Need some encouragement after homebirth transfer

[Heather Lyn]

We planned a homebirth with an amazing team of midwives (a CNM and an LM/CPM) and a doula this September.  The first 12ish hours of labor were painful back labor, but manageable.  I was in the tub, in the shower, on the birth ball, inside, outside, etc., and I felt challenged for sure but not suffering.  My husband was great.  He and I were both born at home in about 12 hours, and were super excited and hopeful that we would have a great experience.

After about 14 hours of labor, I was only 3 cm dilated, which I found discouraging, but everyone kept reminding me that some women dilate all at once, and as a doula myself, I knew this was true (and I'm a first time mom so I knew it was probably going to take a while).  I was definitely prepared to be in labor a long time, or at least I thought I was.  After another 10ish hours, however, I hadn't moved past 5 cm and was really starting to fade, physically and emotionally.  My midwife tried unsuccessfully to turn the baby manually from his posterior position, while I laid on my back in the middle of a contraction.  Yuck. 

After 24 hours of labor, in more pain than I thought was possible, I asked to be transferred to the hospital.  I was done.  When I got to the hospital I got an epidural which completely wore off after 2 hours, so they gave me another one, new needle and everything.  After 6 hours or so, I was still at 5 cm so they gave me Pitocin, which took another 6ish hours to work.

Finally after 32 hours I was complete and ready to push.  I pushed for 4.5 hours and the baby was clearly visible, but not out, and I was starting to really lose it at hour 4.5.  I just wanted him OUT.  I was so exhausted and my back hurt so much, I was getting to the point where I wasn't sure I would even want to hold my son when he was born.  They gave me oxygen.

The OB was great and super supportive, and finally suggested a vacuum extraction so that I could avoid a C-Section (the baby's heart rate was excellent the whole time).  My homebirth midwives told me that they thought the OB was giving me good advice, and I agreed.  One pull of the vacuum got his head out, thankfully, but they still had to do an episiotomy.  On top of that, I had four third degree tears that made it very hard for me to take care of my baby after he was born.

My son was not only OP, but also asynclitic, and everyone agrees that he was never going to come out without assistance.  I believe this is true.  I feel extremely fortunate that I had not only wonderful low-intervention midwives, but also a compassionate, expert, mother-friendly medical team when I needed medical care.  I know I'm also very fortunate that I have a healthy living baby.  Of course.  Not everyone does.  So I feel like I need to leave it at that and move on.

But.

I'm still a little sad.  I have had two friends who had babies after I did, both in 7 hours from start to finish with no pain meds and wonderful memories.  I don't have wonderful memories, even from when my son was born and laid on my chest.  All I remember is exhaustion, helplessness and pain.  There were moments toward the end of my home labor, and the whole car ride, where I kind of wanted to die. 

Now I feel grateful for everyone who helped me and grateful that I have a healthy baby, but my confidence is shaken.  I'm a doula and I was sure that my body was going to get this done on its own.  Instead, it practically took a military operation to get him out of me.  I needed so much help, and by the time I got to the hospital, I was more than happy to be a medical patient, because that's how I felt! 

I feel uneasy when I meet with potential clients now, all of whom want to have unmedicated births.  When they ask me if I had one, I have to say no.  I want to have another baby, but I'm afraid to try another homebirth because I just can't risk going through that car ride again.  And on top of these feelings is guilt, because other people I know recently lost babies, and I didn't, so what am I complaining about, etc.

My doula and other support people all say "you were amazing" and "you're my hero," etc., and even though that's what I would probably tell a client of mine as well, I feel very far from that. 

Thoughts that might help me get some perspective?  Thank you all.

Tag: transfer, hospital transfer, vacuum extraction

[lilikoi]

I just wanted to say that reading your story made me cry. You are such an strong woman. 

[Heather Lyn]

Thank you.  I really appreciate it.  Glad to know someone read the novel I wrote!  :)

[eabbmom]

Okay first of all you did labor without meds. I went through about fifty hours before I begged for them and went on that terrible car ride and got to the hospital- no one can say I do not know about laboring naturally. Second I think that you should talk to your potential clients about the compassionate use of pain medication when they ask about your experience. Your labor does not make you weak it made you strong because you knew yourself well enough to know when to ask for help. Lots of women in your care as a doula will now benefit from your experience because you are not the only woman something like this will happen to and when a client has to transfer or forgo the natural birth plan they have, they know they are with someone that will not pass judgement. You are brave, you are amazing, you got your baby out and you did a great job. My heart goes out to you because I have been where you are and it wasn't all that long ago. Remember that pain is relative and although you do have a healthy happy baby and others don't it does not negate or lessen your pain or saddness. I used to listen to girlfriends in highschool complain about their mothers when I didn't have one and I wanted to say "How dare you be mad at your mom! She could be dead"; but the truth is that if my mom were around I would have complained about her too. Love yourself, you deserve it.

[allisonrose]

DS1 was a hospital birth. DS2 was a planned homebirth and I ended up transferring as well. My midwife suspected he was posterior. Her mentor later said he might have been asynclitic which seems more likely in hindsight. Malpositioned babies are not fun and I am also struggling with disappointment over my birth. He came out of it healthy as did I but the experience was far from what I wanted. I don't have any great advice for you just wanted to let you know you're not alone.

As a doula, you might consider encouraging clients to consider baby position, check out spinningbabies.com and possibly see a chiropractor. If I have another child I will definitely seek out an experienced chiropractor.

[Heather Lyn]

Thanks Allison.  I tried chiro and was obsessed with Spinning Babies - :)  didn't change Oscar's wacky position but I agree that both are good resources.  I love that website.  I found out the hard way how much positioning makes a difference!

[RJones1204]

Mama I really hope you heal from your feeling of sadness! Be honest with yourself.......you labored THAT long with no drugs! You tried HARD and pushed FOREVER to get your baby out! If you are honest with yourself about the energy, the time, and sacrifice you put into your birth...I think there is a chance you will feel better about everything. We don't have control over everything. The best we can do is prepare our mind and body for the labor/ birth process.  When things don't go as we envisioned we can seep down into that dark place of self pity and depression. You should write your own positive sayings and repeat them to yourself allll the time. 

[Everlong753]

Heather, 

I can really relate to the difficult feelings you're experience has left you with.  After about 38 hours of crazy intense back labor and trying everything under the moon, I was sectioned for a posterior/asynclitic baby who was in distress (I was thrilled btw to read that you still birthed him vaginally and that your doctor offered you a choice!).  That experience has left me with so much pain, trauma, doubt and grief. I wont say it was easy deciding to homebirth, or do a vbac or uc the next times,  but in time I found that I knew what to do and you will know what is right for you too.  Just try not to put too much pressure on yourself for what's in the future.  You have every right to feel the way you do right now, you can deal with those other choices later.  

Although it's been an incredibly hard journey for me,  I've learned immensely from it.  I am so passionate about pregnancy and birth and have plans to attend midwifery school.  I've since birthed 2 babies at home with ease and both with wonderful memories.  We're expecting to do the same again in about 6 weeks.  

Even though my first experience was painful, it carved the depth in me to fill with my beliefs and faiths.  Being a doula with that experience gives you even an even greater capacity for understanding the wide ranges of birth.  I have no doubt you'll go on to have a wonderful labor and birth next time around, and that will also give you experience... but the struggle you just went through is unique will become a very valuable tool and allow you to be even better at what you do!  

[hollydlr]

I think your feelings are completely understandable!  What comes to mind is that it could be really helpful for you to look for a processing venue to help you work through your experience and come to a better place about it.  There may be workshops, individual or group therapy, or even something like an ICAN group.  Hugs, mama!  Its never easy when birth doesn't go according to plan, and interventions become needed.  Of course, you are thankful they are there when you need them, but of course it is a big emotional adjustment!  And it sounds like the sheer physical experience of it all was a bit traumatic for you.  Its easy to say that if you have another birth, it will be another story, but the body memory is powerful.  I wish you all the best in your healing process!

[hereyes]

Originally Posted by Everlong753 

I have no doubt you'll go on to have a wonderful labor and birth next time around, and that will also give you experience... but the struggle you just went through is unique will become a very valuable tool and allow you to be even better at what you do!  

Firstly, mama, congratulations on the birth of your son!!!  You are an amazing, strong woman with an incredible birth story. 

I, too, had a very disappointing labor/birth experience with my DD, my first child.  I carried around the guilt, shame, resentment, anger, and even hatred for myself and my unsupportive family for months when I should have been focusing all of my energy on my beautiful, precious, totally healthy, perfect little girl.  I was shaken...in myself and my family.  But, alas, I am still an advocate for natural childbirth/hb/hwb/uc, even though I cannot say that I have had one.  Sometimes I think I sound like a total hypocrite.  Now I just tell people that regardless of their birth plan, it is important to remember that it is not so important HOW your baby gets here, just that he/she does.

You and your medical team agreed that the interventions your received were largely necessary in order to safely birth you son vaginally.  There can be no guilt in that.

As women we have a tendency to constantly compare our bodies, our lives, our births to everyone else's (What is that about?!) and we just need to stop.

When I look back on those particular 29.5 hours of my life of course it still saddens me because I know what I lost in my weakness.  And for me it was purely weakness, not medical necessity.  -ha- My very first intervention was spousal fear/anxiety, and all following interventions were born by exhaustion, constant nurse badgering once at the hospital , and lack of support/an advocate...

...that's where dedicated, educated women like yourself come in.  Your birth experience is not inferior to anyone else's.  It arms you with the special knowledge and understanding that "nature is not always mild" and there is never a guarantee that you will have that "perfect"/"fast"/"easy" birth you envisioned (or even the perfect baby).   

Your faith and confidence in your body will return and I am sure you will attempt a homebirth again down the line...you wouldn't be here if you didn't strongly support it...nor would it bother you so much.

In time, so many more precious memories will fill the void where you thought all those happy labor/birth memories were supposed to go.

[Plummeting]

I haven't experienced a difficult birth like that, so I can't comment on how you must feel, as it would obviously be rude to assume I understand. However, I agree with the others who say that you did labor without medication. Furthermore, should that really matter to anyone who wants to hire you? What if your baby had been transverse? Would that make you less capable? Frankly, I would be much, much, much more likely to hire a doula who had experienced a medicated childbirth for no reason at all other than that she didn't like pain (and you certainly had more reasons than that) than a doula who had no children at all, so I really think you can lay that particular concern to rest. You're more qualified now than you were before you had a child.

[memz]

I know where you are coming from....my first birth was a bit like yours.... I was induced, in retrospect for no reason, with cervidil. After 14 hours of hard but manageable contractions, I was dilated to 4 cm.... Then my doula arrived at the hospital and everything progressed but really slowly. About 8ish hours later I was at 9cm !! Finally I thought, this is going to be over soon....After 3 hours at being at 9, a not so nice nurse, decided to rupture my membranes without asking...but baby was still floating, so I think that that caused her to engage but with her head asynclitic... About an hour later I was still at 9 with unbearable contractions (thanks for breaking my water!) I hadn't slept in more then 30 or so hours...so I took the epidural...after 26 hours of labor.....I was scared and dissapointed, but just didn't have anymore energy.....It still took about 8 hours to get to 10cm...and of course they had to give me pitocin because the epidural had slowed down my contractions.... I started pushing and that is when the dr noticed that my baby was coming down but with her head a bit crooked to the side....She tried to manually turn it for about 2 hrs....after 2 and a half hours of pushing she decided to use the vaccum and if it didn't work was going for a csection....vaccum did work and I finally had my baby....

After the birth I had feelings of being betrayed by body, the medical staff....Now why could'nt my body do this.....And after thinking about it a lot and talking it through with my doula, I realized that maybe I didn't get the birth I want, and nothing went according to plan, and everything went against my birthplan....But I still DID IT!! I gave it my all...everything I had in me, I gave it... I went beyond what I thought I could do, I didn't think I was that strong....I labored for 36 hours, pushed for 2 and half....and I labored naturally for 26 of those hours!! I never thought I could of done that....

So yes, nothing went acconrding to plan, but I can say that I am a strong woman.....

Now I am about to give birth anyday now and of course I hope that this time everything will go smootly, and that my body will do what it is supposed to do.....I guess we'll have to see...but I know going into this that I am strong and able to take on this birth because I already did it once!!

So be gentle on yourself....yes nothing went according to plan, but you did it, you gave it your all, and for that you can say that you are a strong mama!! Think about it....

[fruitfulmomma]

I don't have time to retype it all out again but my story is number 11 on this thread... http://www.mothering.com/community/t/1102671/homebirth-transfer-support-tribe

I had a homebirth, followed by a non-emergent transport during labor, a transfer of care to induce labor, and then 2 more homebirths.

[modestmothering]

When it comes to childbirth,  no one can predict how it's going to go.  You did the best that you could and you should be proud of your experience -- seriously!  What we do is not easy -- none of it -- and each birth is special and unique. 

[pandd06]

I can relate to your story. At 55 hours into OB labor,  I chose some interventions (inlucuding an epi) that I and my doulas felt were medically beneficial to avoid a c-section. It was tough to have "one of those" births, when it feels like I did everything "right" but it still didn't happen as dreamed. My emotions have been up and down and all around. Rehashing with my doulas, journaling, talking with DH, and joining a birth trauma support group are all things that have helped me grieve, process, and start moving on. I think the hardest lingering thing is the explaining it to others part. I like to think that even though my birth cannot be summed up in a one word "unmedicated" it can still be described as "minimal intervention (given what we were dealing with" or "thoughtful intervention". For those people who I wannt to share  a tad more with, I tell them that  I am a firm believer in natural birth and the amazing design of our bodies to birth babies without intervention in most circumstances. For those circumstances where intervnetion is in the best interest of mom or baby, they can be done thoughtfully and done as an educated decision-maker.

I am still working on peace with my birth. Even though logically I understand our decisions were wise (and in reality, perhaps made later than they should've been as a I suffered from pelvic nerve trauma that required months of pelvic PT), emotionally it is still hard to accept. I still run through the what ifs and that is ok and healthy. To deny my emotions would be unhealthy, to be paralyzed by them would be unhealthy. But to aknowledge them, talk (or write) about them, and have some release--even if it is the millionth time--that is a good thing.

[help007]

It took a lot of processing for me to be able to be joyful about my first birth, and it was intervention free (with midwives at a hospital).  When you go into your first birth, you have no personal experience (even as a doula!)- you only have ideas about what it 'should' be like or 'could' be like.  It can take a lot of time to really understand how you need to work through it.  I think one thing that might be helpful is to imagine one of your clients went through exactly what you experienced.  Write 'her' a letter about how you feel and whatever loving and kind thoughts come up.  Then read that letter, every day if you need to. 

The midwife who caught my lovely son came to talk to me the next day, and it was really difficult to hear her encouraging words at the time.  However, looking back, I know she truly meant every word and that conversation has become a pleasant part of my new motherhood.

After my experience, I totally understand why pain meds are available.  If I knew at noon, after 30 hours of labor, what the last 6 hours would bring, I would have jumped on the chance for relief.  Now, as a doula, you bring a whole new world of compassion that your friends with 7 hour labors might never develop.  You will be able to look in a laboring woman's eyes and offer first hand experience of what you are recommending. 

Being completely honest:  Before I had ever had kids, I would have been hesitant to hire a doula who had had an epidural.  Having gone through two intervention free births, though, I would hire a midwife or doula who had experienced a long, painful labor with *any* level of intervention at/near the end than one who had a relatively 'easy' birth.

[CookAMH]

All I can say is I never would have endured as long as you did. You are one heck of a strong woman and mother. You worked SO hard and hung in there to give your baby a good birth.   From my experience and research, baby's position can "make or break" a labor. It affects so much of how long and difficult it is. You had a great team caring for you and I'm especially thankful in the end for the OB suggesting the vacuum. I wish I had done that with my first instead of opting for a c/s (posterior as well).   I tell you what though, man, that baby paved the way for future babies to slide right out!!

[marrymeflyfree]

Your birth story has a lot of similarities to my second child's birth...my daughter was also asynclitic.  I had planned to homebirth and labored for a long time at home - very painful and stop-and-go compared to my first child's birth.  I pushed for over 8 hours at home before electing to transfer.  My labor stalled at that point, had pitocin and an epidural, and an eventual c-section.  It was shocking, disappointing, depressing, confusing.  It really took me a long time to put together the pieces of the physical and emotional puzzle after that birth, and it's something that I'm continuing to work on as I await #3's arrival (hbac, with any luck).  I never really understood why women spoke of their 'healing births' with such awe and gravity - but having had an easy, uneventful birth and a difficult and confounding birth, I'm starting to understand it in a big way.  In a sense, I feel almost grateful to have had so many varied experiences, and I realize that the biggest lessons don't come from the easy experiences.  I had the easy one, the hard transfer c-section, and hopefully will soon have the triumphant and healing hbac.  As wonderful as it would be to have a perfect birth story to share with your clients, what you do have may be more valuable...and when you're ready, the prospect of trying it again may not seem so daunting.  

[miriam]

T

Edited by miriam - 5/25/12 at 11:20pm

[thursday2]

I think your story is such a perfect example of what birth should be - honestly!  You made decisions based on your research and instincts, struggled, did everything possible to have the birth you planned, but you also had the foresight, judgment, and support to be able to know when you needed medical intervention - and you did need medical intervention.  As wonderful and beautiful and miraculous as birth CAN be, birth can also be a frightening, painful, even fatal experience, and has been for all animals since the dawn of time.  If I were a potential client of yours, your story would convince me that you were a doula that I could trust - someone who acknowledges what a woman's body is capable of, and someone who knows when it's time to be thankful for modern medicine.  IMO, that's the biggest issue I have with birth practices in this country - I chose HB because I didn't feel that the hospital or OB were choosing medical intervention when necessary, but by default.  I chose my MWs because I believed them to be capable of exactly that judgment - when to let things happen naturally, and when to say, "This is one of those births that would have gone really really badly 200 years ago.  Let's transfer."  I think you should be proud of your experience on both sides, the home labor and the medical decisions.  You did exactly what someone is supposed to do in these situations.  You could have been bullheaded about things because you felt a professional ego pull to do so, but you didn't.  My heart aches for you that you have to suffer such sadness - 100% understandable, of course; I would have been downright depressed - but you should let the pride of your wise judgment and the clear result of that judgment (healthy mom, healthy babe) rise to the surface.  Don't be embarrassed or uneasy with potential clients, be proud!  "I labored naturally at home for 2 whole days, and then I took the assistance available to me!  I can relate to every possible birth experience you might have!"