Discouraged?

I never really got to experience true labor pain. As soon as my contractions started becoming intense, the nurse convinced me to get an epidural to "stay on top of things". I don't even know how dilated I was, but I don't think it was much at all. I thought she was being helpful and I'm sure she did too. She was fantastic, attentive, and incredibly supportive. But the decision to get an epidural led directly to my c-section, as I explained in my first post.

I am in the process of researching natural birthing approaches for myself (Bradley, hypnobirthing, the assistance of a doula).
Every time I read a drug free birth story I am in awe. I'm inspired, overwhelmed, and incredibly impressed. I am also scared out of my mind.

Doubt is really, really hitting me hard right now. I am questioning my reasons for wanting a VBAC. There are some obvious ones--no surgery, a shorter hospital stay, a faster recovery, a shorter time away from my firstborn.

However, I must admit that part of me simply wants to experience labor. I want to go into labor on my own, to time contractions, to pace around the house with indecision. I want to go through the rite of passage. What does that say about me?

And I wonder--is my desire to VBAC at its base, a simple desire to "control" things? And if so, is that a bad thing? If I have a need to control the birth process (or at least its outcome), how will I handle the pain? In the end, is it necessary to relinquish control, or seize it, or both?

It is a mental and emotional challenge for me at this point. Sometimes I think I need to stop reading.

My Love Affair With Prenatal Yoga

I am taking a prenatal yoga class. I signed up for it in the hopes that it would help keep my pregnancy anxiety at bay. Little did I know how many other wonderful benefits it would have.

First of all, how often do we get an entire hour to concentrate on relaxing? The concept was so foreign to me until now. No one ever tells you that relaxation is a learned behavior. At least it is for me. Breathing may be something involuntary, but who knew that breathing slowly and deeply could have such a profound affect on my body and mind?

We are practicing poses that will be helpful in labor. All week, I look forward to having an hour just for me. And as an added benefit, I am really enjoying the company of the other women in my class. Last night we got to talking about birthing classes. I mentioned that I had learned that it was important to take a class independent of the hospital in order to avoid simply being taught to "be a good patient".

Our instructor knows someone who teaches Bradley classes and is going to bring her contact information to the next class. Any thoughts on Bradley? How about other techniques, such as hypnobirthing?

16 Week Appointment

Well, actually it was 15 weeks and 5 days, or maybe even 15 weeks and 3 days if you go by my first ultrasound. But who's counting?

I met the only female doctor in the practice today (there are also 2 male doctors and 1 female nurse practioner). I had heard that the female doctor (Dr. Z) was very nice, but not quite as personable as the males.

I actually liked her quite a bit, but maybe I caught her on an especially good day. She asked me if I had talked to to any of the other doctors about whether or not I wanted to VBAC. In fact, everyone I've seen so far as asked me about my labor plans. I'm taking this as a good sign.

Since she brought it up, I decided to ask the question I had intended to save until my next appointment with Dr. H. (who owns the practice). I asked about numbers. Specifically, how many successful VABCS the office has delivered.

She thought for a moment, and then said "Hmmm, I'm not sure if I can answer that".

She went on to explain that the practice's VBAC success rate is actually higher than the nationwide average, but that she attributed that to their selection process. In other words, they have a high VBAC success rate because they try to weed out patients that "probably won't be successful".

This had me worried. I asked her what situations would indicate that a patient wasn't a favorable candidate. She explained that the best case scenario would be one in which the patient goes into labor on her own. She said inductions often led to c-sections. I knew this to be true, so that was good.

I asked how long I could go before they would insist on an induction, and she said 42 weeks. I am actually OK with that--it seems longer than what most OB's allow. It's certainly longer than my last OB would have been comfortable with.

Dr. Z. said another scenario that could potentially limit the success of a VBAC would be "if [I] were carrying a 9 lb baby". This had me concerned too, because I know that ultrasounds and other measurement tools are only estimates, and women are fully capable of birthing big babies anyway.

However, she didn't say it would prevent me from trying--only that it might limit my chances of being successful. And she stressed at least twice that the end result would be my decision. So then I asked why this office was willing to do VBAC's when so many others in the area won't.

She answered honestly.

"It's because we've been fortunate enough not to have been slapped with a malpractice suit". And she knocked on the wooden door as she said it.

I don't know. I felt comfortable with her answers when I left. Either the practice is full of bold faced liars or they really do support a woman's right to make decisions about her own delivery.

We shall see.

On another note, I get to schedule my fetal anatomy ultrasound any day after November 11th. DH wants to find out the sex and I think I want to be surprised. It's probably not worth battling it out thought--when I get there I doubt I'll have the willpower not to find out!

Am I a Walking Contradiction?

I've signed up for a few VBAC message boards, and I'll be vague so as not to get myself kicked off of any for copying and pasting specific information.

Essentially, I don't get it. I just read a post written by a woman who was devastated that her cousin's wife had a c-section. She tried to warn the cousin's wife several times that her OB was "c-section happy". The poster also attempted to convince this woman that she needed to do her research regarding the dramatic rise in c-sections in the United States.

However, the cousin's wife ignored her and ended up with a c-section (the details as to why are vague). I would really love to quote sections of this woman's post so that I could accurately convey her disgust with her cousin's wife, but again--I'm not looking to get kicked off.

Today, I'm struggling with the idea that c-sections equal failure--that having one means that I somehow failed as a mother, and as a woman in general. Am I pissed that I had one that might have been unnecessary? Yes, definitely. Am I angry with myself for not doing more research? Well...sort of. But I trusted my doctor. I thought that's what I was supposed to do. She had the degree, after all.

It bothers me that many proponents of VBAC's and vaginal births in general have this extreme mistrust of the medical profession. Am I naive to think that my former OB jumped the gun with my c-section, but that not all doctors are that way? Am I foolish to think that I can trust another doctor to guide my care based on what he or she honestly thinks is best for me, rather than according to his or her lunch plans?

I guess what I'm saying is that I think it is my job to do the research (now that I know better). It is my job to find a doctor I trust. It is my job to check to see that his VBAC stats support what he says to my face, and to stay as healthy and as active as possible. And then it will be my job to let go. I think in the eyes of some people, this means I am setting myself up for failure.

In certain situations, I believe doctors dole out unnecessary advice--say when it comes to promoting sleep training in babies. I have been on the receiving end of such parenting advice (from a former pediatrician), and I did not appreciate it.

However, the ultimate decision of whether or not I need surgery is different, isn't it? If I do everything to set the stage for a VBAC and in the end my baby simply can't tolerate the labor, wouldn't I be insane to refuse a repeat c-section?

I do not see myself becoming a militant VBAC proponent who spouts off the evils of c-sections to any one who will listen. I think the reason is because doing so would feel wrong to me. I believe in freedom of choice, particularly when it comes to one's own body. Some people schedule c-sections according to their vacation plans. Truthfully, I happen to think this is bizarre. But if you have tickets to Belize and need to have a baby beforehand, by all means--schedule away.

Does my belief in another woman's right to choose her care make me less worthy of a VBAC or less dedicated to having one? And if I choose to trust my new doctor, have I already failed?

What Really Matters?

I shave my armpits and my legs. Well, ususally. On the days that I get a chance to take a shower. I have been wondering if this somehow makes me ill-equipped for a VBAC.

I recently dragged my husband to a screening of The Business of Being Born, Ricki Lake's documentary about midwifery in America. We were expecting lots of armpit hair and the overwhelming aroma of patchouli.

To our surprise, most of the people there looked--well, like us. Young couples, pregnant or with small babies, casually dressed in clothes that probably came from the mall.

The documentary was shown at a Cinema and Drafthouse (which was, by the way, one of the reasons I was able to convince DH to go with me). I wanted to go not because I plan to have this baby with the help of a midwife or because I was interested in a home birth, but because it was sponsored by ICAN: the VBAC people.

I knew from checking out their website that they hold meetings once a month at a local library, but I wasn't ready to go to one just yet. I needed to check out the people--to see if my vision of a "VBACer" was realistic. And as I've mentioned, for the most part, it wasn't.

Still though, ICAN has somewhat of a reputation for being "militant"--much like The Le Leche League. I consider myself a lactivist (I still nurse my 27 month old about once a day), but when it comes down to it, I really don't give a crap whether you do or not. Unless you tell me that you think breastfeeding my toddler is "gross", in which case, it's on.

I was afraid that the ICAN people would corner me and shove literature featuring bloody c-section scalpels at me. But they didn't. They had plenty of literature about things such as the dramatic increase in c-sections and the risks of uterine ruture in VBACs compared with the risk of a routine c-section. But if you wanted to read it, you had to pick it up off the front table.

I soaked all this in, while sipping my Sprite and wishing I could indulge in a beer like my DH.

And then the film started. I watched most of it with cautious interest and fascination. The women who had home births were strong, and educated, and funny. They expressed doubts and fears and were cheered on by husbands and midwives and doulas.

But then they started talking about c-sections. As I watched a woman describe the events that led to her c-section, I was shocked to hear her describe the birth of my own first child: from the first intervention to the last, and ending in emergency surgery.

The rational part of me began to shut off the feelings of anger and sadness--and violation, frankly. Because I have a healthy son who got here safely, and as everyone knows, in the end, that's all that really matters. Right?

Except I don't think it is the only thing that matters.

I think it also matters that my OB started "preparing" me for the possibility of a c-section when I was 20 weeks pregnant. And I think it matters that I was admitted for an induction at 36 weeks 6 days pregnant because of protein in my urine that wasn't there by the time I got to the hospital. It matters that I didn't get to hold my son for more than 5 hours after his birth because he was in the NICU and I was unable to move to get to him, having been recently been cut open and all. It matters that he was in the NICU in the first place because he had fluid in his lungs that would have been squeezed out had he gone through the birth canal.

I, like most women (I imagine) always pictured the birth of my child in my head. I pictured hours of difficult labor, coached my my supportive husband. I knew it would be hard, but I couldn't wait for the end result--the doctor placing my squirming, slimy baby on my chest. I pictured holding him and being the first one to look into his eyes, the first one to count his fingers and toes, the first one to tell him how much I loved him, as I had for so many months when he was inside me.

I pictured placing him to my breast for his first feeding and watching as he watched me. But I didn't give him his first feeding. Some nurse in the NICU did, despite my specific instructions that he not receive any bottles. I couldn't nurse him for 24 hours because I was on Magnesium Sulfate to counteract symptoms of Preeclampsia that I may or may not have ever had.

I think those things do matter.

Which brings me to now. I am 14 weeks and 5 days pregnant with our second child. My goal is to have a VBAC. I found a new OB who says I can try. I'm not sure what that means, or if I fully trust him.

The ICAN people say a lot of doctors will pull the "bait and switch" on their patients. They'll tell you that you can have a VBAC, and then at 37 weeks they come up with a reason why it isn't safe. There is much research that I still need to do, and many preparations to be made.

I have some time on my side for now. I figured I'd keep a blog of my experience, so I could have a place to keep track of all the millions of thoughts that creep into my head. Fears and doubts, and hopeful anticipation. Things that matter.