slept for 9 hours while he played and slept with K on his chest. It makes me sad that I missed so much of that first day, but I haven’t slept that long since she was born!

Later that day, I was moved to the room we would stay in for the next three days. It was a private room with its own bathroom, complete with shower and sink, TV, and reclining chair for T to sleep in. One wall was all windows, so we got a lot of natural sunlight. As the spinal wore off, I began to feel more and more pain which I countered with a continual flow of Vicodin, which caused its own issues as I was continually thirsty and suffered from horrible periods of nausea. I was in a drug-induced cloud and remained that way for a few days. It makes me sad to think that the first few days of my daughter’s life, I was not fully present because of the pain meds I was taking. It was a hard choice, I was in so much pain for so long, and trying to choose between being in pain and being mentally clear is a very hard choice.

I had a slight cold, so was coughing periodically and that hurt so much. I held a pillow against my incision as I coughed which helped a bit, but I cringed before every cough. It hurt just to move in bed. The most simple movement caused the most incredible pain.

God bless the mechanical hospital bed. To be able to go from lying down to sitting up at the press of a button, without any assistance from my severed abdomen, was wonderful. I didn’t fully appreciate it until I went home and had to figure out the least painful way to maneuver in bed. I wondered why all those mechanical bed commercials featured only the elderly.

Twenty four hours after the surgery they removed the catheter and my wonderful daytime nurse got me out of bed for the first time to use the restroom. Walking for the first time after the surgery was so horrifyingly excruciating. I had the nurse under one arm and T under the other and I really didn’t think I would be able to walk the five feet to the bathroom. Your world suddenly becomes so small when five feet feels like forever. The pain was unbelievable and I experienced contractions for 2 hours before the surgery and those hurt like hell, but they only last for 30 seconds to a minute and then there is no pain. The pain as I walked the 5 feet to the bathroom was far worse than any contraction. It was the worse pain of my life. I remember wondering how I could possibly care for a baby and endure this pain. But with my nurse under one arm, and T under the other, I walked like a wooden solider to the bathroom.

The next day it was time to take off my bandage and I was terrified to see my incision. The whole area hurt so much, I couldn’t imagine how long it would take me to gingerly remove the bandage that covered my tender wound. The nurse recommended I remove it myself in the shower because the OB would just “rip it off.” That meant walking to the bathroom again, and while it was far less painful than the day before, I walked unassisted very slowly and with great care.

That shower felt so amazing. It had been three days since I had showered or brushed my teeth. After my shower, I changed into my own pajamas and underwear. Up to that point, I had been wearing a blue fabric gown with these horrible webbed mesh, stretch hospital panties. When you still look like you are 5 months pregnant, exhausted, and in pain, it just tops the cake to be wearing the one-size-fits-all hospital-issued underwear. What a relief to be clean and in my own clothes again.

That afternoon, the friends and family descended for a visit. I was so excited to see everyone and wished I had felt better so I could really enjoy them. Some side effects of the spinal reached a crescendo before the visit as I itched all over my body. In my groggy state, I didn’t realize exactly how much I was actually itching. When it finally got too much, I called the nurse and they gave me Benadryl and morphine via my IV. I now understand why people use morphine recreationally. My itching was almost immediately resolved and despite fighting the feeling, I passed out within a few minutes. It was amazing to me how quickly drugs take affect when they are injected directly into one’s bloodstream.

The next few days I struggled greatly with breastfeeding and cried a lot as the hormones that make you feel so great during pregnancy left my body. I also finally noticed how huge I was. When you are pregnant, and your cute tummy is center stage, you don’t realize how big the rest of you is getting because it looks small in comparison to your behemoth middle. Just wait until that tummy is gone my dear and you will see how you could take flight with your upper arms, and your thighs could easily feed a family of four for many weeks. Like most women, I have always struggled with my body image and gaining 40 pounds was very fun on one hand and very depressing on the other.

Despite conventional wisdom, having a cesarean does not mean you will escape the pain of childbirth. With a vaginal birth, 98% of the pain occurs during labor, which might last a day or two. With a cesarean, 100% of the pain occurs after the baby is born and they don’t give you epidurals then! Many women report pain six months after their cesarean (1), so it is quite common for pain to last for weeks, months or even years.

I was in constant pain and then discomfort for months. It hurt to sit up or rollover in bed. I woke up countless times with jabbing, searing pain because I made the mistake of trying to rollover while sleeping. It hurt to stand up. You don’t realize how almost every major physical movement relies on your abdominal muscles until you have abdominal surgery: peeing, pooping, coughing, moving, walking, bending. I took Vicodin for two weeks, round-the-clock post-partum, and was nauseous the entire time, but if I didn’t take it, I was in horrible pain. On top of the pain, and the resulting little sleep, caring for a newborn can quickly turn into a hard and miserable affair.

Going home

I really didn’t get a taste of what life was like with a new baby until she was almost two weeks old. The first few days we were in the hospital. T stayed with us the whole time except Thursday night when he taught his class at the local community college. We didn’t have to clean or cook. The food at the hospital was surprisingly good, or maybe I was just very hungry. When we went home, T took a week off of work. So, that was pretty easy. He could hold K while I showered. While I was exhausted, it was fun to share those days with him. Everything changed when he went back to work. The exhaustion quickly took hold and it was very hard. Looking back, I wish I would have done a few things differently.

Dealing with “Advice”

I should have worried less about what other people thought and instead did what felt natural and obvious to me. I received some advice from well-intended people. As a new parent, there is so much you don’t know. I didn’t want to come across as arrogant, but there were a few things that seemed so clear to me that I really wondered if I was doing the right thing. Also, just because something worked for someone else, doesn’t mean it will work for you. Circumstances vary so much: your personality, your baby’s temperament, your spouse’s involvement, your family dynamic, and your parenting philosophy – it’s really hard to find one thing that works for all families. The most important thing is to find what works best for your family. Below is what worked best for ours.

The most important advice I heard on parenthood was “Follow your instincts. Don’t go by what you read in a book. If it feels wrong, don’t do it. If your baby is crying and you want to pick him/her up, don’t think, don’t analyze, pick her up!” It made me realize that I have everything I need to parent: my natural instincts and my love for my daughter. I realized that this philosophy was the foundation for a variety of parenting behaviors collectively called Attachment Parenting. Two years later, following this advice, I have no regrets about any of the choices I made.

“You shouldn’t sleep with the baby, you will suffocate her!” – The fact was, I struggled so much about K sleeping in a crib vs. a co-sleeper vs. right next to me. The deciding factor was sleep. Ultimately, everyone, K, T, and myself, all got more, higher quality sleep if she slept in our bed. For the first few weeks, I would wake up with K in the middle of the night, take her downstairs, turn on the TV, and nurse her. By the time she was done eating, I was wide awake, interested in a show, and would stay up a little longer. By the time I went back to sleep, she was waking up 30 minutes later. There is a reason why war criminals are tortured with sleep deprivation. It is painful. Once I learned how to nurse lying down, that rocked my world and changed my life. No longer was breastfeeding and sleep mutually exclusive. Now that I could do both at once, all I had to do is wake up just enough to pop K on the boob and then go back to sleep. Plus, she didn’t have to fully wake up enough to cry and get my attention as she slept down the hall. With her right next to me, I could feel her rooting and slightly waking up and I was able to quickly get her attached. It was less traumatic for both of us as neither of us had to fully wake up for K to eat. It was still exhausting, but not so much. Within a few weeks, I stopped worrying about where everyone slept, and concentrated more on how well everyone slept. I’m sure you heard about the AAP’s recommendation to put your baby asleep in a crib with a pacifier. You might find it of interest that the study they based that recommendation on was funded by pacifier and crib manufactures…. not exactly neutral parties. The fact is, co-sleeping is very safe and protects children from SIDS. Both Dr. Sears (pediatrician & author) and La Leache League have publicly disagreed with the AAP.

“You should put her on a schedule.” – Putting her on a schedule simply did not work with my overall parenting philosophy and would seriously interfere with breastfeeding as would giving her a bottle at night. Breastfeeding is based on supply and demand and especially in those first few weeks when your milk supply is getting established, it is very important to feed on demand, not on a schedule. This will ensure that you make enough milk. It is no surprise that “not producing enough milk” is commonly cited as a reason to stop breastfeeding when we live a society that loves putting babies on schedules and getting them to sleep through the night ASAP. If I hadn’t done my reading beforehand or joined La Leche League, I probably would have thought how wonderful it would be to have K on a nice little schedule. Who wouldn’t love more sleep? But the fact is, I just needed to power through those first few months. They are brutal, but co-sleeping and learning to breastfeed lying down, made it easier.

“If you hold her to much, she will become clingy.” – At the time, when I was filled with so much doubt, I wondered if this person was right, but looking at the wonderfully independent, confident little girl K has become, I realize how much that advice was rooted in not being inconvenienced. Babies in the womb are in continual physical contact with their mother. To go from that to post-birth reality is quite a shock. Babies love to be held and parents should enjoy that time as much as possible. Soon your  kids will be dating and most likely won’t be into hugs. I am a huge advocate of babywearing and recommend it to all new parents. My Wilkinet and Maya Pouch were the two best investments I made. I would not live without my Pouch whereas I could easily forgo my strollers (except maybe my BOB Sports Utility Stroller.) I use the Maya Pouch, almost daily, to this day and K is 22 months old. It’s excellent for shopping – no pushing around a gigantic bulky stroller. If K wants to nurse, she can discretely. If she wants to sleep, she does. It’s a great way to give baby what s/he needs (physical contact with you) while freeing up your hands to do things that you need to do (grocery shop, clean, cook, etc.) A sling is the one thing I could not live without. All the other baby do-dads are superfluous.

“You should let her cry it out and sleep train her. It will teach her how to sooth herself.” – Sleep trainers make tons of money because new parents are tired, desperate and are looking for an easy solution. Even so, I knew from the beginning that I was not going to do this. There is a reason why babies cry – they can’t talk yet. It is their only mode of communication and the whole point of “cry it out” is to reduce and/or eliminate crying thus eliminating a baby’s ability to communicate with you. This makes no sense. However, I did give it a try a couple desperate nights. As I sat downstairs and listened to her shrill, I thought back to “Don’t analyze, pick her up!” and I ran upstairs and did. First, it’s very important to understand that babies sleep differently than adults, so it’s unrealistic to expect them to sleep 5, 6, or 7 continuous hours like an adult. Second, there are also other less painful, more logical methods for getting your baby to sleep longer. Third, excessive crying can be harmful to babies. Fourth, there is a reason why babies cry, they are trying to communicate something to us. So even if we can’t identify the cause, that doesn’t mean we should ignore the message. Finally, I reflected on the evolutionary truth of “cry it out.” While we are sophisticated technologically savvy people now, our bodies are the result of millions of years of evolutionary fine tuning. Imagine being on the savannah and consider “survival of the fittest:” those that manage to survive, live to reproduce. Would a baby permitted to cry, unsupervised on the savannah, survive longer than a quiet baby who is held and comforted? I imagine crying babies attracting predators and the quiet satisfied babies surviving. We are now safe in our homes, with no natural predators stalking us, but those ancient behaviors – a mother’s natural immediate response to pick up her crying baby – are hard wired into our being.

What about the next birth?

I’ve since heard that having a cesarean is like being run over by a car and then handed a baby. This is how I felt. I knew I wanted next time to be different. When my OB suggested that I could have a VBAC (vaginal birth after cesarean,) I was all over it and wanted to learn more. All I knew was that I didn’t want to experience surgery again unless it was medically necessary. I wanted to experience birth.

I spent the next couple years wading through the research on vaginal birth after cesarean and frustration ensued. There is a plethora of information available on the internet, but it wasn’t what I was looking for. I wanted recent studies and analysis. I wanted statistics that were properly cited so I could easily read the original medical studies. I wanted to know the specific rates of complications.   I wanted to know how many moms and babies died.  I wanted to know how many VBACs were successful and for those that weren’t, what were the outcomes?   I wanted to understand the risks of repeat cesareans.   And I had heard talk about VBAC being illegal in some states or counties. Or that some women opted to have home VBACs.  What did that entail?

But there was no one place where I could get all this information. How was I to make this huge medical decision when all the information I wanted was scattered across the internet or deep within medical studies which I had no idea how to access? On top of all that, while my OB said VBAC was a possibility, whenever I mentioned it to anyone, the overall tone was that VBAC was too risky and dangerous and why not just have another cesarean? After all, as I heard time and time again, they are so easy and convenient.

Over the years, I slowly and meticulously collected information. And after my son’s victorious birth in 2007, a home VBAC, I created VBACFACTS.com in order to make the studies I had compiled, and the analyses I performed, easily accessible to others. In 2009, I started teaching VBAC classes throughout Southern California to curious parents, birth advocates and medical professionals.

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1. Declercq, E., Cunningham, D., Johnson, C., & Sakala, C. (2008). Mothers’ reports of postpartum pain associated with vaginal and cesarean deliveries: results of a national survey. Birth , 35 (1), 16-24. http://www3.interscience.wiley.com/journal/119404658/abstract?CRETRY=1&S

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20 comments to Jen’s Cesarean

  • Are you my twin? :) So many aspects of your story are similar to mine: breech at 35 weeks, failed ECV (along with every other natural vertex technique), planned midwife birth, C/S, attachment parenting, HBAC for future births … I understand your motivations completely. Loved your HBAC story. Working on my own VBAC facts blog, but I think I may just link to yours!

  • I absolutely loved reading your birth story. My 6th pregnancy resulted in a c-section. I was having twins and baby A was a footling breech. I hated my c-section for many reasons. I hated the disconnected feeling I had from my body and my experience. I hated the way that my rights over my body were ignored. I hated that I spent 4 hours in recovery where I was told my babies and my husband were not allowed to visit (the hospital didn’t have a seperate OB recovery room.) I hated the recovery and the 12 days it took me to be able to lift my other babies out of their cribs/beds and to not be dependent on Vicadin.
    I had a successful VBAC 13 months later and although that birth experience was TONS better, it hasn’t been until recently that I have REALLY started thinking about my rights over my own body and the type of labor/birth I demand to at least attempt. I loved the VBAC but there were many “rules” such as continuous fetal monitoring. I am pregnant again and have been making my wishes known to my midwife and OB. I didn’t realize before how much control I really had. I’m learning though…I really enjoyed your story. Thanks for publishing it!
    angela
    http://www.fontenotkids.blogspot.com

  • Wow, what a story. I too had a c-section, but a very different experience. I was in hard labor for thirty eight hours, at which point the baby and I were in so much danger that we had no choice. During my pregnancy I assumed I would deliver vaginally, but I didn’t have strong feelings about it really. When the c-section became necessary, I was more relieved than anything, because I knew that a.)the horror would be over, and b.)it was the safest thing to do for us. I was able to have my son with me very soon after he was born, and he was never without either my husband or myself from the minute he was delivered. I breast fed, and he stayed in the room with me. I can certainly remember the horrific pain of those first movements in bed, first steps, etc. I also remember the unimaginable pain of labor, and really, that is not something I’d care to experience ever again. I plan to have more children, three more in fact, and I also plan to schedule c-sections with them; based on my first experience I do feel that this is the best and safest option. I do, however, greatly respect you and your decision to do what you knew was right for you, and for your labor and delivery. No matter our birth plans and subsequent outcomes, it is so important to assert ourselves and remember that no one knows how to better care for our children than we do. And who knows? Maybe I’d feel differently about future c-sections if my first were as awful as yours. I’m just thankful I had a better experience (and sorry that you didn’t!). I’m also thankful that I went through both labor and surgical birth, so I know what I’m “in for” either way. For me, c-section is definitely the path of least resistance. Best wishes…

  • michelle

    You have a great story and have the ability to touch and encourage many women. I loved reading your story. I have had 2 c-sections and my 3rd was a homebirth. It was the most wonderful experience to have a baby vaginally and natural. It was amazing to actually hold my baby right away and breastfeed and love him and stare into his eyes seconds after birth….it was even more wonderful than what I imagined it would be like. =) I’ve ended up being an advocate for improvements in childbirth and maternity care since the birth of my last baby.

    About Me: I love to learn and do research on current issues and challenging people’s current beliefs reguarding the truth behind childhood vaccines and the modern maternity care system. also, the importance of eatting organic foods and just heath in general.
    I am a mommy of three beautiful boys: Caleb, age 6. Jacob, age 3. and Joshua, 3 months. I spend my days with them! i homeschool them. =) and I am married to my husband, steve for 7 years.
    i’ve had 2 c-sections and joshy was my successful VBAC! thus, my reason for helping other soon to be mommies and already mommies either avoid a c-section altogether or have a vbac if they want it. =)
    “With everyone set in a pace, it’s okay to run the opposite way.” – Leeland
    Go the opposite way….always.

  • Jennifer

    Stephanie, Thank you so much for your comment! I hopped over to your blog and you seem to be very informed, so I’m sure you are aware of the risks of repeat cesareans and especially adhesions. If you are going to have three more children, I think it’s important to know that the risks of repeat cesareans go up with each surgery whereas the risks of VBAC go down with each VBAC. However, of course, this is something that is entirely up to you. I wish you the best no matter what you decide!

  • Jennifer, While the thought of being in labor again absolutely petrifies me, your website has inspired me to at least explore the option of a VBAC. Seriously, I shudder even as I write that because my only experience with labor was so traumatic. I’m not making any promises…but I’m looking into it, as we are at this time (well not this exact moment) TTC. Thank you for your incredibly researched and very informative website. I’ll let you know how things turn out when the time comes. Oh, and thanks so much for your comment on my blog…still blushing;)

  • Christine

    Your birth story was beautiful, and I cannot express how much I appreciated your frankness about your c-section recovery. I two, have had a c section (2, in fact…one a failed vbac). EVERYTHING you said about the surgery, recovery, nursing, co sleeping, and trusting your own instincts hit home for me. Thank you for sharing something so very personal, and for your honesty. I hope that you indeed have had/will have the vbac that you seek.

  • Jenny

    Hi Jennifer,

    This is almost my story exactly! The only difference is that I didn’t go into labor before my c/s but I had prenatal care with a midwife, baby was breech, had an ECV, felt the same ways you did and practice AP…Thank you for sharing.

  • Dee

    I’ve experienced both vaginal and cesarean birth and by far I prefer VAGINAL birth. My c-section recovery was HORRIBLE. The pain wen you cough, sneeze, walk sit, move, reach (they didn’t tell me I wasn’t supposed to reach). Geez and one night after I got home I felt like I was dieing. My suture and entire abdomen felt like it was on fire and ripping apart. To this day I don’t know what that was about. All I could think during my recovery is “why on Earth would ANYONE choose THIS?” I pray every day that my future deliveries will be successful VBACs. I’m preparing spiritually, mentally and physically for success. Thanks for posting your story. It’s good to know I am not alone in how I feel about c-sections.

  • Ethel

    Thanks for sharing your experience and the rest of this wonderful site! I had a CS with my twins due to the umbilical cord presenting (and footling breech for baby A – but I would have attempted to delay CS if that had been all as my baby was still flipping around). I actually had a pretty good CS experience – virtually no pain, breastfed 30 minutes after delivery, babies were encouraged (not merely allowed) to room with me to help with breastfeeding.

    I’m now persuing a VBAC, because even though my CS wasn’t bad, I want to be able to have more children without an increasing risk of UR in every delivery, on top of normal CS risks. I don’t want my surgical history controlling my family’s growth! I’m hoping for a hospital birth, but realistically I expect to “fall back” on the HBAC option. Even the baby-friendly hospital I delivered at has a mediocre VBAC policy, including scheduling CS’s at 41 weeks – and my family always goes to 42 weeks. I’m only at 6.5 weeks, though, so there is still time to find other options. I really would feel most comfortable in a supportive hospital environment.

  • Jesika

    Thank you so much for posting this. I’m currently 37 weeks pregnant and my LO is breech as well. I have my version scheduled for tomorrow. I too am hoping to have a natural birth and the thought that I might actually have to have a c-section! I’m so glad to hear your experience because no one seems to understand (other than my husband) why I am so upset about it. I feel like I’m being robbed of the experience as well. Hopefully she will turn. Again, thank you for posting this!

  • Thank you so much for your site. I’m currently planning my VBAC and am keeping HBAC in mind if I feel my current care provider changes, though she’s done multiple vbacs this month, routinely does vbac2c and has done a few vba3c

  • I’ll link to your website too, great work. If you have a few mins I’d love a chat via email or else. My birth story is on my website too but incomplete, my memory was bad at the time and I only wrote what I could remember there and then I have to update it with the other infos I got later on from my husband and my papers. I’m still so angry after 18 months.

  • Rebecca

    Thanks so much for sharing your story. I had a very similiar birth with my son. We were risked out of our midwife run birth center when my son turned breech(frank) in my 39th wk. Tried Webster technique, moxibustion, inverted positions, hypnobirthing for turning the baby, nothing worked(doctor wouldn’t do the version since my fluid was low and the cord was around my son’s neck). I went into labor the night before my scheduled csection at 40 wks +5. Great hospital and surgeon, baby roomed in with us, etc. Very painful recovery, didn’t feel back to normal until wk 16 pp. Difficult start to breastfeeding,but kept at it. We are attachment parents as well, bedshare, extended bf, babywearing. I’m now planning a HBAC for my next birth and am so glad I found your site!

  • I have been pregnant 3 times i lost my first two due to preterm labor my first a girl born at 21wks was a vaginal birth and my second a boy at 24wks was a c-section they said having a c-section would be less stress on the baby so i said ok. He lived 12 hours. My healthy 37 weeks 2 days daughter is now 2.5 years old was born by c-section. With my son i had a c-section they said that with the kind of c/s i have i need to have a repeat..i would love to have a vaginal birth. I would love to experience it and have a happy outcome. Is it possible for me to still have a natural birth?

    • Jen Kamel

      Brittany, I am so sorry about your sweet babies. As I am not a medical professional, I cannot advise you. I recommend you get a copy of your medical records for all your pregnancies, find some referrals for VBAC supportive care providers, and make appointments with them to discuss your options. I wish you the best!

  • Laura

    thank you for your story, I too had a c-sec with my first due to breech I decided not to the ECV, I had low amniotic fluid and a big baby (over 9lbs), Labor started two days before the scheduled cesarean, I was laughing and enjoying labor as much as I could, I didn’t even feel the contractions.
    When I had my daughter I wanted to VBAC, I ingored the ban at the hospital, and didn’t go in until I was in labor, staff quickly lecutred me using only scare tactics the first round I fought them off by speaking facts and stopped the anesthesiologist mid your going to die speech and asked him about the risks for repeat cesareans, he stormed out of the room and ignored my question. I enjoyed my labor when I was bymyself and when contractions were coming every seven mintues the dr came back in to yell at me some more, and the contractions stopped, they refused to check me for progress in over a 12 hour time span, along with some other things, I lost my voice and fight not because of labor but because of the way I was being treated. I still find myself asking how can it be called elective when it was very clearly not what I wanted. Now I do have adhesion pain all the time, have since had my tubes tied because I could not go through anther surgery.

  • Kylee Stef

    I’ve read a few of these replies and I have some strong opinions that some people may not like. I’ve heard MANY stories and talked to MANY women who thought their first c-section was great but then were crawling on the floor with each successive c-section. People don’t realize that you develop adhesions and scare tissue that increase ten-fold with each surgery. The first c-section might not have been bad, but the next one and next one will be even worse. Talk to the women who have had hysterectomies because the adhesions stuck the uterus together, or the couples who can’t conceive anymore because scar tissue has cut off the path from the fallopian tubes to the uterus. Our bodies were not made to give birth that way. If someone is afraid of labor pain than they shouldn’t be having children. In the past labor pain was a right of passage, it makes us moms who we are. There is something magnificient in the moment of childbirth. God made it perfect. Much is missing from c-sections, like the hormone release that happens with that terrible pain that tells our babies they need us and tells us that we love them. What kind of parents are we without that spark of bonding? Our society has taught us to flee to the hospital the minute we are in labor, as if we are victims of a major car crash. Labor is beautiful and natural and painful, but it’s NORMAL. We are so scared of pain and do anything to get rid of it instead of accepting it as a normal process that will be over soon. I cannot emphasize enough what women are missing out on with natural childbirth and the lies that ACOG is feeding us.

  • Kylee Stef

    Brittany- I lost my fourth at 27 weeks, with a classical c-section (that’s what they said HAD to happen since he was so small) and he died afterwards as well. It would have been better for him to die inside of me as nature intended and then give birth. YOU CAN VBAC after a classical but the road is long. I have joined my local ICAN group and read “The Vaginal Birth after Cesarean Experience”. It’s filled with vbac stories after classical incisions. 50 years ago it was EXPECTED that women vbac, even after a classical. Now the doctors will scare you to death, like you’re a grenade that will blow up if you breathe too hard while being pregnant. It’s not true. This is the only country where this fear is instilled in women. You need to interview doctors, find out what your state’s laws are with midwives and homebirths, get empowered. You can do it! I am doing it and know many others who are doing it!

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