by KMom
Copyright © 2000-2006 KMom@Vireday.Com. All rights reserved.
This FAQ last updated: February 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: Supersized Moms (300 lbs. plus)
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 births of so-called 'supersized' women. There are many stories from women who are 'mid-sized', but women who wear size 28+ often are even more anxious to hear stories from women in their size range. These are the women most often attacked and vilified for 'daring' to be pregnant 'at their size', and many fear that their prognoses will be especially poor. Therefore, these are the stories of supersized women who have dared to challenge this perception. Their experiences will present both inspiration and some cautionary tales to be wary of.
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!
The term 'supersized' is a difficult one to use, as it can carry a lot of baggage and be emotionally devastating for the mom so described. Yet many, many women have written Kmom and asked for stories specifically of moms over 300 lbs. because they felt all the stories they were seeing were from mid-sized women. They really wondered if women over 300 lbs. even became pregnant, let alone have healthy babies or normal births.
The answer is: YES, THEY DO! The risks for complications do tend to be a bit higher as the weight increases, but Kmom has heard from many women in the 300+ range (and some in the 400+ range) who have had successful pregnancies. She does not have birth stories here from all these women, but she has heard from quite a number in the 'supersized' range, including those with complications and those with completely normal pregnancies and births. So there!
Defining 'supersized' is tricky, emotionally-loaded, and ultimately rather arbitrary. Kmom has chosen to use the most-commonly seen definition in the size-acceptance community, that of being over 300 lbs., or over about a size 26-28 (USA sizing). Of course, some women may be very tall and 300+ lbs., yet not be a size 30 or more, and some women may be short and 280 lbs. yet a size 28 or 30. So the defining line is a bit gray; some leeway in the definition has been used. Women who were very close to the cutoff of 300 lbs. have also been used, but may or may not truly qualify as 'supersized'. Kmom herself falls in the gray area between these two categories, but technically falls under the dividing line.
Again, Kmom apologizes if anyone is offended at being classified as supersized (she's not crazy at being so close to the cutoff herself!), but at some point an arbitrary definition had to be decided upon. If you fall above this arbitrary demarcation, it does NOT define you as a less-worthy person, one who will experience problems in pregnancy, or one who is 'too high-risk' to contemplate conceiving. It simply is an attempt to respond to a frequently-expressed need among Kmom's readers for reassurance about pregnancy in the larger of large sizes. Please take the definition with a grain of salt and in the spirit intended.
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.
Jameel's Story (Supersized, Group B Strep, Homebirth)
Kmom's Notes:
Birth Story
Mike and I have been married eight years. When we met, we both had office jobs. But about three years later he decided to become an over-the-road truck driver. This worked out really well for our relationship, but when we lived in the Midwest, he was only home on the weekends. In the Fall of 2002 we moved to the East Coast, and by the next summer we decided to start trying to have a child. Mike got a trucking job that had him home four days a week and by September of 2003 we were pregnant.
A couple of years before, I had read a book called Birthing From Within and decided then that I was interested in having a child, as long as I could have it naturally, at home. Before that I hadn’t realized how much fear I had had about birth. I think I thought an over weight person automatically equaled an unhealthy person, and therefore, a complicated birth. It was really important to me that the birthing experience be positive, and a homebirth seemed like the best way to accomplish that. The feeling that this decision was the best choice for me was very strong, and I was looking forward to additional research on homebirths and its issues. I discussed it with Mike and he seemed fine with the idea – probably because he had never thought about it before, and had no idea what to expect.
Shortly after we were pregnant I started looking for a midwife. I found “Vee”, a Certified Nurse Midwife who specialized in homebirths. She had worked in hospitals for years and then later decided to open her own practice. I asked her if she had any concerns about my weight, and she didn’t. She provided all the care and services I needed throughout the entire pregnancy.
I only wanted one or two ultrasounds, and we decided we wanted to be surprised with the gender. I had all the standard tests throughout the pregnancy, most of which came back normal. I was concerned about getting gestational diabetes (because of my weight and family history), but my sugar levels were always fine. I did test positive for Group B Strep, so Vee and I discussed possible issues that may arise because of that. We determined that if my water broke early during the labor process it would be necessary to monitor my temperature to see if an infection was getting into my uterus.
The baby was due on June 15, 2004. About a week before the due date I woke in the middle of the night with what I thought were contractions. They were 13 minutes apart, and felt like muscle cramps in my lower abdomen. However, as soon as I sat up, they stopped and didn’t return – false labor. This happened again around the 18th or so. On June 20th, around 7PM, I started having real contractions that felt more like menstrual cramps. They weren’t that painful and I was actually able to sleep on and off that night. Mike called his boss and told him he wouldn’t be in the next week.
By Monday the 21st I felt like I was officially in labor. The surges were regular, lasting about 30 seconds every five minutes or so. However, they weren’t that much work as I was able to walk around between, make phone calls, answer e-mails, etc. I called Vee around 4PM, described the symptoms and she said I should give her a call around 7PM to see how I was doing. A little later Vee came over and checked my cervix and the baby’s heartbeat. She didn’t want to place a number on how dilated I was (because she knew I would be doing the math to try to figure out when this baby would arrive!), but she said everything was progressing along fine.
By then labor was a bit more work. I had figured out that sitting or lying down through a contraction was much more painful than standing. When I had to go to the bathroom, if I would have a contraction while sitting on the toilet, afterwards I would feel so sick I would vomit. This happened twice and I realized that sitting through a contraction was not for me! And if I laid down too long, the surges would slow down or not be as intense. I thought that would delay things too much, so I would get up and walk around, thinking that would speed up the arrival of the baby. I would sit on the edge of my bed, and when a surge would come along, I would stand up, lean on the arm of our treadmill and Mike would rub my back.
By midnight or so, Mike and I were tired, and we needed some kind of feedback from Vee on how much longer this would take. She checked me again, and said that I was still in the early stages of labor and it may be a while before the baby would be born. We decided that I needed some rest, so I propped myself up in a chair knowing things would slow down a bit, but maybe I could get some rest. Mike went to sleep and Vee went home and told me to call if I felt things were changing.
Around 4:30AM on June 22nd I was tired. By this time I realized that I had been a bit arrogant about how much work this would all entail. I remember thinking that I had assumed that this would be easier than it was, and I needed to face the fact that if I wanted this baby out this was going to be hard work. I remember thinking that, although I knew the Lord had been with me throughout this whole experience, my faith in Him was going to carry me through this. My need for prayer kicked in right then.
I called Vee who suggested that I get in a bath to see if that would feel good to me. I was reluctant because I didn’t want to go through the trouble of changing positions again. But I realized something had to change, so I tried it. What a difference! I filled the tub, laid down on my side, and had the shower spray hot water down on me. The surges were very mild and I was actually able to sleep for a few hours.
By 7AM or so, Vee came back and I told her how wonderful the water felt, although I was sure I hadn’t progressed since I wasn’t that uncomfortable. She checked the baby’s heartbeat and my cervix and said that I had dilated almost twice as far, and my cervix was extremely soft. We decided that the birthing tub was the way to go. Mike and Vee started setting up the tub in our bedroom, while I labored next to the treadmill.
They filled the tub with warm water, and crawling into it was heaven! I tried going through contractions in several different positions until I found that leaning over the edge of the tub while kneeling was the most comfortable way to labor. Mike put a warm wet towel on my back and would hold my hips whenever a surge would come along. One of my kitty cats chose a spot on a chair near the tub and we all patiently waited as I labored along. I remember reminding my husband that I’ll need verbal reassurance and support with each surge. At one point he told me that I looked like Sara Connor. “Who is Sara Connor?” I asked. “From the second Terminator movie,” he said. “You look wild.”
Later I felt my water break and called Vee over. She said that I needed to get out of the tub so she could check to make sure my water was clear. I stood up and had a very painful contraction which sent me right back into the water. A few minutes later I tried standing up again – another contraction. She decided to check me while I was in the tub. She checked the waters, my cervix and the baby’s heartbeat. “Jameel, you’re having this baby before lunch!” she said. “What time is it now?” I asked. It was 11:30AM. I shooed my cat off of the chair and used that to crawl out of the tub onto the bed.
I started to feel the urge to push with each contraction once I was on the bed. I tried pushing while on all fours for awhile. Then Mike sat on the edge of the bed while I leaned into his lap. Vee and her assistant, “Ann”, sat behind me constantly monitoring the baby’s heartbeat. All my pushing took a lot of focus and I remember that I didn’t want to open my eyes or be otherwise distracted. Mike would constantly say reassuring things to me, and the midwives were telling me how well I was doing after each push.
After some time I asked her how much of the head was out. She suggested that I reach back and feel, but I didn’t want to. She said she could see the hair. I asked, “Can you see the forehead?” and she replied, “Not yet.” I exasperatingly said, “This is taking too long. In the movies this part is always faster.” She reassured me that this is taking exactly how long this is supposed to take and everything was progressing nicely. So I continued to push with each surge. My focus was to muster the energy to get two good pushes in with each contraction. She asked if I wanted to try a different position, but I was too tired to move around. Ann brought me a cup of orange juice but it was too sweet. I just wanted ice water. I felt her put a cool cloth on the back of my neck, but for some reason I wanted the cloth on my feet instead (??).
I could feel the head coming out more and more, and that motivated me to want to try to push more than twice with each surge. I tried to push a third time and maybe a fourth time, but I was tired. Vee suggested that I wait until I have another contraction before trying to push again. But I wanted the baby out! Finally, Vee suggested that I try a different position again. I turned around and put my back to my husband’s stomach. He held me up while I pushed. I’m not sure how many pushes it took, but it didn’t take much. I felt the baby slide right out and she put him on my chest.
I remember my first thought was, “Oh, well that wasn’t so bad.” Then my second thought was, “Why did I just think that?” I immediately had this burst of energy while I looked at the baby. He was trying to open his eyes, but the light on the bedside table was too bright. We turned off the light and his eyes opened right up. Then I felt another contraction, much milder. Vee said that it would stop once I pushed out the placenta, but I was in a funny position on the edge of the bed, and Mike was pinned behind me. Finally, Mike wiggled out, sat me on the bed, and I was able to sit up. He helped cut the cord and I pushed out the placenta. I laid on the bed to look at the baby. “It’s a boy!”
Quinton Alexander was born at 2:02PM on June 22, 2004.
Since I’ve had the baby, many people have told me that they think I was very brave. That makes me laugh, because I feel like I made the easiest birthing choice. I’m trying to imagine going through all of this in a hospital, and I just can’t. Would I have been able to try so many different positions? Would I have been encouraged to do something to speed things along? And how would have that affected the outcome? And I know that I wouldn’t have felt as comfortable there than in my own home.
Could something have gone wrong? Sure. But I believe the chances of that are greatly reduced by allowing my body to labor the way it wanted to. Also, I trusted my midwife, and I trusted my body that whatever could have happened, would be manageable.
The whole experience was wonderful. The baby is beautiful and healthy. I thank the Lord for all the wonderful blessings he has given my family.
Kathy1's Story (GD, baby's head tilted, vaginal birth)
Kmom's Notes: Kathy's long days of pre-labor ('false labor') and then stalling at 4 cm for a while was a good clue that something was wrong with the baby's position. Unfortunately, most doctors pay very little attention to this, and breaking her waters may have forced her baby into instead of through her pelvic bones. Adding pitocin on top of that poor position to strengthen contractions pushing baby down may well have caused the damage and bruising she saw in her baby after birth, although of course it's difficult to know for sure. Getting up and shifting position probably corrected her baby's position and may well have saved her a c/s.
Birth Story
Kathy1's first child was delivered vaginally at about 40 weeks after being induced on a mostly unripe cervix. She found labor tolerable until the doctor broke her waters at about 3 cm, and then contractions became very intense and nearly continuous (very common occurrence). Eventually she opted for the epidural as a result, and did get some sleep. During transition, she desperately wanted to get up and move around, but was trapped in the bed by wires etc. and began to feel panicky. She began to feel the urge to push but was not allowed to until dilation finished, and had trouble keeping from hyperventilating. Eventually she began pushing, although it was not very effective due to the epidural. After an hour and 40 minutes of pushing, her son was born, weighing 8 lbs, 14 oz. However, the amniotic sac was not delivered with the placenta as it should have been and the doctor had to go get it, which was difficult, caused a lot of bleeding, and caused her to need a lot of pitocin afterwards.
With Kathy's second child, her father was diagnosed with type II diabetes during her pregnancy, and so she opted to be tested early for gd at 20 weeks. She did indeed have it, but was able to control it through diet only. Because of the gd and the fact that her previous baby had been almost 9 lbs. without any gd, her doctor wanted to induce her at 39 weeks. Fearing a pit induction again, she tried a castor oil induction at 38 weeks instead. The following is her story.
"After having mild, non-productive contractions for 3 days, I decided to try some castor oil in hopes of starting real labor. I drank 4 oz of castor oil with equal parts orange juice about 7 pm. After about 3 hours, I began having diarrhea, which lasted for maybe 2 hours. And then about an hour after it ended, the contractions began. By 1:00 am they were VERY strong and about 2-3 minutes apart, and by 2:00 am I was settling into my labor room at the hospital. I was at 2 cm and 50% effaced.
A friend joined us at the hospital and she and I giggled and talked through the early labor while my husband snoozed. I walked the halls, taking breaks to be monitored for about 15 minutes every hour. The contractions weren't bad at all, and I was having no problem dealing with them. About 9 am I was 75% effaced and 3 cm, so the doctor broke my water to speed things up. The contractions got much harder and faster, and I was really breathing through them, but we were all still in a good mood and laughing and talking between contractions. By about 1 pm I was totally effaced and 4 cm, but my labor had stopped. I was getting very tired by then and discouraged. So I tried to rest and see if things would pick back up. They didn't. After walking and trying various things, we started some pitocin about 4 pm. The contractions got much harder, and after about an hour I started to feel panicky, as it was getting more difficult to handle the contractions.. So they gave me a bit of Stadol to try to help me relax, but it wore off quickly.
Just when I thought I couldn't take anymore, my friend Amy arrived. Amy has been an OB nurse for many years, and is now a lactation consultant and childbirth educator. Needless to say, she knows how to handle a woman in labor! I was crying when she walked in, and I started begging her saying "Please...I want an epidural!!" She said "You don't need one. You need to calm down." She got very stern with me and made me breathe with her through a few contractions. When I got panicky, she'd just get stern again and tell me to look at her. Then a strange thing happened. I relaxed and I began to feel empowered. If I paid attention, my body was trying to tell me what positions helped the contractions along. It felt better to be standing and swaying, and pacing around. I did that for a while, and Amy was keeping me focused and helping me breathe through each contraction. I was handling it!! But I was also awfully tired.
Soon they checked me and announced I was at 7 cm, but my nurse and Amy also had begun to suspect that the baby's head was in my pelvis a little funny. Amy had me squat on the edge of the bed through several contraction to open my pelvis, and I felt his head shift down into the birth canal, and the pressure was incredible! I started to panic a little again. I kept saying "He wants to come out NOW!" And Amy would calm me and say, "not yet--breathe." I was breathing and having to focus so hard during contractions, but was dozing off in between. (My husband said I was even snoring!!) Resisting the urge to push was so hard! But thankfully I went from 7 to 10 in about 20 minutes, but when I pushed, he still wasn't moving down. Amy told me to lie on my side and draw one leg up to push. The doctor didn't argue with her although his preference was to use the stirrups! So I got on my left side and drew up my leg and I pushed through 3 contractions, and with every one they were saying they could see more...they could see hair, etc.
On the third I pushed with all I had, and I remember making some kind of growling sound. His head was partly out and Amy said, "If the contraction's over, rest." And I thought "Forget that!" His head was partway out and I had some kind of fear that if I stopped and rested then, he'd be hurt in some way, so I took a deep breath and PUSHED!! I felt something pop and he came flying out onto the bed all at once (not the usual "head then body" delivery). It sure was a good thing that I didn't have stirrups because I don't think the doctor would have been able to catch him!
David's head was very bruised and the bridge of his nose and left eye were extremely swollen--further evidence that his head had not originally gone into my pelvis correctly. I am SO GLAD that I made it through without the epidural. It was hard, and a lot of work, but if I hadn't been able to squat and roll on my side and such, I just might have had an emergency c-section. And I am SO thankful that Amy was there, because she helped me fight the urge to withdraw into myself during the pain of the contractions, which was the only time when the pain would overwhelm me. As long as I could remain focused on something outside of my own body, I was able to stay on top of the contraction and handle it. David nursed right away in the recovery room, and I was amazed that he latched on immediately. He was 7 lbs, 11 oz., 20 1/4 inches long, with Apgars of 9 and 10."
Update: Kathy writes that "My son has recently seen a surgeon...and the surgeon was [able] to provide an explanation for his postpartum nasal swelling that kept him in the hospital until he was 5 days old. He suffered a broken nose due to the positioning of his head in my pelvis. This also explains the extreme swelling across the bridge of his nose and one of his eyes."
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!
Kathy2's Story (induction, vaginal birth)
Kmom's Notes: It's very common to elect an epidural very late in the dilation process when the pain seems overwhelming, get into position for it to be administered, get it, and then be completely dilated and ready to push shortly thereafter. There are several possibilities here: the position that you have to get into for getting an epidural (spine curved over) often finishes the last bit of dilation needed and a simple position change might have eliminated the need for an epidural; or the epidural relief relaxes the woman enough to finish dilating quickly. Probably it's a little bit of both. But often just when a woman needs the epidural most, she's nearly done, and assuming that epidural position can often finish the process for some women without getting the drugs. It's a trick many professional labor support people know to try before actually resorting to the epidural.
Birth Story
My official due date came and went with absolutely so signs of impending labor, so Dr. T scheduled an induction for October 18. We were supposed to report to the hospital at 7:30 am on Monday, October 18, but they were full, so we couldn't come in until 2:00 pm. They gave me prostaglandin to soften the cervix. At 7:00 pm they started the pitocin. For two hours nothing happened. Finally, a little after 9:00 pm, the contractions began. By 11:00 pm I needed to concentrate during the contractions. By midnight I had to start using my breathing exercises through contractions. At 1:00 am, I was between 3 and 4 cm! As the nurse checked me, my water broke.
Contractions started to pick up almost immediately after my water broke, and I asked hubby (DH) to call our doula, H. H and the nurse provided suggestions on different laboring positions, and DH provided my emotional support. DH was completely wonderful, angelically patient, and absolutely perfect throughout the entire experience. During the interval from 2:00 am to 5:00 the mood started to get more and more serious, as my contractions kept getting stronger.
At 5:00 am I was at 6 cm but the baby was still very high at -3 station. The contractions became a lot more uncomfortable, and I started to doubt that I could make it much further without pain medications. By 5:30 am I asked for an epidural. They told me that there was an anesthesiologist on the floor, and that he would be here in about ten minutes. Well, ten minutes took over an hour.
The anesthesiologist arrived at 6:30 am, and it took him quite a while to set up. I had to sit up and hunch over and not move a muscle as he was injecting needles into my spine. This was torture, because I was having transition contractions one on top of another. Finally, at 7 am, the medicine started flowing. But instead of feeling less pain, I felt the urge to push. I was 9 cm with only a lip of a cervix left. It was difficult to blow through the contractions instead of pushing like my body wanted to do. Fortunately, at 7:30 am, I was 10 cm and ready to push! The epidural deadened my pain, but I still felt some pain and a very clear urge to push. I guess I was a good pusher, because at only 7:45 the nurse told me to STOP pushing because we had to wait for Dr. T to deliver this baby!
Finally, at about 8:10 Dr. T had arrived and set up, and I could start pushing again. After one or two contractions, the head was out. After one more "light push", my son was born -- 8:15 am. He cried lustily for a few minutes, long enough to assure everyone that he was breathing just fine, then he settled down. His APGAR scores were 9 and 9. He was 9 lbs., 3 oz, 19 1/2 inches -- a big baby, and perfectly healthy. We were discharged two days later, to go home as a little family.
To all of you who are contemplating pregnancy or are recently pregnant and concerned that your weight dooms you to a problem pregnancy and/or an unhealthy baby, let me tell you that at my experience has been almost entirely problem-free in spite of my weight -- 350 lbs at delivery (yikes!). Other than low progesterone early in pregnancy, I had a completely normal pregnancy. And other than needing to be induced for being 11 days overdue, I had a completely normal delivery. And my baby has a perfect bill of health. I wish everyone the best of luck in their pregnancies. Here's to happy, healthy babies!
Bfing: I had a lot of difficulties with breastfeeding at first. In fact, this proved to be BY FAR the most difficult aspect of bringing my baby into the world. We had a lot of difficulties with latch on, as he would not open his mouth very wide and my nipples did not protrude as much as I would have liked. Also, my breasts are very full and poorly supported, so I couldn't figure out how to manipulate them into his mouth. Then when I got engorged, my breasts turned into two huge rocks. He lost a full pound off his birth weight. I consulted a lactation consultant and things improved for a little while, but then they fell apart again. I eventually resorted to using a pump and bottle-feeding him my expressed breast milk. This was extremely difficult on me and I spent a lot of time crying. With lots of additional support from several lactation consultants, we eventually got him back on the breast and he has been eating well and gaining well since about 2.5 weeks. He is now 10.5 weeks old and exclusively breast-fed. I plan to continue exclusively breastfeeding until at least 6 months, maybe longer.
In this adventure, I learned a few things the hard way. First, be as prepared as possible before-hand with information on breastfeeding. I found "Nursing Mother's Companion" to be indispensable. Read it before the birth of your baby because you won't have time afterwards. Second, get competent help as soon as you THINK you might need it. If you are having any kind of difficulties, they will usually get worse unless addressed properly. Third, experiment a lot with different positions and different kinds of support pillows. Advice that works well for a small-breasted woman might be useless for you. The only thing that I found worked for me was the cross-cradle position using the large nursing pillow from Baby Becoming. I could have spared myself a lot of pain if I had read Kmom's breastfeeding FAQ before he was born, as this document told me most everything which I had figured out the hard way. This advice is pertinent to all women, but especially critical for large-breasted women because a lot of common advice doesn't work "off-the-shelf" for us.
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.
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.
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 sack 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.
Aliza's Story (1 terrible vaginal birth, 1 terrific vaginal birth)
Kmom's Notes: This mom had a terrible birth experience the first time around. Although the birth was vaginal, it was very traumatic and the treatment very poor. (Vaginal births can be very traumatic sometimes. Nancy Wainer Cohen calls these "vaginal cesareans", and they too often need healing.) It's also interesting to note that the poor treatment she received was at the hands of on-call hospital midwives who handled her birth; in her second birth she had the private OB she saw for prenatals in both pregnancies. Proof that on occasion, midwives aren't always better!
Aliza worked very proactively the second time around to change things. Between pregnancies, she sought counseling for food/body issues and really gained more trust and respect for her body. She used her supportive and size-friendly OB for birth too (not just prenatals), hired a doula (professional labor support person), worked on body trust, and actively did positive visualizations of birth, etc. It really can make a difference!
Birth Story
I'm originally from Melbourne, Australia, although I've been living in Israel for the past ten years. The system here is quite different from the States. The public health system allows you to see a ob/gyn throughout your pregnancy and then one registers at one of the local hospitals and your baby is delivered by a midwife who just happens to be on call. You can even have a number of midwives throughout a single delivery as they change shifts every 8 hours. One may also see a private doctor at own expense throughout one's pregnancy and may also take this same dr. for the delivery at the hospital where the dr. has "rights".
First Pregnancy: My first pregnancy resulted in a miscarriage at about 10 weeks in March 1993. After that I tried naturally to conceive including losing a significant amount of weight which my dr. said would help ovulation resume. When that didn't help and I was feeling desperate, I finally said I wanted help. My son was conceived on my first round of Clomid.
Second Pregnancy, First Birth: From the very beginning of the pregnancy I was pessimistic. From the third week (one week after conception) I had severe abdominal pain which my dr. could not diagnose and said that it was too early in the preg. for him to do anything -- either it'll continue or it won't. By the end of the fourth month, the pains subsided (I had basically been experiencing the pains whenever I moved and had quit my job and put myself on bed rest) and I then began questioning my dr. about all the problems I assumed would happen as a result of my weight. My dr. was okay in that he said that certain problems would be more likely; however, we'd deal with *if* they came up. Regarding my weight, he had said originally that I would probably put on less than thin women and he would like to see no more than a 6 kg gain. I lost steadily in the first few months and my the end of the ninth month, I'd gained a total of 8kg which was fine with him.
During the last six weeks of my second pregnancy (first birth), my BP went up a bit and I had to be monitored every two days (b/p, NST, u/s). This constant worrying and not knowing what would happen worked havoc on my sanity and by the time I was induced at 42 weeks, I was a mental mess. The treatment in the hospital was vastly different from my private dr. They made me feel bad as if it was my fault that my BP was up, as if no thin women ever had elevated BP in late pregnancy.
The labour itself was extremely traumatic in a number of respects. Firstly, the hospital staff made me feel like they were doing me a favour and I was induced at 10:30pm, half an hour before the shift change, so as to accommodate the oncoming shift, despite being exhausted from a very emotional day. Secondly, queries by myself, my husband or my labour coach were dismissed as bothersome. Any efforts on our part to create a different kind of labour experience were met with disdain if not direct opposition such as a desire to remove the monitor temporarily, to walk around the labour ward, to change positions etc.
Finally, I don't feel as if I received any support from the staff to boost my confidence in my ability to birth my baby. This feeling was increased when my failure to progress, after having spent 7 hours at 6cm dilation, was met with the on-call dr's saying "either labour progresses in the next half hour or you'll go for a c/s" and saying again after having gotten an epidural (for which I had to wait 3 hours, which took me to 10cm in a matter of minutes) that if the baby wasn't delivered in half an hour I'd again be taken for a c/s.
Fortunately, my son was delivered in exactly 30 minutes weighing 4.32 kg. I don't know if the dr's response was due to my weight or not. The placenta took more than 40 minutes to be delivered and then the midwives were not sure if it was complete. By the time the dr. checked it, I was hemorrhaging, and he had to do an emergency manual D&C without any anesthetic (100 times more painful than childbirth), then I went into shock and had to have a blood transfusion.
Needless to say, I was traumatized. I felt as if I'd been physically and emotionally raped. My body had been invaded, pushed and shoved, pulled and manipulated. It took me many months to realize the extent of the trauma I'd been through. I don't know how much of my experiences with the medical staff was due to my weight but another significant factor that cannot be ignored is the fact that I am an English-speaking immigrant in a Middle Eastern country - the cultural gap is significant and the attitudes towards birth very different. I do know that they definitely did nothing to reassure me that it wasn't my fault and at my six week check-up I discussed these events with my private dr. who reassured me that it had nothing to do with my weight.
Third Pregnancy, Second Birth: My second baby's birth was an extremely exciting and spiritual event and this is my birth story. After my first baby 2.5 years earlier, I was terrified of labor. My son's birth was preceded by 6 weeks of medical intervention which left me feeling like my body was awful and couldn't function as it should have and that my size was the cause of all the problems.
It took a long time but by the time my daughter was conceived, I had begun to like my pregnant body. As the pregnancy continued my self-esteem grew and that confidence was boosted by a completely uneventful pregnancy. For the first time ever I felt like my body wasn't betraying me and I began to respect my body. So although as my due date approached I began to feel anxious, I tried to get in touch with my body and show respect for the process that was happening inside of me. On Friday afternoon I took a bath in lavender oil to help me relax and continued with my visualizations which I'd been doing in the last few weeks - imagining my uterus opening up and allowing by baby to be born through it.
My water broke at 4:30 am the following morning, the day before my due date and since I didn't have any contractions I followed my doula's instructions to stay at home and waited. I spent a lovely day with my family and friends until early evening when I contacted my doctor who asked me to come in. I arrived at the hospital some 16 hours after my waters broke and had managed to induce contractions using nipple stimulation for a half hour in the car on the way in. I was 4cm dilated and 80% effaced and barely feeling the contractions.
My OB gave me a hospital room to rest in for the night and said he'd see me in the morning or when anything started happening. I sent my husband to my brother's house nearby and told him to get some sleep. I decided to try having a shower to see if that would help move things along. By the time I got out of the shower a short time later, my contractions were strong and I was feeling shaky in between the contractions. I was a little nervous so I called my doula who said it was time for her to come.
At 1:15 am my husband and doula arrived at the hospital. For the next three hours I experienced strong but irregular contractions. I varied my positions and walked a lot to accelerate labor but by 4:30 I was only having contractions every 15 minutes. By now, I'd been up for 24 hours so I decided to get some rest. After sleeping for two hours, my OB returned and checked me. I was now 5cm and 100% effaced and very disappointed and very fearful of repeating the scenario of my first birth with a pitocin induction, stalled labor and baby in distress. Since I had discussed these fears with my doula and OB during the pregnancy we had worked out how I would handle such a similar scenario and thus when my OB said he had to use pitocin to get labor going I knew I would get an epidural to help me with the pain.
It was 9am by the time the pitocin was started and my epidural was already in place. The labor went very quickly from then on and although despite two attempts with the epidural, it was not working as it should. By 12:35pm I was 9cm dilated and felt the need to push. For 25 minutes my doula worked with me to help me concentrate on not pushing and at exactly 1:00pm my OB said "okay, push" - the words I had been waiting for. Exactly 6 minutes and three contractions later my beautiful daughter was born. She was delivered straight onto my stomach and my husband cut the cord. A few minutes later the placenta was delivered and I had one stitch to repair a very minor tear. My daughter nursed immediately and we were left alone to bond and rest. A short while after the birth I hopped of the bed, freshened up and walked to the maternity ward full of energy albeit tired.
My doula had been a wonderful source of emotional support and physical help. She knew what my concerns were and was able to help me through the fear as well as rub my back between contractions and give a lot of encouragement. My OB was wonderful also in that he gave me the space to try for the type of birth I wanted. My OB treated me, throughout, like any other pregnant woman and made no comment about my weight. When I asked him about having a higher chance of GD or PIH he said that we'll deal with that if and when we need to. At no time during the pregnancy or labor did he make me feel handicapped by my weight but rather was tremendously encouraging and positive. My husband was there the whole time and I cannot imagine going through birth without his continued presence and support. Throughout, I felt surrounded by people who were caring and considerate of my feelings and what I was going through and they all helped me make this birth experience the best it could be.
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.
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.
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 danger of cord prolapse in a transverse presentation), the baby had some troubles breathing at first and spent quite a bit of time in the NICU (neonatal intensive care unit). Ann also had to have an unusual vertical incision due to the baby's presentation. Recovery at first was tough but all is well now. Breastfeeding got off to a rough start, but they persevered and are now breastfeeding exclusively.
Lisa Z's Story (twins, diet-only gd, vaginal birth)
Kmom's Notes:
Birth Story