VBAC Grief

[AsherahTanith]

I'm not sure who to turn to and, so, I'm turning to you all.

My first child was born on my 18th birthday.  I had absolutely NO idea what birth was supposed to be like.  My mother had three children, all of them by cesarean section.  I was the first, born in a hospital that let her lay alone in bed for a day and a half, in a room next to a screaming man who had jumped from a balcony while on LSD.  My Dad threatened someone into looking in at her and that's when she finally received care.  So, she was no help in my first birth.  She had also never seen it done as it was intended.

So, with my first child, I had a cesarean because of "major fetal distress".  I lay on my back the whole time, couldn't drink anything although my mouth felt like a desert, hooked up to IV, had my water broken, cervix softened - you name it - I had the intervention.

Fast forward 19 years and I'm pregnant with my second child.  I'm more learned now and insist on a VBAC.  Unfortunately, where I live, no doctor will let you have one nor will the only hospital in our city.  So, my husband and I find a VBAC friendly doctor who is two hours away to take care of me.  

I have a wonderful pregnancy with a loving, supportive man.  I start feeling contractions Saturday morning at about 3 a.m.  I continue doing normal household stuff until it starts to get too difficult to do so.  We'd already had a couple of false starts and so we wait until we're sure this time.  I'm mooing like a mad cow [LOL] while I call my doula and she says "get here now!"  And, we leave.  It's a long uncomfortable trip.  I tried to stop by my chiropractor before we go for one last adjustment; but, we can't reach her until we're almost to the hospital.

We get to the hospital and the doula is wonderful.  The nurse tells her not to give me anything to drink; but, she does anyway.  We are put into a room and I'm still mooing.  The contractions are come in waves; but, that's not the pain that I can't bear.  It's the intense pain that is in my hips and running down my thighs.  There's no let up.  On a scale of 1-10, the contractions are about a 4 to 5 - the pains in my hip and legs are a 12.  My doctor arrives and tells me that I need to "rest between the pains".  I tell her there IS NO between the pains, it's constant.  Okay, I shout it; but, you know what I mean.  After a while, she offers me an epidural to rest and I have to take it cause I'm past my endurance.  I take the epi and I sleep for a while.  After a bit, they then tell me that my baby's heart rate keeps going up as her oxygen goes down.  I have to have a c-section.  It breaks my heart; but, I don't want to cause my daughter any pain.  [I can't help but cry as I type this.]  We go in for the c-section and, although it's better than the first one I had, I feel like a failure.

Once it's all said and done, my daughter was born with an apgar of 9 [just like her brother was].  The only difference is that she has a lump on her head now from where they had to suction her back out of the birth canal.  Her head was presented incorrectly.  It wasn't the top of her head [where it molds] that was being presented; but, off to the side a bit which was causing her to get stuck [as I was told].

I feel robbed.  I don't know what happened.  Did I REALLY need the c-section?  Was she on her way out but progressing slowly?  Or, did we do what we needed to do to save her life?  I really don't know and I still mourn for the birth I had planned for.

Don't get me wrong, I am VERY grateful for my little girl who is the light of my life and that she was born healthy and well.  But, was a traumatized for nothing?  Could someone have repositioned her?  I have this feeling that it could have been done; but, that I was given the choice of laboring on my own successfully or get a c-section.  I just think there's got to be a better way.

[Ms. B. Sprout]

I am so sorry. VBAC attempts that end in repeat sections are just heartbreaking. I also went through this three years ago, and mine was also due to malpositioning. My heart truly goes out to you.

I got some good "failed" VBAC insight on this thread. You might find some of the responses helpful, too.

I encourage you to tell your birth story to other mothers who will get it. For me, that was a critical part of the healing process. You may find sympathetic ears at an ICAN meeting. Do you have one nearby?

Be gentle with yourself. It's a hard thing to work through.

[Ammaarah]

I've had two c-sections now for asynclitic babies (heads were tipped to the side so they each came out coned to the side.)  I mean, there is no way I can say they definitely wouldn't have come out OK, but I can confidently say my labors were both obstructed.  The first time, I had the full "cascade of interventions" as some call it, and I blamed all that intervention for my needing a c-section, so the second time I vowed to do it right. 

The second time around, I was mindful about positioning, sat right for fetal positioning, did a lot of squatting and hanging out on a yoga ball, and went into labor naturally rather than get induced.  I spent my labor active and in a million different positions, but ultimately I elected for a repeat cesarean because my water broke and was full of meconium and my labor just wouldn't pick up for long, even with Pitocin.  If I hadn't had meconium in the water, I might have held on a few more hours, but I wasn't comfortable pushing it much in the situation I was in.

My point in telling you this isn't to tell you how to feel about your c-sections.  Personally, I feel way better after the second one because it kind of affirmed that it hadn't been my fault the first time around.  I do believe I have a pelvic anomaly or some other issue which caused my babies to be so poorly positioned, and while they possibly could have come out vaginally eventually, I think I did the healthiest thing when I had my c-sections.  There used to be more vaginal deliveries of asynclitic babies, but they sometimes involved high forceps and other technology that we're pretty fortunate to have left in the past! 

You didn't fail at all.  You definitely needed pain relief with how you describe those pains in your legs and hips.  Your baby was having decels and that can be serious.  You made a hard choice, and those aren't always pleasant, but you did it with your baby's health and well-being in mind and it was nothing but noble.  Please try to forgive yourself for any perceived shortcomings.  You sound like a great mom to me. 

[AsherahTanith]

Thank you both, so much!  My daughter turns five later this year and it still tears at me when I think about how things worked out.  I'm hoping that by purging this on the board, I'll be able to work out some of the anguish that comes up from my birth experiences.  I REALLY did want to have her natural.  :-\  Thanks again, ladies.  It's been hard to talk to people because the impression is that I shouldn't have tried for VBAC in the first place and, of course, I would have it the second time.  So, instead of talking about it, I've just been suppressing.

[jenniro]

I suppressed my feelings about my CBAC 9 months ago for a long time.  I was embarrassed and ashamed that I had spent all that money and time to travel 2 hours away, hire a doula, and then I "failed" again.  I was afraid people would judge me, shake their heads sympathetically, and tell me that the doctors do usually know best.  I smiled and told everyone this c-section was so much better than my first.  In one way it was.  I bonded faster with my son.  But other than that, it was worse.  I hemorrhaged on the OR table, and recovery from that was brutal.  I got a spinal headache.  I felt like such a failure.  I had given up on the VBAC.  I thought it was so important to me, and I just gave up on it?

When I started to talk about how I really felt, honestly, my hubby was disappointed.  I should tell you, though, that it was disappointing to him b/c we were talking about when to try for baby #3.  He thought the CBAC convinced me that I just can't birth babies, so this next time was going to be an easy RCS. (easy for him, anyway)  I told him I will be doing homebirth this next time.  He says he supports me, but is scared.  I've only talked about my plans with two other people.  Another woman in my small town that is traveling to the same town I did for a VBAC.  I think we might be the only two people in a hundred mile radius that are doing a VBAC.  And another woman that was talking to me about doing 2 versions for her breech baby b/c she really wanted to avoid a c-section.  So, I only talk to people who understand.  I am at a point in this process now that I don't care what other people think.  I know I am doing what is right for me and my family, so the nay-sayers can suck it. 

However, in the stages of grief, I am in the really pissed off stage now.  I am really angry at the people I hired/chose to support me through this that didn't.  My doc was unavailable for my labor so I got the on call doc, and she was a bi$tch.  My doula was completely ineffective at helping me navigate a natural birth in the hospital.  She told me the only way to get my labor going was to take pit.  I was 3 cm, for crying out loud!  Not even active labor.  Starting and stopping is normal, which I know now, but didn't at the time.  My mom later told me she was glad I had the c-section b/c she really hadn't wanted to continue helping me labor all day and "some women just weren't meant to give birth."

The point of my rant, other than online "therapy" for me, is that we are grieving the loss of a birthing experience, and what we feel, when we feel it, is normal.  I am working toward the acceptance stage, hoping to truly believe what the ladies say on this board about not being a failure and making the best decisions at the time with the resources I had.  I just keep going, right?  I'm glad your here.  We can work through this.      

Edited by jenniro - 4/8/11 at 8:44am

[AsherahTanith]

I'm glad you're here, too, Jenniro.  Your story sounds achingly similar to mine.  I'm not sure if I will have another child at this point.  We miscarried at 6-8 weeks shortly before we conceived our daughter and, then last year, I miscarried at 13 weeks.  That was the closest I've come to actual birth as it happened in the doctor's waiting room, with me squatting on the floor using the breathing and relaxing techniques we'd learned for our attempted Bradley Method VBAC.  The doctor commented on my strength since I had dilated to three in his waiting room without scaring any of his patients.

I do wish that someone could explain to me if it is possible to assist a child who is "asynclitic", as Ammaarah mentioned, to her reposition her head so it is presenting correctly.  It seems to me that it should be possible; but, I may be speaking out of complete ignorance.

Whether I have another child or not, my goal now is to learn as much as I can so I can do my best to ensure that my daughter does not go through what I have when it's her time to bear children.

[jenniro]

I am so sorry for your losses.  I can't even begin to imagine how that feels.  I'm so sorry.  I haven't started it yet but heard some great things about the book, Reboundig from Childbirth Toward Emotional Recovery by Lynn Madsen.  I know I should probably talk to a counselor about these feelings, but I am worried about the "at least you have a healthy baby" reaction and a little about the cost.  I keep trying to heal on my own.  We'll see.  I also don't know if we will have another baby, but I have to get through this either way.

About your question concerning asynclitic presentation, have you seen http://spinningbabies.com/ ?  They have helpful exercises to do to get baby in a good position.  Also, there might be some torque in your pelvis and/or muscles that prevents baby from getting into the optimal position.  A chiropractor can be helpful if that is the case.  Hope all is well.

[Lyss]

(((hugs to you all))).  I had my 3rd c/s last month do to positioning.  I did everything right.  I tried everything. 

[Ms. B. Sprout]

 

Originally Posted by Lyss 

(((hugs to you all))).  I had my 3rd c/s last month do to positioning.  I did everything right.  I tried everything. 

[womenswisdom]

For those of us who have had a c/s due to positional issues (like myself), you may want to discuss the option of manual repositioning with your OB or MW for your next birth if you choose to have a vbac.  As a doula, I have seen OBs literally put their hands allllll the way inside a mama with an epi in order to rotate a posterior baby or move an asynclitic head into a better position.  I didn't even know this was an option with my first, which was a c/s for persistent posterior (c/s after 4 hrs pushing w/ no descent, baby cut across the nose during surgery so I'm SURE he was posterior).  If I'd known that was an option, I would have insisted that someone try it the first time.  And I was PISSED when I found out you could do that during my second pregnancy.  Why did no one tell me?!  I shouldn't have to be an OB or a MW to have a good birth in the hospital, dangit.  Not all CPs know how to do this or are comfortable with it, but those that do can be life-savers.

With my vbac, my water was not artificially broken and my daughter was able to rotate herself out of a posterior/asynclitic position with the help of some tug-of-war during pushing and manual rotation wasn't needed, but I was glad to know it was an option in my back pocket if that hadn't worked and we'd had to transport.

[Ms. B. Sprout]

I hear ya -- when I found out about this possibility, I was seriously angry at my OB for not even trying to rotate my OP baby. I did not know that was an option until maybe a year after the c/s. Mamas who are able to get this type of assistance during labor are really lucky -- but it SHOULD be routine, and a skill every provider has.
 

Originally Posted by womenswisdom 

For those of us who have had a c/s due to positional issues (like myself), you may want to discuss the option of manual repositioning with your OB or MW for your next birth if you choose to have a vbac.  As a doula, I have seen OBs literally put their hands allllll the way inside a mama with an epi in order to rotate a posterior baby or move an asynclitic head into a better position.  I didn't even know this was an option with my first, which was a c/s for persistent posterior (c/s after 4 hrs pushing w/ no descent, baby cut across the nose during surgery so I'm SURE he was posterior).  If I'd known that was an option, I would have insisted that someone try it the first time.  And I was PISSED when I found out you could do that during my second pregnancy.  Why did no one tell me?!  I shouldn't have to be an OB or a MW to have a good birth in the hospital, dangit.  Not all CPs know how to do this or are comfortable with it, but those that do can be life-savers.

With my vbac, my water was not artificially broken and my daughter was able to rotate herself out of a posterior/asynclitic position with the help of some tug-of-war during pushing and manual rotation wasn't needed, but I was glad to know it was an option in my back pocket if that hadn't worked and we'd had to transport.

[Cellist]

womenswisdom - thank you for the information on repositioning.  I had a c-section due to weird positioning, too, and think my body could DEFINITELY have had a vaginal birth if not only for that.  I'm going to ask for what you're describing if there is a next time.

I am so sorry for the grief in here...

[sharpmamma]

I feel like I'm reading my own story here from about a month ago.  I was totally okay with my first c-section since it was my first baby and she was feet first.  More and more now I am learning about spinning the baby around which my doctor said would be very painful and no meds would be available for it.  I've learned otherwise since then as well.   This really ticks me off now.  When I went into labor and didn't realize it, she was trying to turn herself.  Then she flipped back up.  I had her by c-section the next morning.  I healed fast and everything was fine.  I think this was due to the fact that I'd had months to absorb that I was getting a c-section.  I was seriously the girl who told everyone I don't know why everyone thinks a c-section is awful.  I had no complaints. 

Fast forward three years, I'm preggo again.  After being told I would HAVE TO HAVE a repeat c-section since I had one before, I looked for VBAC doctors.  I knew I wanted the option.  Since my first c-section was fine with me, I was okay if I HAD to have one, but I wanted to experience REAL birth.  My doctor's office was less than nice when I had my records sent elsewhere and they all said "that doc doesn't to VBAC."  UMMM yes he does.  

Everything planning up to the VBAC went well.  I was approaching my due date and had false labor twice, but my doctor said I'd need to schedule a c-section at 41 weeks if I didn't go into labor myself.  I did everything under the sun to go into labor.  I probably shouldn't have done so much looking back.  

The day before I was due, I was in labor at the docs office and I was sent to the hospital to get monitored.  I was just a one and I HAD TO ASK to be checked.  I'd been in labor at home with contractions ten minutes apart for 24 hours.  My contractions slowed when I laid down so I asked to be unhooked so I could walk.  (But my nurse already said my doctor would come in after work to break my water and she felt confident I'd have the baby by morning.  She was very supportive.)  I was so excited so I wanted to walk to help myself as much as I could.  Talk about contractions.  I stopped a lot in the halls because they were so strong.  But they just checked and I was barely a 2.  How was I just a 2 with this much pain and I was a 3 when I went in last time with my first child?  No pain in that 3 at all but this tiny 2 with contractions was not fun.  

After walking for a hour and losing my mucus plug, my contractions were coming faster and faster.  I asked the nurse to hook me back up.  I was really going and they hurt in my lower abdomen a lot.  The nurse had me breath with her since my hubby was on his way and she said I was starting to hold my breath.  Within ten minutes, I basically had one non stop contraction since they were coming so fast, but I was still a 2.  What the heck?!?  

My nurse started an IV "in case."  Then I saw the baby heart rate drop.  So did she.  Another nurse came in too.  She started another IV line in case I needed blood.  

By this point I was wishing for pain meds to calm me down so the baby heart rate would get normal, but since I was a VBAC, the only thing they "seemed" to think would help me at all was a c-section.  My nurse called the doctor and then my room was swarmed with people.  THEY decided after a FEW minutes of a baby heart rate drop that I needed a c-section.  (I know they would have tried much longer and done many more things to get the baby heart rate back up if I had not already had a previous c-section.)  

I wasn't even admitted into the hospital yet, but I was shaking and hurting so badly.  The baby heart rate was still low.  I was brought millions of papers to sign.  I'm sure I signed the c-section one then too.  I was able to call my husband and luckily he was in the lobby.  I told him I had to have an emergency c-section.  

LEaving out the birth story, I am healing so slowly.  I didn't know people get scabs at their incision since I was stitched last time.  After one month, my incision is still not healed.  I never needed pain meds with the first and I had to go to the doctor for more with this one.  I feel it when I walk, get in the car, basically all the time.  What the heck was this?  After I got home from the hospital, everything sank in.  I cried for a month off and on about losing my VBAC.  I think I was not emotionally ready for this one as I was last time.  I also feel I was screwed into it.  I'm no doctor so I don't really know about baby heart rate and wait time to fix it, but I feel I was RUSHED.  Then I cried because I would not have any more children.  I would not go through that again.  HUGE physical and emotional pain.  Then I was pissed I was going to let some doctor and a bad c-section experience decide my future with future kids.  

I've been researching VBA2C already.  I know if I get pregnant again, I'll need to be ready with a team of supporters.  (My family, and I pretty much mean everyone including my husband don't seem to understand.  They think just get a c-section since you can plan it and get a healthy baby.)  What about me?  My baby was totally fine.  I am SOOOOOOOOO not.  I was not okay and I still am not okay.  Then when I think about "just do a c-section next time and be done with it," I get mad at myself because then I'll be letting everyone else tell me how I should do it.  

I'm not a natural birth person who wishes to do things at home, but I'l to the point of I'll do whatever it takes to get a VBA2C. It has to be easier than a repeat c-section.  

I still cry off and on and I feel I have no support.  My husband doesn't understand why any woman would want a baby to pass through "that hole."  My mother even said I should be grateful for c-sections.  I sort of am but then I despise them as well.  I have great, healthy babies!  No one in my family immediate or extended has ever had a c-section.  I told my mom my doctor said it would be safest to have a c-section again if I had another child.  She thinks the c-section is what I should do.  I reminded her that she had never been through it and she is one of the only people whom I've let see my pain.  She even forced me to call my doctor.  She had her children vaginally without medication because the doctors told her medication hurt the baby.  At least then she agreed.  This blog is the only way I get any support.  I'm tired of people saying that the c-sectionw as best.  ALL OF THEM have never had one.  They got their babies the natural way.  I now feel I was not told about turning babies, and then I was rushed into a RCS.    

So what's next?  Don't know...

[Ms. B. Sprout]

Big hugs, sharpmamma.

Do you have an ICAN chapter nearby? A key part of healing for me has been attending ICAN meetings and telling my birth stories over and over again.

[jenniro]

sharpmomma, I am so sorry that you went through that and have no support.  Online forums have really been a life saver for me.  NOONE gets it IRL, and I don't have an ICAN chapter in my entire state.  Your only a month out from your CBAC so things are still really raw.  I remember feeling exactly the way you did.  I had been stalled at 4 cm all night, maybe b/c the bi#&ch of a doc kept coming in to tell me I couldn't do it, so in the morning I was tired, scared, and unsure of myself.  I mention maybe I want the c-section, and BAM, within 15 minutes I am in the OR.  Not one person, including the useless doula I hired, had me slow down to really think about what I wanted.  I kicked myself every day.  It has been 10 months and I feel better.  I still get sad, but I think that will always happen.  But I have come to forgive myself and realize that I did the best I could with what I was thinking and feeling at the time. 

You are grieving the loss of the birth of your child, so your feelings seem completely normal to me.  You'll work through this grief, though.  Hopefully you have access to an ICAN chapter, but if not, vent to us, we get it. 

[roadfamily6now]

Once baby is deep in the pelvis, a Doula or other support person can try using the REBOZO and see if they can work baby out of the pelvis and resettle in a better position.

Hugs Mommas!

[*Jade*]

I'm sorry you are feeling so bad about your c-section :(

I really hate hearing people wonder if they have "failed" because of their c-section, and I say this as someone who was induced (or attempted!) for 4 days before a c-section, 4 doses of gel and I didn't dilate a bit!  But I don't think I failed, and I would never think anyone else did too. 

Do we ever judge ourselves for other medical issues?  Do we fail if we can't pass gallstones by ourselves?  Do we fail if our appendix bursts and we need surgery?  I realise I'm simplifying the issue, but it really saddens me that as women we hold ourselves so responsible that we start to blame ourselves.  Could I force myself to dilate?  No.  And while I would have loved a natural vaginal birth I'm not going to hold myself responsible for things that were outside of my realm of control.

I hope that you get some peace over what happened.

[obdoc]

Originally Posted by *Jade* 

I'm sorry you are feeling so bad about your c-section :(

I really hate hearing people wonder if they have "failed" because of their c-section, and I say this as someone who was induced (or attempted!) for 4 days before a c-section, 4 doses of gel and I didn't dilate a bit!  But I don't think I failed, and I would never think anyone else did too. 

Do we ever judge ourselves for other medical issues?  Do we fail if we can't pass gallstones by ourselves?  Do we fail if our appendix bursts and we need surgery?  I realise I'm simplifying the issue, but it really saddens me that as women we hold ourselves so responsible that we start to blame ourselves.  Could I force myself to dilate?  No.  And while I would have loved a natural vaginal birth I'm not going to hold myself responsible for things that were outside of my realm of control.

I hope that you get some peace over what happened.

I like this way of thinking---I hate it when a patient feels guilty.  I have worked with doulas who after a woman has pushed for 6 hours, and then I deliver with forceps actaully say to the woman "See--there WAS enough room in your pelvis---you could have done it!!!"    I have called them out right on the spot and asked them what therapeutic form of communication were they using--as all they did was MAKE the poor woman feel like a failure--instead of supporting her decision.

[ablepearl]

My first VBAC had his head tilted the same way.  He progressed far enough that they were able to use low forceps to un-tilt his head.  Had I not been in a teaching hospital (military to boot!) this may not have happened.  Had I been with the provider I had for my fourth child, I would have been in the OR.  My son was also having issues with his heart rate during contractions, the nurse was the one that told the doctor to try something else.  She said, "She has worked so hard, she deserves every chance we can offer her!"  I am so glad she was there with me, especially since she stayed 2 hours past the end of her shift so she could be there with me :D

I have a history of malpresentation, not just with my first VBAC, but with all of them!  My first was breech, so were #'s 2 & 3, with successful ECVs.  With number 4 I started seeing a Webster trained chiro at 23 weeks.  She was the only one that turned on her own.  I don't know if it was the chiro or not, but it seems like it didn't hurt.  I think any woman that has repeat malpresentation should consider seeing a chiro during her pregnancy!  Or even before to get things perfect before pregnancy comes and knocks it out of whack even more!

To the OP, you are not a failure.  Delivering babies that are not in optimal position is very, very difficult!

[justKate]

Hugs all around!

I can't tell you all how much I appreciate you sharing your stories.  If anyone is interested, there seems to be overlap here with this thread: C/S support thread  I know there are some ladies on both but it has provided some comfort for me; just thought I'd share.