Tuesday, March 01, 2005

H2o HBAC!

So, a woman called the midwife I work with most of all… the same midwife I took to the Hand's-Off birth several months ago… because her OB was telling her stupid stuff about wanting a VBAC, something he’d promised her the entire pregnancy. She was then 34 weeks along.

Her first birth was in Australia and for a variety of odd reasons, she was induced at 36 weeks along. When that failed, she had a cesarean.

This time, in the US, her hand-picked doc said, “oh, yeah! VBAC? No problem.” At 34 weeks, she brought her birth plan in and he rolled his eyes, trying to be somewhat discreet, but then went on to say things like, “your uterus might explode during pushing,” and, “we just don’t want to meet in a courtroom with you showing a picture of your dead baby.”

She left horrified and that is when she remembered her former childbirth educator turned midwife and called her. She came to see us the day after that appointment, but on the way to my office, she picked up her records.

In my office, we’d just had our conference committee meeting, so Tonya Jamois, the president of ICAN, another doula, the midwife and I were all available to share with her… and we did. The woman and her mom sat on the couch in my office and showed us her records. The last note said something like: Reviewed birth plan. Consider general anesthesia for repeat cesarean. She was stunned that he would put something like that… and she would never have known had she not gotten her records. She would have gone in for a VBAC, been railroaded into a cesarean, and had general anesthesia to boot.

Thank god she woke up.

So, at 35 weeks, she decides she is leaving the doc and choosing to have a homebirth… something she had not ever considered. Her husband needed one meeting with us and he was convinced.

Because her previous birth had come at 36 weeks, this full-term pregnancy was forever-long. She kept saying how she wanted to have the baby and we chuckled, telling her we would remind her of this moment in the throes of labor. And, as all women do, she went into labor… 40 weeks and one day.

I got the call to come over at about 7am and got there at 8:30 or so… damn that San Diego traffic.

Mom sang her heart out during contractions. Her sister was there, her husband, and the right-before-pre-school twins. The day was sunny… the first one in at least two weeks. A lovely morning, in a beautiful home overlooking hills and mountains in northern San Diego County.

The pool was filling up and mom moved around, waiting to climb into the water. Once she got in, she didn’t get out again. From side to side, to hands and knees, she felt SO much better in the pool than out. Her sister clung to the mom’s hands for awhile, but the kids needed attention and mom wanted hands to clutch; I became the clutcher.

Along the way, dad got into the pool with mom. He was so calm and loving and gentle. He was great.

The sister was interesting though. She’d had two hospital births and wasn’t quite sure where she needed to be or do. She massaged her sister hard, like she was getting her warm after she’d been in the snow for a day and a half. And at one point, her “relax, relax, relax, relax, relax, relax, etc.” needed calming, so I gently said, “please don’t use that word” and she stopped saying it.

Nearer the end of the labor, I needed to move from the hand-holding so I could ready stuff for the birth (it was all in the bedroom; we were in the living room) and sister took over again. I came close at one point and the sister grabbed my arm and looked me in the eye and said, “I’m scared” and I sat next to her for a second and told her how perfect everything was, how wonderful it was all going… and the moment she could, she excused herself from the handholding and asked me to take over.

I held mama’s hand as she puuuuuuushed. She never held her breath and wasn’t even sure she was in second stage.

She asked for a vaginal exam a couple of times, but her midwife was able to deflect. It was great! She would ask, “where do you think I am?” and her midwife would say, “where are you?” She would ask, “can you check me?” and her midwife would say, “you can feel… where is the baby?” and it always worked! The only time the midwife checked was after imploring (mom’s) and the baby was a knuckle inside the vagina; no cervical checks at all. Listening to fetal heart tones was very occasional.

We did our best to honor the marriage bond, the mother’s desires, and remain just under the radar. Unless asked.

So, mom is pushing… grunting with all her voice… and from above our heads, her sister says, “put your chin on your chest!” and I nearly busted out laughing. The midwife and I looked at each other and the midwife repeated that she was pushing exactly how she needed to, that the baby was advancing perfectly… and sister didn’t say anything else about how to push.

For days after the birth, I could hear those words – put your chin on your chest – and it made me laugh out loud, several times. It was hysterical and sad all at the same time, how indoctrinated every woman (almost) is in the American Way of Birth. Blessedly, there were enough of us around to counter the brainwashing. I wondered about my own gradual un-brainwashing… and its continual evolution.

Mom loudly sang her wonderful 9 pound baby girl out in the water over an intact perineum. Her uterus did not explode in second stage.

As the baby came out, they were giddy with joy. “I did it! I did it!!” and mom and dad, embracing their daughter, cried in words and tears.

Blood began oozing out into the clear water. The water began getting murkier and dad was a tad concerned, so mom stood up, stepped out of the pool and delivered the placenta into the bowl.

She walked to the toilet, dried off, and then climbed into the bed with her family and nursed her big ol’ girl for hours.

We did the three day home visit yesterday and talked and laughed and cried about the birth. The tears came from hormones and her observations of her Self during her birth. She spoke of her sheer joy that we never took her power, even when she offered it. That we were so respectful and careful to keep her in her power… how we encouraged her to believe in her own knowledge, to know that she could feel her own body. She spoke of her own pride, over and over, and that made the midwife and I so proud, so filled with joy that we, too, wept.

Mom told us we changed her life. Dad said he has now become a crusader for homebirth and has told everyone at the office they should consider it, how joyous it was. We told them both that they, too, affect our lives, that their joy, their power, their belief in their Truths, reminds us of what we are doing this for.

The most tender moment of yesterday came when she took my hand and looked at me and told me that one of her highlighted moments in her labor was when she needed help and opened her eyes and looked at my smile and my bright blue eyes and felt safe and could go on. It means so much to me that I can remind a woman of her perfection in those moments of challenge and, even sometimes, fear.

What a joy this birth was!

And her uterus, her vagina, her family, her nursing relationship, her psyche, and her spirit… all remain whole and intact.

2 comments:

Mommaroo2 said...

Is it just me, or are all these doctors going to a "VBAC Deception" class? They all have the same techniques--agree to a VBAC, then back off from the promise in the third trimester, and try to scare the mother out of her wits and guilt-trip her into a c-section. I've heard this story over and over, and gone through it twice myself.

My current doctor is young and well-indoctrinated in the anti-VBAC rhetoric. Not only that, but at my first visit, he tried to talk me out of having more kids altogether, because more c-sections would be dangerous and risky. Hmmm, note that none of the doctors who talked me into the last two c-sections mentioned that. Naturally, his statistics were exaggerated. But it is true, more c-sections mean more risk. I'd be statistically better off having a home VBAC, which I now plan to.

This woman's birth sounds wonderful. I am hoping to have the same experience. I've already found a few midwives who will take me, even though I've had 3 c-sections. I just talked to a woman who had a home VBAC after 4 cesareans, and she said her experience was wonderful, and not to listen to people who just want to scare me out of a homebirth.

I'm really excited, I can't wait!

Navelgazing Midwife said...

Please please tell me your story when you have your baby! I would love to hear it.

And you are absolutely correct - bait and switch is THE name of the game in VBACs.

I believe in you.