by KMom
Copyright © 2000-2006 KMom@Vireday.Com. All rights reserved.
This FAQ last updated: August 2006
DISCLAIMER: The information on this website is not intended and should not be construed as medical advice. Consult your health provider.
BBW Birth Story Pages
BBW Birth Stories: C-Section Stories
CONTENTS
Many women over the years have requested a section for birth stories of plus-sized moms. Large women come into pregnancy with so many fears and body issues that reassurance that other large women have indeed done this is important. Pregnancy books and most websites do not fulfill this need; mostly they are filled with warnings not to get pregnant until you lose weight, dire predictions of disastrous pregnancies filled with complications, or horror stories designed to scare you into compliance.
Although there are many birth stories online, most are of women of average-size. While these are also important to read, many large women have longed for a collection of stories of plus-sized pregnancy---normal births, complications, special births, just plain births---warts and all. It is important for us to see that many of our large sisters have traveled this journey before us.
This is a collection of BBW birth stories collected by Kmom over the years. Stories have been separated into various categories (vaginal birth, c-sections, twins, gd stories, etc.). Because some stories fit more than one category, many will repeat on different pages. Some stories are already up on the web in a more complete form elsewhere; with the mother's permission, Kmom has linked to these sites and urges readers to click on the link and read the more complete story.
Unless specifically requested, all identifying information has been removed or changed to protect the privacy of the participants. All stories are copyrighted; none may be used elsewhere without specific written permission from both Kmom and the mother involved.
This particular FAQ presents the stories of the cesarean births many large women have experienced. Big moms do have a higher cesarean rate, though many are probably unnecessary. For some large women, a cesarean is no big deal, for others it is unwanted but endurable, and for still others it is a horror story, full of fat-phobic treatment or intense trauma.
Since large moms are often not given the chance to pursue Vaginal Birth After Cesarean, Kmom has also made a point of adding a section showing that many fat women HAVE turned their cesarean births into vaginal births as well. Giving birth by cesarean does not mean that you always have to give birth that way. However, the point of this FAQ is not to promote one particular style of birth, but to show the wide spectrum of births that large women have experienced.
More stories will be added over time, so keep checking back if you are interested in reading further stories. If you are interested in sharing your birth story, click here for more information, birth story format, and submission guidelines. New birth stories are always welcome; Kmom updates the birth stories FAQs about once or twice a year so be patient for your story to show up. If you do submit your story, please carefully follow the format and directions given in order to shorten the amount of work involved for Kmom. Kmom's family will thank you!
C-Sections: Different Meanings for Different Women
Do Large Women Have a Higher Rate of C-Sections?
In general, larger women DO have higher rates of c-sections, for many reasons. They tend to have somewhat higher rates of complicating conditions that often result in c-sections (pre-eclampsia, gd, PCOS which often results in pre-eclampsia or gd, etc.). In addition, although it's not true for all fat women by any means, some fat women are out-of-shape and don't eat properly or exercise, which also tends to increase the rate of complications in pregnancy. Unfortunately, medical studies rarely differentiate between large women who take excellent care of themselves and those who do not, making the risks seem to apply equally based on size alone. Therefore, many providers apply interventions equally to all women of size, when only a few may actually need them.
Large women also suffer size prejudice; there are OBs that force their fat patients to sign elective c/s permission forms early in pregnancy long before it could possibly be justified as 'necessary', who berate their fat patients over any pound gained or tell them to lose 40 lbs. while pregnant, or tell their fat patients they will have a heart attack and die during labor (yes, these are true stories!). Or the size prejudice can be somewhat subtle, from doctors expecting that you WILL develop complications (often a self-fulfilling prophecy), to treating you as ultra high-risk or telling you that you'll probably not deliver vaginally anyway, etc.
Or the size prejudice can be extremely subtle, such as the very common practice of inducing large women early so the babies will be smaller (a practice shown in medical research to actually increase the c/s rate instead of decreasing it). Studies show that large women are induced at much higher rates than average-sized women, and often are not given the same chances at Vaginal Birth After Cesarean that average-sized women may get, resulting in more repeat c-sections. All of this increases the c/s rate, but is mostly due to patterns of provider bias rather than problems inherent to being heavy.
Another example of this is the recent news release which trumpeted the high rate of c/s of fat women at a certain hospital and then suggested that large women should have an epidural put in place early in labor so that if a c/s is needed she is all ready. Since a number of studies and meta-analyses have found that epidurals (especially in the beginning of labor) result in higher rates of c/s, and these doctors have already been told to expect fat women to 'need' a c/s, the number of fat women having a c/s at this hospital is likely to remain high. Is it the fat causing the high c/s rates, the patterns of provider treatment and expectations, or both?
In addition, there are often subtle psychological battles for large women to combat as well. Many fat women have been programmed all their lives to believe their bodies are 'defective', incapable of performing normally, and often have very significant body trust issues that tend to come out during pregnancy and birth. They are often disempowered by the people around them, who may make them feel like they should apologize for even 'daring' to be pregnant at a larger size. They often face a world hostile to the idea of larger women having romance, let alone having sex or giving birth! Most childbirth books are full of dire warnings about being pregnant at a larger size, and these horror stories and warnings tend to lead large women not to expect a normal birth. Some research also suggests that larger women have a higher rate of being abused (especially sexually) which could also easily increase the c/s rate as well.
So although larger women tend to have higher rates of c-sections than average-sized women, it is unclear how much is due to problems from size and health concerns, how much is due to provider bias and patterns of expectations, and how much is due to deeply-placed body trust and empowerment issues. However, it's worth noting that many 'alternative' birth attendants note that with proactive attention to health, nutrition, exercise, and empowerment issues, they have found that even very large women usually have excellent birth outcomes.
Although larger women currently DO have higher c/s rates, it is NOT a given that a large women must have a c/s. In fact, studies show that even with bias and emotional baggage and complications, the MAJORITY OF LARGE WOMEN STILL HAVE NORMAL VAGINAL BIRTHS MOST OF THE TIME.
Research from the 50s, 60s, and 70s shows that cesarean rates in women of size used to be much lower. If fat were truly an intractable cause of cesareans, these low cesarean rates would not have been possible even back then. In fact, many studies then showed that fat women had no higher cesarean rates than other women. It is practice patterns and expectations that have changed the cesarean rate in women of size, not size itself.
Now, many OBs and even midwives believe that having a cesarean is a logical consequence of being fat; that fat women cannot birth normally. But we know from history and the many fat women today who choose alternative births that this is not true. Fat women could birth normally in the past, and today they can STILL birth vaginally.
With truly supportive and unbiased care providers, a proactive attitude towards nutrition and exercise, and an empowered and informed approach to birth, the c/s rate for fat women can almost certainly be reduced greatly. Unfortunately, the biggest obstacle is sometimes getting people to believe that this is possible, or even to care that it happen. But together, we can act to change this indifference. Women, fat or thin, do NOT all need to be cut open in order to have a baby.
Women Who Love Their C-Sections and Women Who Hate Them
In our current societal climate, it is true that a significant percentage of larger women do have c-sections. Some then go on to have subsequent vaginal births, some try to have vaginal births but end up with repeat c-sections, and some are happy to choose another c-section and bypass vaginal births altogether. In fact, as in average-sized society, some women actually prefer to have a c-section from the very beginning and are relieved if they develop a condition which necessitates one.
C-sections can be a very political issue. It is very important that we all understand that a c-section means different things to different women, and to RESPECT our differences of opinion over that fact. For some women, a c-section experience can be almost akin to rape or assault, yet for others it can be a perfectly normal or even highly gratifying experience. There is a great deal of bad feeling generated on email lists between those who 'love' their c-sections and those who do not. The key is to try to understand and empathize with the other person's feelings and recognize their right to have a different opinion.
To a woman who has had a c-section and is not happy with it, it is insulting to be told that the important thing is that the baby is healthy and it doesn't really matter how the baby gets there. Of course the most important thing is a healthy baby, but for many women it does matter how the baby arrives. To have a disappointing or disempowering birth experience DOES matter; to have that experience dismissed as unimportant or insignificant is tremendously frustrating. The mother matters too.
In some cases, a c-section truly is life-saving and the mom can be grateful it was there to help. While some women feel only gladness and relief over a life-saving cesarean, it is completely understandable and normal that some women might still feel upset after a frightening or less-than-ideal birth experience. Even when a cesarean is truly necessary, women can have ambivalent or even negative feelings about it.
However, many c-sections are not necessary, or only become necessary after a great deal of intervention and questionable management. Some studies estimate that almost 50% of c-sections in the U.S. are not truly necessary! Imagine the bitterness of moms who must face not only their disappointment in having a c-section, but also to know that it was probably an unnecessary one. That's a tremendously bitter pill to swallow, and it has long-lasting implications for any subsequent pregnancies and births.
Women who are disappointed in their births need and deserve to grieve that experience, despite being thrilled to have a baby in their arms. Yet few moms with disappointing births are allowed that space to grieve. They are often told to 'just get over it' or to 'move on' with their lives, or 'just be grateful' they have a baby. But although most women valiantly try to move on, it is very difficult to move on until the original experience has been fully grieved, and there is very little understanding of this in our society in general. A c/s is simply thought of as 'no big deal' and just a 'different way' to give birth. Women who feel differently are rarely given validation or space for their feelings.
On the other hand, some women 'love' their c-sections and would never choose any other way to give birth. For some, a c-section was a truly necessary intervention and they only feel deeply grateful it was available. Some women truly fear a vaginal birth or labor pain, and a c/s can feel like a relief, a 'way out' of a threatening circumstance. Some women fear episiotomy more than major abdominal surgery (!), and a c/s feels more 'normal' and less threatening.
Some women had long hard labors (often induced) full of pain and difficulty coping; in this circumstance a c/s can feel like a dream come true, a 'rescue' from an unending cycle of pain and exhaustion. Some women have histories of sexual abuse and are uncomfortable with feelings 'down there' and may find a c/s less threatening. Some women simply don't see a c/s as 'any big deal' and don't really care how the baby comes out. Some women are relieved to simply schedule their birth and remove all the unknowns; the enticement of a known and familiar outcome is less threatening than the uncertainty of not knowing what the outcome will be. There are as many reasons for 'loving a c/s' as there are flowers under the sun; no one should be made to feel bad or 'less than a woman' for having had a c/s.
Women who are not disappointed in their births also need and deserve to treasure that experience, even if it doesn't meet someone else's expectations of a 'good birth'. No one should have the right to make someone else feel bad about their birthing experience. Although our society is currently mostly supportive of women who have had c-sections and liked them, occasionally you will find people who may try to tell you that you are 'less of a woman' for having birthed differently, or that you 'wimped out' when you chose the c/s, or that you are 'defective' for having needed a c/s. Not so!
In the end, most women who undergo a c/s do it because at the time they feel it is best for their babies and/or themselves. To choose to undergo major surgery for another person is an act of love, no matter the circumstances.
It is VITALLY important that we understand that as women we all come to our c/s experiences with different expectations, needs, fears, and 'emotional stacks' (previous experiences that color our interpretation of a new experience). For some women, a c/s can be a disappointment, a hurtful experience, or even a trauma beyond measuring. For other women, it is simply no big deal, a tremendous relief, or a treasured and beautiful memory. We need to understand and RESPECT that our feelings and reactions may not apply to someone else's experience, and to allow them the space to have different feelings than our own.
About This Cesarean Stories FAQ
In this FAQ, all kinds of c/s stories are told. Some cesareans herein clearly saved the lives of the baby and/or mother, some cesareans were questionable, and some cesarean experiences were clearly horror stories. Some women were delighted to have a c/s, while some women, far from being delighted, likened the experience to being raped.
This FAQ is a kaleidoscope of all different kinds of cesarean stories and reactions. Readers are urged to understand and respect all the varying perspectives on c/s herein.
Bias Disclaimer: Kmom has had 2 c-sections, one a truly horrible experience and one a relatively good and loving experience. Thereafter, she also had 2 VBACs (Vaginal Birth After Cesarean). Although she has not personally voluntarily chosen a c/s, she fully understands the lure and appeal of it, and she does not judge women who make an educated decision for a c/s. Please do not read that into this FAQ.
However, Kmom's personal opinion is that as a society far too many women (and especially fat women) are being cut unnecessarily, and that this has deep public health implications that should not be ignored. Cesareans are NOT simply 'another way to give birth,' and they DO have significant health risks and implications for future births. You will find this opinion reflected in Kmom's commentary. However, this is in NO way a judgment about any woman who is happy with her c-section or who chooses further c-sections in the future. For some women, a c/s can be a wonderful experience or a truly unimportant way of getting the baby into the world. Although Kmom does not feel that a c/s should be a commonplace method for birth as a society, she does not judge individuals' decisions.
Most moms will recognize most of these terms, but women new to reading about childbirth may be puzzled by some of the terms and abbreviations used in these stories. This section briefly defines some of these in order to help women understand the stories better.
Shawn's Story (c/s, posterior)
Kmom's Notes: The circumstances of the labor suggests that this baby might have been posterior and gotten 'stuck'. Shawn confirms that her baby was indeed 'sunny side up' but that this was not noted in her medical records. This is not unusual; many doctors don't see posterior position as relevant and fail to note it in records or mention it to parents, yet many other providers feel that it is the cause of many c-sections. Positioning often helps facilitate rotation, but Shawn was not able to try these.
Also, although the midwife felt that rupturing the bag of waters more fully would help dilation by bringing baby farther down, doing this tends to fix baby in its poor position and make a normal vaginal birth difficult to impossible. Breaking the bag of waters is the last thing that should be done if baby is in a poor position for birth.
Birth Story
When I went to see my OB about fertility treatments, I remember one of her first comments being, "You really should try to lose some weight prior to beginning treatment...but I have had patients close to your size who have conceived." "Whatever," I thought, "just give me the prescription." After the first cycle of Clomid, we conceived and we were both surprised and elated. MY OB was skeptical, however, and ran at least 3 progesterone tests and two ultrasounds before she was convinced.
My physician had not been derogatory in our visits, but I was concerned about her pessimistic approach to my care. After my second U/S the technician was able to see the baby's heartbeat. What a sigh of relief! Prior to seeing the U/S the doctor kind of walked back and forth past me as though she was preparing to give me bad news. When the U/S Technician finally put the report in the doctor's box she appeared amazed that it turned out so well and then stuttered over the words "Have you rescheduled your OB appointment yet?" Of course I hadn't because a week prior, she had told my to wait to schedule the appointment until after the U/S (as if to say if it's bad there will be no NEED for an OB appointment) So much for positive thinking!
After a great 'start OB care' appointment the doctor commented, "Things look really good, but because of your low progesterone I don't want you to get your hopes up until after the first trimester." I thought I would never get the green light that my pregnancy was fine. Although the pregnancy had been progressing fine and all signs were good, she was treating me as though the pregnancy was a risky one. Her attitude when I visited her was usually apathetic. I remember feeling that she just couldn't believe that someone my size was having such a healthy pregnancy. Nine UNEVENTFUL months later...to the day (my original due date had been 11/20, but was changed to 11/13 after my third U/S), I began my birthing journey:
Wednesday: False labor pains begin at 2:00 AM and continue on and off throughout the morning and afternoon. About 3:00PM I lost the first of what would be several parts of my mucous plug followed by general crampiness for the rest of the day and evening.
Thursday, 12:00 AM: Contractions begin at 7-10 minutes apart. I figured it was more false labor pains since I had not had a bloody show (but ultimately learned that these were in fact the real thing). I called my midwife when the office opened at 9:00. She thought I may be right in assessing the pain as false labor. I had not slept all night from the pain and she prescribed a sleeping pill. She said, "If it's false labor, the pills will stop them and you'll sleep, but if it's the real thing, you won't be able to sleep through the contractions." I decided not to take the pill just in case. I didn't want to be in pain AND groggy!
At 2:00 PM my water broke (although it wasn't as much water as I had expected) and the midwife asked me to come in to be checked. Once there, she confirmed that it in fact my water had broken and then informed me that the fluid was stained with meconium. She also stated that I was only 1 cm dilated and at this point I had been in labor for over 13 hours. She recommended pitocin to get things going. I'd learned that those moms induced with pitocin had very hard labor pains and my midwife confirmed that this may be the case. I told her that I wanted to try it without an epidural and knowing the c/s rate for overweight women, reminded her how important it was to me to wait as long as possible before a C-section was considered. We then left for the hospital.
4:30 PM Contractions still irregular and topping off between 70 and 80. I am confined to bed with external fetal monitor. I am told that I may be able to walk the length of the bed if the baby responds okay to the contractions. So far so good.
8:00 PM After 18 hours of labor, the pain is more than I can handle. I admit defeat and request the epidural.
10:00 PM According to the monitor, contractions are double and triple peaking at 100. I breath a sigh of relief that I can't feel anything but pressure. Midwife checks and I'm still only dilated 3 cm. She waits for a contraction and stretches the cervix another 3 cm to 6!
Friday,12:00 AM: Midwife tells me there have been a few drops in the baby's heartbeat and asks to insert an internal monitor for more accurate readings. Realizing this would confine me to the bed but wanting to do what was best for the baby, I reluctantly agreed. Midwife discovers that my bag of waters had not completely ruptured and may have been delaying the baby's drop into the pelvis. She breaks the sack and the baby moves to -1 station. (NOTE: looking back, I realize that if we had know this back at the office, I may have avoided using the pitocin altogether since the unruptured sac was preventing the baby from moving down into the pelvis, thus stimulating more productive contractions.)
3:00 AM Dilated 6-7 cm. I am exhausted and disappointed, but ask to be given more time before considering a C-section.
4:30 The midwife brings in the doctor-on-call to evaluate. The baby had several heartbeat decelerations after contractions and she was concerned. I am dilated 8 cm and he tells me to push although I have not yet felt the urge. It is unproductive and a C-section is recommended. I begin to cry from the exhaustion and disappointment, but after 28.5 hours, I agree.
5:10 AM Our darling daughter is born. We had chosen not to learn the sex of the baby and although we both wanted a girl, we felt very strongly it was a boy. When the doctor announced "IT'S A GIRL" I cried and cried and cried. She was suctioned well and the meconium had minimal effects on her. Apgars 8 and 9. My husband left to go video the baby for me and I was whisked off to recovery.
I invested a lot of time developing my birth plan and although this is the farthest from my dream birth, my daughter far surpasses any hopes I had for my baby. There were times during the months following her birth when I thought I could have done something differently to lessen the need for the c/s, but in time I have learned to focus less on the way she arrived, and more the sheer joy she brings me and my husband now that she is HERE! I wish all of you the best in your pregnancies and pray that each of you have an uneventful labor and delivery.
akp's CS Story (induction for macrosomia, botched cesarean, surgical complications)
Kmom's Notes: Her c/s story is a good lesson in all the things that can go wrong during a c/s and afterwards, and why inducing for a "big baby" is usually a bad idea. Things were bad; fortunately they didn't turn out even worse.
Birth Story
In 2001, my husband and I were told that I had almost zero chance of becoming pregnant (we had been trying for over a year) and that if we did get pregnant, that I had almost zero chance of carrying to term. The reasoning given for my inability to get pregnant were: polycystic ovaries, hypothyroidism, a tipped uterus, twisted fallopian tube and I am overweight (270s at the time). I realize now how ridiculous most of these reasons are, but I had doctor worship issues at the time. So, we decided to start saving to adopt.
In 2002, I found myself pregnant. At the first visit (7 weeks), the doctor sent me straight to a perinatologist because I was too high risk. The peri couldn't find a heart beat, so he told me that I most likely was going to miscarry and to schedule the D&C as soon as possible. I was heartbroken, but I believed him. However, I didn't schedule because I needed to hold onto hope for this blessing in our lives. At 8 weeks, I went to the ER with major abdominal cramping--thinking I probably was miscarrying. They did an ultrasound and again, couldn't get a good heart beat, but said everything looked normal and that there wasn't any bleeding. So, they looked around and found a large cyst forming on one of my ovaries. I was told again that I should abort b/c the cyst would most likely interfere, if not burst while pregnant, causing an infection to me at a minimum--death all around at worst.
Hubby and I just could not wrap our heads around why we would be given such a blessing, only to have it taken away. So, we decided to wait and see. At 10 weeks, we saw the Peri again - he did another ultrasound and finally found a good heart beat. Yay. Of course, he also saw the cyst and a fibroid on top of the uterus. The cyst had grown since the ER visit, but the fibroid was small. Again, he recommended abortion b/c we were "running out of time" and it was unlikely I'd carry to term anyway.
(Grrr.)
At 11 weeks, my cyst burst and caused excruciating pain. I was afraid to go to the doctor at this point as I didn't want to hear abortion again. At the 12 week visit, I had a 102 fever and major abdominal pain. The peri did an ultrasound and saw the fluid around the ovary (assumption that the cyst burst as it was no longer there). I clearly had an infection, so he put me on antibiotics. I can't remember which one, but it was a class C I believe. I also had a UTI, so it would take care of both (said the peri). Anyway, he said again that I should abort as he couldn't say whether the antibiotic would hurt the baby or not "better safe than sorry-right." Again, hubby and I chose to wait it out.
At 16 weeks, the peri did an ultrasound that showed everything seemed to be going okay. Baby looked "normal" and my infection was gone. I was reminded that it didn't mean everything was fine and that I should be getting the AFP and so on very soon to see. I also was sent to do a glucose test since I was overweight. I had lost weight so far, but since I was fat, obviously I had to have GD--grrrrr.
At 18 weeks, I decided I had had enough of the abortion talk and can't carry to term stuff, so I switched to a regular OB with a different practice. She ordered the 20 week ultrasound and changed my due date to 4/22/03. We hadn't talked about it much with the old practice since they didn't believe I would "produce" a baby anyway. I believe her due date was 4/26 by LMP. I was happy to have an earlier due date though--I wanted to get this pregnancy over with (so sad I thought this way) and see if she would be healthy. At the 24 week visit, I was told that everything looked good (including no fibroid growth), but after examination, my pelvis would not do well with a large baby. Large baby, by that OBs definition, was anything over 7 & 1/2 lbs. Yep, even being a very large woman, I clearly couldn't birth a baby of normal size. And the cesarean talk started.......
At 26 weeks, I went into mild pre-term labor (I say mild b/c I think now it was BH rather than labor). I was a good patient and went straight to the ER where the contractions measured just enough to call it
pre-term labor. Fortunately, I had a great nurse who sheltered me from all the interventionists (I had told her about my experience so far) and she helped tremendously. She put me in a quiet, dark room. Soothing music and lots of water. Had me lay down for two hours and then re-checked. Contractions had reduced to what they considered safe and she got me sent home.
By 36 weeks, the OB had me do another ultrasound for size. Baby girl measured in at 7 & 1/2 lbs. I believed them. More cesarean talk and my relief at having "what appears to be a normal baby" was replaced with the destruction of my wish to have a vaginal birth. For so many of the wrong reasons, at 38 weeks we scheduled my "induction" for the due date. To the OBs credit, she did say that I was not a good candidate for induction--she told me I would end up with a cesarean. I believed all of it. Induction, however, was my last ditch effort at a vaginal birth as I was having this monstrous 10 lb baby and was just high risk (I thought). I'm so sad for my lack of knowledge and for what I put my poor baby through as I let the hospital manage my birth.
On 4/22, I checked myself into the hospital and gave up all rights to my body. I was contracting when I arrived, so they waited two hours before starting with the cervical softener and pit (doh, I wish someone had told me that I could go home at this point. I wish I had thought of it. I wish.....). I was hooked up to machines, given a blanket to put between my legs and told to not move, but try to go to sleep. Huh--I've got monitors,
Vaginal Exams, pit and Cytotec (I believe) being administered. There was no way I could sleep. 10 hours later, I was only dilated to one and the pit was getting hard to handle. I was only 25% effaced. The OB on call came in and told me that she could break my water, but it would hurt. "It should start labor though." Great, since I was "failing" in my labor, I'd do anything to get things moving.
So, at 1cm dilated and 25% effaced, I agreed to AROM. Gushing, gushing fluid and way more pain. 5 hours later--yup, still only dilated to 2 and 50% effaced. At this point, the pit had been going strong for over half a day, being turned up every couple hours and I was in a lot of pain. My OB came in as she was starting her shift and told me that I was not progressing and should expect a cesarean. If I wanted to keep trying, she'd "let me go longer." She also said I could have an epidural since the pain level was getting so high and there was no way I was going to dilate fully anyway.......... I got the epidural around 22 hours after pit started. At about 11:00 pm, after being at the hospital for 25 hours, I couldn't take it any more. I needed sleep. I needed food. I needed the constant negativity to end. The monitors showed slight dips in baby's heart rate with some contractions and I signed the paperwork to get my cesarean.
I was broken. I thought I probably had a baby with major problems and I was in pain with constant fluid running all over the place from AROM. I gave up. At 11:45. I was wheeled into the OR. I weighed too much, so I had to help the nurses move me from bed to operating table (just the beginning of the too fat punishment). My arms were strapped down and the anesthesiologist started the numbing process. My BP dropped drastically and I tried to throw up, so they started administering several medications (not sure which ones) to help with that. I was "re-stabilized" and forced to breath through an oxygen mask as I was so numb, I was having trouble breathing. I know my BP dropped several times as the nurse kept telling the doctor that my BP was too low again and medications were administered. More anti-puking meds were given each time as I kept feeling like throwing up.
At 12:07 a.m., my baby girl was surgically removed from me. They held her up over the screen for like 2 seconds and then brought her over to the warmer table where the
pediatricians worked on her. She didn't make a sound for what felt like an eternity, probably 2 full minutes, but then we heard her and felt relief. At least she was okay for the moment. Elizabeth's apgar scores were 6 and 9. All of the constant interventions had caused some distress, but she was okay. A healthy 9lb, 12 oz baby girl.
I began swelling immediately afterwards, even though I had almost no swelling in pregnancy. I was also in a lot of pain. I kept asking for more pain medication and received a lot of percocet. Nothing seemed to help with the pain though. It was searing, burning pain.
And Elizabeth wouldn't nurse. She had been heavily medicated via my induction and then was given formula while I recovered--the staff had told hubby that Elizabeth was hungry and since I was in recovery with no visitors, he would have to feed Elizabeth formula (grrr again). About 4 hours after the surgery, my mother and husband came to see me. Where's Elizabeth? She's with my sister and brother-in-law, bonding with everyone but me. So, my sister finally brought her in and I got to see my baby. I was still too numb to lift my arms, so everyone had to pass her around and hold her so I could look at her.
Finally, about 45 minutes later, I could move my arms enough to hold her. She wasn't interested in nursing and began her extended sleeping regimen. Nursing never worked out well. 18 hours later, the nurse came and pulled out my cath and told me I had to go on my own. She wouldn't help me out of bed b/c I was too big and I'd hurt her (why was she a nurse then? Why didn't she get help?), so I developed tendonitis in my shoulder getting in and out of bed over my four day hospital stay. Elizabeth lost a full pound and was taken to the nursery where she was given formula again w/o permission.
Finally, I decided I couldn't take it any more and asked to go home. I was released with a prescription for vicodin and went home. At my 8 week checkup, I still complained of being in pain and was told that I was too overweight and out of shape. If I'd work on exercising more, then I'd heal faster. Of course, the OB did find a strange bulge in my abdomen and ordered an ultrasound. Ultrasound showed nothing, so I never heard from the OBs office again.
16 months later, I felt a cyst growing in my abdomen and thought it was probably a very large ovarian cyst. At 17 months post partum, I went to my PCP because I was getting uncomfortable and the cyst was too big to be an ovarian cyst. He felt it and told me I probably had cancer. Basically, he said that 17 months out from having a clear abdomen, it didn't look good and that I should start making plans for my death. He sent me to get panels of tests for cancer and another ultrasound. Everything came back negative (no cancer and no baby). By 18 months Post partum, the cyst had grown to the size of a 20 week fetus. All the tests kept coming back negative, so I was sent for a cat scan.
The cat scan showed that there was a lap sponge and surgical tape with something that looked like metal strings. Apparently, the nurses did not bother to do the sponge count and no one saw the surgical tape and metallic edging that is supposed to help keep this from happening during/after my cesarean surgery. For months after my cesarean, I was told that I was just fat and had no tolerance for pain because, of course, there couldn't actually be something wrong with what the OB or staff did during the cesarean. For almost two months, I thought I was going to die and leave my 1 year old with no mother. All of that because I believed the doctors from before I even got pregnant that I was broken.
18 months post-partum, surgery was scheduled to remove the damaged tissue, lap sponge, tape and so on from the botched cesarean. Everyone was still thinking it was no big deal, so a laparoscopy was performed. That failed. There was too much damage and the "foreign objects" were too big. So, I then had open abdominal surgery. There was a ton of scar tissue, of course. I was told that it would be highly unlikely that I could get pregnant, but if I did to at least wait a year or more to ensure my abdomen could handle such a high-risk thing. There was no additional scarring to my uterus, but I'm "just so high-risk now."
Six weeks after the open surgery, I got pregnant with my second baby. Most OBs had heard of my case and didn't want to see me as a patient. I interviewed 3 and found one that I thought was going to be VBAC friendly and sympathetic to my history. By 20 weeks pregnant, I had decided to go the homebirth route and so begins my VBAC story............
Kmom Note: akp's VBAC story can be found in the BBW VBAC FAQ.
Stacy's Story (3 pregnancies; gd + ketones with 3rd; 3 c/s)
Kmom's Notes: Stacy's extreme problems with ketones in gd are unusual. So was the level of calories she needed to have normal levels. Most gd moms are given around 2000-2200 calories; some docs restrict obese gd moms to 1500-1800 calories but this raises the danger of ketones and brings up whether the mother is adequately nourished at that level. However, Stacy ended up with the highest caloric totals I've ever seen for a gd mom---2800 calories! She also had to stop exercising to stop the ketones; this is very unusual. However, her ketones had probably become so out of whack previously in the pregnancy that such drastic measures were needed to stop them. Fortunately, her providers did measure them regularly (not all do) and experimented till they found what worked best for her. They didn't simply apply a uniform protocol, which helped a great deal.
Birth Story
I was diagnosed with GD at 28 weeks. With my other two pregnancies I had failed the 1 hour glucose test, but passed the 3 hour one. Not this time. My fear for the health of the baby and being absolutely terrified of blood tests, wreaked havoc on my emotions. I was determined to do everything possible to avoid insulin injections, even though I knew that it may be inevitable.
First, a little history. This was my 3rd pregnancy. My first baby was born when I was 29 years old. I was a dress size 20 when I became pregnant with him and gained less than 5 lbs during the pregnancy. (Not because I was trying to not gain weight, I ate very normally. My body simply didn't gain weight.) At 32 weeks gestation I noticed that he had become suddenly a lot less active. (Thank God for the doctor recommending counting kicks early on.) I went in to see my OB and was put on a fetal monitor immediately (non-stress test). The baby was having dips in his heart rate. They rushed me to a local hospital that had a more advanced neonatal ICU. As soon as we arrived there, his heart rate took a drastic plunge and he was born by emergency C-Sec. within minutes. He is now a perfect, simply amazing, brilliant little 6 yr. old.
Baby number 2 was born 14 months later. My dress size was still a 20 but I had gained about 10 lbs since the first pregnancy. Again, with this pregnancy I gained little weight. I was not diagnosed with G/D but once again I had failed the 1 hour blood glucose tolerance test and then passed the 3 hour test. On his due date, after 14 hours of labor, the baby went into fetal distress and was also born by an emergency C-Sec. His situation was totally unrelated to his brother's. He was born with a rare skull bone abnormality, that was corrected by surgery when he was 2 months old. But because of that problem, his head was simply unable to pass through the birth canal. He is now a perfect, hilarious, brilliant little 5 yr. old.
Ok, now back to baby number 3. With this pregnancy I was 35 years old and had again gained about 10 lbs since the last pregnancy I was now a size 22. At the beginning of the pregnancy, after much discussion with my OB, I decided to have a planned C-Sec. this time. Once I made that decision, I was completely relaxed about the rest of the pregnancy. We also decided at that time, that this third child would be our last, so I planned to have a tubal ligation at the same time. The decision was made long before the GD diagnosis.
After being diagnosed at 28 weeks, I began the diet and exercise program given to me by the doctor and registered dietitian. I stuck to it to the letter, but something wasn't working right. My ketone levels were registering "high" everyday. I had been very inactive due to an accident I had been in for a few months prior to and throughout my pregnancy. So, not only was I a plus size person to begin with, but my metabolism was certainly not normal either. Although, like many large women, I had gained almost no weight up to this point in my pregnancy.
Within 2 weeks of starting the diet/exercise program I had lost 8 lbs. At first the dietitian and doctor told me to not worry about it since many people lose weight when they begin the program. My blood sugars were all fine. But then when they saw my ketone levels they decided to take action. I figured that my body was just in so much shock from actually exercising, that it just couldn't help losing weight. I cut the exercising down to 5 minutes after meals.....and they raised my caloric intake to first 2500 calories.....then to 2800 calories.....and then finally to 3000 calories per day. Finally my ketone levels went down to "small" and "trace" readings, but I was still losing weight. With the agreement of the dietitian, I stopped exercising altogether. In my case, that worked. I stopped losing weight, had no ketones, and by just lowering my calories back down to 2800, my blood sugars stayed within normal range. I was able to control everything without insulin injections. Yippppeeeeee!!!
At 38 1/2 weeks my daughter was born by C-Sec., healthy, weighing 7lbs 5oz.and was 19 inches long. A planned cesarean is a LOT more relaxing than an emergency one. (Although, due to my fear of blood tests, as mentioned above, I was MUCH more fearful of getting an IV than the surgery itself. Go figure.) Everything went as planned to the letter. It was almost comical, shaking the doc's hand and saying "OK, now go get my baby." It was incredible, magical, wonderful. I was given a spinal block and had no ill side effects from it. For some unknown reason, the baby's blood sugar was low at birth. It registered 29 which was well below the hoped for reading of 40 or higher. My husband was handed a bottle of formula and he fed her about an ounce of it right away. Her blood sugars came up to normal and have remained that way ever since. I was a little concerned that she might not want to latch on to me after trying a bottle nipple first, but she latched on like a pro on the first try, a couple of hours later. The baby did not have any shoulder dystocia any other troubles associated with GD or anything else, for that matter.
It was a lot of work, but very much worth it, and I have a whole new understanding of my body and my metabolism. My emotions went through typical upheaval after her birth, but I think that was probably due to lack of sleep as much as due to hormonal fluctuations. I am now slowly adding exercise back into my daily routine and am amazed at the difference it is making in me both physically and emotionally. My boys like Richard Simmons better than Big Bird. Ha Ha ;)
Charlie's Story (fraternal twins, c/s)
Kmom's Notes:
Birth Story
Basically a regular pregnancy... we were a bit concerned at the beginning because of the size I was becoming (rather early). Also because of my age there were concerns that the baby would have problems (down's syndrome, spina bifida, etc) so the clinic did test for AFP.... The results came back high, which led to more concerns and we were scheduled for an ultrasound. At the ultrasound, we found out that the reason the AFP was high was because there were 2 babies, not one, which was a great relief.
The pregnancy was generally uneventful, other than the fact that I was miserable through most of it because of my size and it being a twin pregnancy. I had horrible heartburn most of the time, sciatica (which I have still)... no morning sickness to speak of, although if I got too hungry that would turn into nausea if I took too long to get around to eating and then smelled food.
The doctors initially suggested to me that if we made it through to 7 months that would be great and then we'd see how it was going, since twin pregnancies generally wind up being pre-term. However 7 months came and went and I remained pregnant and miserable. Then they suggested 8 months and they would consider induction since I was so uncomfortable... didn't happen. 9 months.... They tell me, "Well, lets just let nature take its course... " I said, "that's how I got this way to begin with!!!" They still didn't induce.
Finally (since I was going in to be seen about twice a week by then) I had been experiencing some liquid leaking for a couple of days and mentioned it, thinking it was a new kind of incontinence problem (another side-effect of the twin pregnancy), and they checked it, found out it was amniotic fluid and decided to let me go and have my babies. Originally they indicated that we would try and have them vaginally, but since the boy baby hadn't turned (as we had hoped he would) they just went ahead and did the c/s to avoid their chins possibly locking on exit.
That was 2 1/2 years ago. We think (every once in a while) about having another baby, but since the fact that we HAD twins was entirely my fault (the older you get the more predisposed to having multiples) and now I'm 38, I don't think we'll be having any more... Two is plenty and we have a boy and a girl and they keep us pretty busy. Who knows???... next time it might be triplets!!!......and then I'd really be up the creek.
Jessica H's Story (breech, PROM, c/s, spinal headache)
Kmom's Notes: Jessica's doctor felt that because the baby was large at 34 weeks and had low blood sugar, she must have had some undiagnosed GD. There is no way to know this for sure. Yes, the baby WAS large for 34 weeks and DID have very low blood sugar at birth. However, between being premature, having been exposed to brethine and steroids before birth (which raises maternal blood sugar levels, which then can make baby's blood sugar drop after birth), low blood sugar in the baby would not be an unusual finding. On the other hand, it IS possible that she could have developed some late GD between the usual 28 week test and the 34 week delivery. Progesterone levels don't peak till week 32 so it is possible, if unusual, that if she was borderline before, that progesterone peak at 32 weeks could have pushed her over into GD. Still, it is not a foregone conclusion.
Jessica also experienced a "spinal headache" with her c/s. This is one possible risk of both spinals and epidurals. Spinals are placed into the innermost space by the spinal cord, with the drugs going directly into the Cerebral Spinal Fluid. Because they are making a hole in the membrane that surrounds this fluid, sometimes that fluid will "leak" out the hole and the brain will not have as much fluid cushion as it is used to having, causing a temporary but very unpleasant headache. Although an epidural is placed in the space just outside this membrane and in theory should not cause a "spinal headache," sometimes that inner membrane is pierced anyhow and the headache occurs despite a different "space" being used for the anesthesia.
The usual treatment for a spinal headache is to give the person lots of caffeine (as they did Jessica) and to give them a blood patch. In a blood patch, a little bit of the woman's blood is injected into that space so that the blood can clot and hopefully block the "hole" and the fluid leakage. It's unknown why they did not go ahead and give Jessica a blood patch; that might have significantly eased and shortened her discomfort.
Birth Story
Saturday the 8th, following our birthing class (!) my water broke while
I was napping in our bed. I'd never felt so a large SPLOOSH in my life. I hollered for
DH, and ended up leaking even more fluid. I eventually soaked through a beach towel and the mattress by the time the
doctor called back.
When we got to the hospital, I was already at 1-2 and 80% effaced, and at 34 weeks, they didn't want to hear that. So I was put on bed rest,
brethine (asthma medication to stop contractions!) and antibiotics. The
brethine didn't work, so I was put on Magnesium Sulfate. The steroid celestone was given too to help develop the baby's lungs. Since he was
also [footling] breech (feet first), I was to be sectioned. No luck with an external version with no fluid!
So I was on bed rest, and bed pans (yich) until Monday evening when both steroid injections were on board, and I was taken off the Mag Sulfate.
The side effects from the Mag (constipation, numbness and fluid retention) were pretty severe by this time, and it was good to at least
get some circulation in my legs.
Tuesday, my contractions picked up, and I was on the external monitor still, listening to Rascal and watching the Tocometer measure
contraction strength. I did pretty well until 5 that night, and called the nurses insane for not believing I was in pain. By 9:15 that night I
couldn't think straight, and was crying. The doctor checked me on a fluke (don't want to check someone with ruptured waters often) and I was
at 7-8 cm fully effaced with Rascal's feet descending down through the cervix.
I was sectioned within a half hour, and had a rough 3 sticks, 2 for a spinal and then 1 for an epidural. Rascal was lodged in my cervix, so
they took careful time to dislodge him and his head was pushing up into my diaphragm as they did so. It was hard to
breathe for a few minutes until they unstuck his legs and delivered him feet first.
I didn't hear any announcement of sex or anything, they were worried about his lungs etc... but he was a champ with Apgars of 7 and 9! Now,
he's a preemie, 34 weeks, and he weighed in at 3630 grams, or 8 pounds! He didn't require any suctioning, but his first glucose check was 12, so
there was some late developed and un-caught GD with me.
I saw him for a quick few seconds, and my husband went off to be with him during all newborn procedures (pre-planned). While they were
stitching me up, the Duramorph in the epidural was fading, and I felt the last layers of tissue and the staples being put in-- ouch!
I did get a narcotic to last me through that part, and was wheeled into my
post partum room, right across from the nursery. I did get very itchy from the
Duramorph, but wet washcloths to my face, and a drug in the IV took care of that. I had eaten dinner (they fed me!) so I was pretty
nauseous most of the recovery time. I felt tired and drugged from the narcotic, but it helped with my resting that night, and I was on Oxygen
until morning since I wasn't breathing deep enough. DH came in to tell me all the news, and update me before we went to
sleep. I developed a spinal headache and am on high-caffeine intake until it fades. This is a NASTY headache, and I don't wish it on
anyone.
So it looks like all the complications were: premature rupture of membranes, pre-term 34 week gestation labor, frank breech, undiagnosed
GD, and C-section, and spinal headache (from epidural).
Poor Gideon is still in the hospital on a monitor (rooming in with me now) for Premature infant apnea, and his colon is under developed since
he's a preemie, and we're fighting his high bilirubin levels.
On a side note: The C-section was the most relieving thing that happened to me all weekend. My recovery is perfect, wound is clean and dry and
healing well, and I'm walking as well as I was when I was waddling when pregnant.
Never feel a section isn't a real birth! To me, it was a breeze, and I wouldn't mind having to have them every time (provided I
can get a good epidural!).
Bec's Story (insulin-dependent gd, induction, c/s)
Kmom's Notes:
Birth Story
My story starts with the fact that I was trying to get pregnant for about 3.5 years. I was able to get pregnant a few times, but miscarried. After one run-in with a fat-phobic doctor, I found a doctor who was willing to help me (350+ pounds at the time) get to the root of the problem. We never got a definitive answer, but worked on the premise that I have weak ovulation leading to a luteal phase defect (the time after ovulation and before next menses was too short). With the use of 100 mgs of Clomid on days 3-9, 150 IU of Fertinex on days 10-11, hCG injection on day 14, intrauterine insemination and sex on days 15 and 16, another hCG injection for progesterone support on day 21, and finally 50 mg of progesterone twice a day through the end of 14 weeks LMP.
I had some early scares because of bleeding, but was allowed frequent ultrasounds to check the baby. I was watched carefully throughout the first trimester, having many more appointments than the average patient, because of my recurrent miscarriages. At 16 weeks I was told I was officially an average patient and no longer considered high risk. I chose to do the triple screen at 16 weeks which came back fine and a level II ultrasound at 20 weeks revealed all was well.
I was diagnosed with gestational diabetes at 27 weeks. It wasn't a big shock since I was 33 and have a family history of diabetes, but what did surprise me is that my one hour glucose test came back at 217. I opted against taking the 3-hour GTT since my one-hour test was high enough to prove glucose intolerance, but my doctor did insist on a fasting level for confirmation.
I was given the choice of trying to control my GD by diet or with insulin. My doctor felt that insulin was the best control, and I did some research and found studies indicating a lower incidence of macrosomial infants when GD was treated with insulin. I had already been pretty much following a diabetic diet, so I didn't feel there was much adjustment that would help. I saw a nutritionist who only increased my calorie intake to about 2000 and frequency of meals, not the balance of what I was eating. A diabetic counselor taught me to monitor glucose levels at home, give myself insulin injections, and discussed walking and arm exercises to help reduce blood glucose levels. Between all of these things, I had the GD in good control within a week, and perfect control (levels under 100) for the rest of my pregnancy. My insulin levels were adjusted periodically, including adding a second smaller injection when my dinner levels were a bit higher than I wanted.
I think my main issue with GD is that I felt that I was on a very rigid schedule since I was supposed to test my fasting level and 2-hour postprandials (four pin-pricks per day) and eat every 3- 4 hours. I even had to wake up at 2 a.m. to eat a small snack so I wouldn't have ketones in my urine in the morning. I exercised after breakfast and after lunch everyday, and tried to do after dinner but was often too tired by then. I figured at least I would be in good shape for labor. Even with GD, I feel I had a pretty easy pregnancy and that I felt very healthy throughout.
I switched doctors at 35 weeks to a doctor/midwife team. While my previous OB might not have induced me for another week, the new one didn't want me going past 40 weeks with GD. We knew my exact dates and I felt more comfortable not going past my due date myself; I actually would have pushed the other OB to induce me at 40 weeks! My son didn't show signs of distress, but my insulin need was dropping, something that can indicate the placenta is beginning to fail. It was hard to find good information on insulin-dependant GD . . . most of what I could find was for insulin-dependant diabetics and being extrapolated to women with GD. My original OB didn't feel that it should be, and I agree.
At 39 weeks I had a vaginal exam with the intent of stripping my membranes. I was only fingertip dilated and 30% effaced, so that didn't happen. At 39w5d I was admitted to the hospital for prostaglandin gel applications to the cervix. I had some gel in the morning, did a lot of walking trying to get things going, and then had more gel in the afternoon. I went from fingertip to a bit more than one and 70% effaced. I also started to lose my mucus plug, but had few contractions. I was sent home at 7 p.m. and told to return the next morning for pitocin.
I'm not sure why I was being optimistic about the pitocin since I know it doesn't tend to work well before someone is dilated to 3 cm, but I guess I just figured I needed to labor, needed to get the baby out soon, and somehow it would work. Even the pitocin didn't do that much for me immediately, and it was restricting my movement since I was on a monitor and it wasn't cooperating; if I moved, we would lose the heartbeat. I really didn't want to be stuck in bed and it was very uncomfortable. It was pretty clear mid-morning that my perfectly positioned baby decided to move and give me back labor. Every time I had a contraction, I would get a sharp pain in my butt and down my leg. In the early afternoon I was thinking I would be unhooked and sent home, but all of a sudden I felt something akin to a balloon expanding and then popping followed by a gush of fluid; my water broke, and there was meconium in it. I was on the clock . . . baby within 24 hours.
I was at 3 cm and the OB put an internal monitor on me, something I hadn't intended, but appreciated since it allowed me some more mobility. The pitocin and IV insulin were turned up since my blood sugar was rising. The midwife was wonderful trying to help me find more comfortable positions and massaging my back. The best position for me seemed to be sitting up in a rocking chair. In the evening, I was so exhausted I decided that the pain might be discouraging progress, so I had a small dose of narcotics to take the edge off. It worked and allowed me to sleep between contractions which were 1+ minutes on, one minute off for hours. I was rechecked late in the evening after my son showed a few decelerations. I had not made any progress and was still at 3 cm. The OB said I might just be too small (based on my tiny feet and short stature) to birth the baby and I should consider a c-section. She would let me go another hour or so and check if I wanted, or we could make the decision immediately. Since a friend of mine had recently lost a healthy full-term baby, I chose to do the c-section. My son was born at 12:44 a.m. on his due date. He weighed 7 pounds 11.5 ounces, 20.5 inches long, and apgars were 9 and 9.
My biggest regret about the c-section was that I ended up so exhausted that I didn't really get to hold my son and nurse him until he was 9-10 hours old. I know the pro-breastfeeding nurses were upset with the anesthesiologist about it, but I didn't really understand why I wasn't woken. Maybe it was the meds. I also missed my son's first bath, but I have seen most of the firsts since then and that has helped diminish the pain I had from that (which did cause some post-partum depression). My surgical wound healed easily and my blood sugars returned to normal within 48 hours. I was released 3.5 days after having the baby and my staples were removed 5 days post-partum. After a rocky start, my son is still nursing at 20 months.
Margaret's Story (malposition, c/s, severe post-surgical infection)
Kmom's Notes: Margaret experienced a very severe infection after her c/s. It is unclear why she had such a bad infection afterwards, although the use of an internal monitor is known to increase the risk for infection. Still, very few women with internal monitors experience an infection as severe as this.
Although she was not plus-sized before the pregnancy, by the end of the pregnancy she was, and could have benefited from some of the preventative measures doctors can take to reduce the risk of infection in women of size. These include doing subcutaneous stitches in the fat layer, placing a drain in the wound, prophylactic antibiotics (hopefully with weight-based dosing), etc. Eventually the doctor did order some IV antibiotics, but Margaret may have benefited from an even more aggressive approach (i.e. multiple dosing, staying in the hospital longer for monitoring, etc.). According to Margaret, "I didn't have a drain, or stitches under my skin. I just had those big staples. Afterwards though, I had no closure at all, besides the stitches in my uterus."
After going home, Margaret's wound re-opened with infectious material. She ended up back in the hospital, having the wound drained in an additional 3 hour operation, probably debrided, then packed. She was in the hospital 5 days for infection management. She then ended up with home health care 2x per day, packing and cleaning the wound for another 6 months. The wound stayed open for another 3 years before finally closing, and to this day she has numbness and sometimes pain in the area.
Never let anyone tell you that a c/s is low risk. Although most women do not experience infections as severe as this, infection is a significant risk to cesareans, and at much higher rates than after vaginal births, especially in women of size. Although there are things doctors can do to lower the risk for infection, it is never possible to lower the risk for infection to zero, and occasionally infections become so severe they require major interventions or put the woman's life at risk.
Birth Story:
Hi, I'm Margaret. I'm 28 and pregnant with my second child. I would like to share the story of my five year old daughter's birth, where I contacted an infection after a c-section. I feel not only will this story help clear my head of the trauma I experienced, but it could also help someone else at some point in time.
Before I even knew I was pregnant with my daughter, I must have gained 15 pounds. I weighed 145, the most I had ever weighed. Upon finding out about the pregnancy, I began overeating in an extreme way. I was newly married, unhappy and very depressed. I thought marriage was like the Cinderella story, no one told me about the roller coasters! My husband & I barely made it through...we actually filed for divorce when my daughter was 6 weeks old. Thankfully it never happened. We have been married for 5 1/2 years.
I had bleeding during my pregnancy that continued well into the 6th month, I was terrified I would lose the baby. I was put on bed rest and gained a lot of weight. My OB was unsympathetic and told me I would end up "being a fat woman for the rest of my life". I weighed 220 pounds at the end of my pregnancy. I have been overweight ever since.
I went to the hospital at 6:30am on November 6, 1998. I was induced and contractions followed shortly after. There were nurses in and out of the room constantly, checking my cervix and making sure I was comfortable. My water broke at about 2:00pm, and an internal monitor was used. I
dilated to 5 and was feeling pretty confident about my body's ability to give birth. A nurse made a comment about there being "no need to be a
"martyr"....I caved pretty quickly after that and received an epidural at 3:00pm. I was complete in an hour, the epidural was turned off and I began pushing. I pushed and pushed for four hours. The doctor told me I may be able to deliver the head, but if the body was unable to come through, he would have to push the head back in. I was terrified by the thought of that. I began doubting myself and wanted to give up. We prepared for a C-section.
The procedure was virtually painless, just some pulling and pressure, after about 15 minutes our daughter was born. My husband was crying and came to show me our new baby. Since my arms were bound to the table, I could only turn my head and sneak a peek. I looked at her for the first time and it was as if we had met somewhere before. I looked into her eyes and said "how weird"...she was taken to the nursery and I don't remember much. I was very tired and unable to open my eyes.
A few hours later she was brought into my room. I began nursing and loved seeing my new baby. In hindsight, rooming in would have been less stressful for me... I hated when they took her away from me. At one point they told me I could not see her because the doctor was coming to check her. I was very upset that I was told I couldn't see my own daughter.
I was given sleeping pills because I was unable to sleep due to the excitement of it all. On the second day the nurse came in to change my bandages and look at my incision. She was not very happy when she saw the area red and swollen.
But I wanted to go home, I wanted to dress and bathe my baby. I wanted to play her music and show her our home. I told the nurse my incision was red because of the tape. I must have a tape allergy. She shook her head "I have seen this before". The doctor was called and he agreed with me, it was a tape allergy! I guess he just wanted to be sure, so I was given antibiotics by IV. The doctor ordered a water filled heating pad. I placed this on my incision to help with pain.
One night I was having severe pain that the pills were not touching. My hemorrhoids were out of hand, due to pushing. I called the nurse and asked her for tucks and my heating pad. She left me for two hours because she had to "verify" this information with my doctor. Instead of giving me the damn tucks...she said "you had a c-section".
I was allowed to go home on the 4th day. I called the hospital and complained about the bitch nurse. The woman, who happened to be the head of the nursing department said "Oh yeah...I know who you are, you're the one that got the infection"...I guess she knew something I didn't.
When we arrived home, I lay on the bed and cried. My husband was shocked, I had been so happy and strong at the hospital..what was happening? I told him the pain was impossible, I needed something for the pain. He didn't know what to do for me, and I spent the first night home in agony. I continued to feed our daughter and clean the house on the second day home. I was in the kitchen washing dishes when I felt something warm near my incision. I looked down at my white shorts to see a green stain forming near the stitches. There was green/yellow fluid oozing out of my body. We headed down to the ER.
My mom came to the ER and held the baby. She started crying to be nursed, and my mom took out some formula and fed her. She wasn't used to the quick flow of a bottle and vomited all over the waiting room. I couldn't stand watching her drink from the bottle. I was supposed to be able to feed my baby. I wasn't supposed to be back at the hospital. I wasn't supposed to be in this much pain. The doctor in the ER said she needed to remove the sutures and examine the incision. I almost crawled up the ceiling at this thought. NO WAY! I demanded that they call my doctor, he arrived shortly after and I was set up for surgery.
They re-opened the incision, in order to clean it out. The operation ended up taking over 3 hours. I don't know what they did while they were in there, but the pressure seemed to be gone. I was admitted to the hospital and put on a regular nursing floor. I began pumping my milk for my husband to take home. I was determined to breastfeed. I was not going to allow this to interfere with my plans. I had to pump every 2 hours, around the clock. Because of the amount of medication in my system..I was told to pump and dump my milk. If I couldn't feed my child, I was going to keep up my milk supply. No one thought this was very important, even the doctor. "It's ok Margaret, sometimes things just don't go as planned" I ignored them. I was going to nurse my daughter.
My husband took our daughter home the first night I was admitted, he came to see me the next day looking very frazzled. He didn't know anymore than I did about babies. The little I knew came from books. He was very scared and nervous about being alone with her. She was crying, he was crying and I wanted to disappear.
A nurse appeared and said she was going to be changing my dressing. I assumed it was just a layer of gauze like it was before, with sutures underneath. She removed the first layer and then the second and then the third....then she began pulling out gauze that seemed to be rolled into a ball inside my abdomen. She pulled and pulled and pulled on the gauze...It began to stick on the inside and I started to cry, then scream, then moan. My mother in law and husband came around the curtain to see what she was doing. My mother in law started screaming at the nurse to take her hands off me. The nurse and her began a screaming match, as I lay there with dirty gauze coming out of me. The doctor was called in. After strongly medicating me they wet the gauze and removed it. It took over an hour to get it all out. There was an endless roll of gauze in my abdomen.
Until the incision had healed a little on the inside, the doctor gave orders to wet the gauze with sterile water. I still didn't realize that my incision was so deep. It went down to the muscle. The doctor recommended that I shower without the gauze and hold my abdomen open. He said it was an unsterile wound, water would do it good. I was afraid to touch it, let alone shower it. When nurses came in to change the dressing I freaked out. I was given a shot of Demerol and a vicodin a half hour before dressing changes. If they hadn't medicated me I would have ran away from the nursing staff.
My sister in law offered to take the baby for a night. She came back the next day, glowing. There was a pacifier in my daughter's carrier and she smelled like formula. My sister in law was smiling when she told me the story about a couple she met in the elevator. "They just thought she was the cutest thing..and she is, you know?" "The man couldn't get over what great shape I was in..ha ha" "I just thanked him and smiled."
I guess she missed the tears in my eyes at that point, she just kept talking about what a great eater she was..and how she loved her formula.
I grew this baby with my own body. I had loved her for 9 months, talked to her all the time. What nerve she had to take all the credit. I was so upset and pissed off at everyone. I wanted to scream.
My total stay in the hospital, the second time, was 5 days. I was sent home and visited by home health nurses twice a day. They changed my dressing and took measurements of my incision. One of the nurses wanted to take a picture of it for me. She thought I might need to document this one day. I refused. I just wanted this to be over. Hair began growing around the incision. One of the nurses recommended that I shave it, to avoid irritation. The thought of shaving that area still gives me chills.
I continued to pack and clean my incision for 6 months. It was a gaping wound, left open from the inside out. It took 3 years for the outside to close completely. I have numbness and pain sometimes when pressure is applied to the area. I can't imagine ever having that area opened up again. I lost 40 pounds after the birth of my daughter, but because of the drawn out healing process I suffered from a deep depression and ended up gaining it all back. I have been on every anti depressant in the book over the last 5 years.
I am now on disability due to depression. I don't think the infection is fully responsible for this, but I'm sure it wasn't any help either.
I am determined to have a VBAC.
Lisa L's Story (induction, c/s)
Kmom's Notes: Lisa shows classic signs of a malpositioned baby: prodromal labor for a long time (including going overdue), back labor, feeling an urge to push too early, no progress in pushing despite strong pushing for a long time. The baby was also big, which could also have been or added to the problem, but it's difficult to know for sure what happened. If the baby was indeed posterior, breaking her waters committed the baby to that position and basically ensured the c/s. In a follow-up, Kmom asked her if the baby might have been posterior. She wrote back and confirmed that "she turned during labor and was face-up which contributed to having the cesarean."
Birth Story
I was 42 weeks pregnant, very healthy, but baby did not want to come out. On the day that I went in to be induced I was 1 1/2 cm dilated and 40% effaced and had been in mild labor for two weeks. I went into the hospital on November 24 and had a cervical pill inserted to help soften my cervix which would hopefully help me dilate more. They inserted this pill 3 times at 4 hour intervals but labor got strong just an hour after the first insert (7:00pm on 11/24).
After a restless night and much back labor, accompanied by many showers and much walking, they broke my water at 7am on 11/25. By 11am I was only dilated to 2 cm and getting antsy as my contractions had been one on top of the other for 17 hours. Finally at noon I received an epidural with no complications at all. During this and throughout my pregnancy my weight was never an issue.
At 5:00 I felt the urge to have a bowel movement and when the midwife checked me I was 6 cm dilated and progressing quickly. By 6:00 I was a full 10 but only 90% effaced and I began pushing. After two hours of watching her head bob in and out with contractions and pushing they decided on a c-section because her head was too large.
D was born at 8:13 pm on 11/25/98 perfectly healthy at a whopping 10lbs 4oz. Mommy healed well and overall the birthing experience, though long, was well worth the end result. I am now due soon with a boy and hope to be writing back with a successful VBAC story!
Danie's Story (PROM, posterior, partial abruption, premature, group B strep, c/s)
Kmom's Notes:
Birth Story
The full story can be found at www.childbirth.org/articles/stories/aidan.html. A very difficult birth story; the baby and mother turned out fine in the long run, but getting there was very traumatic for them both. Below is a brief summary.
While visiting a dying aunt, Danie's water broke at about 35 weeks. She did not know it but she had group B strep (infections can cause the water to break prematurely). She had a terrific OB who was very Bradley-oriented and supportive of natural birth, but due to complications she eventually needed a c/s (a truly necessary one).
Her baby was posterior and so labor was painful and not very effective, and during labor her placenta began abrupting (pulling away from the uterine wall). The baby went into distress. When the baby was born, he got pneumonia from the group B strep, one lung was punctured by the suctioning they did, and he was eventually found to have a hole in his heart. However, they did manage to establish long-term breastfeeding despite all the barriers, and he is doing well now in the long-term.
Pam's Story (PCO, insulin-dep. gd, placenta previa, c/s)
Kmom's Notes:
Birth Story
After 2 years of trying to conceive due to PCO, we got pregnant. I had all day morning sickness for 14 weeks. At that point I was diagnosed with GD. Despite diet changes etc, I had to go on insulin at 18 weeks since my fasting sugar levels wouldn't come down. I was also diagnosed with placenta previa (low-lying placenta) and told to take it easy for the pregnancy.
By 36 weeks I was told that my GD was controlled so well (baby was not big at all) and that the placenta had shifted enough, I was going to be able to have a vaginal birth. At exactly 39 weeks I started bleeding and since the baby hadn't dropped and I wasn't dilated or soft AT ALL, it was decided that an induction would be pointless. A c-section was scheduled for 3 hours later. I was comfortable with this choice.
I had an epidural, which the doctors had NO problems putting in. I was easily shifted from my bed to the OR table, even after the section when I was totally numb and couldn't help. I was awake and conscious for the section and my DH was right next to me. Despite the fact my placenta had broken apart and was hemorrhaging, my boy was born totally healthy and fine. Apgars 8 and 10. My arms were restrained by a blood pressure cuff and the IV's, so I couldn't move much, but the nurse freed my one arm so I could touch and caress the baby while DH held him.
Baby never left my sight until DH took him across the hall where I was being taken minutes later. I tried to BF an hour after his birth (the soonest they'd let me) and he wasn't interested. He didn't nurse well at all that day and he finally got a great latch the next morning. From there on in, BFing was not a problem, even on the inverted nipple. I had trouble getting him to latch for a few days, but that was due more to my inexperience and FF breasts. Once we got the hang of it, there was no problem (as long as I used the football hold exclusively). My milk came in by gallons on day 3 and we kept it up until I weaned him at 15 months.
My pain level was easily controlled with Tylenol 3s and I was walking around in less than 24 hours (in fact at 10 hours I walked (slowly and with help) to the bathroom). The staples were taken out on day 4 when I was discharged. I never had any problems with the incision. It healed over easily. By 4 weeks postpartum I was able to run and do pretty much everything. I stopped taking extra strength Tylenol after 10 days. My GD completely disappeared immediately upon delivery, and I've been healthy and happy ever since.
Ann's Story (transverse presentation, c/s)
Kmom's Notes: Ann experienced some size-phobia and hassle from a previous provider, and decided to switch mid-way through her pregnancy. Unfortunately, her baby settled into a transverse position (shoulder/side first) and her doctors' policy was not to attempt external version. Because the baby did not change position on her own, Ann needed an elective c/s.
Birth Story
Ann's story can be read on her website at www.adairmedia.com/ann/elizabeth.htm. She had a pretty ordinary pregnancy, but had a c/s when her baby was found to be transverse. Because it was an elective c/s (no labor beforehand because of the