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Angela and Anna
Planned for Home Birth, C-Section Delivery at 41.5 Weeks

My story begins long before conception. As a preteen, I remember reading a book where a young girl was asked to photograph her neighbor's home birth. It portrayed the birth as so peaceful, rewarding, and natural. I had little knowledge of women's individual experiences at that time, and the story made sense to me. When I was a teenager, my sister, then pregnant, attended a fantastic childbirth education class. I heard her tell of little tid-bits of information: episiotomies being unnecessary, the fear-pain cycle, etc. Again, it all made sense to me. I began reading everything I could find on natural childbirth, midwives, and home birth. I was able to develop a friendship with her CBE, Carolyn, who encouraged me greatly. I aspired to be a midwife. I had an insatiable desire to learn and understand the pregnancy and childbirth process. I was awed by the way we are designed by God.

Upon graduation from high school, I enrolled in the nursing program at the university I had chosen. After two years, I switched to health. I found the nursing approach overly medical, much to my dismay. I realized this would limit my midwifery, but I was willing to sacrifice that to avoid the brainwashing I felt I was getting, constantly having to use a mindset geared toward illness. I wanted to help healthy women deliver healthy babies. And even if I didn't go after midwifery, I could go toward childbirth education. That would complement my ambitions to be a mother!

My husband and I wanted to have our first at the "perfect" time. We considered it in the fall of '96. I called around for information packets from various midwives. I was working outside the childbirth field, as I had put that on hold while he was gaining his masters degree. I found the perfect midwife. All of the information she sent was a perfect match, both in personality and philosophy. We decided to wait longer, and that I would go for a well woman check with her right before we started "trying." Like many, we didn't get to that point! We got pregnant in September of '97. We were thrilled! I called this dream midwife, only to find that she was no longer taking new clients! I was so disappointed, but knew there were many in our area (Ft. Worth, Texas).

I met Helen when I toured the birthing center. She was in her 60's, had been a midwife for years, "caught" over 2,000 babies, and was so peaceful. I was drawn to her. She also had a home birth practice, which was our true desire. I asked about going overdue (they do an ultrasound, as long as everything is good with baby, we wait), AROM (it's illegal for lay-midwives to do in TX), transfer rates (1 in 10, 1 in 5 for first time mothers, unless you're stubborn, then it's 1 in 10 too!) and many other questions. Everything seemed in order. For goodness sake! She had trained most of the midwives in our area! Who else could be better?

Because of financial reasons, we contracted with her intern (she tries to keep at least one at all times) to actually handle our pregnancy, with Helen overseeing. I was eventually in a good relationship with Mollie. She was 21, but seemed to really enjoy her work.

I loved being pregnant! I felt great! I ate my veggies and whole grains, as commanded, and have never felt better. In February, I came in with a long list of questions. Mollie answered most, but Helen was in and out, adding her .02 worth. One was "How do you handle, very specifically, overdue ladies?" My mother had been three weeks over with her first. I felt sure that the baby would be at least two weeks late. I had been slow to show, slow to feel baby move, etc. They said, again, at 42 weeks, an ultrasound is performed to be sure there was adequate fluid and that the placenta was still functioning properly. If all was well, they would wait longer. They may have said they would repeat the ultrasound at various intervals. Not sure on that.

Around March, my hemoglobin levels didn't have the typical drop, so I was told to be sure to get 100g of protein a day. I did as told, after asking all about the reasons behind it.

In late April, there was some concern on my part that the baby was still transverse. Helen assured me that I needn't worry: there was still plenty of time. She said that they would attempt a version around 30-32 weeks if baby hadn't turned. We discussed have an ultrasound to determine location of placenta before an attempt would be made. I felt this would be wise, but the baby moved, as expected. Head was down, baby seemed anterior (my sister had a c/section for posterior, AROM, so this was one of my concerns), everything looked good.

Helen then commented that she was unable to feel the head very well and hadn't in the past. She suggested a sonogram to rule out any problems. When pressed for specifics, she mentioned the possibility of anencephaly, a disorder in which the brain does not form. Babies with this disorder do not live. We struggled with whether or not to have the ultrasound. My husband was in agony over it, so we decided to go ahead. At the ultrasound, the head was more than adequate and brain very ample. It was then I wondered why a pelvic couldn't have helped determine that the head was as it should be. Upon expressing the anguish we had felt through the whole process, we received the response that she hadn't thought the baby had anencephaly, but was required by the state to suggest an ultrasound anytime anything seemed remotely out of the ordinary with the baby's development.

Another "finding" of the ultrasound was the estimated weight of the baby was 7 lbs, 4 oz, at 34 weeks. I expressed concern over the size of the baby and was assured that sonogram weight estimates are very unreliable. At the next visit, I asked Helen to estimate through palpation the baby's size. She guessed baby to be around 7 pounds, commenting that the baby could end up around 9 or 10 pounds, but quickly added, "the bigger they are, the harder they fall! I'm sure you're instinctively drawn to upright positions?" I was. We discussed the benefit of gravity, using the birthing stool, etc.

My due date came and went. I still felt great, except I knew Helen was going out of town one week after my due date. The Saturday before she was to leave, I called Mollie asking about stripping membranes. I was frustrated that my mother AND in-laws were in town, just waiting for the big event. (All our family is in another state.) I hated the thought of Helen not being present for our birth. Mollie talked to Helen, who said, "If she's wanting to just to have me here, it probably won't work fast enough." I was very discouraged and started to cry. Mollie reminded me to trust God. I reminded her it was easy for her to say. I said, "I feel like my dream-birth is disappearing before my eyes."

At my 41.5 appointment, we talked about me going so long in the pregnancy. I had been reading on the factors in an "overdue," large baby. I read in "Heart & Hands" that there was a chance that the head could grow too large and overlap. I asked her about this, as I knew although I was 1 1/2 cm, the head was still not engaged. She told me she was not concerned about Baby's size and that if I didn't stop reading that book, she would come take it. I told her I wasn't getting worried, I just wanted to make informed choices, as we had been discussing trying to stimulate labor. We set up for an ultrasound that weekend. I asked why it was needed. Mollie reiterated the fluid and placenta. She said I could sign a waiver if I didn't want to have it done. I had been keeping a fetal movement chart, and that sweet baby would move the 10 times within 15 minutes, let alone 6 hours! I knew the baby was fine. I told Mollie on Thursday that I didn't want to have it. We agreed that if I hadn't had the baby by Monday, I would have an ultrasound Tuesday. I felt better about that. I had such strong, negative feelings about having this one done. Friday night, Helen called me (after getting back into town) and said the group would no longer cover my care if I didn't have it done. Why I didn't challenge that, I don't know! She mentioned a client who she'd "allowed" to not go, since she was having early labor contractions at time for 42 week scan. The baby died before it could be born because the placenta was so compromised. She mentioned in passing she wanted to check on size too. I didn't think much of that, as she was nonchalant about it.

I mentioned to one of our friends that I felt the baby was around 10 pounds. Yet, Friday was the first day I was tired of being pregnant. It was the first time I felt ready to have the baby. That night, I had good early contractions, and even had some nausea. We had my mother, my in-laws, and my best friend in for games and snacks to get our mind off of it. (In-laws had no clue). My mother was weepy, certain this was "it." I went to bed around 12 and slept very well. The next morning I was discouraged to realize I would have to go for the ultrasound.

I busied myself about the house, cleaning before we went. My husband later told me he couldn't believe how fast I was getting things done and knew I had to be "nesting."

When we had the scan done, baby looked great, plenty of fluid, and the placenta looked "pretty good! I've seen a lot worse!" was the comment from the tech. The hitch was the ultrasound was estimating the weight to be over 13 pounds now. She said she didn't think it was right on, but that the ultrasound was very clear and the baby was definitely very large. The foot was measuring 8 cm long, for example. Helen, who was there, began acting very nervous. "Well, we knew the baby was big, but I was hoping she'd just go early." She asked if I minded one of her colleagues palpating to estimate the size of the baby. Of course I said that was fine. This lady (Don't remember name--Barbara maybe?) had delivered almost twice the babies, but I didn't know anything else about her. As we went to the examining room, Helen babbled about the possibility of dystocia and fetal death with a large baby. My mother, who was unsure of the home birth idea, was appalled. I asked her to wait until we could speak in private!

Helen felt around and estimated the baby to be 11-12 pounds. Barbara? said, with a chuckle, "There's no way this baby is 13 pounds, that's for sure! I think it's more like 10 or 10, 2 ounces, but certainly not 13!" They both did internals, and I was still 1 1/2 cm and the head was not engaged. Barbara? had much bigger hands and actually seemed to be able to determine more of my dimensions than the other two had done. Helen went on to say that I would not want her at my birth, because she had "seen too many things happen!" She suggested I try a newly licensed midwife from the group, whom she knew I didn't really care for (personality clash), as "she hadn't seen enough to be scared." She said they could both be there, if I wanted, but she was certain I wouldn't want HER there. Or, and she said as if she were much more comfortable with this, she could refer me to an OB for evaluation. I couldn't believe my ears.

She acted so apologetic and sad; I was gone. For crying out loud, she had cited every known dystocia in our area, literally back more than 10 years to one baby who died! She said she had prayed for us daily and had an unsettled feeling about it. While the decision was technically ours, I felt I had no choice. My husband and I said we would go home and think about it. She said she would do some calling around to find out what doctors were available and willing to accept me.

We went home heavy hearted. How could I go forward with our home birth? I had such confidence in Helen and her judgment, I lost my sense of instinct and sound judgment. We decided to see what the doctor said, knowing we would be, at best, looking at an induction, at worst, an automatic c-section.

When we talked to her, we found the doctor wanted to see us that night, to do an ultrasound and possibly a stress test. I knew the slightest bit of pitocin would put me in full labor. While putting some things in a bag, just in case, I lost my mucous plug. I cleaned all our home birth supplies off my dresser.

The doctor was very kind. He did his own ultrasound, which gave the same 13 1/3 lbs. estimate. He discussed very factually the risks of such a large baby. He said if he thought the baby were only 11-12, he would consider a vaginal birth. He pointed out that the ultrasound could be in err on the large side, however. I wish I could have convinced him it was not, but I was foolishly silent. He said we would schedule the surgery for Monday morning. My mother asked about the possibility of me going into labor before then. He checked me. I was four centimeters and not the least bit uncomfortable. The next 45 minutes or so were pretty blurred. I do know that I was never explained the risks of a c-section or of the spinal. By the time I was on the table, I was still in utter shock and disbelief.

Surely I was not having a cesarean! I could see my belly in the reflection of the overhead light. I was terrified that if I watched the surgery I would come unglued. I had to be strong--I could mourn my loss later. I asked the anesthesiologist to pull the drape up higher. I could still see little bits of red flesh, but it was like flipping past the Discovery channel. My husband was great--rubbing my arm and talking to me. I have no idea what was said. Soon, Dr. O'Neil said, "Dad, take a look at the sex!" "It's a girl! I knew it!" We had our girl. I so yearned for a little girl. When I first saw Anna, her cord had been cut, she had been dried off. Could she really be mine? She was rooting for the breast even before they put her on the warmer. She cried so hard, it broke my heart. She was wiped off and her prints taken. She was bundled to protect her from the freezing chill of OR and handed to her daddy. She was pulled close and instinctively turned to nurse. Only I couldn't nurse her. My tummy was open to the world! I put my finger in her mouth and she sucked vigorously. After about 5 minutes, my husband carried her to the nursery to be evaluated. It seemed forever before they finished. My back and neck hurt so badly. I thought it would never end.

I was somehow transferred to a bed and wheeled into recovery, where Mom, my husband, best friend and my in-laws were, along with my baby. My baby who had just been removed from me like a tumor. She weighed ten pounds and four ounces. I wanted to scream. Even the doctor later commented that he felt bad that she was that small, since he'd done the surgery.

Finally, about 45 minutes after her removal, I was able to hold my little Anna. My mother shooed everyone but Steve out so I could nurse. I was so thankful that the nurse had thought to give me a nursing gown. She was so beautiful, but after she was taken with her daddy to the nursery again, I was overwhelmed with how awful I felt. I shook, I hurt and I felt so numb emotionally.

She was removed (I just can't say she was born) at 12:44 a.m. Sunday morning, but I didn't get her back in my room until around 3. She stayed with us the rest of the time. I left Monday evening, despite the reservations of the doctor. He did see the support was abundant.

While I recovered quickly physically, I am far from recovered emotionally. Part of me wants to have another baby NOW to do it right this time, as if that would somehow undo the hurt I feel. Another part of me wants to NEVER have another. How can I trust a part of my body that was sliced open?

I've cried and cried. I didn't know I could grieve so deeply the loss of a dream. I've searched for ways to help people understand, but am so limited. I know you know what they're all saying: well, she's healthy and that's what matters. I thought of this: my sister wanted for years to be a teacher. She studied for years. Imagine if, once she was finally ready, they told her she could be paid for a year, but would not be able to teach. Now she didn't just want to get a paycheck! She wanted the joy AND work of teaching! Yes, the ultimate goal was a career, but she was hoping for job satisfaction and enjoyment.

Someone asked me what I feel like I missed. Perhaps you sadly chuckle with me as you reflect on what you felt like you missed with your c-section. Kind of hard to put it all into words, isn't it? I said, I didn't get to see her umbilical cord. I didn't get to have her daddy catch her, as I pushed her into the world. She wasn't born in the bed where she was conceived, liked we'd hoped. She didn't breathe fresh summer air. I didn't feel her warm body, still wet from the womb, on my just sunken belly. She didn't get to keep her vernix. I didn't get to have the satisfaction of knowing I gave her birth. I didn't get to be in my bed, when I wanted to sleep soundly. I didn't get to enjoy the food we'd bought ahead of time for a birthday party. (The cake at the hospital was nice, but it wasn't what I'd wanted for us.) I didn't get to have those first moments, cherished in my home.

Instead . . .

I touched only her head and hands for the first day and a half of her life. I wasn't even able to change her diaper for a while. I couldn't rock her. I couldn't walk with her when she had a tummy ache. I couldn't nurse her like I wanted. I had pain killers that made me so sleepy, it was hard to even get through nursing.

There are so many things I would do differently: second opinions, relying on my instinct instead of Helen's, waited to see the doctor another day, had membranes stripped earlier, and on and on. One of the hardest things is accepting the fact that I can't change it.

The bottom line is, I missed my dream. If you made it this far, thank you. I appreciate you spending the time. I long for the day when my vertical, red line fades and pray my disappointing ache fades with it.

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