Saturday, April 17, 2010

Beatrix Story

After my previous post about Cesarean Awareness Month, I realized that I have yet to post the birth story of our beautiful new baby, Beatrix. When David and I were pregnant with Charlotte, I absolutely adored the name Beatrix. It satisfied every single criteria of my neurotic baby-naming list. In the Biblical tradition, or the tradition of any good science-fiction or fantasy novel, we required that the name be more than just a word we used when we wanted our children to clean their rooms or come to dinner. We wanted our children's names to show intent, the wonderful purpose we hoped their lives would hold. If you've ever read "Earthsea" by Ursula K. Leguin (or even "Inkheart"), you'll know that there's a strong tradition of names having a true meaning or inherent power. Geeky to the extreme, I know.

Beatrix means "bringer of joy." Her middle name, "Story," is a little more difficult to explain. We get a lot of strange looks about that one, but we were largely influenced by a book Donald Miller wrote, "A Thousand Miles in a Million Years," where Miller talks a lot about the powerful influence of creating our story, or more accurately our God-story. We knew Beatrix was such an integral part of the story God was writing for us, even from the very beginning. We wanted Beatrix to know that she was a beautiful creation, something epic that unfolded anew each day. She was a blank page to be written, an adventure waiting to happen, a page yet to be turned. She was, and is, our joyful story.

(Well, she wasn't yet, as she was still in utero at that point.)

As Charlotte was born via C-section, I knew that I had two options with Beatrix: a VBAC (Vaginal Birth After Cesarean) or a repeat Cesarean. Although I had a great experience with my section, and an incredible healing time, I really wanted to attempt a vaginal birth. Everything I read convinced me that the risks were relatively low (under or around 1%) and the recovery times were faster and easier. Plus, I dreaded the thought of recovering from another section with a sixteen month old underfoot! However because of liability concerns and insurance practices and God-knows what else, finding someone who was even willing to attempt a VBAC was in itself an act of labor. I interviewed 5 doctors and midwives, only to find that none of them would accept an "untried pelvis" or "initial VBAC" or attempt a trial of labor with only 16 months between births. I finally found a midwife 45-minutes away who was thrilled to let me attempt a VBAC (I was less thrilled about the idea of driving 45-minutes in Chicago traffic in early February). Everything was wonderful... until I discovered that my insurance wouldn't cover the midwife or the hospital charges.

"Bummer" is putting it lightly.

So I found a new obstetrician with my familiar practice. She was willing to allow a trial of labor, as long as I went into labor spontaneously (no induction) by 41 weeks and as long as there was no need to augment my labor. A large part of the reason that VBACs are so rare was because, in the 90s when VBACs were the rage, doctors used Pitocin in a rather willy-nilly, reckless fashion. Women ruptured, women sued, and instead of discontinuing the practice of using Pitocin to augment labor (which almost doubles rupture rates and creates longer, stronger, unnatural contractions of the uterus), doctors and insurance companies decided to just nix VBACS.

I was fine with these restrictions, with the exception of the 41-week rule. The science on that is a bit iffy. The chances of a successful VBAC go down quite a bit after 41-weeks, but that was no reason for me not to try. So, I fudged my LMP (last menstrual period) just a bit, giving me the option of going to 42-weeks. Yeah, I'm a bad girl.

Anyway, we scheduled my section, if necessary, for the lastest possible date, February 5th. As that week approached, my Mom came up to the great white north to help. It was the Tuesday, February 3rd, two days before my scheduled end-of-the-line section, and I was getting antsy. Beatrix was in an excellent position (left occiput anterior, if that means anything at all to you); basically, head down and facing forward. I was doing lots of techniques to keep her in that great position, and using lots of Red-Raspberry Leaf Tea and Evening Primrose Oil to help soften and prepare my cervix for labor. Everything was golden, but like all potential VBACs, I was feeling the pressure from my due-date/timeclock very acutely. I knew that if I didn't go into labor by that Thursday, I'd have to have a section.

No pressure, right? Anyway, that Tuesday I started having some pretty strong contractions, unlike the regular Braxton-Hicks. I was so excited I called my OB who decided to have me come in for a non-stress test. And just like a girl, Beatrix decided to exactly the opposite of what we expected, staying completely still and quiet the entire time. I'm pretty sure that the OB on call thought I was faking. She gave me some patronizing advice about how "sometimes those Braxton-Hicks can be pretty strong" and sent me on my way. Looking back, I'm sure it was just prodromal labor. I was pretty embarrassed after that, and being a hormonal-pregnant woman, I decided to console myself by esconcsing myself in my kitchen and making an inordinate amount of food. I distinctly remember that I made an excellent Coca-Cola Pot Roast from Southern Living's cookbook of comfort foods and the best Oatmeal-Raisin cookies in the world.

If you ever want to go into labor, by the way, I highly suggest that delicious combo. After cleaning up and going to bed, I woke up at 2 am. My first thought was "Oh, great, I peed the bed. I am never in my life going to live this down." It didn't even occur to me that my water might have broke, because everything I read said that rupture of membranes usually happens when you're settled into a good pattern of labor. I got up gingerly, hoping to avoid waking Dave, and sparing the myself the ignominy of being forever known as a 25-year-old bed wetter. And, gush, like Niagara falls, water spilled all down my legs. I walked (gush, gush, gush) to the bathroom, changed my clothes (gush, gush, gush), and went to change the sheets. I'm blaming the early morning for the fact that it took me an hour to even think that, "Hey! Maybe my water broke." I'm not exactly the sharpest crayon in the box at that time of the morning.

The thing that really tipped me off (and ticked me off) was that I couldn't walk two feet without gushing all over myself. Ladies, don't be fooled. Your water breaking is not like peeing-your-pants when you laugh (another common pregnancy woe). It's more like dropping a Route-44 all over your pants every time you moved. So I woke up my Mom and Dave with the gentle "If I have to be up at this ungodly hour, you better get up, too. Oh, and by the way, I think I'm in labor." Another good thing to know? Who exactly to call when your water breaks at 2 am. I called everyone, got a lot of run around, and finally decided just to head to the hospital after about an hour and a half of waiting.

After we dropped off a very sleepy Charlotte at our friend's house, we got checked into labor and delivery. I got set up on all those nifty machines that go beep and waited. If you ask either Dave or my Mom, they will tell you that I was a very unhappy, cranky person. And I wasn't even in labor, technically. I distinctly remember threating to kick Dave out of the room if he dared, dared have the audicity to turn on ESPN while I was having his child. Unfortunately, my OB wasn't coming in until the next day. sp I was left with the on-call OB, who, conincidentally, was the OB who delivered Charlotte.

When the nurses came, I was excited to see how far along I was (a pipe dream in retrospect as I wasn't even contracting). I wasn't very happy because I was crouched in a strange position to keep Beatrix's heart from doing strange decels, all the while gushing everytime I laughed or talked. Gross. I was not a fan of that sensation. I was hoping that I was at a 2-3, but to my dismay, I wasn't dilated AT ALL. My cervix was high, firm, and closed. I even asked my nurse how it was possible that my water broke but I wasn't dilated or contracting. I had an extremely unfavorable Bishop's score, so the OB decided to do a section. I knew that was a what we had determined best, because of the problems with augmenting labor, but I felt that I had come so close.

So, they wheeled me to the OR. While they prepped me, I layed out my section birth plan. (I had a plan for both scenarios, which I think was tremendously helpful). I wanted a spinal, and I wanted someone with me at the time, because the process of getting a giant needle in your back is extremely unnerving. I wanted a lot of anti-nausea medication, because the wonderful drugs in the Duramorph make me vomit like no one's business. I wanted the catheter AFTER I was numbed. I cannot fathom why they would put it in before you're numb, other than to just torture you. And I wanted glued back together, rather than stapled, which not only left a disgusting Keloid scar because of my (previously unknown) metal allergies, but also made me look like Frankenstein.

And all was well. Beatrix was screaming before they even had her completely out, which was such beautiful and amazing sound. She was also a petite bean, weighing in at 7 pounds, 2 ounces (smaller than Charlotte), and 20 inches long.

Friday, April 16, 2010

Happy Cesarean Awareness Month!

To christen this blog of mine ( which is largely to chronicle our family's misadventures and my own personal neurosis to thoroughly debate everything with myself) I'd like to highlight that April is Cesarean Awareness Month. Now, you either know this already, or you're in the camp that's verging on veering towards another website because this topic is just so, well, not-your-cup-of-tea.

I'm here to wish you all a happy Cesarean Awareness Month. If you're a woman, or if you know anything about childbirth, you're probably aware that the C-section is the debate du jour of the interwebs nowadays. It's a useful point of conversation and argument, but also a convenient straw man that many like to wheel out on occasion and set fire to. My point here is not to create a debate between "natural childbirth" advocates and the rest of us (the "unnaturals," shall we say?), but to provide support for the minority of women who have had a C-section. Yes, minority. Because, despite rising C-section trends, the total rate in the US is still 30%, leaving us women who have been sliced and diced in a ever growing minority. Now, don't misunderstand. This isn't intended to glorify a surgery. You'd be hard pressed to find anyone that thinks that a C-section is the optimal way of birthing. It's very tough, has a big "eww" factor, and definitely not what I would have chose, given the opportunity.

After my first cesarean with Charlotte (that stubborn lady who presented frank breech at 39 weeks and 6 days), I felt horrible sense of guilt and failure. You know, the classic "I'm not a whole woman until I've pushed a ten pound baby out of my vagina" kind of feeling. Which isn't to diminish all that pushing. I hear it causes the hemorrhoids. (Which, consequently, is the most difficult word to spell in the English language). I knew that C-sections were riskier to both mother and child, but I also knew that attempting a breech birth with an inexperienced physician was even more risky. Plus, I didn't want to risk shoulder dystocia, which is a real concern, seeing that that it can cause temporary or even permanent paralysis. I knew that with my next child, I wanted to try for a VBAC, and my OB assured me that I had a great chance of success, seeing that breech presentations are rarely a reoccurring issue in subsequent pregnancies.

What I couldn't understand was WHY I felt guilty. Guilt is, technically, the remorse one feels for committing an offense. Who had I offended? Was a "natural" childbirth right and a cesarean wrong? I visited multiple internet forums, and the response I received varied from armchair OB-ing ("Don't you know that if you had done A, B, and C-255, then you could've had your baby the right way?") to the downright outlandish scare-tactic articles about the horrible atrocities that will befall both you and your baby if you dare, DARE, have a C-section. Like necrotizing fascitis, or more commonly, flesh eating bacteria.

There were Cesarean healing kits, to recover from the emotional trauma, Cesarean themed art, to deal with more emotional trauma, or Cesarean support groups to, you guessed it, handle more emotional trauma. I spent a lot of time here; sometimes they fed my need to heal from the "guilt" and feelings of failure caused by my C-section, but more often that not, they fed my Hulk-sized anger towards the birth community. A community that was so quick to second guess all my medical treatments or decisions. I felt attacked; I could sympathize every "sinful abomination" that had ever had Biblical verses stuffed mercilessly down their gullet in an effort to convince them how wrong they were. There was no grace, and very little love. I distinctly remember crying after I was told that my child hadn't really been "born," but rather was "surgically extracted."

Not cool.

I noticed that there was no place of support for women like me, women who either, by choice or by medical necessity, had a Cesarean. Women who weren't emotionally traumatized by their surgery or had dealt with the false-guilt created by the false dichotomy between natural and surgical birth. Women who insisted that their birth experience was just as worthwhile, just as wondrous, just as full of awe as any vaginal birth. Women who loved and thanked their obstetrician, and held faith in the medical community, rather than demonizing them.

So with Beatrix, my second, I strove for a VBAC. I fought for it. I interviewed various doctors and midwives, exercised, and used every herbal supplement known to man to prepare me for a vaginal birth. But I promised myself, and my husband, that if I needed a C-section this time, I wouldn't feel guilty about it. I would recognize that I did my absolute best, and I would leave the rest in the hands of a grace-filled God who knew better than I what the future would hold. So, when my water broke spontaneously at 40 weeks and 3 days, I was ecstatic. But when contractions didn't follow and my body didn't start dilating, I felt both resigned and comforted. I do wish that I had been able to have that VBAC, and I'm not unsure that I won't try again (making it a VBA2C), but I wasn't comfortable augmenting with Pitocin (you know, the Devil-drug) because it increased the risks of uterine rupture. So, off I went, to be sliced-and-diced, as I affectionately term it.

And you know what? I'm perfectly happy with it. Both with the results. And with the experience.

So Happy Cesarean Awareness Day! Wear that scar with pride. Because, it does look like a smiley face, you know.