Tuesday, May 29, 2007

Birth story

Quite a few people have mentioned that they’d like me to post Thomas’ birth story. I haven’t until now for a few reasons. One is that initially, it was too hard to even write. The second is that it was so horrible that I haven’t been sure I wanted it posted for all to read.

Thomas is three months and two weeks old. He is a beautiful baby, and I can honestly say that I wouldn’t go back. If I could somehow choose to go back and not go through the experience and not have him, I don’t think I would. I have a lovely child and on top of that, I think I learned quite a bit from his birth.

I also think that I’m well on my way to becoming a childbirth activist. ;)

So here is the story. I hope that it makes you think. I hope that someone who reads it will ask more questions of her doctor. I hope that someone who reads it will understand her rights, and her responsibility to educate herself. I hope that someone who reads it will realize that she is stronger than she thinks she is.

My labor with Thomas did not start with a bang. It started on Thursday, February 8th, with something called “prodromal labor”. Basically that means that you have contractions, real ones that hurt, about every 10 to 30 minutes. For hours, and hours, and hours. It is hard to sleep because you’re awakened every few minutes by another pain. It is hard to focus on other things because you’re sort of kind of in labor, but not really, but maybe soon, but not yet…it isn’t an easy way to begin. My midwife (Sue) explained what was happening and recommended rest, rest, and more rest if possible, as well as trying to keep my mind off it as much as I could. Because we didn’t know when I’d really kick into labor, we sent Jonathan to stay with Jessica that night.

Friday was more of the same, only more so. The contractions stayed about 10 minutes apart. Gabe and I followed Sue’s instructions and got out of the house, although by that time I was very tired and the last thing I wanted to do was go anywhere! We went to get coffee at It’s A Grind, and lunch at Subway. It is quite an experience, trying to time walking in and out of a store so that you don’t end up doubled over and providing quite a spectacle for all the other patrons. I didn’t always time it correctly. :)

It was rather wasted food, unfortunately. I couldn’t eat any of it – I was pretty nauseous by that point. We went to Jessica’s house for a bit to see Jonathan, and then headed home, intending to pick up a movie on our way for more distraction. We did get the movie, but by the time we got out of the video store I was convinced that this was now REAL labor. The contractions came one after another with very little break, and all I wanted was to get home as quickly as possible.

Once home (at about 4pm), Gabe called Sue and I draped myself over the birth ball and made lots of noise. It was good noise, though – low and sort of gutteral, and as strange as it sounds, it helped. Sue listened to me going through a contraction over the phone and said she’d leave immediately (she was in Pasadena at the time!) and called Katie (her assistant) to come as well in the hopes that she’d get to me first.

They both arrived at the same time. I can only imagine how many speeding laws Sue broke on her way. :)

So it was real labor. For awhile I felt like it was going well. The contractions were steady but manageable. I could move around as I liked and use the birth ball or the couch or the bed as a support. It was pain, and really tough pain, certainly. But the techniques that I had been taught actually seemed to work, and I felt like I was “in charge” of how labor was going. This lasted for about 2 or 2.5 hours.

Then I hit transition. And stayed there. And stayed there. And stayed there. I had moved to the birth tub and the water definitely helped. I could relax (almost sleeping, sometimes!) lying back in Gabe’s arms between contractions. But when the contraction hit, it really hit hard. For awhile I still felt like it was manageable – that it was horrible and the worst thing I’d ever felt, definitely – but I could remember that it would eventually end and that there was going to be a baby at the end.

But it didn’t end. After about two hours of that, I lost control of the labor. Now it was just something awful that was happening to me, not a job that I was participating in. And I had forgotten that it could ever end. I was lost in a world that hurt, and hurt, and never stopped hurting, and all I could think of was that I wanted it to stop. Please.

Weariness played into this a lot. I’d been in some sort of labor for two days, and had very little sleep the previous night. I also hadn’t been able to eat anything other than a very light breakfast Friday morning, and although Sue and Katie kept giving me juice, it wasn’t enough. Eventually my legs started shaking too badly to hold me up, even just on my knees leaning against the birth ball, and Gabe and I decided that it was time to go to the hospital. Although I had wanted to deliver at home without medication, at that point all I wanted was something to manage the pain so that I could rest. We thought that if I could go to the hospital and get an epidural (or even just some kind of drug) that I could sleep, regain some strength, and then finish pushing our baby out.

So we (somehow!) got me into some clothes and headed for the car. I threw up all the juice all over the kitchen floor on my way out. (Blessings on Katie, who cleaned up the house while I was in the hospital!) Somehow I walked to the car. And we drove to the hospital. May I recommend that you never, ever, ever drive to the hospital in transition? At least not unless it is a seriously life threatening emergency. That was the longest fifteen minutes of my entire life.

We got to the hospital at about 9:30pm. Gabe parked the car outside the ER and helped me walk in. Gabe told the nurse at the desk that I was in labor (which in retrospect is really funny, since I was yelling/groaning and obviously in labor!) and someone brought a wheelchair and wheeled me up to labor and delivery. That part happened so fast that I thought maybe things would be ok – until I heard a nurse say that Dr. Purdom was the doctor on call. That made me scared, because I have friends who have had him for a doctor before, and everyone has said that he prefers to do c-sections.

Once in the labor/delivery area, I was taken into a tiny room and (I think) examined. They wanted to get me into a hospital gown, but I didn’t want to and they didn’t push the issue. I think they realized that I was pretty far along, and they moved me back into the wheelchair and took me into a much bigger delivery room. Throughout all this, they’d been asking me lots of questions (paperwork stuff) and I kept crying and asking “please, could I just have something for pain?” In retrospect, I know that they were doing the best they could – just following regulations – but it felt like forever and it was so hard to answer questions while hurting so badly.

It was also difficult because during this time Gabe and I were on our own – Sue was following us but it took her a little longer to get through the ER and up to our room. I don’t remember exactly when she arrived, but I was so relieved to see her!

Once I was in the delivery room, a nurse checked me. I don’t remember exactly how dilated she said that I was, (although I remember thinking that Sue had said I was farther than that – 8 cm) but I remember her saying that the baby was at a –1 station. This made no sense to me at all, since I could reach down and feel the baby’s head (and Sue had said that I was at +2). Things were happening so fast, though, that I didn’t say anything about it. I was still just crying and asking “please, could I have something for pain?” And the nurses were still asking questions, which made Gabe mad. He lost his temper a bit and yelled something about “is this really necessary?” and the nurses told him to calm down, that it wouldn’t help anything to get mad. I was glad he was sticking up for me, though.

Dr. Purdom walked in about this time. He was casually dressed and smiled and looked like a friendly, grandfatherly type. I felt slightly hopeful – maybe working with him wouldn’t be a problem after all. That lasted for all of about a minute. He checked me and informed us that I needed a c-section right away. I refused my consent for a c-section, and things went downhill from there. He told us that I was stuck: that I had a swollen anterior lip of cervix, that the baby was at a –2 position, that my hips were such that the baby wouldn’t be able to fit out even if he dropped into a lower position, and that the baby was in distress and needed to come out now. He told us in no uncertain terms that VBACs were unequivocally dangerous and should not be attempted, and should never never never be attempted at home. He told Gabe that his wife and child could die without a c-section, and that he needed to “be a man” and give permission for a c-section. He told us that he had a duty to follow ACOG guidelines, and that was what he was doing. (Note: ACOG guidelines state that women should be offered a VBAC trial of labor, and I had no indications for that “trial” to be over.) He tried to evict Sue from the room a few times, too. This all happened across my bed as I was crying, asking for pain meds, and yelling through contractions (the pain was definitely not under control at this point and I was not handling the contractions well at all). Voices were raised and tempers were lost. Throughout all of this, I continued to refuse to accept a c-section, and I also at one point said that if Sue had to leave the room, I was leaving the hospital as well. Thankfully, they didn’t press that point and Sue stayed with us. It was so hard to think because of the pain, but I had done my research and I knew what the right decision was, and I knew that all I had to do was say “I do not give my consent” and they couldn’t do it to me. So I just kept saying it, over and over.

It really was sort of surreal, listening to Dr. Purdom “explain” why he wanted to do a c-section. He just sort of listed off every major reason that I’ve ever heard about for why a c-section might be needed. Only most of them simply didn’t apply to me. I knew that the baby’s head wasn’t stuck above my pelvis, because I’d felt it already in the birth canal. I knew that a lip of cervix wasn’t reason for a c-section, it simply meant a needed a bit more time to dilate. And above all, I knew that my baby was not in distress. When I was in labor with Jonathan, we spent an hour watching the monitor while the nurse tried to alleviate Jonathan’s distress. When they did recommend a c-section, we watched for another 10 minutes just to make sure. Jonathan’s heart rate was showing clear decelerations – it would drop as low as 65 or 70 beats per minute and took a long time recovering. And even then, it wasn’t an “emergency” surgery. So I knew what distress looked like, and I knew that this baby was not in distress. His heart rate stayed between 120 and 140 for the entire time, save once or twice when it dipped down to 100 during a particularly strong contraction. I had asked the nurse to turn up the sound on the monitor so that I could hear the heart rate, and I focused on listening to its speed so that I would know if the baby was still ok. He always was, which gave me the strength to maintain my refusal of the c-section: I knew beyond a doubt that Thomas was not in imminent danger.

Gabe tried really hard to explain that all we wanted was some pain medication so that I could rest, and then see how things went. But Dr. Purdom just didn’t listen to anything we had to say. After a few minutes (I don’t know how long – time was so bizarre) he lost his temper and said “If you won’t accept my recommendation, then I refuse to treat you.” And he walked out of the room. Gabe asked the nurses to please find out if there was another doctor in the hospital who would treat me and give me medication for pain. Someone left to find out, and after awhile a nurse came in and said that they had called the Head of the OB department, and that there was no one else in the hospital who would treat me under these conditions (i.e. unless I submitted to a c-section). She asked us where we’d like to be transferred, and left to let us think about it, but we didn’t ever say and it never came up again.

Gabe also followed Dr. Purdom out into the hall to try again to reason with him and explain our position, but to no avail. We feel the Dr. Purdom had made his decision before he ever entered my room: he simply believes that VBACs are never safe, and had no intention of letting me continue to labor.

During all of this, Sue was on her cell phone talking to a nurse and a doctor at a different hospital. The other doctor agreed to meet us at Anaheim Memorial Hospital, give me pain meds, and let me finish laboring as I wished. I was seriously considering leaving and taking this option, because it was abundantly obvious that no one at Whittier Presbyterian Hospital was going to help me. It was such a feeling of helplessness – realizing that I was simply at the mercy of a doctor who refused to treat me, at the mercy of the pain in my body, and that there was nothing I could do but somehow get the baby out.

Maybe it was that realization – that no one was going to help me do this – or maybe it was the adrenaline, or maybe it was being so angry, but right about then my body decided to push. Sue had just told me that she didn’t think leaving was a good idea, because she thought I’d end up having the baby in the parking lot. And I decided that if I was that close, I’d just go ahead and have the baby here in a hurry.

When Dr. Purdom had left, and Gabe had followed him out, all the nurses save one had left, too. One nurse, Michele, had stayed to watch the monitors. Periodically she would ask if she could check me, but I always said no. At this point I felt so betrayed by everyone in the hospital that I just wanted them all to leave me alone and let me get on with it. In retrospect, I think this wasn’t very fair to Michele – she was an outstanding nurse and Sue said that she was really trying to be helpful. But it is hard to be charitable in a situation like that! Anyway, I wouldn’t let her touch me, and technically Sue wasn’t supposed to check me, either, since she was in the hospital and her legal status was only that of my “coach” now. But when I started pushing, Sue checked me anyway, just to make sure that I was fully dilated and wasn’t going to hurt myself. I was, and she quietly said “you’re complete, go for it” in my ear. So I did.

I’m glad that none of the hospital staff was really there at that point, because it gave me the freedom to labor the way I wanted to. The head of the bed was all the way up, and so I could kneel upright and lean against it and let gravity help bring the baby down.

Pushing was actually a huge relief. Physically, the pain finally felt productive – like it was happening for a reason. And between contractions, there were pretty long rest periods where I could lay my head down and almost go to sleep. Compared to transition, it was heavenly to be able to rest like that. And emotionally it was a relief because everyone had left, and no one was yelling over my bed or at me. I felt like if I could just hurry up and push the baby out before anyone came back, everything would be ok.

Gabe came back in right after I started pushing. He was really upset, because Dr. Purdom was putting so much pressure on him and scaring him about what horrible things could happen to me and to our baby. Sue told him that I was pushing, and he said “Sue, if she can push this baby out, I’ll kiss you!” I think he was as relieved as I was to finally be at the pushing stage!

I actually pushed for two hours before Thomas was finally born, but it didn’t feel that long. Time is so bizarre when you’re in labor. When I was close to delivering, Dr. Purdom came back into the room. This time he was in scrubs, and he informed us that he would deliver our baby after all. It was a rather “thanks for nothing!” moment, but I was so tired (I’d just switched into a side-lying position instead of upright, because my legs were so tired) and I just didn’t care at that point. So I said that was ok.

They had me lie flat on my back and put my legs up in stirrups. Part of me thought that wasn’t a good idea – after all, I knew that it wasn’t the most optimal position for pushing – but I was so tired and frankly having my legs supported felt pretty good. They covered me up in blue drapes, which I thought was silly, and I rather wished that they hadn’t, because it meant that I couldn’t see. In retrospect, I wish I’d asked that they move them, but I so was tired and didn’t want to deal with more fighting.

Dr. Purdom recommended an episiotomy, which I refused. Then he recommended a local anesthetic “just in case you tear”. I refused that, too, because Katie (our Bradley instructor) had told us that a local makes you swell and much more likely to tear, and that because of the pressure you can’t feel a tear anyway. But I did say that I’d like anesthetic after the fact if I did tear, and needed stitches! I think Dr. Purdom thought I was a completely crazy woman – he sort of gave me the impression that he was thinking “fine, have it your way, whatever!” But he did do a good job with the delivery. I couldn’t see it, and it hurt too badly for me to think much about it, but Sue said that he was gentle and careful and very good at what he did.

Thomas was born at 12:30am on February 10th, 2007. He weighed 7 lbs, 11oz, and was 20 inches long.

17 comments:

Sarah said...

Em,

I'm so sorry you had to go through all of that! No matter what, it's wretched not to be heard.

Thanks for sharing the story, though. Does having gone through that make having your Thomas all the more precious?

Sarah Marie said...

wow, having babies sounds great!

Rachel said...

WOW. That's horrible! I'm so sorry you had to go through that!

Kelly said...

My goodness! That is quite the birth story! Your attitude about it all really amazes me. May God bless you abundantly for the suffering you underwent for you son. A severe mercy, maybe? Honestly, it is really encouraging to read your birth story. As horrendous as the events were, your courage and persistance is very moving.

On another note, did Sue have any idea why you were in transition for so long?

Emily said...

Sarah Marie,
Honest, it is worth it. ;)

Kelly,
Yes, Sue thinks that it was because I'd had prodromal labor for so long. She thought I just got stuck and my body just didn't have the energy to get past that point. So I guess in a way being at the hospital WAS a severe mercy - it made me angry enough to get an adrenaline kick! :)

In any case, Sue thinks that it was a fluke and that it shouldn't happen again. In fact, if I do have prodromal labor again, she'll have her (new) back-up doctor give me sleeping medication. And then (in theory, please God!) I'd actually have a pretty short labor.

Bethany said...

Wow, Emily, thanks for sharing that story. I'm amazed at your strength. I, too, had contractions 10 min. apart for a long time (though not two whole days!), and I can say without a doubt that it's a good idea to take some sleeping medication.
I'm so glad to have read your story, though. Strange as it sounds, it inspires me to have a different birth experience, next time around. I'm motivated to get educated!

Amber said...

Wow, Emily, I'm so sorry you had to go through all that. We are so much stronger than we realize, aren't we. Thank goodness you had such a great midwife and you knew what your rights are!!

After reading that I was left feeling sick to my stomach and quivering with indignation. And that "doctor"!! Ooh, I do not have any charitable thoughts about him right now. I read this before starting dinner preperations and I was so worked up that I burnt the quinoa. Never done that one before!

But seriously, thank you for writing this all out. You did a great job putting it together and I really appreciate you sharing it.

Emily said...

Bethany,
I am so glad that you're motivated to get educated! That is really why I finally decided to post it. I hope that anyone who reads it has the same reaction!

Amber,
Thank you for your empathy - and I'm sorry you burned your dinner! :)

Christopher said...

Wow Em!
What a story!
Tell Gabe he is more of a man for sticking up for his wife and chewing the doc out! :)

MirCat said...

thank you for sharing such a painful story, Emily...you are an amazing, determined woman, and I'm amazed at your intelligence and inner strength.

Anonymous said...

Wow I really loved hearing your story I am looking forward to having a VBAC this is alittle about my situation……..

With my first pregnancy I read nothing about c-sections in my mind I wasn't having one I was having a "natural birth". I had imagined the moment over and over all the hard work, the pain, and the pushing for the greatest gratification a healthy baby. I had allot of scares but overall my baby was healthy although very small for a full term fetus. I had non stress test 2 times a week from 32 weeks to monitor the baby and myself. On a Wednesday at 38 weeks I went to see my doctor and I had began dilating she said that if I wanted she would induce me Friday. I told her "no I wanted the full experience I wanted the moment where I knew I was in labor and the excitement.” On that Friday I was at the hospital for my weekly non stress test and so was my doctor doing her rounds she stopped in to see me and said that she noticed the heart rate didn't seem normal that she thinks it would be best to induce, afraid for my baby I agreed. Less then 3 hours into labor my babies heart rate drooped and my doctor was in another delivery at another hospital, (her husband who is her OBGYN partner) came into the room and said that a c-section would be safest for the baby, knowing that the heart was so low I new it was safest to but I was still so devastated . After the baby was born I was anxious to feed and hold and see her. They put me back together, then moved me to recovery all I could think is where is my baby and your saying I have to stay here for 2 hours and wait with out my baby!!!! I think I had a nervous break down at that point! The experience was horrible, recovery was the hardest thing I’ve ever had to do, and emotionally I suffered more than anything.

Now 2 years later I’m having my second baby I want more than anything to have a VBAC. I decided to go with the same doctors I had with my first pregnancy it’s a husband and wife team and when I had the c-section they said “next time you can try natural” I thought they supported VBAC’s from that comment. On my first visit I asked about a VBAC (this pregnancy I have seen the man most of the time) he said that none of the hospitals allow it in my area, he said if I go in and I’m in labor that their might be a chance that the hospital wont stop the labor. So at that time that was my hope, “I would just have to go into labor!” then I started to read and read and learn everything about my rights with a VBAC and then I started calling hospitals to make sure they had ban VBAC some of the hospitals had but the hospital I chose to go to hadn’t , it was up to the doctor that the hospital allowed it as long as the doctor allowed it. I went back to the doctor and said I want a full attempt at a VBAC that I know the hospital allows it. He told me ok didn’t put up a fight at all. At 36 weeks for the first time in this pregnancy I seen his wife, she told me I needed to schedule my c-section, I let her know that I was attempting a VBAC, she proceeded to tell me negative stories about VBAC’s to scare me. I then felt very upset and looked into changing doctors at 36 weeks, none of the doctors in my area were real supporters of VBAC’s to go to a doctor out of my area I need a referral. I researched the real risks of a VBAC and that 1% isn’t high enough risk for me, although in every woman’s testimony they said “ I never though that I would be that 1%” most woman with uterine rupture they are older, have had more then one c-section, are over weight before pregnancy, and are usually induced or go way over their due date. I think I am the perfect candidate for a VBAC.

I am now 38 weeks and still head strong on having a VBAC none of my friends understand and even my husband has tried to discourage me, my mother stands by my side and understands why it is so important for me to have a natural birth rather then another c-section . I also feel my doctors have tried to do mind tricks on me I think that they sometimes want you to things and convince you it’s the best thing for you so you do it. Like being induced my baby properly would have been fine if she wasn’t induced the medication from inducing her made her heart drop if she would of came at her own time I think things would of went smoothly . I want so badly to have a VBAC but I don’t think I could be as strong as you and refuse a c-section if god forbid something happen to me or my baby I couldn’t live with that guilt, thank you for sharing your story!

Emily (Laundry and Lullabies) said...

Anonymous,
Good for you for researching your options and standing up to overbearing doctors. :) I'd encourage you to spend these last two weeks researching what TRUE emergencies look like. What does a truly crashing heart rate look like? What are all the REAL reasons that a c-section would be necessary? Then you'll be informed and you'll know if you really need one when the time comes. The reason that I was able to refuse a c-section is because I knew that nothing was actually wrong with the baby, and that the doctor was just saying stuff.

Good luck and I hope you have a lovely birth!

Anonymous said...

hi Emily I was the person that wrote the Anonymous comment I wanted you to know that I had a successful VBAC. I was the first at our hospital in 5 years to have a successful VBAC. It was a hard labor i had been contracting for 4 days before I had her. My contractions would get close and steady and then slow down and get far apart and less intense but the contractions helped me dilate i was a 5 by the time i went to the doc and he said go to the hospital and he will break my water to make the contractions steady it worked and 7 hours latter we had a baby :) thank you for your story it helped give me the courage that i could do this! Betsy Santos

Emily (Laundry and Lullabies) said...

Congratulations, Betsy! I'm so happy that your VBAC went well! :)

Anonymous said...

Thank you for sharing your story. My first son was born the end of december by c-section. I feel that so many things happened that didn't need to and I really wish I had it to do over again. Since his birth I have been reading up on VBAC's and have high hopes that with my next child I will be successful at having a natural birth. There are so many scary things out there that make you think it isn't possible. Your story has really empowered me to know that it is possible! Thank you.

Anonymous said...

I'm jealous Purdom even gave you the choice of an episiotomy. I put in my birth plan that I didn NOT want one, my doula told him I didn't want one, and he ignored both and gave me one without telling me...now I am going through a painful recovery, he was the most negative part of my birth, so SO rude, no bedside manner at ALL. I fought him on everything he wanted to do too, if I hadn't I am certain I would've ended up with a c-section! I regret ever walking through his doors!

Emily (Laundry and Lullabies) said...

Anonymous, I'm so sorry that happened to you.

Have you considered contacting the hospital ethics board about your experience? If you said "no" and he did it anyway, he committed a huge ethical violation. Actually you'd be within your rights to sue him for assault.

Did you deliver at PIH? If so, here is a link to their "Patient's Rights" page. It includes contact information if you want to file a grievance.

http://www.whittierpres.com/ContentPage.asp?Id=31587&FatherId=291&FileGroupid=263&Main=Info+For+Patients&Title=California+Patient+Rights&Page=http://dev.pih.net/Hospital_el/263\ifc_california_patient_rights.html