How would you plan your next birth if you were me?

[crunchy_mommy]

Brief overview -- I gave birth to DS last year after ~40 hours of labor. I have a history of sexual abuse that made L&D very difficult. Couldn't allow my OB to check for dilation. Finally needed to sleep & they "needed" to check me so I agreed to an unwanted epidural (after 2 other unwanted meds! ). I was at 6cm (I believe labor was stalling because of positioning + my anxiety over being "checked"). They started pitocin & broke my waters without asking me. Every time I pushed his heartrate plummeted & I was on oxygen. He was vaccum extracted because of the heartrate issue (was seconds away from a c/s). Wasn't breathing when he was born, but started up soon after (though it felt like an eternity). I tore extensively (took months to heal) and DS was kept away from me for most of his first 8 hours or so. The whole experience was very traumatic for me & even DH... one of the worst experiences of our lives (though totally worth it for my sweet little boy!!) complicated by prejudice due to previous mental health issues I am RECOVERED from & lots of interference post-partum with BF'ing etc. and ignorant student nurses (I could go on & on)...

ANYWAY so... I'm not pregnant again but hoping to TTC once DS is taking more solids & less reliance on BF'ing. I definitely don't want to redo all that trauma. DH would kind of like a homebirth but he was so useless during my first labor (he slept through most of the 40 hours!!) & doesn't research things etc. so I would feel very much "on my own" with that. I also was so tired & in so much pain with DS that I can't imagine NOT having the epidural next time (even though I totally don't want it, if that makes sense!) and plus there is the issue of being "checked" (and no, I'm not even comfortable learning to check myself, BTDT!!) And during DS's birth the OB kept putting her fingers inside (to check how I was pushing maybe??? I asked her not to & she said she "had" to) and that was difficult for me even with the numbing of the epidural. I am scared to have a homebirth (I am very anxious, particularly when it comes to body things) although I fantasize about a wonderful UC with DS & DH by my side!!! There is only one birth center around here & it's really just part of the hospital & can fill up quickly, but there is a mother-friendly hospital not far from me that I could try using. I'd like to get a midwife but my mom keeps telling me "they won't let you get an epidural even if you really want/need it" and I'm afraid once I'm in the situation I will need it, psychologically.

Ahhhh so many thoughts floating through my head...

I guess my question is, given everything I've said, what would you plan for your next birth if it were you? I know things can't be guaranteed to go according to plan but I am SUCH a planner and I get very upset when things don't go as planned. So I'm trying to minimize my own disappointment & personal trauma as well as think of what the best outcomes for the baby would be.

[GoBecGo]

I would have a planned homebirth with a midwife. I would start looking around before i ttc'd for a MW i was comfortable with and who can deal with me not wanting to have any vaginal exams (i am also a SAS). I would accept i might have to go for one which is not a CNM.

There is no need to check for dilation, it happens whether there are fingers in there or not, most women in the world and pretty much ALL animals give birth without anyone ever checking their dilation. Likewise the fingers inside during pushing - that is horrific. I'm sorry you were assaulted like that, there is NO reason to do it, and NO excuse for her continuing to do it after you told her not to.

I think someone who could endure what you have both in the past and during your birth can DEFINITELY do labour without an epidural, provided it was a labour where you were treated with humanity and not sexually assaulted, medicated and stressed out. I would also look into hiring a doula or other similar female support companion to look after you if your DH decides to check out again.

[Tizzy]

Definitely find a doula! That's the first thing that comes to mind after reading your post. You need the support that your DH can't offer.

[sarahn4639]

Well *I* would have a homebirth with a MW that has experience with survivors and agrees to no vaginal exams. There are plenty out there that have no problem not checking unless there is a *true* medical reason. (Such as funny heart rate and needing to know if baby is coming now or if they need to transport or something like that.) I would also get a doula for sure, ask them about their experiences with survivors as well. Interview a couple of them, heck, maybe even hire 2 if you can afford it. Honestly, it would be this or a c/s when labor starts. I wouldn't risk the trauma again, it sounds like you were treated horribly and I'm so very sorry for that!

[Gena 22]

Check out the "Rule of 10" thread in Birth Professionals. It links to a fascinating article that supports going without most or all VEs.

As a knee-jerk answer to your question - homebirth is the place to be if you're interested in trying for a private and peaceful vaginal birth. I'm a huge fan. Ask around, I'm sure you could find a MW who's a good fit for you.

But if you're really anxious and need more certainty, and especially if you plan only one more child, you might consider scheduling a c/s. C/S are vilified, by me included, but there is a time and place for them. If finding a skilled and gentle surgeon, and maybe full anesthesia, would be better for you, it may be worth considering.

Good luck, whatever your choice!

[mamatogirls]

So sorry that had that experience with your birth. I do not have experience with sexual abuse but all of my births traumatized me is some way. I was planning on doing Hypnobabies with the pregnancy that I recently lost to help get over the fears I had b/c of my previous births. Hypnobabies could help to release your fears, it's worth looking into. I would personally choose a homebirth, but if that's not for you I would try to start with a Certified Nurse Midwife out of a hospital or birth center. Most homebirth midwives I have met do not regularly check you unless requested and rely on their observation of the mother in labor for where their cervix is at and don't need to keep their hands in your vagina when you are pushing to "see if you are making progress". I'm sure you could find a CNM in a hospital or birth center that would be sensitive to your situation as well. I would start interviewing soon so you don't have to worry about finding someone when your pregnant again. Good luck.

[MegBoz]

Originally Posted by GoBecGo

I would have a planned homebirth with a midwife.

ITA with that whole post! Great post!

Especially the doula... I also think you might want to set some expectations. If you DO want DH to be your primary labor support, then take a Bradley class. It may be difficult to commit the time to the 12 sessions with a little one, but that's what I'd recommend. IF, however, you're OK leaning more on the doula, then I say go for that. & DH can be "support" by taking care of DS, making sure you & the MWs have food, setting up the pool, etc. Be sure you are in agreement in that situation! Doula = primary labor support for mama. So you don't find yourself disappointed or annoyed that he isn't stepping up to the plate. (& the doula understands that you expect her to be primary support.)

Sounds to me like your fears of being out of control, coerced into vag exams, etc. probably outweigh your fears of the pain. Bear in mind that subsequent babies generally come much faster. You can also get into a pool in an HB, which helps with pain tremendously. I definitely think HB is the way to go for you.

(that being said, if the birth center is truly hospital-attached, you very well MAY be able to get an epidural even if your HCP is a MW. I had DS with CNMs at a hospital & I could have had an epi there. OB care isn't required for an epi.) However, you have to consider if you could emotionally relax in a hospital again- even with the best MW & nurses.

[GoBecGo]

Another good thing about birthing in a pool is that it would be really very difficult for anyone to get anything into your vagina without your consent - it's really easy for you to move away and really hard for them to keep close to you!

[crunchy_mommy]

Yes you are all right, I would have a very difficult time relaxing in a hospital again. I definitely don't want a c/s (I want more control than that!! LOL!! Plus I do want more than 2 kids!) and homebirth does sound like a nice option, although my biggest fear with that is something happening to the baby. From what I've researched it sounds like the same problems could arise at home or in the hospital, but if I were in the hospital I wouldn't blame myself to the same degree. But I do live less than 15 mins from the closest hospital so that's some consolation. Part of me thinks I should just go to the hospital & get an epidural immediately, but I hated how "out of it" I felt with the epi, plus I don't like meds!! I think in a perfect world the next baby would just suddenly be born before I had a chance to make up my mind lol. I sure hope the next labor is shorter, and I do think I could handle the pain IF I wasn't afraid (of the docs/nurses) and if I didn't get to that point of total exhaustion. Maybe I need a plan & a backup plan or something.

[Right of Passage]

Like others have said in your shoes I'd plan a homebirth and also hire a doula. My MW has talked with my DH about his presence because birth kind of overwhelms him, the primal mama that comes out in me is something he's not used to so he has worked on being more educated and will do everything he can to be my support this time.

Mostly I just wanted to send you love and healing. You've been through so much and I hope your future birthings are beautiful, peacful, and respectful of your whole body and mind.

[crunchy_mommy]

Originally Posted by GoBecGo

Another good thing about birthing in a pool is that it would be really very difficult for anyone to get anything into your vagina without your consent - it's really easy for you to move away and really hard for them to keep close to you!

Hahaha great point!!

[crunchy_mommy]

Thanks all for the hugs & positivity!!

[triony]

Originally Posted by MegBoz

Especially the doula... I also think you might want to set some expectations. If you DO want DH to be your primary labor support, then take a Bradley class. It may be difficult to commit the time to the 12 sessions with a little one, but that's what I'd recommend. IF, however, you're OK leaning more on the doula, then I say go for that. & DH can be "support" by taking care of DS, making sure you & the MWs have food, setting up the pool, etc. Be sure you are in agreement in that situation! Doula = primary labor support for mama. So you don't find yourself disappointed or annoyed that he isn't stepping up to the plate. (& the doula understands that you expect her to be primary support.)

Absolutely agree. We are near the end of our Bradley class. While my husband listened (amazingly so) to all the research I had done, my Chiro's hubby didn't listen to her. After they took the class, he decided he really wanted to do a homebirth (though he had resisted his wife's suggestions before that point). I also recommend doing a lot of your own research, besides Bradley.
I haven't take a hypnobirth or hypnobabies class, but the couple of mothers I know that have really recommend it.
Your DH will really benefit from the information either way.

I wholeheartedly recommend going for a homebirth. Find a midwife who is hands-off, you'll be more comfortable. Having a CPM has made my whole pregnancy a real joy rather than the struggle I hear about from the mainstream mommas around me.

<Hugs>

[GoBecGo]

There is nothing inherently safer about being in hospital. You are closer to the OR if you need a cs, BUT the average emergency cs takes place 45-90mins after the ob says it is required. You are 15mins from the hospital, your MW could call ahead if you needed to transfer and say "i'm bringing in a mama with xyz who will likely need theatre" so they can begin prep before you even arrive.

I know how you feel, except i'm the opposite - if i went to hospital and something happened to the baby i would beat myself up over it because i believe where i can be relaxed and birth safely is home, and i know no matter what complication arose, if it arose in hospital then i would blame myself for putting me and my baby somewhere where i knew i'd be fear-filled.

I really wouldn't want a cs either - for me (very personal) i felt that if i had a cs to avoid futher trauma relating to the existing trauma from the SA i suffered i would basically feel it was something else my abuser had taken from me.

I think if you were not fearful you would find your pain was significantly reduced.

[crunchy_mommy]

GoBecGo -- thanks so much for your insight!!! I totally agree & I am warming up more & more to the idea of a homebirth... DH joked that we'd have to remodel the house (because when DS was born it was just a mess that the nurse said they needed to get a new table ) but he is really leaning that direction as well. It's not normal at all around here to have a HB -- illegal for a MW to attend technically -- so I feel like it's a risk, but you're right that if something happened in the hospital I'd have similar regrets. I really hate that my prior experiences are influencing my own child's birth, so anything I can do to gain back that control is crucial. Luckily I have time to sort this all out before I even get pg

[Ardor]

There is a book by Penny Simkin called "When Survivors Give Birth" and another one by Mickey Sperlich called "Survivor Moms: Women's Stories of Birthing, Mothering, and Healing after Sexual Abuse" that might be of interest to you. I haven't read either so I can't comment on how good they are. You can find both on Amazon and the second I also found at www.midwiferytoday.com in the store section.

[dannic]

I birthed in a BC and my midwife checked me every hour and during contrax. Awful.
My third was born at home with a mw and I was never checked (even touched at all) during the entire labor. She guided dh at catching the babe and helped with the cord. It was perfect.
I agree that I would interview midwives on their policies as some can be more hands on than others. (my bc mw was a nurse prior to mwing and I think her checking was ingrained in her).

[Belle]

I had one vaginal exam during labor that I consented to about 30 minutes before dd2 was born. I did not have any at all during my prenatal exams. Oh, had a homebirth. During my hospital birth they had their fingers in their at least every half hour. Not needed in the least.

You may also want to check out the documentary Orgasmic Birth. There is a story in there about a survivor mom giving birth at home. They didn't show video that particular birth, too private. But they did show some stills of the birth and the mom talked about her experience. It moved me to tears.

[Bellabaz]

I would plan a homebirth with a midwife. My midwife checked me once with my permission only during my whole labor with dd2 (which was only 3 hours). Otherwise she simply used a doppler every 20 minutes or so to monitor the heartrate and this was also with permission only. (I had a hospital birth for dd1) I get what you are saying about your dh, but maybe if he is already on board for a homebirth he wants to be more active this time. I mean I think being in a hospital with nurses and docs etc, can make the other person there feel useless. BUt when it is in your own house and its just your laboring partner, midwife and you its a different dynamic.

Barring this option, I would definitely serach for a more understading provider and be very blunt and upfront about your demands for this birth. Do not present them as "preferences" because docs then just like to say "we will do what we can". These things are very serious for you and should not be comprimised (barring life or death situations, I know)

I hope you can work it out and I am sorry about your traumatic experience. But my midwife asked for permission anytime she did anything, both during prenatal care and during labor, etc. And like I said she only checked me internally once during the whole thing and that was closer to the beginning. So the "need" is not valid to me.


ETA: Btw, my first labor was about 12 hours and the second was only 3 hours 15 minutes. I know its not the same for everyone but most people have shorted second labors so exhausting yourself this time around may be less of an issue. Plus if you are at home with a hands off midwife, you are likely to be more relaxed which facilitates an easier labor. And like you said you are really close to hospital, the perfect distance I think.

[CallMeMommy]

I'd suggest at least interviewing some midwives about a homebirth. You don't have to commit to anything at this point. At my last homebirth I was never checked. Not once. And you know what, that baby came out just fine. The right midwife for you would definitely be sensitive to your past and not force anything on you that you didn't want. But no matter what you do, I'd definitely hire a doula next time.