Friday 29 November 2013

Recommendation

Happy Friday to all!

By way of an addendum to my last post, I'd like to recommend highly a blog I came across last summer.  Mama Birth features every kind of birth story you can imagine, and she has a special section devoted to VBAC birth stories.  Everything from HBAC to VBA4C is captured, and the stories are incredibly emotional and inspiring, written by the Moms themselves.  If you are looking for something to sustain your courage and determination to VBAC, look no further!  You can find Mama Birth at http://mamabirth.blogspot.com.  

Also, check out this powerful video compiled by ICAN and featuring music by Superchick for another reminder that your dream is well within reach.



Monday 25 November 2013

My CBAC and Harvesting the Good

WARNING:  If you or your partner are currently expecting a child and planning a vaginal birth, please do not read the birth story at this time, as it may plant inappropriate images, thoughts and feelings into your subconscious mind which are not supportive of your goals.  There will be plenty of time to catch up and read the story when you have your babe safe in arms after a healthy and happy birth experience.  Your baby thanks you!


It was a Thursday during the summer of 2012, reportedly the worst summer Ireland has seen in the past 26 years, or in the case of Cork in the past 50 years, going back to the first year in which records were kept.  Nevertheless, when I woke up early that morning with my 2 1/2 year old daughter, Pebbles, the sun was shining, and I realised right away that the day was full of promise in more ways than one.  The slight twinges I had been experiencing for weeks had distinctly grown in intensity from mild menstrual-type cramps to a more uncomfortable, sore sensation, and I noticed that a small but steady trickle of fluid had begun.  I texted my parents, who had extended their stay in Ireland since our baby had decided to arrive fashionably late to his own birthday.  I was ecstatic and full of giddy energy.  The time had finally come.  Our baby was ready to be born!

For almost 2 months, a very slow, gradual process of preparation for this delivery had been very obvious, and I kept thinking, "Any day now, it will be any day now."  Our family seemed to be in constant celebration mode:  chocolate cake here, dinners out there, trips to the beach another day...  It was incredibly beautiful and quite fascinating to see this natural progression of unfolding events.  It made me giggle to think that I was a like a Transformer in slow motion.  It was as though my body was slowly and dramatically morphing from a baby-making and -nurturing machine into a baby-delivery system.  I felt like an egg that, fragile yet incredibly strong, had begun to crack open as my pelvis opened up and the soreness around my hips and sacrum became more and more pronounced.  With every step (or waddle) I took, I could feel my baby's head incrementally making its way downward like a nail being hammered into place one swing at a time.  He felt so low down at this stage.  And I was just so heavy!!!  My "cankles" were swollen like an 80 year old woman's, so much so that going up and down the stairs became very sore and I could only manage one step at a time.  I hadn't been able to wear my wedding rings for some time because my hands and fingers were also thick with oedema.  My fingernails looked abnormally small for my now-enormous fingers, which were stiff with every movement they made.  My face was puffy and red, and my nose had begun to spread across my face.  I looked like a cartoon character.  It was all so amazing and unexpected since nothing like this had happened when I was expecting my daughter.


Two days prior to this, on Tuesday, we had gone to the hospital to see Diana Prince, our obstetrician, the same one who had been our consultant during my pregnancy with Pebbles.  I was now 40+5, and we knew that if my cervix looked favourable she could do a stretch and sweep.  I was pretty nervous before we went in.  I really wanted to let everything take its natural course and didn't want to interfere with the process.  I believed that things were progressing just as they should.  I worried that messing about with things might result in accidentally rupturing the membranes or that the labour wouldn't progress properly if we brought it on artificially, leading to further and more invasive interventions.  However, I was weighing this up against the fact that my odds of VBAC success would decrease, albeit slightly, the more overdue I was.  Great news, not only did she say that my cervix was favourable but said I had already dilated 1-2 cm and that she could feel our baby's head!  I was literally in a state of shock and awe.  She had actually touched our baby's head.  Our Spud was really coming and would be in my arms soon.  We went home triumphant and relieved after the stretch and sweep, and I spent almost the entire next day sleeping.  I just could not keep my eyes open.  My body was conserving energy for the huge task ahead.  All was right with the world.  So when the cramps and waters came, I was in no doubt as to what was about to transpire.


We had another appointment with Dr. Prince set for late in the day, around 3:30 or so, and we knew we would not be coming home right away.  My husband and I were taking photos of ourselves with Pebbles on our last day as a family of three, photos of the cats, photos of Nana and Pop, photos of Pebbles and her toys.  We could not contain ourselves.  Throughout the day, the contractions grew stronger and stronger.  They were never even close to unmanageable, but they were very regular every 2-3 minutes and more uncomfortable than my usual menstrual cramps.  I had not expected contractions to be so closely spaced at this early point in the labour, and this, combined with the information Dr. Prince had given us two days prior about the state of my cervix, led me to believe that things were perhaps moving a little more quickly than we had anticipated.  Our original plan had been to labour at home until the last possible moment.  I assumed that labour could take at least a day or two all told.  But now, I was walking a fine line between excitement and nervousness.  I was also beginning to worry about how able I would be for the hour-long drive to our nearest maternity hospital.  Although my conscious mind knew and believed in the natural birth process and the innate ability of all women to give birth, my subconscious mind still resided in the realms of fear, reinforced over a lifetime's worth of birth horror stories and cliché television shows.  In addition, my parents had been with us for over a week, watching and waiting for this baby to be born.  They would be very old school when it comes to anything to do with the medical profession.  We should race to the hospital at the first twinge, in their view.  They wanted their daughter and grandchild safe and healthy, after all.  I knew I could not sit in front of them all day (or longer) and pretend that nothing was happening.  I was a child again in a way, the way we all are when we want to please our parents, no matter what age we are.  We hugged our baby girl goodbye and left her on what would be the first night she'd ever spent without the arms of her parents around her.  We hit the road.  There would be no turning back.


Inexplicably, I decided en route that we should go directly into the hospital rather than attending our scheduled appointment with Dr. Prince.  She's only going to tell us to go over there anyway, I reasoned.  We live too far away for her to send us home.  We might as well.  So we rang her office to let her know we were going to the hospital instead.  How had this happened?  I have been incredibly hard on myself about these early decisions in particular.  Staying at home until the baby was actually emerging between my legs had turned into, "Let's just get in and get settled."  I was not even aware that I was afraid, but all of my unacknowledged fears and my lack of belief in myself were actually running the show.  I was and remain utterly disappointed in myself, but I am learning to temper that with a measure of compassion.


I feel it is important to mention here that my ideal birth during my pregnancy with my son would have been a home birth, but of course I was not eligible under the HSE guidelines due to my previous caesarean section.  Nevertheless, my husband and I sought to create a kind of “home from home” birthing experience at the hospital, and we did not think that it would be difficult to achieve this as private patients in a brand new, state-of-the-art, metropolitan maternity hospital.  We arrived at the hospital with a birth plan, which we had written with great conviction and attention to detail.  We summarized our approach with the following statement:  “Above all, our aim is to allow the normal physiological process of giving birth to take place unimpeded with a minimum of disruption and interference as long as it is safe to do so.”  We were confident that this approach would result in a successful vaginal birth for us and our baby.  However, the hospital’s model of care did not seem to be compatible with our goals.


The reception with which we were greeted in the Admissions Department was less than enthusiastic.  I was expecting midwives to be jumping for joy.  “Hooray, your baby is coming!”  This was not the case.  We had entered a place of business, and the atmosphere was detached and aloof.  I met with the first midwife by myself.  For some reason, my husband was told he could not come into the examination room with me.  I had to sit up on a table in a semi-reclined, very uncomfortable position while she informed me that my bump was a very strange shape and that the skin on the underside of my bump looked unusual.  I’m not entirely sure what she was trying to accomplish with this critique.  Later, we had our admissions trace and my first vaginal exam.  Again, they required that I be awkwardly semi-reclined.  We were unceremoniously told that I was not dilated, in fact my cervix was "barely allowing a finger." 


Our baby bubble was well and truly burst.  The giddy excitement with which we had arrived at the hospital, anticipating the birth of our baby, had been replaced by a strong suspicion that maybe my body was just not working properly.  I asked, “You’re saying I’ve gone backwards, even though I’m having contractions?”  The midwife shrugged her shoulders and just kept repeating the same weary comment about her fingertip.  She told us that, although I was not "in labour," it was hospital policy for us to be admitted because my waters were trickling.  In hindsight, we should have just gone home, but being so green and unsure of ourselves we did as we were told and made our way up to the ward. 

The first midwife we met there was very young and had a positive mental attitude.  Gentle and smiling, she advised us to disregard the comments of the admissions staff, reassured us that vaginal exams are not an exact science and encouraged us just to carry on awaiting the birth of our baby.  I tried to take her good advice on board, and my husband was also trying to keep me focused and positive.  However, after three miscarriages and the caesarean birth of our first child, my fragile self-confidence was all too easily shattered.  I realise now that because of my history I possibly needed to be treated with kid gloves.  Throughout the day, the paradigm that says, "Birth is scary and dangerous" was accompanied in my subconscious mind by the paradigm which believed that my body was somehow flawed and unable to meet the demands of pregnancy and childbirth.  Our paradigms control our perception, and we generally attend only to what is in harmony with our paradigms and to think thoughts and feelings that are supported by those paradigms.  They act as a filter.  Due to these inappropriate and inaccurate beliefs, I was unable to focus on any of the positives going on and could only focus on the negatives.

How I wish that lovely young woman could have stayed by our side throughout the night, but it was late in the day and her shift was coming to an end.  She had been too busy to spend much time with us.  A very different midwife took her place.  The first thing she said after meeting us was that she thought it would be best if I took some pethidine.  We were taken aback, as our birth plan clearly stated, “Please do not offer pain relief medication.  If we need it, we will ask for it.”  When we explained that we did not want drugs, she stifled a laugh.  She mentioned that she had seen in our birth plan that we wished to use aromatherapy to assist with pain relief.  Again, she chuckled when she saw the little bottles of essential oils arranged neatly in a small plastic box.  She grinned and remarked, “Wow, you brought a whole kit!”  We felt so foolish and feared that the pain of labour would be well beyond our ability to cope.  At this point, my confidence had been seriously undermined.

I was very afraid that if I didn’t start progressing quickly and soon, I would be in danger of having to undergo another surgical delivery for failure to progress, and the fear and stress were making my experience more and more painful.  We paced the corridors and walked up and down the steps for hours in an effort to encourage speedier progress.  We were utilising the shower, aromatherapy, massage, listening to music – anything we could.  Every time we saw the night midwife, she spoke to us in a condescending and slightly ominous tone.  At one point, she said something to the effect of, "If you are not in labour by 11 p.m., we will have to give you antibiotics because your baby will be in danger of infection.”  It felt like a warning of dire things to come.  Also, I understand that, medically speaking, there is a difference between the latent phase and the active phase of labour.  However, to a lay person who has been experiencing ever more powerful, regularly spaced contractions over many hours and whose waters are leaking, that is the definition of labour!  To be told repeatedly that you are not in labour when your experience is clearly telling you otherwise, especially when you are tired and in pain, begins to make you believe you may be losing your mind.

This midwife was anxious to be rid of us for several reasons.  First, she repeatedly offered us pethidine, which we repeatedly refused.  She never seemed to get her head around the fact that we did not want pain medication.  Second, I was too noisy and presumably disturbing the other women on the ward.  We were and are confused since women making noise must be commonplace in a maternity hospital.  I had read the famous books, “Ina May’s Guide to Childbirth” and “Birthing From Within,” and in these and other sources I had studied during my pregnancy, I learned that utilising vocalisation and chanting techniques with a wide-open jaw was one method of encouraging the cervix to open.  I was not screaming wildly in agony but deliberately applying an acknowledged technique of coping with labour pain and assisting the efforts of the uterus to contract and open the cervix efficiently.  I can see now that it was much too early in my labour to be attempting methods such as this, but again I was in a panic and trying to avoid surgery in whatever way I could.  I am truly very sorry that I made our midwife’s job so difficult that night and that I was disruptive to the other mothers on the ward, but I hope that readers can understand our perspective, too.  We were facing our first labour scared and alone.


The final straw for our midwife came in the middle of the night when my waters officially broke and spilled all over the floor of the room.  In response to this, she remarked in an exasperated tone, "A pair of panties and a pad wouldn't go astray, Kali.  You are not on the labour and delivery ward."  I can recall thinking, "A pad is not going to do a thing about the 12 litres of water that just poured out of me!"  I will never forget my poor husband taking towels out of our overnight bags and trying to mop up the floor, apologizing to her.  We felt like small children who had been scolded.

She insisted on performing another vaginal exam, despite the fact that I begged and pleaded with her not to because I could not handle any more bad news at that point.  Although I was only 2 cm dilated, we were banished to the labour and delivery ward.  She explained to us that we would have access to gas and air downstairs, and believe it or not some people can survive labour using only entonox.  She still could not understand what we were trying to accomplish or what we needed to be successful.  Even though we had spent good money as private patients to purchase a private room, it seems we were not permitted to labour on the ward unless I was highly medicated, quiet and docile in the bed paging through a glossy magazine.

My contractions were becoming more serious, and at the time I was glad to be leaving that midwife, who was clearly not on our wavelength.  However, if I had known better, I would have fought to stay on the ward.  At least there we had access to the shower and could labour in the dark room.  When we arrived in Suite 3, several midwives were there in a huddle, clearly perturbed and flustered.    They flicked through our birth plan and discussed it amongst themselves in hushed, angry tones.  We heard remarks such as, "This is ridiculous!"  One of the midwives asked my husband, "Didn't you discuss any of this with your obstetrician?" 

We had, of course, discussed the birth plan with Dr. Prince.  To be honest, I did include an item to which she had not agreed, namely that I did not want to be subjected to continuous electronic fetal monitoring and wanted the option to labour in water.  I was well aware of the limitations and risks of CTG and was keen to see, quite frankly, if I could get away with it.  Everything else in the birth plan, however, was truly almost commonsense.  We simply could not understand why everyone was so enraged.  They seemed to be offended by our very presence.  Was it because of our birth plan?  Was it because they did not want to attend a “high-risk” VBAC?  Was it because we should not have been sent downstairs at only 2 cm dilation?  For some reason, we seemed to have incited a rebellion.  At any rate, we were abruptly informed that our birth plan was out of line and that I had no choice but to be hooked up to the CTG.  Everyone left except for the one midwife to whom we had been assigned.

While in L and D, rather than being chastised, we were being ignored.  I had written in our birth plan that I preferred a quiet room with conversations, interruptions and questions kept to a minimum.  By this, I meant to say that I did not want people to and fro in and out of the room or to have to discuss the latest episode of some television programme with anyone.  I did not mean that encouragement and advice from our midwife was unwanted.  I assumed that this was a given.  Yet she seemed to follow this particular request to the letter and barely looked at or spoke to us throughout the many hours we were in her care.  Her eyes and focus remained fixed on the monitor.  It seemed to us as though she was on some sort of work-to-rule.  I cannot ever remember her looking me in the eye until the end of her shift when she wished me all the best and left.

Simultaneously, she disregarded my request for a quiet room by having Red FM blaring from a radio, and the place was lit up like the Fourth of July in spite of my request for dim lighting.  Every once in a while, she pleasantly and casually remarked, “You’re doing fine” while continuing to look at the monitor.  She also occasionally held out the mouthpiece when she noticed a contraction coming and reminded me, “Use your gas and air.”  Again, I was not allowed to make any sort of sound and had to put something into my mouth to stifle any labouring sounds.  She did not seem to understand that I was putting down the mouthpiece because I didn’t want to use it.  For one thing, it was making me feel a bit queasy and extremely thirsty.  In addition, it was preventing me from opening my jaw during contractions, which was necessary for me to employ the aforementioned vocalisation technique.  Time and again, we asked if the sound on the monitor could be turned down or if it could be positioned in such a way that we could not see it, as it had become a major source of distraction and worry, but she was unwilling to reach a compromise on this.  My husband and I were both so exhausted and tormented, feeling somehow shamed and rejected, that neither one of us even had the courage to move or speak to change the conditions in which we found ourselves. 

I did have moments of clarity during which I attempted to escape my plight.  On three separate occasions (once when our midwife was on a tea break and we had a replacement whom I hoped would be more understanding), I tried to use the toilet, sure that the cursed belts would be removed temporarily and I could get a brief respite.  I was hoping to try another technique about which I had read in Ina May's book, sitting on the toilet backwards in order to facilitate dilation.  No luck.  On each occasion, the midwife followed me into the toilet, pulling the monitor along with me as my husband helped me to walk amidst all the wires.  The result was that I did not successfully manage to use the toilet all night long.  When I was finally hooked up to the epidural, urine gushed into the catheter bag.  Such a full bladder surely would have impeded the baby’s descent.  I also begged repeatedly to be allowed a 5-minute shower or bath to help with the labour pain.  I was denied again and again, and in response to my final request our midwife impatiently demanded to my husband, "Put an end to this!"  I have spoken to other women who were permitted brief intervals without the CTG to use the toilet at the very same hospital, and I do not understand why I was not allowed this common courtesy.

At some point, I looked at the clock and realised with relief that morning, and a change of shift, was coming.  I asked at what time did Dr. Prince normally arrive at the hospital.  I was desperate to see her, sure that a familiar face and her reassuring demeanor would turn things around for us.  I knew she would tell me that what I was experiencing was all completely normal and that I was doing a great job.  However, by the time Dr. Prince arrived, the damage had already been done.  I was still at 4 cm, and my cervix had begun to swell.  In addition, the baby had developed a caput, and the CTG had picked up early decelerations in our baby’s heartbeat.  I was put on an epidural for two hours in an attempt to reduce the swelling and get things back on track, but to no avail.  It was not going to happen.  Our VBAC attempt was over, and we were taken to theater. 

To be fair, our second caesarean birth was a much more positive, family-centered experience than we had had during the birth of our first child, and fortunately neither my son nor I suffered any serious physical side-effects.  Dr. Prince allowed me to have immediate skin-to-skin contact, and I wept with joy as I felt my gooey, slimy baby all over my naked chest.  She also never revealed our baby's gender to us.  They lowered the screen just in time for me to see a baby being lifted up out of me.  His back was to me, but I saw something dangling between his legs!  What a thrill to see for myself that our precious little Spud was a boy. Then, she turned him around towards me, and I could see two huge blue eyes gazing around the room, awake and alert and raring to go.  The anaesthesiologist was also nothing less than brilliant.  She absolutely mothered me, helped me to sip water from a straw, informed me of everything that was happening and put me at ease every step of the way.  She even checked in with us later on when we were in the recovery room to congratulate us. 

Similarly, the second midwife who attended us after the change of shift was equally amazing.  By this time, I had been given an epidural in a last-ditch effort to reduce the swelling in my cervix, so “labour” as such was no longer in progress. She talked to me gently about my disappointment over not having a vaginal birth, and she reminded the surgical team about my wishes for skin-to-skin.  She was chatty and encouraging, relating her own experiences as a mother of four to my own journey of growing into motherhood.  Having a midwife present with me during the caesarean made a huge difference in terms of my ability to handle a challenging situation, and in a way I enjoyed the birth.  Although I had desired a vaginal birth with all my heart and soul, ironically it was the surgical team that made me feel pampered, relaxed and focused on the arrival of our brand new baby.  They treated me with dignity and respect and made me feel like a queen before, during and after the surgery.  I felt as though I’d been lifted up onto a pedestal after all the negativity we had endured during the labour.  Perhaps I was simply relieved that my ordeal with the midwives was over.




(end of birth story)






Our Baby Boy Bamm-Bamm was born on Friday afternoon at 1:35 p.m., and later that evening I was alone with him for the first time when my husband went home to be with Pebbles and relieve Nana and Pop of their child minding duties.  For as long as I live, I will never forget sitting on the hospital bed staring at the blank white wall in front of me holding an 8 lb. 6 oz., healthy, strong, eagerly nursing newborn in my arms and feeling absolutely certain that I was going to die.  I had no idea how anyone could ever possibly right this wrong.  How could I have allowed this to happen again?  I felt so deeply ashamed of myself and humiliated, I was sure I could never look at myself in the mirror again, let alone look my son in the eye and explain this.  I couldn't even stand to be in the same room with myself.  I was draped in self-loathing, having let down myself and this precious child so.  I couldn't even face him.  He deserved a better mother than me.  To add insult to injury, Dr. Prince came to see me on Monday morning and told me that if we were to have any more children they would have to be delivered by elective c-section.  I would now never birth my own child.  I was completely and utterly devastated.

These dark emotions haunted me for many months.  It goes without saying that I am eternally grateful to have a healthy, happy son and a longed for younger sibling for our daughter.  Yet I suffered from post-natal depression, devastated that I had been unable to give my son the normal birth every baby deserves, and this had a major impact on our family and on the earliest days of my son’s life.  There was no medicine I could take to keep me going and to sustain me except to gaze at him and Pebbles lovingly and endlessly and try to summon up the strength to go on.  I knew I could not simply dissolve and leave two motherless babies behind.  Even if I was a failure and a good-for-nothing, I was still their mother, and every baby needs a mother.  Although we had always planned to have three children, I was sure I would have to give up that dream.  I couldn’t go through another surgery.  


I did not die in hospital, but the woman I was, in no uncertain terms, was annihilated that day.  My day of reckoning had come.  I could almost physically see all of my beliefs, assumptions, desires and values falling to pieces like broken glass raining down on me, cutting and scarring me as the caesarean knife had done.  I had been hollowed out, traumatised, empty of my baby, empty of myself.  Again, I lay weary and broken in a hospital bed, the sheets crisp and crimson with dried blood.  Again, I was maimed and branded a failure.  Yet this time, I had a secret weapon.  I had actually laboured.  Although I had not enjoyed the enthusiastic support, companionship and calm presence of a skilled, experienced midwife, my husband had been wonderfully encouraging and tirelessly supportive throughout, even though he was just as scared and confused as I was.  Somehow, in spite of a disastrous cascade of events, working with him had enabled me to access some other plane of existence beyond my everyday world.  I was not permitted to enter, but beneath the groggy veil of birthing hormones it was within arm's reach, a promised land where a different life path and a better world in which to raise our family lie.  The altered state of consciousness I had entered during labour had provided me with an escape hatch into another realm outside the boundaries of my subconscious inner fearscape.  In those early days, I had yet to find it, but I knew that it was there.  As a result, something in me rebelled when I heard my doctor pronounce my lifelong sentence of prohibition against vaginal birth.  My intuition told me that this could not possibly be right, that more surgery could not be the answer and could never fix what ailed me inside or out.  I had to find the answer.  I held tight to my baby through my tears and anguish, groping in the darkness of my despair and inner turmoil, until at last I found it and won my freedom.


My quest has led me to spend the past 16 months reading and studying various sources and doing some serious soul searching in an attempt to understand how I failed so spectacularly in my VBAC attempt.  One of my great discoveries has been the philosophies of the functioning and faculties of the mind, and the power each of us has to control and direct the mind, to which I have alluded in previous posts.  My acceptance and understanding of these ideas may never have been possible but for the caesarean births, which primed my mind to receive the information.  I will dedicate my next post to describing these in detail.  However, of equal importance was the self-examination which I undertook, endeavouring to discern the role I played in all this and, without an attitude of judgement or accusation, to seize this opportunity and to use this tragedy to create positive change in my life and the lives of my family.  Michael Beckwith has said that in any situation, no matter how challenging, we must accept it, harvest the good and forgive all the rest.  Similarly, Napoleon Hill asserted that within every failure or difficulty there is always a seed of an equivalent benefit if one is open to receiving it.  This is wise advice which I have dedicated myself to following.  I have been challenged to face up to some very hard realities and questions, but through this I have begun to realise the true gifts of my caesareans (apart from my radiant, healthy, gorgeous children, but of course that goes without saying!!!), which have actually revolutionised my life and my thinking.  I can see clearly that the way I was living and choices I made before and during the pregnancy, not just once I went into labour, led to the second c-birth.  

I realise now how incredibly stressed I was leading up to and throughout the pregnancy and how those feelings probably contributed to my being unable to dilate efficiently.  Before I became pregnant, I wanted so desperately to conceive again.  Even as I was walking out of the hospital after Pebbles' birth with a precious newborn in arms who required my full attention, I was anticipating another pregnancy, another baby and a chance to do it right next time.  I was grieving the loss of my natural childbirth dream, but rather than approaching my feelings constructively, I hardened myself.  I was not going to let anyone ever hurt me so deeply again.  It is so obvious now that I did suffer from post-natal depression, although I had never acknowledged it, and it prevented me from fully becoming the mother I'd hoped to be.  I never had confidence in my ability to mother my child, to keep her safe, to make sound decisions and to love and be loved by her freely without inhibitions.  I became full of temper, quick to anger and slow (if ever) to forget.  Admittedly, I was also red-hot jealous that my husband was staying home minding our daughter while I had to go out to work.  This was a sound financial decision which we had made jointly and which has benefitted our family to no end, but I missed Pebbles so much during the long days away from her.  This was unexpected for me.  Before Pebbles was born, I thought that six months of maternity leave seemed like an eternity, and I wondered what I would do with myself during all that time.  I never anticipated that my desire, or perhaps my need, to be with my child would be so all-consuming.  I am sorry to say that my husband bore the brunt of all my unresolved feelings of inadequacy and frustration, and my relationship with my daughter is still often characterised by impulses which are reminiscent of the caesarean:  her asserting herself, testing my patience by doing her own thing, and me reacting by feeling angry and sorry for myself rather than responding in a thoughtful manner.  Fortunately, Bamm-Bamm's birth gave me time away from work to focus exclusively on my family.  Taking the time to reflect upon all of this and make conscious efforts to do things differently has given us all an opportunity to heal, but I still have fences to mend with them both.

My desire to provide Pebbles with a sibling was also a source of stress for me.  I was very concerned at the time that I did not want Pebbles to be an only child.  The miscarriages I had made me question whether or not her very existence may have been a fluke and wonder if another baby might not be on the cards for us at all.  As the months went by, I allowed myself to fly into a panic that I might be getting too old for more children or that my body simply was not equipped to carry them.  After all, subsequent to Pebbles' birth I was informed that she had suffered with IUGR, and I had had 3 miscarriages.  My subconscious mind was prepared to accept more bad news about the inadequacy of my reproductive system.  In fact, the memory of those miscarriages and the pain of losing a baby shadowed me and my pregnancy day and night until around late January or early February when I finally began to believe that this pregnancy would, in fact, end with a baby in my arms.  This fear became yet another huge impetus for me to want to manage and control a new pregnancy and birth.


There were so many other reasons why I was looking forward to another pregnancy.  I wanted to experience all the incredible happiness and specialness I had when expecting my daughter and which I felt had been cut short by her early arrival.   I longed to have and hold a newborn again and enjoy that adventurous first year together, milestone after milestone.  I wanted to have another chance at motherhood because I really felt that, if given a second chance, I could make up for the mistakes I'd made with my daughter, including a less than ideal birth and the aftermath of PND.  And I was sure that having a vaginal birth would help me heal some of the deep emotional wounds I still carried as a result of my daughter's caesarean birth.


Clearly, I had put myself under a lot of pressure to get pregnant again, but I was not prepared for exactly how demanding it would be physically to make a baby and mother a spirited, nursing little girl, all while simultaneously working full-time.  I felt I was spread very thin throughout the pregnancy, and this caused me to feel guilty because I had so little time and energy to devote to Pebbles.  I never knew how much my ability to mother my daughter would be affected while I was trying to make that little brother or sister for her.


Under these many layers of emotion, I was as tight as a clam throughout my pregnancy with Bamm-Bamm.  It was like I literally clenched and squeezed my body shut so tightly that it couldn't release that baby.  No way was I going to let him go.  I would not miscarry this time.  And no one, not even my husband or my daughter, could touch me.  I was a private patient with Dr. Prince as I had been during my pregnancy with Pebbles, and although I believe she is an exceptional obstetrician, going privately was a mistake.  At the time, I thought (or wished) that so many visits to the OB would keep my baby safe somehow, but really all it did was reinforce over and over again in my mind that something was wrong with me and that this pregnancy, because of my previous caesarean and my miscarriages, was somehow "high-risk."  Anyway, why was I hiring a surgeon if I wanted a vaginal birth?


There were warning signs during the pregnancy that I needed to relax and get more in touch with my feelings and my softer side, but I did not respond positively.  It's no wonder I found myself unable to physically open up on the day of Bamm-Bamm's birth.  I actually developed a cyst behind my right eye during the second trimester which blurred my vision throughout the remainder of the pregnancy and up until Bamm-Bamm was three or four months old.  The specialist told me that this usually occurs due to raised levels of cortisol, which is a stress hormone.  He said that levels of this hormone are normally raised a little bit during pregnancy, and this could have been the cause of the cyst, but I think that to say my stress levels had nothing to do with it would be sheer denial.  I read all the right books like Ina May's Guide to Childbirth and Birthing from Within.  I listened to the GentleBirth CD's every night.  But I was living from the neck up.  I thought I could make pregnancy and birthing into an intellectual endeavour.  Like passing an exam, all I had to do was study hard.  However, because I was so emotionally and spiritually cut off, I couldn't integrate any of the important skills and information I was trying to acquire.  All my thoughts and actions came from a place of fear, not love, which is the antithesis of the attitude one requires during pregnancy and childbirth.  You can't take a command and control approach to a visceral/emotional/spiritual experience like birth and mothering and expect it to work well.  


As I worked to turn this story into one of hope and learning, I realised that I had to forgive myself and abandon this grudge forever if I was going to be able to move on. For a long time, my husband and I blamed ourselves and our naiveté for the debacle.  I know that we made numerous mistakes in how we handled the labour.  We certainly could have been more assertive about our wishes, and perhaps I was not as mentally and emotionally prepared for the demands of labour as I could have been.  Yet we trusted the birth professionals to understand our objectives and to make every effort to help us achieve them, and we felt badly let down.  It is impossible to know definitively the extent to which the stressful hospital atmosphere contributed to the need for another surgical birth, and correlation does not indicate causation.  However, I am certain that our birth experience could have been happier, safer and more personally fulfilling if the environment had been more attuned to our desires and needs.  In fact, we believe that it was the hospital system itself, rather than any individuals involved, that was not equipped with the facilities or the policies that would have helped us to make our dream come true.  Now that we know better, we intend to do better.  You can read an eloquent and powerful message which takes a compassionate view of the birthing couple here:  http://www.whole-woman.com/index.php/a-birth/114-never-your-fault

Through my reading and research, I also came across information about VBA2C which, to my surprise, indicated that the risks of uterine rupture are comparable to those associated with VBA1C.  Far from the horror stories one hears or at least imagines about exploding uteri and dead babies, the overall risk of UR during a non-induced, non-augmented VBA2C is likely in the vicinity of 1%.  This means that a VBAC is still very much within our reach and highly preferable to another surgical birth, as it is a well-known and established fact that the complications resulting from caesareans increase with each surgical birth.  After much discussion and weighing up of risks and benefits, we are satisfied that having another child and pursuing a VBA2C is the best course of action for us and our family, and we can’t wait to welcome another child into our lives to love and cherish forever.  At first, I was extremely reluctant to see Dr. Prince again even though she was our obstetrician for both of our children’s births and we always enjoyed a wonderful working relationship with her.  After the fiasco that had occurred during the birth of our son, I felt so humiliated that I wasn’t sure I could return to the same hospital and face the same doctor again. I did some investigating and talked to several medical professionals, however, and it seems that all avenues lead back to Dr. Prince when it comes to evidence-based care and facilitating a couple’s right to a VBAC whenever it is safe and reasonable to do so.  I mustered up the courage to return to "Caesarean Central," as we jokingly refer to it, and ask for support, and both my husband and I were thrilled to receive her wholehearted encouragement.

Our journey continues. . .


I will close this post with a song.  I know it's really a break-up song, but it describes so well how I felt during all those months when I was looking for answers.  Long after I accepted that I was the only one who could heal the wounds within, I desperately wished that someone could make it all go away with a wave of a magic wand, a potion or a spell, a gaze into a crystal ball.  It's cheesy, I know, but this song always made me feel that I was understood.











Saturday 2 November 2013

... And Breech Baby Makes 3: Our First Caesarean Birth

So how did I find myself in this position?  How is it that an otherwise normal, healthy woman ends up having two surgical births in spite of all her best intentions and wishes to the contrary?  When you are headed for a caesarean, it often begins with inadequate knowledge, lack of appropriate support for normal birth (by health care providers, family or whomever) and fear.

Prior to becoming pregnant with my first child, I had a rigid and fixed idea about the importance of having a natural, unmedicated childbirth.  Years ago, when I was just out of college, I was working for a small company and had an absolutely wonderful boss whom I admired quite a lot.  She was roughly ten years older than I was, successful, funny, intelligent, confident and hard-working; so many things I hoped to be when I was finally ready to become an "adult."  She had one child, a daughter, and had told me once or twice about her birth.  She had made a choice not to use epidural or other pharmaceutical pain-relief during her labour, and this was a completely radical idea to me.  At that point, I knew absolutely nothing about babies or having them, but I definitely believed that all women were medicated during childbirth.  I don't think it ever even occurred to me that a woman could do such a thing without drugs, and why would she want to, anyway?  My boss really made an impression on me when she raved about what an amazing experience it had been, how the rush of endorphins was such an overwhelming pleasure and how she was awed by her strength and felt she could accomplish anything.  There she was, just 20 minutes after the birth, high on natural birthing hormones and full of energy, asking others around her if she could make them a cup of tea.  This was the antithesis of everything I had ever seen or heard about birth.  It certainly doesn't look that way on tv or in Hollywood movies!  Birth is something to be feared, a life-threatening emergency.  After hearing her story, my outlook about what birth could be was forever changed.  I was worlds away from wanting to have children of my own at the time, but I determined that if I was ever going to have any, surely that was the way to do it.

Flash forward many years.  A different country, a different job and a different life as a newlywed, but I still had the same idea about the kind of childbirth I wanted for me and my baby.  However, two things happened after our wedding day that impacted on my ability to prepare myself appropriately for it, yet I wasn't even aware of the psychological effect these events had had on me. The first of these occurred just 5 months after we'd been married.  We were spending the Christmas holidays with my family in the USA, and I had just stopped taking the pill.  We were on top of the world.  Everything in our lives seemed to be going perfectly, and we were ready finally to start a family of our own after 7 1/2 years as a couple.  During the trip, however, my husband very suddenly developed a large lump just above his left collar bone.  We had both recently had a chest infection and a heavy cough, so we thought at first that it might be somehow related to that.  Yet I was feeling fine again, and he was still coughing, the painless lump slightly changing size and position day by day.  By the time we returned to Ireland, we were very concerned.  Our GP knew right away that it was some form of lymphoma.  He got us a hospital appointment for the very next day, and what was meant to be just a CAT scan ended up being a week-long hospital stay, full of invasive and painful tests and unbearable stress.

This was certainly not the way we had imagined spending our honeymoon period.  We were shocked, devastated, frightened of an uncertain future.  We were so young, and neither one of us really had any experience of hospitals and doctors.  To us, the uninitiated, the hospital seemed like a bizarre and backward world, almost Dickensian.  Some of the men on the ward were seniors and were clearly heading for their final days.  Others, though, came and went with various medical issues such as asthma and heart trouble.  We were struck by the way in which the new guys, whenever they arrived, waltzed in, and it wasn't immediately obvious that they were sick.  They seemed essentially bored during the early part of their stay.  They would pace the floors, try reading, anything to pass the time in this busy factory-like environment.  But eventually they would get sick, either because of the illness they had in the first place or because of the drugs, tests and treatments to which they had been exposed. Nothing about this place made it conducive to healing of any kind.  It was noisy.  Strict timetables were observed.  The food was appalling and clearly devoid of any nutritional value.  All of the "sick" people were crammed together in a holding pen, sharing dis-ease and getting sicker.  Possibly the most uncomfortable and scary thing of all was the withholding of information.  We knew that the doctors knew exactly what was wrong with my husband.  We could see it in their faces when they spoke to us and detect it in the way they avoided answering our questions directly.  They knew, but they couldn't tell us anything until they had satisfied themselves that they'd conducted an exhaustive battery of tests and had determined the appropriate course of treatment.  The hospital, it seemed, was not a place one should go to get well, but to get sick or sicker.

When they finally decided to pronounce a diagnosis, a team of doctors, nurses and students took me, alone, into what seemed to be a large closet full of medical research journals and files.  My husband was undergoing a biopsy at the time.  They told me that he had Hodgkin's Disease, that the prognosis was excellent, but he would have to have several months of chemotherapy and possibly radiotherapy following that.  He would lose his hair and be quite ill.  As a result of the treatment, they informed me, there was a chance that he would be infertile.  They asked me if we had any children, and I said no, we had only been married five months.  They asked me if I had any family nearby, and I said no, all of my own family were in the States.  That was when I lost it.  Right there in a closet full of medical professionals, with my husband elsewhere lying on an operating table, I broke down in tears in front of them all.

My husband endured 6 months of chemotherapy.  Thankfully, he did not require follow-on radiotherapy, and we are eternally grateful that he has been "all-clear" ever since.  The care he received from the hospital staff was excellent, swift, confident and comprehensive.  Any reasonable person in similar circumstances would have to agree that his treatment was second to none.  However, taking the individual brilliant doctors and other medical staff out of the equation, the hospital as an institution left its mark on us as a world unto itself.  A frightening place where painful things are done to you for your own good, and where the very same people who hurt you re-emerge later as your heroes to cure you and make it all better.  A place where the sick go to get sicker.  A place in which vital information relevant to decision-making is withheld, where doctors have the knowledge and the facts and you as a patient do not.  A place similar to a prison.  We were told my husband couldn't leave, that it would be too dangerous, while he was being assessed during that week.  We had to beg to be "released" for a few hours to go out and have a relaxing dinner.  All of these paradigms would be reinforced time and again throughout our journey into parenthood through our interactions with the maternity hospital.

We decided to wait for 6 months after the end of the chemo before we would try for a baby for the first time, and we were unimaginably lucky when we conceived the very first month we tried. We were ecstatic.  We didn't tell anyone right away except for my parents.  I had heard that it was not a good idea to spread the word too quickly because alot of first-time pregnancies end in miscarriage.  (So from the outset, fear was a presence in my thoughts and feelings.)  We privately relished our news and busied ourselves with making plans for our baby, considering everything from baby names to which college s/he would attend.  Several weeks of sheer joy went by, and quietly, gradually my tummy didn't seem to be quite as swollen as before.  My breasts weren't sore as they had been.  Things seemed different, and I felt more like my normal self.  Although worry about a miscarriage was at the back of my mind, I wasn't consciously aware that something had gone wrong.  Maybe I just didn't want to be.  I reasoned that if I had a miscarriage, surely there would be bleeding and cramps and all sorts of drama.  It was my first pregnancy, so I had no way of knowing what to expect anyway.  We continued merrily along our way until one afternoon when I returned home from work.  I was exercising with a pre-natal yoga DVD, peacefully connecting with my unborn child and gently strengthening and stretching my pregnant body, filling both of us up with energy and vitality.  When I had finished, I went into the bathroom to shower.  There was a little bit of pink blood.  A few hours later, I met my husband at the door as he arrived home from work.  I simply said, "I'm bleeding."  His face fell.  Just like that, it was all over.

I am not going to talk too much about the miscarriage here, as I will devote a future post to my experiences with miscarriage.  It is such an important topic to address for me because I believe that our culture attaches stigma, shame and secrecy to a heartbreaking personal trauma that so many couples suffer.  For now, suffice it to say that the midwife we met during this, the first occasion when we visited the maternity hospital, was less than gently sympathetic, which clearly exacerbated the generally suspicious and negative feeling I had subconsciously developed towards hospitals in general during my husband's illness.  It also had the effect of calling my body's ability to create, carry and birth a healthy baby into serious question.  It didn't matter what I read or how many people told me that it wasn't my fault, there was nothing I could have done differently.  I was horrified with myself.  I hated my womb.  I was a failure.  I had never failed at anything in my life, but when it was something really important, something that really mattered, I was a failure.  Maybe I'd left it too late.  Maybe I was just too old to have children.  Whatever the problem was, it was my fault.  I never took the time to drill down into those feelings and heal myself, and again, although I wasn't consciously aware of them, they remained, and they were controlling my behaviour and my perspective unbeknownst to me.

All I wanted was to get pregnant again.  I can remember tearfully telling my husband, "I can't make this pain go away until I get pregnant again.  That's the only thing that will make this better."  I wanted to will it away and almost pretend it had never happened.  So we didn't wait for long.  We did get pregnant again during the very first month we tried.  (So much to be positive about!  But only the negatives were registering with my subconscious mind.)  At first, I was cautious about getting "too emotionally involved" with a baby who might not stick around, but it didn't take long before I was head over heels in love with a baby again.

My pregnancy with my daughter can be summed up in one word:  blissful.  I felt I was queen of the world.  I indulged myself in rest and relaxation, believing in the old maxim, "Happy mom, happy baby."  Everything was about this baby.  I would come home from work and promptly do whatever I liked to relish and enjoy the special time I alone could share with this new and wondrous life force growing within me.  I attended pre-natal yoga classes regularly and read the books, magazines and websites, eager to learn as much as I could about everything that was happening in this secret garden in my womb.  However, I managed to skip over all of the chapters and articles about caesarean section, in an admittedly somewhat haughty fashion.  I wasn't going to need to know about that sort of thing.  I had seen the headlines before about women being "too posh to push."  Caesareans were perhaps for other women but clearly not for me.  I was bringing forth life.  I was going to be the incarnation of the goddess herself. 

My plans and desires were sincere, but the last six weeks or so leading up to the birth were quite stressful and worrisome as the pregnancy seemed to take a sudden turn for the worse.  First of all, my daughter had been in a breech position for a long time, and it did not seem likely that she was going to turn.  I tried everything from reflexology to acupuncture and moxibustion to practicing strange hips-up positions on the floor, all to no avail.  She simply was not budging.  We had an appointment on a Wednesday at the Fetal Assessment Unit.  Our consultant was going to attempt an External Cephalic Version, but after doing a scan she determined that there was not enough fluid around the baby and that the risks of the procedure probably outweighed the benefits in that it was unlikely to be successful.   She advised us that breech babies were normally delivered by caesarean, although she pointed out that this was based on what many critics say is a deeply flawed study and suggested that we could Google it to examine the evidence ourselves.  She told us that we could attempt a vaginal birth, but so many stipulations were attached to this option (induction at 39 weeks, epidural, and forceps to name a few) we felt that the benefits of a vaginal birth would be all but lost, and there was a good chance that we would end up with an emergency caesarean anyway when all was said and done.

I was distraught.  My daughter would not have the benefit of being born in her own time on the day she selected.  She would not have labour and the hormones of birth to prepare her for life outside the womb, and I would birth on my back, numb, rather than feeling my baby make her way down, through and out of my body with the tremendous surges of energy that herald the arrival of a strong, pulsating, new life force.  I was in a sheer panic thinking that my baby would be born premature, that her lungs would be too immature for her to breathe on her own and that the operation would damage her irreparably in some way.  There would be no labour pains in the middle of the night, no rushing to the hospital, no false alarms - none of the things that often make a birth story so singular.  It would be a very sterile, assembly line-style affair, exactly like every other major abdominal birth that ever has been and ever will be.  I was also quite simply terrified of having to undergo major surgery, and all of my fear and loathing of the hospital bubbled back up to the surface.

There was definitely also grief involved in coming to the end of the pregnancy, and this is a feeling that is not acknowledged in our culture.  Society focuses on how horrible the pregnancy is, how heavy and awkward a woman becomes and how she is so glad finally to have it over with.  That may be one aspect of pregnancy, but it certainly is not the only one and was never my experience.  As much as I longed to see, hold and cuddle my new baby in my arms, I knew I was going to miss my bump and all the unique sensations of sharing my body with another tiny soul.  From the barest flutters to the biggest kicks and wriggles, it had all been so strange and indescribably lovely.  I had had her all to myself for so long, and from now on I'd have to share my secret treasure with the rest of the world.

The caesarean was scheduled for a Monday morning.  In just a week and a half, our pregnancy would meet an abrupt end under the blade of a knife.  In the meantime, however, I had to return the Fetal Assessment Unit the following Wednesday for a check-up.  My consultant would be on holidays that week, but she wanted us to be monitored to make sure that all was still well.  A certain degree of doubt about the baby's health and well-being seemed to have crept into the picture of late, but there was a disturbing vagueness about it all.  The consultant had not been particularly happy with the fluid levels and with the baby's lack of continued growth on the last visit.  The day before had been my last day at work before taking maternity leave.  I was weary.  My husband was working, and I went up to the hospital alone.  We had no idea that things were going to happen so quickly.

In spite of my best efforts, I was never able to ascertain from any of the doctors or midwives involved exactly what was wrong.  Suffice it to say that a lot of very alarming language was being used.  I heard things like, "The environment in the womb is poor" and "Your baby is no longer growing" and "The levels of amniotic fluid are dropping, which indicates that the placenta may not be functioning optimally anymore."  They told me that the fluid levels had been 8 cm the week before, whereas now they were down to 4 cm. (I learned much later that the baby's bladder was full.)  From what I had read in my pregnancy books, I understood dropping fluid levels to be an indicator that the pregnancy was coming to a natural end and that labour might commence soon.  I asked if they were afraid that I might go into labour, which of course they wanted to avoid at all costs since the baby was breech.  The response was, "That's one of the things that could happen," but they were very cagey and would not elaborate.  Every time I asked a question they would give me some kind of evasive answer like that.  Without the calm and reassuring presence of our usual consultant who always communicated so well with us, I felt vulnerable and frightened.

Up to that point, the pregnancy had been completely normal, and I couldn't understand what had suddenly gone wrong.  How could this be?  How could my own baby be struggling and suffering inside my body when I was feeling well and healthy?  How could I, her mother, possibly be the last to know?  I perceived this as another deep betrayal.  Just as my body had lost my first baby, it was now turning on this one.  My womb was a poor home for my baby.  Enough said, really.

They hooked me up to an electronic fetal monitor for a while because they were not sure if they wanted me to spend the night in hospital.  The beeping monitor kept track of my baby's heartbeat, and I had to press a button every time I felt her move.  I was texting and talking to my husband frequently, but I was incredibly nervous not really knowing what all the fuss was about, and I definitely did not want to stay in the hospital at that point.  I was not a big fan of the environment there as I always associated it with my miscarriage and the less-than-gentle treatment I felt I received at that time.

In the end, they took me off the monitor and reported everything to another OB, who was taking care of all of my consultant's patients for the week.  While they deliberated over the phone, another one of the doctors said to me happily, "I think you might be meeting your baby tomorrow!"  I felt a surge of terror.  I was still only 38 weeks pregnant and was so afraid that my baby was not ready.  Moreover, I suddenly felt so unprepared for parenthood.  Throughout the pregnancy, I had assumed that I was likely to go over my EDD by at least a week, and now I was going to be almost 2 weeks early.  The baby's room wasn't ready yet, the house was a mess and I had still been at work just the day before.  It was a big mistake not to have taken time off before the birth because I was mentally and physically exhausted before they ever wheeled me into theater.  Not the healthiest way to start off life with a newborn!

The medical staff decided they would *let me* go home for the night, but I had to be back at the hospital at 7:30 a.m. the following morning for the surgery.  I had to take a couple of tablets, one late that night and one at 6 a.m., which were meant to prevent me getting sick from the spinal block.  So I drove the hour's journey back home a nervous wreck and then promptly told all my family and friends via Facebook that Spud was coming a little early.  I spoke to my parents and a friend who had recently had a c-section with her first baby, also for frank breech presentation.  Talking to her and hearing her baby girl gurgling in the background got me super excited about meeting my brand new baby!  There was no way I could sleep knowing what was about to happen, so I spent most of the night trying to organise and tidy up the nursery.  I tried to rest as much as I could, but I think I only slept for about 4 hours.

In the morning, I was so tired and so filled with mixed emotions:  excited, anxious, scared, thrilled.  I was full of adrenaline.  We had had an unusually cold winter, and the roads that morning were treacherously frosty.  We practically had to crawl up to the hospital.  (If I can just digress with one thought for a moment, just in case others are dealing with a similar situation right now ... If I had known then what I know now... They wanted to section me because the baby was breech, pure and simple.  I will, in a later post, describe why I am certain that their other purported causes of concern were bogus.  I probably still would have chosen to have the caesarean because I wouldn't trust them to know how to attend a breech birth.  However, I would have demanded that they keep me in hospital for however long it took until I went into labour spontaneously.  Then, and only then, would I have given consent for the caesarean.)  We were a little late arriving at the hospital as a result of the frost, but it didn't seem to matter too much.  They took us up to a ward where we had to sign a bunch of consent forms.  A student midwife asked if I had shaved, and I was like, "Nobody told me to shave!"  I felt like a total idiot.  She shaved me with a little electric razor like the one I had when I was about 12 years old.  I had to put on my gown and get ready to go down to theater.  We met the substitute doctor, who had a completely different demeanor than the consultant with whom we were acquainted.  She was much more abrupt, cold and emotionless, and made it clear that she was calling the shots.  I made one final effort to find out what exactly was going on with my baby inside my womb.  I said that we were going to have an elective caesarean no matter what because the baby was breech, but I was wondering why we couldn't just wait until our originally scheduled Monday date and give the baby a little extra time.  She shook her head in a kind of half-exasperated way, her fringe wagging back and forth rapidly in front of her eyelashes, and replied, "Well, that would just be stupid.  There's no point in doing the scan if you're not going to do what the scan says."  That shut us up.  We laughed about it afterwards.  We still laugh about it because if we didn't laugh about it, we would cry.  There we were, trying to do our best by our baby, and with just a few barking, condescending insults we were taken down to the operating room without so much as a proper explanation.

Before we knew it, I was headed down to theater on a bed with my husband following along.  We had to wait in some kind of acute care ward for a while until they were ready for us, as they were squeezing us in among all the other scheduled caesareans.  We were alone for most of that time just chatting quietly.  When our number was finally up, my husband had to put on his scrubs, and they made him wait outside the operating room while I was having the spinal block inserted.  This was a disaster for me at the time.  I was really petrified of having a needle put into my spine, and before I realised I was going to have a section, I had been much more afraid of the prospect of having an epidural than I had been of labour pain.  I couldn't believe it when they said I had to do it alone.  When the anesthesiologist came in and started trying to insert the needle, there were so many instructions to follow.  Round your back, lean this way or that.  She was asking me if I could feel the needle in the middle of my spine, but I was shaking with fear and had no idea what I was feeling except that it was an incredibly odd, tickly sensation.  Then, my right leg started hopping up and down involuntarily, and I thought, "Oh God, I am going to be paralyzed if she keeps on playing with my spinal cord!"  At that point, I broke down in tears.  A really nice woman was beside me, holding me and wiping my nose and cheeks as I wept.  There were so many people in the room, and I felt like a small child.  The substitute OB was pacing around in her white clogs, phone in hand, checking in on the progress of her other patients I presume.  It was all business, very cold and with very bright lights.  I was so sad that my baby was going to be born in an operating room.

When the ordeal with the needle was finally over, the anesthesiologist was none too pleased with herself.  "I made her cry," she announced to someone or everyone.  Of course, it probably couldn't have been helped.  I was so nervous about the operation I probably would have cried no matter what, but I wanted to choke her and punch her in the face.  This is not about you, you awful bitch! I thought.  It's about my baby.  My heart was racing as I lay down on the table.  Another drug guy took over from the anesthesiologist, and he and another nurse started to paint my belly with brown disinfectant.  The man told me that the spinal block would soon take effect and I wouldn't be able to feel anything.  After a few minutes, I could hear clinking and clanking of metal instruments somewhere down towards my feet, but I couldn't see what was going on.  "You know I can still feel that, right?" I asked.  I was afraid they were going to start cutting me before I was fully numb.  I needn't have worried.  I got numb all right.  Even my arms and hands were all trembly and weak.  Everything from the neck down was pretty much dead weight.  Finally, they got the screen up, and my husband was *allowed* to join me.  I was trying to breathe deeply and slowly to calm my soaring pulse, but I don't think I was very successful.

Everything was happening so fast.  It's all a bit of a blur, but the operation felt like it was taking forever.  At long last, they told me that my baby was coming.  Earlier, I had requested that we get to see you all wet and sticky just after the birth, so I was anxiously anticipating the moment of holding her in my arms and cuddling her while she was still all gooey with vernix and amniotic fluid.  I couldn't wait to see her.  Then suddenly, the substitute OB lifted her over the screen for an instant, during which all I could see was a wet, bluish-red ball which disappeared again almost immediately.  For a few seconds, I felt relieved thinking that the operation was finally over and our baby had been born, but then I realised that she still wasn't making any noise.  I couldn't see what was going on, and my husband couldn't see, either, because our baby was surrounded by medical staff.  We were looking at each other, scared and helpless.  Finally, we started to hear some little cries.  Then, the OB said something I can't actually recall about the baby, but then she said, "...and we'll bring her over to you."  I kind of laughed and shouted out, "Her?!" because I had convinced myself that we were having a boy.  We were so relieved and thrilled.  One of the crowd brought our daughter over to us.  They had already dressed her and wrapped her up in blankets.  I couldn't hold her because my arms were too weak, but my husband held her and I started talking to her and touching her hand.  I was saying hello, and telling her that she had such a beautiful voice, and that she and the whole world was hearing her lovely voice for the first time.  As soon as she heard my voice, she stopped crying.  Her eyes were open, and she seemed alert, albeit shell-shocked perhaps.  Her tiny lips were rounded as if she were singing, "Ooooohh."  Her hands immediately drew my attention.  She was clasping her hands together and gracefully flexing her fingers.  They were such dainty, girly, expressive hands.  I was stroking her fingers and hands while Daddy cuddled her.  I wanted to hold her so badly, but my husband kept her right beside my head.  Her skin and hair were so dark, I could hardly believe she was ours!  She was the tiniest baby I have ever seen, our teeny, tiny Thumbelina.  My husband and I kissed and cried a little.  I couldn't wait to get out of there and have some privacy.  It felt like they were stitching me up for ages, but they finally took us to the recovery room.  My darling baby love had arrived . . .