I've tried a few times to write a reply, but just couldn't get through it. It pains me to report that I ended up having another c-section. I'm still thoroughly in the middle of processing it and have been sobbing buckets every time I think about it, which is only about every third second of the day. This is a bit long, but maybe someone else can learn from my mistakes.
It was the culmination of a lot of factors. One, heavy pressure from the hospital, the OB, and even the hospital-based midwives (the one truly supportive midwife in the group was out of the office for the last weeks of my pregnancy with a family emergency...as guilty as I feel for thinking it, I do wonder if this changed my course...). By coincidence, the hospital was in the process of tightening up their policies for birthing women right around the end of my pregnancy, and a post-dates vbac was definitely more than they wanted to deal with. There was also some disagreement about my due date. The early ultrasound I'd had put me 6 days ahead of my dates. I *KNOW* my date was correct. The CNM group agreed to use my date, but the OB absolutely refused. So as far as the hospital was concerned, I was well beyond 43 weeks at this point and well out of their happy place. Also, my husband travels for work and the day was quickly coming when he would have little choice but to go back. He had taken 5 weeks of vacation to be home for the birth and beyond (it's laughable now, but I really didn't think I'd go as long this time for a few reasons), but that had run out...he was by this point out on a sick call under less than great circumstances. All of that was bringing up huge anxiety for me because it's exactly what happened with my previous birth: I ended up finally going into labor the day before he was to leave for 6 weeks. That birth turned out to be a cesarean...I had a 17mo at home and no family nearby and a recovery and...it was a scramble to get help here, steal a few extra days off for him, and hubby literally left to race to the airport within seconds of dropping me off at home. That aspect of that birth was like the traumatic icing on the crappy cake, and we were looking at the very real possibility of repeating that. And most importantly, the fear was really taking over. The night before that last prenatal appt had been really rough for me. I was tired, getting scared, anxious. I'd lost my zen place. I knew that I probably should cancel the appointment and call my homebirth midwife, but I felt an obligation to go, to do their tests and document that all was still well as of this moment as far as anyone could see. I wanted to be just compliant enough to keep them on my side in the event that I really did need them, I guess. In the end, my compliance, my desire to appear responsible, hurt me.
It was a Friday afternoon appointment. There was a lot of pushing to go ahead with a repeat c, and to do it now. I had planned to hold off on any decisions about anything until at least 43 weeks, which would have been the following Monday. The midwife was not able to get me on the schedule for anything on Monday and was concerned about who would be on call, how I'd be treated, if I just came in to L&D. I think it was true concern to a point, but manipulative also. They refused to do anything induction-wise, and the baby was still too high to wisely consider AROM. I was still barely 2cm, 50% effaced, and virtually no contractions to speak of...a couple of minor ones at night, but nothing significant no matter what I did. Cohoshes, birth ball, nipple stim, orgasms, chiropractic, acupuncture, etc, etc...my poor hubby was starting to feel like little more than a prostaglandin factory. I was afraid to use castor oil with the scar, but I wish I had. Anyway, the point is that the fear had taken hold, hub would have no choice but to leave soon, and I was feeling beyond dejected about the seeming lack of any action in my uterus...and I broke down in the CNM's office and caved. We walked over to the hospital, and the speed with which everything happened after that is just breathtaking to me. I know I'm seeing things a bit dramatically, but jeez...it was like the vultures had been circling and dove in as soon as I acquiesced. My appt with the midwife had started at 1:20 and we were there for a good while, and my son was out of me by 4:30. I was in a fog, like a bad dream. I fell into playing the 'good little patient' role and of course taking care of my son, but it all really hit me within a few hours of being home. Like a ton of bricks. I just kept thinking what the hell happened here?! What was I thinking?! How did I end up here?! How did I let this happen?! Over and over. It still baffles me. I was an excellent vbac candidate. I had birthed vaginally before, and quite easily. I was beyond healthy. My baby was healthy. There were no signs of distress in the least. He was in a great position, not tangled up in his cord, not super huge by any stretch (just under 8lbs), blah blah blah. And worst of all, I hadn't even planned to be in the stinking hospital to begin with. They were supposed to be my backup, my 'lets be responsible hbac'ers and do co-care just in case'. And despite a ton of knowledge and wisdom guiding me otherwise, despite it being completely antithetical to my personal philosophy, I let them and their fear-mongering into my head, and for that I am SO pissed off. I am angry at the system for pushing me into that corner, and I am really angry with myself for allowing it. When I broke down and agreed to the cesarean, I was honestly embarrassed to call my homebirth midwife. I asked my husband to call her while they were prepping me. When I think back over the last couple of weeks when things were getting really tense for me, I realize that the only time I truly felt good and confident and relaxed was on my way home from her house after an appointment. I should have called her that day before agreeing to anything, should have called her that morning before the appointment when I knew I was feeling low.
I'm usually not one to second guess myself, but I have a lot of 'should haves' and one enormous regret with my son's birth. I still cannot believe that I did it, that I just handed over my autonomy and my son's right to a normal birth. It just feels so hollow, so disappointing. I don't feel at all like I've given birth, and honestly my bonding with him at this point is somewhat forced. At least I had a good long labor and very long second stage before transferring with my first cesarean, so I still felt like I was part of the process and came out of the surgery feeling like my daughter and I went through it all together. I had gone into labor spontaneously, so at least I'd given it a chance with that one. But this time...is different, and I am so sad. He is my last baby. He was the bonus 'do over' baby, was to be the healing birth that I hear so much about. But what happens when you don't get your healing birth? When it is, by far, worse than the one you wanted closure from? And when it was, more or less, your choice?
My take home lessons from all of this are many, but there are a couple of things that I feel are really worth mentioning in this cautionary tale. I think that if this, this unnecessary repeat, can happen to me, it can easily happen to just about anyone. I went into this armed with a huge amount of knowledge and motivation, with a great support team, and with every confidence that I could birth a baby. I felt better in this pregnancy than I had with my other two and couldn't wait to labor again. And somehow it all fell apart in the end, and now I really intimately understand why the repeat c-section statistic is so high. The box in which birthing women must fit in hospital-based care is pretty tight already, and it shrinks considerably when you're attempting a vbac. I realize that there is no safe place for me in conventional care. Odds are very, very slim that I will have another baby, but I absolutely will not participate in conventional care if that should change. I had only out-of-hospital midwifery care with my first two pregnancies and was pretty relaxed and confident right up until the end with both despite very long pregnancies. I was supported, and my midwives' only concern, truly, was for our good health and well-being as a family. Our care was individualized to our needs and our situation. This time, it was painfully clear that decisions were being made about me based on the hospital's liability first. Our specific circumstance and needs were ignored by the OB even when this was directly questioned. Instead, we were reduced to statistics and probabilities and worst-case scenarios, and the end result was an unnecessary surgical birth. It's case closed for them, but it will impact me for the rest of my life.