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
PolyCystic Ovarian Syndrome Birth Stories
CONTENTS
Many women over the years have requested a section for birth stories of plus-sized women. 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.
After several years of collecting these stories, Kmom published a collection of BBW birth stories. Stories were 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. Many women have written and shared how valuable it was for them to read these stories, hear the variety of experiences, and know that they were not alone.
Eventually, Kmom began hearing from women with PolyCystic Ovarian Syndrome (PCOS), who wanted a Birth Stories FAQ of their own! Since many women with PCOS are BBWs, it makes sense to house these stories here. However, it should be noted that not all women with PCOS are large women (just as not all large women have PCOS). So while most of these PCOS birth stories will be those of larger women, average-sized women with PCOS are welcome to also submit their stories here too.
More stories will be added over time, so keep checking back if you are interested. 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.
Links for Information on PolyCystic Ovarian Syndrome
Special Note: For those who do not know what PCOS is, it is thought to be a disease/syndrome of insulin resistance. Women with PCOS tend to have several (but usually not all) of the following group of symptoms: irregular periods, excessive facial or body hair (hirsutism), thinning scalp hair, cystic acne, fertility problems, obesity that does not resolve easily with diet and exercise, insulin resistance (and therefore a tendency towards diabetes), Syndrome X (high blood pressure, high cholesterol/blood lipids, tendency towards diabetes), etc.
There are many resources available for more information on PCOS. If you think you might have PCOS or simply wish to find out more about it, Kmom strongly recommends visiting the sites listed below. They will have links to many more sites on PCOS.
How To Submit Your Own Birth Story
Note: The rules for submitting a PCOS Birth Story are basically the same as for a BBW Birth Story; women who have PCOS but are average-sized are welcome to submit their stories too. Please follow them carefully, as follow-ups and clarifications take a great deal of time away from Kmom's family.
If you would like to submit your birth story, you can email kmom at kmom@vireday.com with your birth story. You need to fill out the format in order to provide some basic information, then include your simplified birth story (please be fairly succinct in order to save space on Kmom's website!). If your story already appears elsewhere on the web, feel free to fill out the format and give a basic summary of the story, and then submit the link to your page. It is also vitally important that you explicitly state permission in your email for Kmom to use your birth story on this website and/or in any future publications (such as a book or magazine article on plus-sized pregnancy).
Kmom welcomes all types of stories, including wonderful empowering births, 'average' birth stories, so-so stories, and horror stories of disempowerment or assault. All types of birth stories have lessons to teach us. Kmom particularly wants to collect stories of beautiful, natural vaginal birth in order to contradict the popular medical viewpoint that large women cannot have a normal birth experience---too many books contain only the scare tactics of how 'high-risk' our births must be. Large women can and DO give birth normally all the time, and often without medication or other interventions! Being large does not have to mean lots of intervention or unusual care. If you have a wonderful birth experience, please take time to share it with other large moms so they can be inspired! (Notice that the largest section of stories in this FAQ is the collection of vaginal births!)
However, large women also experience horror stories in birth, just as average-sized women do. These experiences should also be heard. In addition, some large women definitely experience fat-phobic care, and these experiences need to be documented so that cautionary lessons can be learned from them. Therefore, Kmom strongly urges women with these types of experiences to share them as well. These are often difficult to write about, but many women find that the writing begins the healing process. This has been Kmom's experience as well. Starting the writing is the hardest part, but the more you write and speak of it, the more healing takes place. Unresolved grief stays in the body and often harms us further. Getting it out is the first step on the path towards healing.
Regardless of how wonderful or not-wonderful your birth was, the exact moment-by-moment details of labor are less important to portray than what kind of treatment you experienced, helpful hints for pregnancy, what helped you prepare for labor best, the emotional processing you went through for pregnancy and birth, lessons you learned, etc. Think about what you would most like to tell other women from your experience, what would have been most helpful to you to have heard when you were pregnant, what the main lessons from your experience were, what you learned as a large woman, etc.
If you wish to submit your birth story, please fill out the following format, explicitly give Kmom permission to use your story, type in your story (no attachments please), and edit it to see if you have filled everything in and corrected any errors (please do this, it saves time for Kmom!). Feel free to use a 'pen name' or initials in order to protect your privacy. Unless specifically requested, personal information is usually omitted.
Birth Story
Type in your birth story here; no attachments please!
Then email your story to kmom@plus-size-pregnancy.org and mark it 'birth story'. Kmom reserves the right to edit and add commentary to the stories. Check the website every few months; Kmom will periodically update and insert new stories in the FAQ as they accumulate and as her toddlers permit! At times this will be every few months, and at times this may be only once or twice a year, so please be patient.
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.
Stephanie's Story (PCO, gallstones, unmedicated vaginal birth)
Kmom's Notes: Although it does NOT occur with all PCO moms, there are some who develop problems with milk supply, even when being extremely proactive. Other PCO moms are able to breastfeed without problems; no one knows currently why some PCO moms are affected and others are not. More research is needed, but little is being done.
Birth Story
We had a very healthy pregnancy and uncomplicated vaginal delivery which I attribute primarily to two things. First, we were careful to find a size-friendly practitioner who didn't treat me as if I were a train-wreck waiting to happen. Her exact words at our initial visit (8 weeks pregnant) were, "Yes, you have some additional risk factors, but right now you're fine and we'll assume everything is going to be fine. We'll just keep a close watch on you." We chose an OB rather than a mid-wife because of my risk factors, but she was as committed as we were to having as natural a pregnancy and delivery as possible.
Second, we did everything we could to have a healthy pregnancy, following the Bradley method of education, diet and exercise. I think this really made a difference and allowed me to have an easy pregnancy. In fact, I think the fluid retention/blood pressure problem I developed could have been avoided had I been able to continue the Bradley diet. (The low fat diet I had to follow for the gallstones didn't have the amount of protein I think I needed.)
I went into labor 4 days after my due date. Latent first-stage labor was fairly straight forward and slow, as is typical in first-time mothers--about 15 hours to get to 6 cms. I didn't do anything special for pain management other than using the techniques I had learned in class and through my reading. Mostly I tried to remain physically and mentally relaxed, used even abdominal breathing, and lots of visualizations. At 15.5 hours, I got the urge to push, but had only dilated to 7 cms. The next 20 minutes were especially difficult. I had to try NOT to help my body push, and the pain was very intense as my cervix finished dilating and the baby began her descent.
Fortunately, I went from 7 cms to 10 cms during those 20 minutes and was then told I could push. It took one or two contractions to get the hang of pushing, but I pushed my daughter out in only 15 minutes! The only intervention we had was an episiotomy (2nd degree with no tears or extensions), and our daughter was and is wonderfully healthy.
We had our first breastfeeding attempt in the delivery room, and kept our daughter with us for about an hour. Then my husband accompanied her to the nursery, where she was weighed, measured, and bathed (he dressed her for the first time, with a little help from the nursery staff). She roomed in with me during my hospital stay and we came home 2 days later.
Things I didn't anticipate: how much delivery would hurt, how annoying hemorrhoids would be post-delivery, that my pelvis would hurt after delivery as my bones began to move back to their pre-pregnancy positions, and how much more I could love my husband and daughter as the days go by. P.S. We're planning baby number 2 next year!
Paula's Story (gd, severe pre-eclampsia, induced premature vaginal birth)
Kmom's Notes: Paula's first pregnancy was complicated by primary hypertension, which she was on medication for. Primary hypertension can often become worse in pregnancy, becoming pre-eclampsia despite medications. This is what happened to Paula. In addition, she developed gestational diabetes (diet-controlled) at about 18-20 weeks. Had her pre-eclampsia not worsened, she would have been induced at 38 weeks because of the gd and blood pressure concerns combined. As it was, when her pre-eclampsia worsened, they elected to induce at 36 weeks instead. Induction probably succeeded so early because she was already partially effaced and dilated before they began, although they did nothing to ripen the cervix ahead of time.
Between pregnancies she developed overt diabetes. Because her PCO is very significant, she and her doctor elected to have her take Metformin (Glucophage, 2000 mg per day) throughout her second pregnancy (but not for nursing). Although her blood pressure remained a concern (and she was "maxed out" on 3 blood pressure medications through the pregnancy to keep it under control), she did not redevelop pre-eclampsia in the second pregnancy, which she credits to the Metformin. They did add insulin during the pregnancy later on. Paula was induced at 38+ weeks because of the type II diabetes. She felt she had a terrific doctor for her pregnancies, very size-friendly. Not all of the doctors in the pregnancy were as size-friendly, but her primary doctor was "GREAT".
Birth Story
Baby #1: I was induced 4 weeks early due to severe pre-eclampsia. I was given magnesium sulfate and pitocin at 6pm on Thursday. I was already 80% effaced, and 2cm dilated. By 6am Friday I was 100% effaced, and dilated to 3-4 cm. The broke my water and I began having contractions with in an hour. I dilated quickly to 10cm by 9:30am and delivered vaginally at 12:03 pm. Labor in all was about 6 hours. I only required one internal stitch for a small internal tear.
I did learn through this whole process to listen to my body. The labor nurse was trying to get me to push differently then what my body was telling me. She wanted 3 shorter pushes when my body wanted 2 long ones. When I finally listened to my body I delivered very quickly. After discussing this with my OB I did what my body told me and had much better pushes then what I had been having.
I did have some problems breastfeeding at first due to the fact that she was 4 weeks early and didn't want to latch on very well. She had been tube fed, finger fed, and cup fed and like the 'instant gratification' that provided, versus having to 'work' for her food. [But nursing did work out in the long run, despite the slow start and the severe PCO.]
Baby #2: Our second child was conceived through an injectable cycle. I was 410 when I conceived this child. [I was on Metformin before the pregnancy and remained on it for pregnancy.] My OB had actually read up on the use of Metformin in pregnancy and was going to suggest it to me if I wasn't already on it. I had approached him before my first appointment because both my RE (Reproductive Endocrinologist) and Endocrinologist wanted me to stop UNLESS my OB agreed to let me take it.
There are so many benefits to taking Metformin during pregnancy, and I really wanted to avoid the pre-eclampsia that I had with my first pregnancy. I also did not want to risk going off of Metformin because of the dramatic decrease in miscarriage rate while on it. The fact that there are no known deformities or problems while taking Metformin in pregnancy made me feel comfortable enough to take it. I know some doctors will not give Met in pregnancy because they are uncomfortable with the fact that no US studies have been done, but all of the information coming from other countries seems to indicate that it is safe.
[I was induced at 38+ weeks, due to the diabetes.] I arrived at the hospital at 1 p.m. and began the paperwork and all. The IV was started around 3 p.m. with Pit; I didn't need any prostaglandin gel because I was already 2 cm and 50% effaced, baby at -1 station. The Pitocin was started; they increased it every 30 minutes.
Around 6 p.m. I began having contractions about every 2.5-3 minutes. They were tolerable and I could breathe through them easily enough. We were waiting for the doctor who was supposed to show up around 5 p.m. for AROM (breaking the waters). Finally around 7:30 p.m. he arrived and ruptured my membranes, the contractions slowly began to get worse, and the baby was doing okay. Around 8:40 p.m. we had a scary deceleration where her heart rate dropped from the 140s to 75 with internal monitoring so we knew it was an actual drop. The intern came rushing in to do 'fetal scalp stimulation' which brought her heart rate back up. I then was told I had to lay on my side and that seemed to keep her heart rate up.
The contractions while on my side were getting pretty uncomfortable and combined with the drop in heart rate I decided to get the epidural. The funny thing is that while sitting (for almost an hour) to get the epidural I couldn't feel the contractions at all, and even had to look at the paper to see if I was still having them. Talk about positioning making all the difference.
Once back on my side I could feel the contractions again until the epidural took full effect. About 10:30 p.m. I felt like I had to urinate with every contraction, but that was all I was feeling. I figured it was just the pressure form the contraction. Finally at 1 a.m. I asked the doctor to check me. My bladder was so full he couldn't feel the baby. I was straight cathed (catheter) and checked and was 7 cm. About 10 minutes later I felt like I had to push. [Kmom note: A full bladder can impede labor progress! It's important to pee every hour or so in labor.]
I waited 2-3 more contractions and decided it was time to call the nurse. My nurse was gone to lunch and another nurse (who waited another 3-4 contractions before coming to the room) told me I was only 7 cm 20 minutes ago, and I really didn't have to push; that the epidural should be working fine and I should be able to get through the contractions without any problem. I told her my last one went from 5 cm to 10 cm in 45 minutes and I felt like I had to push. The stupid woman still wasn't going to check me. I insisted and she reluctantly checked me. I was at 10 cm and it was time to push.
The doctor got to the room and got the stirrups up. I began pushing and he was going to check to see where the baby was. He asked how long it took last time; I said 1.5 hours of pushing. He commented it wasn't going to take as long this time. I could feel her head almost crowning at this point, then with the next push she was crowning and out. I pushed for a total of maybe 5 minutes, and out she came. So much for not having to push. Her apgars were 8/9 and we got to nurse her right away. It was such a different experience from my first.
Apparently I am 'wired' a little differently than most and with an epidural I am mostly numb except for the vaginal canal and perineal area (my epidural last time did not work completely properly either). I didn't realize this was any different from 'normal' until they went to put in a stitch (I needed 2). I could feel the needle and began in with "OWIE OWIE", and the doctor asked, "You can feel that?" I told him I couldn't feel my toes but I could feel that. So with one stitch left, they just put it in without any numbing agent (with my permission). I figured I would get stuck once with a stitch or once that I would feel with the Novocain and either way I was going to feel it.
I know that one of my BIGGEST concerns [before my pregnancies about my size] was that the monitoring belts would not fit around me. Not only did they fit, but the contraction monitor actually worked! I know they used an internal monitor last time as soon as possible because they did have a hard time finding a heartbeat without my laying in a very uncomfortable position and then holding the monitor there. I just figured that if they didn't get the heart rate all the time it was really no big deal, that the fading in and out (which includes the rate dropping sometimes because of the monitor) was just because I was moving or the baby was moving. With my second I just assumed the same thing until they got the internal monitor on.
My doctor is GREAT! [Very size-friendly.] I wish I could say that for all of the doctors in the practice. I had one who complained every time that she saw me because they told her to measure me. She didn't understand why they even bothered to measure me because I was so "off the charts". I may have been off the charts, but I did grow according to the curve they use, so it was useful in following the growth of the baby. I can't think of anything differently my doctor did with me that he doesn't do with every other woman. I did see him more frequently, but that was due to the type II diabetes and insulin monitoring than anything.
I am nursing; it's the only way to go for me!! I always tell everyone I am too lazy to bottle-feed; there is too much work involved. [I stopped the Metformin for nursing.] I would LOVE to be back on the Metformin, but my doctors are not comfortable with women taking it while breastfeeding. I know there is the same issue in pregnancy, but I can actually find information on Met in pregnancy but I can't find any on Met and nursing. I did realize the other day that I was on Met while I was breastfeeding #1, but she was almost 2 years old and I was in the process of weaning her. I think once this one is eating more solid foods, I will start the Metformin again even though I will still be breastfeeding.
Lisa Z's Story (twins, diet-only gd, vaginal birth)
Kmom's Notes:
Birth Story
My story, despite the fact that I gave birth to twin boys, is actually rather boring (thank God!). I did develop gestational diabetes very early on in my pregnancy, and I was expecting that to happen for many reasons (family history, my weight, the fact that I was carrying twins - all increase risk). However, I was able to control my GD through diet and it proved to be not much more than a minor inconvenience during my pregnancy.
I became pregnant with the help of Fertinex and IUI (Intra-Uterine Insemination). I suffer from PCOS, and do not ovulate without pharmacological assistance. I did conceive once before with the help of fertility drugs, but it was an ectopic pregnancy, which we were able to abort with drugs and managed to avoid any kind of surgery. At the beginning of my pregnancy I weighed 308 pounds. At the end, I weighed 323. After delivery, I was down somewhere in the 280's, but alas, that was short-lived, and I am now back up to somewhere around my late pregnancy weight.
As for my labor - my water broke 2 days shy of 36 weeks. I went to the hospital and basically sat around a lot waiting for labor to start. About 12 hours after I checked into the hospital, the contractions started. A couple of hours later I had an epidural, which came out and had to be redone. Because of this, they gave me MEGA-doses of meds, which caused me to be completely paralyzed and numb from the waist down. My dh and I fell asleep until the doctor came in early in the morning to check me (which required both my OB and my dh hoisting my deadweight legs into the air so that he could examine me) and promptly announce that it was "showtime." He had me start pushing in my labor room, but once the 1st head appeared, I was taken to the operating room, which is standard precautionary procedure in multiple births.
My delivery progressed very normally - Baby A arrived after not much more pushing, and Baby B, who had been breech until then, flipped his little self around to be delivered head first. It took 23 minutes and the help of forceps, but both boys were delivered vaginally and in perfect health - 5 lbs. 12 ounces and 5 lbs 13 ounces! I took them home with me 2 days later.
Carol C's Story (PCO, Group B Strep, vaginal birth)
Kmom's Notes: Carol's story of back labor, difficult pain, waters breaking before labor, and having difficulty dilating beyond 3 cm at first raises the question of malposition (posterior or asynclitic, etc.). However, either that was not really the problem or the position corrected itself because her labor proceeded on to a normal vaginal birth. Also note that this baby was almost 10 and a half pounds; according to many OBs, this is 'too big' to birth normally, but obviously Carol had little trouble.
Birth Story
The only time my doctor ever mentioned my weight was when I was losing too much from queasiness during the first trimester - and even that was just to make sure that I was TRYING to eat sensibly and not trying to diet during pregnancy.
My whole pregnancy was pretty uneventful. Morning sickness was limited to queasiness and disinterest in food - I hardly ever actually got sick. My blood pressure was always fine. All those other routine tests they do were always fine.
I was still feeling pretty good when we checked into the hospital, and determined to have a natural birth, in spite of back labor. We had taken a Bradley class, and were prepared with a bag full of massage toys. DH was getting me through the contractions okay. That is, until 8 hours had gone by since water breaking, and I hadn't gotten past 3 cm. :( The doctor on call insisted that we start the pitocin, because of the Group B Strep.
I was still handling it okay, until the second time they increased the drip. There were a yucky couple of hours there, with lots of vomiting (MAN, was I glad that I wasn't the one who had to clean up my messes!), sweating and moaning. And so I caved and asked for the epidural. The pit had done its job though, because when the anesthesiologist got there, I was at 6 cm, and by the time they finally got the epidural right (3rd try), I was at 9 +.
I'm disappointed that we didn't have the birth of my dreams, but I'm happy with how things turned out. I really did feel great after the epidural, and pushing was a breeze. I got to have a mirror, and that was really neat! My nurse massaged and stretched me for an hour, and I give her some credit for me not having to get an episiotomy and only having minor tears with my big boy. :) Well, my wide hips might have had something to do with it. too!
My precious son is just the most wonderful little person in the whole wide world, and I'm thanking God several times a day for blessing us so greatly. Being a mommy is just so indescribably wonderful!
Suzanne's Stories (PCO, unmedicated vaginal births, gd with #2)
Kmom's Notes: Please note this PCO mom did not have trouble breastfeeding, nor did she get high blood pressure. PCO does not have to equal these problems! Also note that this mom went from 5 cm to complete (10 cm) within 15 minutes of getting into warm water in her first birth, and that it was also helpful in the second birth.
In her second birth, despite developing insulin-depending gd, Suzanne had several things going for her. Her first baby was born vaginally and naturally, making a vaginal birth this time more likely. She got good control of her blood sugars, plus a supportive set of providers (and when she found an unsupportive one she switched!). Her baby was average-sized, which makes them more willing to give a trial of labor. She had a midwife and doula for her birth, both of which tends to cut the c/s rate significantly, and she was able to use water for laboring as well as a standing position for pushing and birth. But SHE was the one who did it, and admirably too!
Birth Story
I am a plus size mom. I weighed 270 pounds at the beginning of my first pregnancy and gained and lost 3 pounds over the 9 months by eating healthily. I had no complications during my pregnancy or birth. Here is the birth story of my first child.
My due date was September 19, I went into labor at 4 AM Monday morning September 18th. I woke up to what felt like light menstrual cramps coming at about 20-minute intervals. I checked the time tried to go back to sleep. I dozed a little until 6 AM then decided to take our dog for a walk around the block (if it was false labor that should make it go away). The contractions didn't go away, this was the day! After the walk my partner and I went to a friend's house to labor and I decided to take a bath in their very large tub. After that we took another walk, I started around the block and the contractions were getting more and more intense. I could walk and talk between, so we were not too concerned. We got back timed the contractions, they were one minute long and five minutes apart. We thought, "Wow, maybe we should go to the hospital." It was about 10AM, I called our midwife and doula, getting pagers for each. The doula called back first. She said I was too jolly between contractions and she would be over in a few minutes.
She arrived and said she didn't think that we should go to the hospital yet. She started to help me through the contractions. My favorite spot was in a big leather chair in the family room. I would lean back, the doula would stroke my hair and my partner would push on my knees in toward my pelvis. At first I could talk between contractions but after a while I didn't want to talk much anymore. Periodically, my doula would tell me it was time to change positions and I would walk around the room. Standing contractions I did mostly hanging off of my partner's neck, with one knee locked and the other relaxed. I also spent some time leaning on a hassock on my knees. The contractions were very painful in that position, so I thought; "these must be working well." I was having double peaking contractions for a while. One would come and I would deal with it, be breathing a sigh of relief and be broadsided by another one. Once I got used to the pattern it was easier to deal with. I breathed through contractions until about 1 PM and then asked the doula, "When are we going to the hospital?" She said, "That's up to you."
I was on my way out the front door as everyone gathered stuff to bring to the hospital followed behind. My partner drove me and the others followed in their cars. The hospital was 10 minutes away and I had 3 or 4 contractions on the way. We left the car and headed for admitting. The doula was right behind us and was there as we headed for the room. It was a very long walk to the maternity wing from admitting, they offered me a wheelchair three times but I declined. I didn't feel like sitting. So we walked down the different corridors stopping for contractions then moving on, up the elevator and finally to our room. The nurse monitored me for 20 minutes with the belts and did an internal and pronounced me 5 cm dilated. During the rest of the labor a hand held Doppler was used to monitor the baby's heartbeat.
When the tub was ready we trotted off down the hall for a soak. My doula and partner stayed with me. I was trying to figure out whether the jets were helping or annoying the hell out of me when I was hit by a contraction that felt very different from the others. I made a sound that came from very deep inside me, a grunt. Lindsey recognized the sound as the one a laboring woman makes when she is completely dilated. She yanked the nurse call-cord and our nurse came running. I was completely dilated. I had been in the tub about 15 minutes, 2 or 3 contractions total. I got out of the tub. They wrapped me in a blanket and off we trotted back down the hall to my room.
The midwife hadn't arrived yet. She had been eating lunch with a friend when we arrived at the hospital at 5 cm. She thought she would have time to finish lunch and then come over. The nurse called her back and told her to get over to the hospital ASAP. We had to wait for her to arrive. The nurse kept telling me that she could deliver the baby, she was studying to be a midwife...but don't push unless you have to. So I huffed through the contractions only pushing a little at the end of each. Not pushing was the hardest part of the labor. The midwife finally arrived I could push. I held on to the edge of the bed and squatted to push. Between contractions they pushed a little stool under my bottom and I would sit and rest. Once the baby came down and stayed down I moved onto the bed with my doula at my head and my partner holding my leg up. I pushed for about 45 minutes total.
My daughter was born at 3:59PM. Her APGAR scores were 9 and 10. Total labor was 12 hours from the first contraction, 6 hours of active labor. I had 2 stitches for "skid marks" but my perineum was intact. I did not need nor want any anesthetic at any point in the labor.
Suzanne's 2nd Story: My second pregnancy and birth were totally different from the first. It took 2 years and 16 cycles of trying to conceive #2. I ended up with a diagnosis of PCO and treatment using clomid to stimulate a follicle, Hcg shot to cause ovulation, then Intra-Uterine Insemination. I found out Dec 23 that I was pregnant. What a wonderful Christmas present!
I started getting morning sickness at about 6 weeks and continued with it until I was 25 weeks along. Then I was diagnosed at week 28 with gestational diabetes. I was shocked and found that my caregivers were all working from scraps of paper and seemed unsure of the acceptable glucose levels. I called around and finally got in touch with an endocrinologist and he assured me that they were following the standard of care. I ordered a book on GD and read up. That helped put my mind at ease. Then I had a goal to reach.
I started testing my blood 4x a day, fastings and 2 hours after each meal. I also would test extra times if I was curious or was feeling a low blood sugar reaction coming on. So I would test 4-8x a day. These are the numbers that we used:
They sent me to a nutritionist who was useless. The diet she put me on...contained too many carbs in each meal and too much food overall. When I cut out all but one carb exchange (~18g) per meal I could almost control the daytime glucose numbers. That turned out to be too little food for someone in later pregnancy. They also lump in the management of fat and salt along with management of carbs and I did not have a problem with fat and salt. The whole regimen seemed to be geared to the elderly and didn't seem to apply much to me. I refused to limit my fat and salt intake (I was losing weight for-goodness-sake!); I did not have a problem with my blood pressure. I was sane about it, but did not limit non-carb foods. I consulted a friend of mine who is a nutritionist and she helped me to choose more whole foods and food combinations That was they key to keeping my numbers good. I began walking .8 mile per day, with a second walk if my numbers were off.
But I lost 12 lbs. in 3 weeks and my fasting glucose number first thing in the morning could not be changed by diet and exercise. So I had to take insulin. I started out with one shot in the evening but that didn't work. Then they had me on a shot in the morning and one in the evening. They also combined regular insulin (fast-acting) and a slower-acting type (NPH). I would load the syringe and take a pinch of flesh near my belly button, poke the needle in at an angle then inject the insulin. It is not as bad as it sounds; the poke doesn't really hurt, but the insulin makes the area of the shot sore for a little while. I had to watch out for low blood sugar reactions, which I had often (shaking, sweating, disorientation). Insulin-dependent diabetics have to eat frequently and keep in mind when the insulin will hit. The dr. warned me that my insulin needs would increase as the pregnancy progressed but they did the opposite. My dosage decreased 2 times near the end.
Getting gd felt like my dreams of another natural birth were going down the tubes. I was referred to an OB who told me, "If you have an 11 LB baby it is an automatic c-section; unless you want to sign a paper stating that a paralyzed left arm [the baby's] is OK with you." She was trying to scare me of my birth but only succeeded in scaring me of HER. I asked this OB about how she would deal with a large baby and it was clear from her answers that she delivers women in the lithotomy position and usually anesthetized When I asked about positioning she said it wasn't quick enough. Translate that as: there is no way to get you onto hands and knees with an epidural. [Kmom's note: These interventions are thought by many to increase the incidence of shoulder dystocia and birth trauma/paralyzed arm the OB is referring to. One of the hardest parts of gd is distinguishing the true risks of the condition from the doctor-caused problems that come from standard management like this.} My midwife on the other hand has delivered 11 lb babies vaginally (not that I wanted to :-)) I wanted that OB to be as far from my birth as possible. (It turns out that this OB gives that same speech to all overweight moms. My feeling is that she is a fatphobe.)
I switched to a different OB who was great and had no problem with standing by just in case the midwife needed her. She praised me on my management of the gd and was not concerned at all that the baby would be too large. From 34 weeks on I did 2 non-stress tests (NSTs) per week and had an ultrasound at 38 weeks. Everything looked fine so I was able to keep my midwife with the OB standing by just in case. The OB was fine with monitoring my insulin and NSTs and letting the midwife do the rest. That was just right for me because my nightmare was to lose my chance at another natural birth. [Kmom note: See, you can too have a midwife in a gd pregnancy! And some midwives will co-manage even an insulin-dependent pregnancy if all is well.] I delivered 6 days before the due date. [There was no pressure from my doctor], she was cool. The baby showed up as 8 lbs two weeks before his due date and they found that acceptable. Also, I was not measuring larger than expected. My gd was very well managed.
My labor started at 8 am. I had 3 contractions in a half an hour. I called my support people and they soon started arriving. I used the same doula I had with my first birth so we slipped easily into the pattern of her helping with my concentration and relaxation. We hung out at the house while my contractions got more intense and closer together. A short walk around the neighborhood was helpful in the beginning but things got going very quickly. I did some contractions on hands and knees or sitting but most were standing and leaning. I breathed normally through the whole labor. We tested my glucose level every hour during the labor. The last test before leaving for the hospital showed low blood sugar and I ate a couple of glucose tablets. This saved me from having to have IV glucose because they didn't know what the dosage was on the tablets. No IV!
When we got to the hospital I was 6 cm and went directly to the tub. I felt the baby drop as I stood to go to the room with the tub down the hall, it felt so good! The contractions were hard but the time between them lengthened and the water made the labor seem like a breeze. I went through transition with a little shaking and burping, then I was ready to push. This is where may labor got really hard. I knew that it was too late for an epidural but I would have had one if it were possible. The rest of the labor was such a breeze that there was no way I would have asked for pain relief. There is no way that I would recommend having an epidural just in case it got bad later.
I got back to my room between contractions and couldn't bring myself to get on the bed. Physically I could have climbed on, but it didn't feel right. I had planned on helping Nicholas "out" and the midwife had agreed but when we got to the room I preferred to stand for the delivery so the midwife warned me that I wouldn't get my wish. I told her I didn't care. Consequently, I delivered Nicholas standing up with one foot on the floor and one knee on the bed. I yelled, "NICK! NICK! NICK! OUT! OUT! OUT!" One nurse, in her 50s or early 60s, was very concerned about me delivering standing up. The midwife told that that is how it was going to be. That nurse came in when she went off shift and hugged me and told me she thought I was "heroic".
I pushed for a while and when I checked for the head I couldn't feel it. I almost lost hope, but buckled down to business. Soon I could feel his head and knew it would be over soon. The midwife stood behind me and passed him between my legs within seconds of his birth. Nicholas was born "in the caul" meaning he had the amniotic sac over his head. The midwife had to break the sac and suction his airway. Nicholas was born at 4:28 PM after 8.5 hours of labor with about 2 hours of it spent at the hospital. I pushed for about 40 minutes. I had a small tear where an episiotomy would have gone, it took 2 stitches. Pushing caused a hemorrhoid that has healed completely. I retained a small bit of placenta which came out at 4 weeks postpartum with a gush of blood but no other problems.
Nicholas had to be fed formula every 3 hours for the first 72 hours because his pancreas was working overtime due to my gd and he had low blood sugar. I used a Supplemental Nursing System (SNS) with a thin tube going down to my nipple from the bottle of formula. I had requested this in my birth plan to avoid having problems with nipple confusion. [He nursed every 3 hours, and while he was nursing I slipped him the tube so he would also get the formula. They added some glucose water to the formula in the SNS because his numbers didn't rise enough at first. After the first 3 days, he has been 100% breastfed.]
My partner's sisters visited me later and I told them, "Get an epidural." I regret that now that the memory of the pain has faded. I am happy and proud that I have had 2 natural births. If I had it to do over I would not choose to use pain meds. Nicholas is 4 months old now. Since he was born everyone has commented on how alert he is. I think that he is alert because he was not drugged at birth.
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 3's 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.
Sherie's Story (PCOS, hypertension, PROM, induction, compound presentation, c/s)
Kmom's Notes: A short cord and baby's hand by the head
could definitely cause a long hard labor.
Birth Story:
At about 3 in the afternoon, at 37 weeks along in my first pregnancy, I started
spotting. I had never had spotting or had any kind of bleeding at all during the
whole pregnancy. I knew that this was most likely the mucous plug and some blood
caused by the cervix beginning to dilate. I had no contractions and thought it
would most likely be awhile before labor started. I went to take a shower during
the shower my water broke! I called my husband to come home from work, we ate a
light dinner and about 5:30 we went to the hospital.
My contractions were 2-3 minutes apart and I was dilated to a 3cm when I was
checked shortly after I arrived. They put external monitors on me to track the
contractions and the baby's heartbeat. The baby was moving around so much that
we couldn't keep track of the heartbeat and they inserted a internal scalp
electrode. They told me that I needed to be dilated to 6cm before they would
give me an epidural. They said if given to early it could slow down labor. About
9 pm I was checked and had dilated to 4cm. I was having extreme pain and the
nurse gave me Stadol. After that wore off I was checked again at about 12am and
was still a 4cm. The nurse had me go get into a warm water bath to try to relax.
I got ice chips and more Stadol. At 4am I was checked and was 5cm. I had nausea
and threw up twice. I sat and rocked, I couldn't walk because of the extreme
pain of the contractions and the nausea. My doctor came to check me at 7am and I
was still 5 cm. At 9am my doctor said I could get the epidural, I was 5cm.
I had contractions all day and threw up 3 more times. I was given pitocin about
2pm because my contractions had slowed way down. At 6pm I had dilated to 7 cm
and was exhausted. My doctor wanted to do a c-section because the water had been
broken for more than 24 hours, I was exhausted and wasn't progressing despite
the pitocin and my epidural wasn't working any longer also the baby's heartbeat
showed he was stressed and needed to come out. I was so tired that I snored
during the c-section, I could hardly keep my eyes open and when they showed me
my baby I was so out of it I could hardly even look at him. He didn't cry much
and he was so small, he didn't look like I thought he would. My husband wasn't
allowed in the surgery because it was an emergency. They let my husband hold him
a few minutes after he was born.
Later I found out that I had 4 large fibroids and the cord was unusually short.
Also my baby had his hand up by his head and had a bruise under his eye were his
hand had been. I was just glad it was over and that my baby was healthy and
doing well. He had apgar scores of 7 and 9.
It was disappointing to have the c-section. It took some time to accept and come
to terms with those feelings.
Franny's Stories (PCOS, induced vaginal birth, posterior, forceps; cesarean for breech baby; home VBAC)
Kmom's Notes: Another case where the baby's position makes the birth difficult until it is fixed. In this mom's first birth, it was probably the combination of the hands-knees maternal position and the doctor using forceps that helped the baby to turn and be born vaginally.
Franny's second baby was breech. This may reflect a tendency among women who have had prior malpositions to have future malpositions as well. This may reflect a pelvic misalignment more than anything else, and we speculated that regular chiropractic care could help prevent position problems in the future.
She got that chiropractic care in her 3rd pregnancy. Did that help her to a vbac? Hard to prove. It's notable that this was the only pregnancy of the three without a malposition, so the chiro care may well have helped. However, she might have had a VBAC even without that care. It's more like an extra step to take, just in case.
Another notable thing about Franny's story is that she was told that she had to sign up for an elective repeat cesarean because her hospital didn't offer VBAC anymore. Fortunately, there were other choices in her community, and rather than being forced into unnecessary surgery against her will, Franny gave birth at home with a good midwife. And then she had the strength of will to write about it for her local paper!! She put those local doctors on notice that women will NOT be forced into unnecessary surgery!
Birth Story
Baby #1: I gave birth at the hospital where I worked at the time. I am an RN; I was working OB at the time and delivered with my 2 best friends as my nurses.
My B/P was elevated at my 38 week appt. and being the beginning of July and very hot and busy on the hospital floor where I worked, my MD sent me home with bedrest. I was swelling, but not spilling any protein and my labs were ok. I got a Non-Stress Test (NST) and baby looked fine. The next week we scheduled my induction because B/P and swelling continued and my cervix was favorable (ripe).
I entered the hospital at 6 a.m., my IV was inserted and pitocin began. I was having contractions, but they weren't anything. I was 4 cm when I started out. I walked the halls and rocked in the rocking chair. My husband and his parents were there. I worked on OB at the time and a Radiant Warmer Representative was there to in-service the staff on a new Warmer. I stood in the hallway with my IV pump and listened to his in-service at 9 a.m. By 9:30, he was done and I was tired, feeling contractions, but they weren't uncomfortable. I thought, if this is going to last all day I'm going to try to get some rest.
I went back to bed, got hooked back up to the monitor and my contractions were every 2 minutes, palpating moderate, but not uncomfortable. I had been laying down for 15 minutes and just got my eyes closed when I had 3 strong contractions that I had to use my breathing techniques through (I had coached so many other labor patients that I felt like I could do it). Then my water broke. Talk about warm soup down your leg! The contractions got really strong then. I was 5 cm. Got up to the bathroom to get cleaned up and got some pain medicine, Nubain 10 mg. I got back in bed, turning side to side and in 2 hours I was 8 cm. The contractions hurt, but they ended and knowing there was an end to every pain was a relief in itself. Back rubs, ice chips, and a cool washcloth over my eyes helped tremendously.
At 1 o'clock in the afternoon I started pushing. I pushed sitting up, lying on each side, on the toilet, standing up, squatting, and regular old lithotomy. I just couldn't get him to budge and I had pretty bad back pain. He was posterior. After 2.5 hours of pushing, I got on my hands and knees and pushed every other contraction because his heart rate was dropping. Finally, my doctor came in and I got a spinal in case I would have to go for an emergency c-section. They got me all set up for delivery and the doctor used forceps. After 3-5 contractions with pushing and pulling, we got him turned face down and delivered at 4:35 p.m. He was a bit exhausted and got a little oxygen, but cried well and after an hour of stitching, mom got to feed him. He nursed for 20 minutes like a trooper.
Baby #2: I was due 4/7. We knew dates for sure because we got pregnant with the assistance of Clomid and Glucophage for PCOS. My pregnancy really went quickly and pretty smoothly. From about 28-34 weeks baby was breech except for one brief period. Around 34 weeks I started doing the routine to turn her---lying on the ironing board, used a moxibustion stick at home, homeopathic pulsatilla, prayer, relaxation, imagery, talking to the baby, flashlight, music, the whole nine yards. I was on the verge of a breakdown about 35 weeks...called my midwife crying, "What am I going to do?"
We had talked about delivering breech and they weren't really sure. I had an appointment on Friday 3/14 for a consult with the OB (he's probably in his mid-50s and still does some vaginal breech deliveries) who backs up my CNM and possible External Version. We had planned to deliver at a birth center. That was all I was planning. I was thinking positively, I was relaxing and working on the imagery I was planning to use for labor...this baby was going to have a peaceful delivery and I was going to have a healing, positive birth.
I am a RN and work as a prenatal care coordinator for a community health clinic. I do home visits, education and referral for pregnant moms on the Medicaid program. I have worked as a doula in the past, but don't have time for it at present. I teach childbirth classes and had a class on Tuesday 3/11 from 5-7. Talked with a couple for about 30 minutes after class, then drove home, picked up my son at church (my husband is a pastor). We came home, I [ate] and read my email. I had just got Ina May's new book via Fed Ex that day and while my son was winding down...I started reading in the recliner. I had been sitting there about 15 minutes when I felt warm and wet---I jumped up so I wouldn't get the recliner wet and freaked out, "OH NO, that can't be my water!" When I pulled down my pants in the bathroom there was a lot of blood. Now of course, I'd just worked about a 12 hour day, moving constantly, and not really noticing much movement from the baby. In class that night we talked about Cesareans and abruption was going through my mind. I'm absolutely losing it, my heart was pounding, I was shaking all over, I'm shaking now just remembering how I felt. I read Prenatal Parenting early in my pregnancy and I had worked really hard on remaining calm and talking to the baby, taking fetal love breaks, especially when I'd had a rough day---now when she decides to come, I'm a mess.
I called DH on his cell phone. "Come home now, I'm bleeding." It was about 10 p.m. My son could tell I was worried because he was right there. "Mommy, are you ok?" (Side note: The next evening at Bible Study he asked for prayer for Mommy because she "Pooped blood in the toilet and it looked like Koolaid." He's still talking about that night!) DH got home, helped me find my midwife's phone number and we called her. She was a voice of complete calm, "I'll meet you on OB. It's probably just your water." DH has never driven so fast in his life! Now I was nearly a month early, I had just gotten finished saying that night at class that I would probably go close to my due date, I was too busy to have the baby early, I had home visits scheduled through the end of March, blah blah blah. I had no bag packed, had no comfort items gathered, had only 2 outfits for baby clean...I didn't have the crib pained, had no mattress, didn't have a pediatrician picked out, had not pre-registered at the hospital, I was going to deliver at the birthing center for heaven's sake!!----I WAS NOT READY!!!!
We got to the hospital and up to OB. They wanted me to change my clothes, I wanted heart tones. 130s, but very little variability...My midwife cam in and did a quick ultrasound, the baby's head was under my right rib cage, her bottom was inside my right pelvis, and her feet were over my cervix. My midwife sat on the bed with me, held my hand, and said, "We are not comfortable with delivering her vaginally this way, you need to make some decisions." DH went down to sign me in. When he came back I bawled in his arms for a few minutes then collected myself. My midwife and I talked about VBAC and she said that the doctor still did VBACs and was very pro-VBAC and had a good rate....I think she said ~80% success rate for VBACs. I made it clear that if the baby was OK, she was to be with me at all times. If she was not with me, DH would be with her. My midwife said that the pedi on call was a stickler about the baby going to the nursery, but she would do what she could.
DH's parents arrived to stay with my son during the birth. IV started (after 3 tries), into a gown, consent signed, we went to O.R. After the anesthesiologist got my fluids in (she about froze my arm off pushing about 700 cc in 10 minutes), she sat me up for my spinal (again, third time was the charm). The doctor was at my feet, my midwife at my side, and nurse on the other side. They were all awesome!---kept trying to recruit me, though. I laid back down and felt everything go to sleep, boy that is a funny sensation. With [my first child], the spinal took the pain away, so it didn't feel so weird. With no pain, it just feels like they put lead in and made it all go to sleep, kinda pins and needles sensation. They put my catheter in (gave me the option not to have it at all, but I figured I'd probably not want to get out of bed for a little bit once the spinal wore off and I knee it was also in place to make sure my bladder wasn't nicked during the surgery, so I got it).
I informed everyone that if my baby was ok, I wanted to keep her with me. I got this weird sense of humor and was defensive by joking about things, I was kinda strange. My BP bottomed out at 60/40 and my heartrate was going nuts in the 120s. She gave me something for my BP and I felt a little better. DH at my side, they started my baby's birth; tears rolling down my face, I asked him to pray with me. DH prayed from the moment he placed his hand on my face until we heard them say, "Here's baby." My heartrate came down to the 90s while he was praying and the anesthesiologist said, "Wish we could bottle that."
During prenatal ultrasounds, we had a brief peek to see girl parts, but never saw them again (breech), so I was not getting my hopes up. I knew that they would see sex before she was even out, but they weren't saying anything! After her birth, the doctor made the comment that he went in and felt limbs, he grabbed two and started to pull them out, but had an arm and a leg, had to go back and find a matching set. She cried quickly and after a peek at her, to the warmer. The pedi checked her over and I kept talking to her, "Keep crying," "Hello Amy," etc. I had tears streaming down my face and into my ears. They wrapped her up and handed her to DH; I got to touch her. The anesthesiologist held her face right next to mine so I could talk to and kiss her.
The doctor held a section of cord up for me to see. "See why she wouldn't turn around?" She had a true knot in the cord that was really pretty snug. He felt that she was lucky to be here and that she would have probably not tolerated the version we had planned for 2 days down the road. Now, I have seen true knots before, even after vaginal deliveries, and everything was okay, but I also assisted a twin delivery where one twin had a knot and was stillborn, the other was ok.
The anesthesiologist offered Demerol to help with cramping and I refused because I didn't really want to see my supper again. I asked to have my placenta and the anesthesiologist said, "Well, what on earth for?" I said, "Because it's mine!" I got my placenta in the freezer, going to plant it with a Magnolia tree outside Amy's bedroom window. (I had a Magnolia tree outside my window growing up.)
The pedi took her to the nursery. DH followed and picked up our son and my in-laws so they could see her and 10 minutes later when my surgery was over, the nurses and doctors took me to recovery, and my midwife went to get Amy. I got her to the breast within about 45 minutes after delivery. She was cuddled up with her head on my breast...My son came in and asked me, "Did you get your miracle, Mommy?" More tears. He got to see her, my in-laws were in the hallway looking in, and DH was walking around with my placenta in a bucket under his arm. Back up to the OB floor at 2 a.m., got my morphine [Patient-Controlled Analgesia] pump and slept off and on through the rest of the morning with Amy on my chest. [We] ended up skin to skin for quite a bit of that time. They checked me often, but basically left me alone, never asking to take her to the nursery for her admission bath, etc. I got out of bed for the first time around 10:30 a.m. the next day, got to oral pain meds and my IV out around noon. Kept Amy with me around the clock and nursing went well. Went home Thursday afternoon around 3:30 p.m. I refused her Newborn Screen on discharge and brought her back that Saturday.
OK, the last thing I wanted was a cesarean. But what I was praying for was an empowering, positive, healing birth and even though I didn't have the natural birthing center birth, that wasn't what I was praying for. Next time I will be more specific, but I did get control in my birth experience, I was hyperaware of what I was feeling emotionally, physically, and mentally, and I feel I was so prepared for coping with pain that it has made my recovery super rapid. As far as healing, in that I feel like I can delivery vaginally without the medical need for management. I have not had that yet, but our daughter is named for 3 very special women, 2 very dear to me. Amy's birth was healing to me in that way, a healing I didn't even know I needed, but God took care of nevertheless. Positive, a resounding yes, I have a beautiful baby girl with a perfect round head, she has dimples just like mommy and lots of dark hair.
Did I get what I wanted---no, but I did have control over what I did get. Did I get what I needed---definitely. I will no longer feel sorry inside for women who had to have a cesarean, but instead I will ask how they felt about their birth. That is so much more important. A cesarean is not fun, it's not natural, it can be unnecessary, but it does sometimes save lives, and it is a birth of a precious little one, and an event that is no less memorable or special...Sometimes we just need to be reminded of it.
Amy was 6 lbs., 14 oz., 20.5 inches. She is a good baby, nursing well. At three weeks of age she is 8 lbs. 5 oz., solely breastfed, and I have an additional feeding built in for pumping. I love the Lansinoh Ziplock bags for breastmilk storage, and the Avent pump is great. It's like "I can't believe it's not electric!"
Update: Franny went on to have a home VBAC too. This is her VBAC story.
10 days past my due date I was miserable and called my midwife for help (this pregnancy lasted more than 2 weeks longer than my first and 6 weeks longer than my second...I felt like I was pregnant forever, add to this that I took off work for maternity leave at 38 weeks and I felt a little like an elephant, in more ways that one). My midwife recommended that I see the Chiropractor and get a massage. I chose the latter and by evening (Wednesday) my contractions had started.
I went about my normal activities, fixed supper, went to church, bathed the kids, put kids to bed, went for a walk. Contractions were regular, but not very strong, more like annoying. Thursday AM we were to drive an hour away to see the midwife...I didn't think I could handle being in the car that long, so I told her to head our way. (She has 7 kids of her own, the youngest just turned 1 in November). I napped and felt like they were fading away and she said she'd just drop in to see how I was. I had gone into work for a bridal shower on Tuesday and one of my co-workers, an OBGYN Nurse Practitioner said I should just go to the hospital and have another cesarean since I was so far over my due date...had a lot of mental work to do to get over that.
Midwife arrived at 3 and I told her what I was thinking/feeling and she helped me get rid of it and by 3:30 my water broke. By 5, my doula and our friends that were going to watch our kids were present and I was starting to get uncomfortable. Around 7pm, I was 4cm (the first time my midwife ever had her hand in me). I got in the tub ( borrowed a spa in a box from a friend) and got hot, then had to get out to cool off. I had just attended a Michel Odent conference and had his words in my head. If a woman gets in the tub at 4 and makes no rapid progress after 2 hours, he recommended a cesarean. I kept thinking that I didn't have the urge to push, so had I made progress? After dark (9ish?) I got back in the tub and was very cold, my husband found a space heater and was holding it on me next to the tub and jokingly went "oops" faking dropping it into the tub and it took me over an hour to get back into a regular pattern. Had to get into the shower to get warmed back up and they encouraged me to drink some really salty hot broth.
By 11 I was loud and hurting, they also tried to cram a peanut butter and jelly sandwich and juice down my throat...PB is NOT easy to get down with 'labor mouth'. I was all over the place position-wise, remember enjoying a forward leaning position. I starting pushing around midnight, although my midwife said I wasn't *really pushing* until about 1 or so. Was in the tub when I started to push, but kept a rim of cervix and got out to the birth stool so the midwife could help hold it while I pushed. While on the birth stool I remember saying, "I give up. Take me to the hospital, Help me" and they gave me some homeopathy. When she was crowning I got back in the tub.
The midwife said I have 'a large perineum' and so it felt like crowning took FOREVER. I remembered what It was like with Daniel and I realized that I ever got to the point where I could push past the pain and make progress...I finally figured out the pushing thing this time...but the pushing into the pain to make progress, then the contraction ending and feeling the baby slide back up and knowing I'd have to push back through that pain again with the next contraction was nearly overwhelming. I was on my knees in the tub, resting my head on the side of the tub, Aryn put his arm along the back of the tub so I could rest my head and I accidentally bit him...didn't even realize I was doing it until he flinched.
I got to the point where I felt like my urethra was going to explode and I reached down to support my labia and felt her head...It didn't take long from that point...it was so empowering to realize how close I really was. Once her head was out, her body followed quickly, the midwife just allowed the water to catch her. Once she was out, I flipped over and reached for her. Within seconds, I was pulling her up so I could see her, unlooped 2 nuchal cords and brought her out of the water to my chest. She opened her eyes and looked at me and started to whimper. No lusty painful scream, but more like..."Wait a second, what just happened?"
I felt between her legs and discovered she was a girl, but waited until our son came into the room to lift her out of the water for him to see and announce. I was convinced I was having a boy because my pregnancy was so much like it was with Daniel...Instead I have a little girl that looks just like her big brother. I was out of the tub about 30 minutes after her birth and we left the cord attached for about 2 hours, at that point we were able to cut without clamping and it fell off when she was 4 days old. I had a small 'scuff', but nothing worth messing with suture-wise. My midwife had a herbal bath to soak in with Abby and it felt wonderful...had to learn the hard way to strain out the herbs though :-0 clogged the tub.
Abby nursed very well and my milk was in by 24 hours. She never lost weight. Was 8-5 at birth, 2:04am Friday, October 14th and was 8-9 on Monday evening. Abigail has been a joy, a wonderful baby. Sleeps through the night (started at about 1 month) and was smiling by 6 weeks. She does have some gassy spells, but they are brief. Will definitely do it again!!! But will wait until Abby is in preschool or Kindergarten...a newborn and a strong willed 2 1/2 year old is just way too much for me!
This was an editorial I sent to our local newspaper after my daughter's birth explaining my decision and outcome in relation to the release of 2004 C/S rates. Several of the OBs in our area were really ticked and found out that I was the Childbirth Educator at the local Medicaid clinic and were not happy. Our Medical director wanted me to assure him that I was not teaching or encouraging homebirth in my class. I replied that I simply told my story and that I did not believe that homebirth was an option for our clients for 2 reasons...they can't afford the out of pocket expense of homebirth and local docs refuse to provide back up.
The results are in and 2004 saw another increase in surgical birth rates -- 29.1 percent of women delivered their babies by cesarean last year, according to a National Center for Health Statistics report released last week.I chose not to become a statistic
Some doctors cited the reason for the increase was that more women are having elective cesareans, but keep in mind that "elective" does not mean that it was the woman's choice.
Earlier this year when we discovered we were expecting our third baby, I visited my OB/GYN to begin prenatal care. I was informed that we would be forced to have a cesarean if our baby was born at their hospital simply because I had a cesarean with my second child.
The cesarean rate has increased astronomically in the past 30 years: 5.5 percent in 1970, 16.5 percent in 1980, and 22.7 percent in 2000. The World Health Organization states that the cesarean rate should be 10 percent to 15 percent. Our bodies have not changed in 30 years, but medical management has. Although some babies have been saved by surgical delivery, a look at maternal and infant mortality rates show that nearly 30 countries lose fewer moms and babies than the United States and most of those countries have lower cesarean rates.
Having a vaginal birth after cesarean (VBAC) carries nearly half the potential complications than repeat surgery. Due to a 0.5 percent to 1 percent risk of uterine rupture, The American College of Obstetricians and Gynecologists has put very strict guidelines on VBAC, stating that the doctor and operating team need to be immediately available.
American Academy of Family Physicians guidelines noted that there are other problems that occur more often, and they found no evidence suggesting better VBAC outcomes based on the availability of resources. American Academy of Family Physicians went on to state that policies for VBAC "appear to be based on malpractice concerns rather than on available statistical and scientific evidence."
So, how'd I do it? I hired a midwife and kept my OB/GYN as backup. I found a doula -- someone trained to provide emotional and physical support during labor... and obtained a portable hot tub for pain relief. I ate well and read to educate myself. When labor started, my midwife came to me, and my daughter was safely born at home in water.
I'll do it again with my next baby. As long as doctors and hospitals do not allow alternatives, such as midwives, birthing centers and natural options for pain relief, more informed women who want to be able to make their own decisions will join me.
Elayne's Story (PCOS, triplets!, preemies, c/s)
Kmom's Notes:
Birth Story
We knew going into trying to conceive that things would be
difficult. I knew at 17 that I didn't ovulate, and I'd been on the pill ever
since. After nine months without a period off the pill, I started infertility
treatments, namely Clomid. I was told there was a 5% increased risk of twins,
and no mention was ever made of triplets or more. We thought twins we could
handle.
On my successful cycle, we'd gotten up to 150mg of Clomid, and the doctor said
that if it didn't work this time we'd have to go up to the injectible drugs. But
I did have a good follicle, and the doctors decided to give me an HCG injection
to induce ovulation. Nobody bothered to tell me this could increase the risk of
multiples.
I tested positive, and made my first appointment with the midwife I had selected
for my homebirth. At 5 weeks, I had some cramping and bleeding on a business
trip, so when I got back I scheduled an ultrasound with my OB to check on it.
We saw four sacs and three heartbeats. Apparently, I conceived quadruplets and
then miscarried one, which accounted for the bleeding.
Things were pretty uneventful for a while (if you can call triplets uneventful).
I was forced out of my job and just took it easy, little to no physical
activity, limited errands, etc. At 20 weeks, when I went for a Level II
ultrasound, they discovered my cervix had dilated to 1.5cm. I wasn't
having contractions, just uterine irritability, so they decided to just do a
cerclage. I was on and off bedrest after that. Every time they let me off
bedrest, I started having contractions. I'd come in to the hospital, they'd give
me IV fluids and sometimes keep me overnight, then send me home on bedrest
again. Every time I went to the hospital, they put me on the toco monitors, but
no contractions ever registered, regardless of what I was feeling.
At 24 weeks, I began developing gestational diabetes. With diabetes running
rampant in my family tree, and being hypoglycemic myself, I am very familiar
with blood sugars and testing. I already had my own monitor, more of a toy
before but used seriously now. I checked my fasting sugars every day, and
occasionally checked after meals. At 24 weeks, I began getting very high
readings after meals, 160+. That week, I also had sugar in my urine. Despite all
this, my OB insisted that it was impossible to detect or even develop diabetes
before 28 weeks, and he refused to test me. Knowing better, I put myself on a
strict diabetic diet, allowing for multiple gestation, and kept track of my
sugars. This was very difficult in the hospital, though, because I couldn't
control my diet. More than that, nobody seemed to understand how much a triplet
mom needs to eat to have big healthy babies, regardless of her size.
At 26 weeks, I went into full pre-term labor. At first I thought it was gas
pains, because it was all in my back. A couple of hours later, I realized that
gas pains don't come every seven minutes on the dot, and the contractions also
started to radiate across my belly. We went into the hospital, and they
immediately put me on the toco monitor, and spent the usual hour trying to catch
all three babies on the strip at once (never happened). As usual, no
contractions registered on the monitor. They started to blow me off, and I
protested that I was really feeling strong contractions. The nurses tried to
feel them through my belly, but they said they couldn't feel anything. I asked
them to please check my cervix, like they had always done every time before.
They refused. Instead, they sent me home on a sedative, Seconal, treating me
like I was nuts. The sedative knocked me into a daze. I was still feeling
contractions, and just barely aware enough to register the times (moving through
6 minutes into 5 minutes apart during the night), but I wasn't coherent enough
to think, "Gee, maybe I should call another doctor or go back to the
hospital."
By the time the Seconal wore off the next morning, my contractions were very
strong, 5 minutes apart. I still waited a little while, out of pure
sheepishness, because after being sent home the night before I believed them, I
thought surely I was imagining it. That morning, though, I started suddenly
bleeding heavily, and we did go back to the hospital. Sure enough, my cerclage
had ripped out. Not only that, but I was dilated to 5 cm already. Even with all
of this, though, my contractions, though painful, STILL never registered on the
toco monitor. They admitted me and put me on bedrest, and gave me magnesium
sulfate, terbutyline, and antibiotics and steroids for the babies. The
tocolytics worked almost immediately, shutting my contractions down to nothing.
Unfortunately, it was too late. I dilated to 6 cm before the drugs kicked in,
and 24 hours later my water broke.
There was no hope for a vaginal birth of triplets, certainly not at 26 weeks.
They were too small and fragile to really withstand the stress of a vaginal
birth. So we went for an urgent c-section. The anesthesiologist came to talk
with me beforehand, explaining how the spinal worked, all of which I knew after
having a spinal for my cerclage. I told her about the spinal wearing off before
I even left the operating room last time, and added that painkillers in general
have little to no effect on me. She blew me off (like everybody else), telling
me not to worry.
We went into surgery at about 11:00, and my babies were born at 12:09, 12:09,
and 12:10, about 30 seconds apart. I got to touch the girls briefly as they went
by. My boy needed resuscitation more urgently, so I only got to see him in the
portable incubator before he was taken upstairs. By luck, my L&D nurse had a
student nurse working with her that day. The student had to be there for
the section, but couldn't do anything. So we gave her a camera, and she took a
ton of pictures of the births. Bloody, but they're the only pictures I have of
my babies not attached to anything for the next three months.
By the time my third baby was born, I was beginning to feel more than I should.
By the time they were stitching me up, I felt every stitch and every twitch.
They made my husband leave the room, but he saw them pump four or five drugs
into my IV before he did. None of them really worked. They finally gave me
Verced, so the end is a little hazy...yet Istill remember a good deal of it.
On the upside, I did get a letter of apology and reference from that
anesthesiologist, for me to show at any future surgeries.
Breastfeeding was a complete failure. Not on my part; I was a milch cow. I was
putting out 50 ounces a day when I quit. I tried and tried and tried to have a
"No Nipples" order put on the babies' charts, because I was concerned
about that interfering with breastfeeding. The hospital staff insisted on giving
them bottles anyway. They breastfed exclusively for two weeks before getting
their first bottle, and they were doing well, getting latched on and getting
decent amounts of milk out. The hospital still insisted, and the very day they
got their first bottle, they refused the breast. I continued to pump until they
came home, but with no help I did not have enough time to pump and bottlefeed.
We now have one baby with cerebral palsy, and the other two have a tendency to
wheeze and catch bronchitis from every little cold, which we understand is a
result of their having been on ventilators for almost two weeks after birth.
Other than that, fortunately, they are doing well. We're working on getting
pregnant again, hopefully with only one baby this time. I'm taking Glucophage to
control my PCOS, and it seems to be working well.
My babies' website, www.y2kbabies.net/littlebits,
has even more information about the pregnancy and birth.
ShortandBubbly's Story (low amniotic fluid, planned c/s, respiratory distress in baby, NICU at another hospital, breastfeeding problems)
Kmom's Notes: This mom did a great job under less-than-ideal circumstances. At 37 weeks they found that her amniotic fluid levels were quite low. Instead of trying to aggressively hydrate her to see if that would improve things (research shows this can significantly improve amniotic fluid levels, often enough to prevent the need for immediate delivery), they chose to do a cesarean the next day. Because the cesarean was done without the benefit of labor and because baby was 37 weeks, baby had respiratory distress (difficulty breathing, common in elective cesarean babies). His breathing problems led to him being transferred to another hospital's NICU.
The separation, plus the delay in getting a good pump, plus the nipple confusion from having bottles, plus possible oral aversion problems all led to great difficulty in breastfeeding. Supply was also an issue, which might be due to the circumstances and/or the PCOS. Hopefully, next time, she will be able to avoid this cascade of problems, get to hold her baby right away, and have an easier time with breastfeeding. She did an admirable job under very difficult conditions, though, and that's all any of us can do.
Birth Story
Even as I look at my son as his first birthday is less than two weeks away, I still cannot believe that my body was able to create something so beautiful. I had been experiencing symptoms of pregnancy such as fatigue, slight morning sickness, and not being able to eat things that I used to be able to eat. I was also late for my period, which wasn't unusual. But what alarmed me was that I did spot for a day and it stopped. My husband (who was my boyfriend at the time) and I were living together, but having a hard time with our relationship. I bought a test at the drug store and right before I went into the bathroom, I said, "It will probably be negative." Imagine my shock and surprise when that second line appeared in seconds. I remember shaking and tearing up from happiness. We went out that night with my best friend to celebrate.
It was a pretty uneventful pregnancy. No major complications. The only thing that was bothersome at all was the unbelievable swelling that I had in my legs, knees, ankles and feet. I never experienced any real morning sickness or heartburn. There was only one time where I remember waking up with heartburn. Teaches me for drinking orange juice right before going to bed.
We found out I would be having a boy when I was 28 weeks along. It got real fun when I could start to feel him move around. I will never forget the first time I saw him kick. I was laying down on my bed and all of a sudden, I saw my belly move! It was the most amazing thing I have ever felt before. Towards the end of the pregnancy, about a month before a delivered, it was impossible for me to go to bed before 4 a.m. I would lay in bed, and I would feel very energetic and restless. I spend lots of nights cleaning or playing online.
I was 37w4d along when we went to my appointment at the ob/gyn office. Little did we know, it would be my last visit. We were in the ultrasound room and the ultrasound technician asked if I had felt any fluid come out. I had told her I hadn't. She seemed concerned and called the front desk to have the midwife come in and look at it. The midwife came in and looked at the ultrasound picture, and then told me to move into the next room where they would hook me up to an external fetal monitor. The heartbeat sounded good and strong, and they were asking me questions about the baby's movement. Finally I asked, "What's the matter? Do I not have any fluid left?" I was informed that I had very little fluid in me and that baby needed to come out. They checked for dilation, and I was not dilated at all. Nor was his head in the birth canal. He was-head down, but not in the canal, and his body was slanted off to the right. We were instructed to the across-the-street to the hospital. We would have having a baby that day or the next day.
We arrived at the hospital and they brought us to our room where I was told to get undressed and get into the hospital gown. They brought in a portable ultrasound machine where they looked again. Apparently, I had more fluid than the other machine showed, but still very little. I was then told I would be having a cesarean the next day. They prepared me for it by having me take a bath and scrubbing my belly clean and hooked up an IV into my neck because we couldn't find a good enough vein in the arm. I have deep veins. I was then instructed not to eat after 10 p.m.
The big day was here and I hadn't slept a wink! My boyfriend put scrubs and a mask on and they wheeled me into the room. In there they put the epidural in my back, and it didn't take long before I wasn't feeling a thing! When I felt a little pulling, I knew that it was almost there! I know I heard a cry, although I don't remember it. He was born at 12:13 p.m. I was told that I cried a little bit as they stitched me back up. Once I was stitched back up, I was wheeled back into the room and hooked up to a pitocin drip so my uterus could contract back to normal. Thank god for the epidural is all I can say.
I hadn't gotten a chance to see my baby yet for he was having problems with breathing. Unfortunately for all of us, he had to be shipped to a different hospital's Neonatal Intensive Care Unit. It was a very hard few days on me mentally as well as physically. I had to wait four days until I could see my boy. And he was so beautiful! Full head of hair and I could hardly see his eyes for he hadn't really opened them up for me.
I had planned on breastfeeding my boy. I wanted that bonding experience, along with giving him the best I could. Unfortunately, since he was at a different hospital, I didn't have a real chance at that. About 36 hours after my operation, a nurse brought in an electric breast pump. The first night, I didn't even get an ounce. But my other half still brought it back to the hospital where our baby was staying. I would try pumping a few times every day until I was out of the hospital. Once I was out and was able to visit, we tried to get him to latch on. He tried but once he latched on, no milk came out. I tried to keep going, but he was getting real fussy because he was hungry and didn't want to wait for his food. So he got a bottle.
The next day he came home and we tried again. For a while, I used a manual pump, and I still got hardly any milk to come out. After a week of using manual pumps, we went to the hospital to rent an electric one. I was able to give him about 6-10 oz. per day using breastmilk.
I think the other problem was that my nipples are a little on the flat side, which made it hard for him to latch on all the way. Plus, about a month after I had him, I caught a real bad cold. So I didn't pump for 3 days because I didn't want him to catch it and I was so tired. As soon as I felt better again, I tried to pump and nothing came out. I pumped for an hour and only about 1/4 of an ounce came out. I was devastated. I wanted nothing more than to be able to give my baby my milk. But I just had to tell myself that I did the best I could and that is what counts.
[Looking back on the birth,] I wish that they had waited it out [to see if I could improve my amniotic fluid level via aggressive hydration], especially once they saw that I did have some fluids left. I often wonder, if they had waited, if he would have still had breathing problems.
It's almost a year later, and I can't believe how fast the time flew by. The recovery from the cesarean was very painful. But would I do it all over again? Definitely! Next pregnancy, whenever that may be, I am going to do my best to eat right and keep active and try and have a VBAC. I want to experience the feeling of holding your baby afterwards and bonding with it.
Sal's Story (PCOS, GD, PIH, fall down stairs, induction, vaginal birth)
Kmom's Notes:
Birth Story
I have PCOS and took Glucophage in order to ovulate. All was well during the first trimester. At 16 weeks of pregnancy I had an extremely abnormal AFP level. Then at 20 weeks I developed pregnancy induced hypertension. After 16 weeks of bedrest my OB recommended that we induce at 36 weeks if an amniocentesis showed mature lungs. The night before the amnio we were preparing for the baby and I fell down the stairs (14 steps), fracturing my spine in 3 places, breaking my tailbone, and injuring my shoulder. The injuries were evaluated and found to be stable and not in need of surgery (thank goodness!). The amnio was performed and my doctor missed on the first attempt, had success on the second attempt, and the lungs were immature. However, the amnio triggered contractions so I had to spend a day in L&D. My blood pressu