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The Journey pt 2

Making a decision

By Stephanie Coleman

     I seemed to be looking, searching... for something. Anything. Wasn't there a better way to have a baby? Could I have a baby normally? Whatever I was looking for, I wasn't completely comfortable about my decision to have a C-section again. What about the risks of major surgery to the baby and me? So, I began to research on my own. I read books about birth and pregnancy and VBACs. I read until I couldn't keep my eyes open and my thinking began to change. I found the report my OB had talked about. It was in Obstetrics and Gynecology and it was not a new report. The women in the study who suffered from uterine rupture were usually induced with oxytocin Uterine rupture was counted as a "symptom" of uterine rupture whether it was complete or not. There were many other factors in the study as well that were inconclusive and yet, the risk of rupture was found to only be 1.5 to 2.5%. I could have a VBAC! My chances of getting preeclampsia were higher than that! I was uncomfortable with some of the OB's I had seen and I knew they wouldn't support a VBAC. My chances of getting the one OB I liked to deliver my baby was very small. Unless I decided to schedule a repeat c-section.

So, I switched to a practice of CNM's (Certified Nurse Midwife). I had been reading about midwifery and "woman- centered'' care and I knew that was for my baby and me. There were four CNM's and they practiced out of the same hospital. I took my list of questions with me to interview them when I was already 33 weeks pregnant! Time was ticking away! The CNM answered all my questions perfectly and reassured me that I could do whatever I wanted to in labor.

No pitocin, no drugs, no IV no EFM. etc. I wasn't 100% convinced. How could she guarantee that? There was something about her that didn't feel quite right. Maybe I was

was finally comfortable. He was going crazy with me changing my mind so often. When we left their office, I felt a weight lift off of my shoulders. I borrowed a ton of books from Gail about VBAC and homebirth.  We went home and watched "Gentle Birth Choices" I devoured every book and felt uplifted by the thousands of testimonials of VBAC women! If they could do it, then so could I!  I had been learning how to change my thinking. Pregnancy and childbirth is not an illness, a disease, or an emergency waiting to happen. Birth is usually normal, healthy, and a natural part of life. My body is not defective. My uterus is healed and strong. I drank more raspberry tea. My uterus is strong! ! My body is made for birthing! I was slowly beginning to realize how many unnecessary C-sections are performed everyday and how brain washed and ill-informed the women In our society are! Including myself. That was many years of un-brain washing I had to do. Instead of trusting my own body and instincts, I had put all my trust and faith in my doctors. I was beginning to discover that OBGYN's were for pregnant women who were high risk or were ill. Midwives were for the majority of normal healthy pregnant women! And oh how we need midwives! Unfortunately, in our highly technological society, we are programmed to believe that birth is scary, dangerous, and needs to be "managed" by an OB. Wouldn't it be wonderful if we had a system, like other countries such as Holland and Sweden, where the midwives and doctors worked together with the midwives taking care of the normal healthy majority of pregnant women and the OB's caring for the few women who develop problems or an illness? I found a "Birthing From Within'' childbirth class that held the same philosophy as the book I had read. Birth art was used, feelings were explored, and I went through a few soul searching exercises that helped me make peace with my body and learn to trust myself. I believed I was finally there almost. Little did I know, I still had one more hurdle to overcome.

All my life I have had a hard time making decisions and sticking with them.

Especially when the decision is hard or unpopular. How much easier it is to let someone else choose for me and let them take all the responsibility off of my shoulders! So, as I was choosing to have a homebirth, I began to have second thoughts even after we had hired Gail and Bonnie. Two CNM's taught the childbirth class together. One of them worked at a "radical" hospital that allowed women to labor and give birth however they wanted! The hospital was about 45 minutes away from our house, though! She talked about her hospital at every class and how wonderful it was. Meanwhile, I found myself in a very defensive position. I had recently told my mother, my grandmother, and friends that we were having our baby at home. Needless to say, there was not much support in favor of my choice. My mom was worried for me and it was rubbing off on me. (She had been with me in the office the day that my OB had told me about the new report and that all my babies should be born by C-section! ) My great aunt Elaine was a woman I respected and admired and she had said I was making a very unwise decision. (She used to be a nurse) That really hurt me and I felt like maybe I was doing the wrong thing since everyone was against it. My grandmother called me and tried to talk me out of it and said I was crazy and that I could die. (She had been born at home! ) My dad said to make sure I had a will made out! I spent the next few days trying to convince everyone that I was doing the right thing for my baby and myself. I never convinced them. They all thought I was being crazy and defiant. I just wanted to have a natural, normal birth and give my baby a better start at life than Hannah had. I felt myself becoming unsure. (it was the responsibility factor.) The CNM at our childbirth class told me that a VBAC was possible but that since I was too scared, I shouldn't be having my baby at home. That gave me a way out! The nurse said I had to have my baby at the hospital, so I changed my mind again. I believe I was too afraid to do what I felt was right even though it was not popular and I didn't have much support. Again, I was letting someone else choose for me. I called Bonnie and I guess you could say that I fired them. Bonnie respected my decision but I could tell she thought I was being crazy too! She said that she sees normal natural homebirths all the time and she knew that my chances of having a VBAC would be smaller in a hospital. I felt terrible after I hung up with her. I still felt like I wasn't making the right decision. I had felt so comfortable with my midwives and the decision to have the baby at home. I knew that for my baby and I to be safe and have a healthy birth, we would need to be free of the technology and limitations that are placed on VBAC women (and ALL women for that matter!) in a hospital setting. But, making such an important decision as this one was difficult. It meant taking complete responsibility for my choice even if something went wrong. I know now that I was too scared to take responsibility for that choice. I have had a hard time trusting my own heart without second guessing myself. It is much easier to do what everyone else says I should do- that way I am able to escape fault or responsibility. That way I can't be wrong. This was part of my journey learning to make a decision - and sticking with it. Learning to follow what my heart desires. Doing what I feel is best for my baby and me. I decided to sit down and read my postoperative report about my C-section from the previous year. I then called my OB from California and ask her some questions about my C-section and my uterus. I guess I was searching for reassurance that my uterus and scar was tine. She asked me when my doctor was doing my section. I told her I was having a VBAC. She spent the next five minutes trying to convince me that I needed a C-section and a VBAC was too dangerous for me. When I hung up with her, I didn't feel any better. I felt more resolved in my choice of a midwife. My OB said if I were still in her care, I would be having a C-section because she "...would rather be safe than sorry." I wonder what her C-section rate is? What about the risks of a scheduled repeat C-section? Hemorrhage, infection, respiratory distress to the baby, and effects of the anesthesia? I sat down to write in my journal about Hannah's birth and my feelings about it. I hadn't done that yet.  I "dealt with my demons and cleaned out the closet". Finally. And then I knew what I had to do. I called my midwife Bonnie and told her I had just had cold feet'' and had temporarily "gone crazy'' and that it wouldn't happen again. I wanted them back. I wanted to have my baby at home. I knew in my heart that my chances of having the VBAC I dreamed of would lessen considerably if I went to the hospital- any hospital. My husband had faith in me and trusted my judgment. That helped me more than he knows.  No one else- including myself- seemed to trust me. My friend Alyeen was there every time I felt scared and began to doubt what I was doing. I called her numerous times for encouraging words and to remind me why I was doing this. There was no turning back now. I was already 38 weeks pregnant.

Two days later, at our church services, I began having regular contractions. They were consistent and close together for a couple hours. III rubbed my back and gave ' me her stopwatch to time them. Five minutes apart. After we got home from church, l called our midwife. Gail arrived an hour later and checked me. l was 1 cm dilated and 90% effaced. She told me my body was just swarming up'' for the real thing. Pre-labor.  After Gail left, I was disappointed that I wasn't in active labor but I felt so comfortable and relieved having the midwife come to my home. I didn't have to worry about when to go to the hospital. My own environment- comfortable and familiar. I was surprised to realize that this was where I felt the most safe.

It seemed to me that now that I was comfortable about my decision to have the baby at home with our midwives, I wanted my pregnancy to be over. I was through battling with decisions and I felt settled so now I wanted to meet the baby. Again, I needed to learn another lesson about waiting for the baby's own time to come. No matter what I did, that would be up to the baby to decide when he was ready to make his entrance into our world. I was tired of being pregnant, I was big and uncomfortable, and I was anxious to get the show on the road. So, Alyeen and I went walking at the mall a couple days during the week to try and get me into labor. I took evening primrose oil every night to help soften and ripen my cervix. Nothing seemed to happen. The next day, I began taking blue and black cohosh and Alyeen and I went walking again. My contractions were coming hard and fast and started out at 5 minutes apart. After they had been 2 minutes apart for over an hour, I called Gail again. I was sure I was in labor this time. When I told Gail what my contractions were like. She said it seemed strange that they were coming so fast and they didn't start out at least 10 minutes apart or so. She asked if I was sure that this was it I don't remember my reply, but I remember feeling unsure. How was I supposed to know? I had never gone into labor before on my own! Gail arrived an hour later to check me. I was still 1 cm dilated and 90% effaced. Gail gave me a pep talk then. Don't try so hard to make the baby come when he isn't ready.  The baby will come in his own tame. I was told to stop taking the blue and black cohosh immediately- they were causing meaningless contractions for no reason. The baby wasn't responding to it so they were not effective. I resolved to let things be and wait for the baby to come. I think I had been afraid that since my body had never gone into labor naturally before, that it wouldn't know how to do that. I thought I needed to help it out. I was wrong again. And that was okay. Just another step in my journey. How amazed I was to realize that my body DOES know how to birth a baby. I went into labor a week later- on October 11- four days past my due date. The night before, my husband and I had decided to try bringing the baby into the world the some way he was conceived. It worked!

The Journey pt3                             The Journey pt4