I need some insight regarding my birth

[mamaginabean]

I went to a CNM for my pregnancy. I wanted a homebirth, DH was nervous as this is our first child and so we compromised with a hospital birth with a midwife. I so badly wanted a natural unmedicated labor and delivery. I did not allow any internal exams, the office policy is starting at 35 weeks I think it was that they do internals but I declined. At 37 weeks I started having prodromal labor, and was leaking what I thought to be amniotic fluid. She did an exam to check and see if it was in fact amniotic fluid, which it wasn't.

At that time, she also checked my cervix and said she felt the baby. She got a weird look on her face and sent me across the hall for an ultrasound. There they confirmed what she thought she had felt- a butt rather than a head; baby was breech. She also said I had very low fluid, and was worried about a cord accident. She said that because of the fluid and since I was so far along that they would not be able to try to turn the baby.

Here is where I am so upset with myself- instead of going home and researching, I got sent to the hospital for an emergecy c-section. I was just so worried about the baby, and shocked. I had gone in for my regular 37 week appointment and gotten slammed with 1) the fact that baby was breech and 2) it would be best to deliver today:

I feel that a big part of my postpartum depression is due to the fact that I blame myself for the c/s. I keep thinking that somehow I could have changed something.

She reassures me that I will have a VBAC- I will probably be going to her for prenatals, but I will definatley be having the next one at home.

I guess I'm not sure what I'm looking for with this post. I know there is no way to go back and undo what has been done. I have a beautiful baby boy, no matter how he got here. Maybe tell me if there was something I could have done, or maybe tell me there was nothing I could have done. I don't know. I'm just so depressed, this was not what I wanted at all.

[lactivist]

I think it is very normal to look back at our births and wonder what we could have done differently. I don't think beating yourself up about what you could or couldn't have done will help. I think that researching about breech, low fluid, c-sections for breech, natural births for breech etc etc. will help give you some understanding about what choices you could make in the future that would change your decisions. You have every right to be disappointed and upset that your birth didn't turn out how you wanted. As much as everyone says "well at least you have a healthy baby" that doesn't change the disappointment and hurt that goes along with a different outcome than we expected. You may be able to make different choices in the future but that birth will always be what it is. I think processing our births is very important work and can help us gain insight into what we could do differently next time. I also think it is important to come to terms with how the birth actually was rather than how we expected it to be. You are doing the really hard work right now. When you are in a position where you think your baby's health could be in jeopardy it is very hard to take the time to do research. The medical model often uses our fear of something happening to our baby to do exactly what they want. It doesn't mean you did anything wrong, only that you reacted and did what you thought was best at the time. Hindsight is 20/20 so try to keep that in mind when looking back at the birth. You can't go back and change your decisions but you can look at them with fresh eyes. Be kind to yourself it is hard work becoming a mother and it doesn't just happen suddenly, it is a process. You are learning and growing and you did your best at the time.
Wendi

[erin_brycesmom]

I'm so sorry mama! Questioning the birth is a good thing. Please don't beat yourself up about it though. I would definitely research it a little more. Research is always good. Knowledge is power.

So she told you that your fluid was so low that you had to have an immediate emergency c-section at 37 weeks? Wow. I have never heard of that in my life. I have heard many times of people having low fluid but I thought there were ways to try to build it back up. Your fluid is constantly replenishing itself. Even if there was no way to build it back up I don't understand why you'd need to have the c-section right that second. How does having low fluid for a day or two more put the baby in danger? What was your actual fluid level? These are the questions I'd be looking for answers for if I were you. Maybe you already know the answers. For me personally I would not use this MW for prenatals the next go round.

FWIW I had an induction at 18 days "past due" with my first and the reason was because of low fluid. It was not a c-section but it was still filled with interventions that I hadn't wanted and I did become depressed about it. I researched like crazy and took charge of my birth the next go round and had a truly wonderful natural birth (intervention free) the 2nd time. It was heeling.

ETA- I also wanted to add that with my 2nd I was confirmed breech at 37 or 38 weeks and they wanted to do an ECV followed by an immediate induction if successful or a c-section if not successful. I went home researched like crazy and then went for Webster with a chiro instead. Webster worked for me, but I don't know about my fluid level, no one mentioned it being low or anything.

[alegna]

Typical bully situation. What could you have done differently? Chosen a midwife with a different philosophy (homebirth, not hospital) Refused the u/s. Refused the section. Found a midwife comfortable with breech birth.



BUT no use beating yourself up over things that were. When you know better, you do better.

-Angela

[Ruthla]

You did the best you could with the information and resources you had available at the time, in the situation you found yourself in. Part of that situation includes the fact that your MW said "we need to rush you over to the hospital for a c/s immediately!!" and not "let's schedual a c/s for next week."

You were a nervous, hormonal, first time mother-to-be, which is a pretty vulnerable position to be in! It really sounds to me like your trusted MW let you down, and took advantage of that vulnerability. Or maybe the OBs in the office did that, and your MW failed to protect you. Or maybe nobody did anything "wrong" but it was just a sucky situation all around. It's OK to be angry about the way that 37 wk visit was handled. It's OK to grieve for the birth experience you didn't have. I don't think you'll be able to fully move on and enjoy life's current blessings until you acknowledge the anger and grief and/or whatever other emotions you're feeling.

[sandy'smama]

Oh, I do feel your pain. I was sent for an observation because of high blood pressure and the next minute told I will be induced bacause of risk of pre-eclampsia (all my tests were clear though). I was so bullied into everything "bacause of the good of the baby" (more like we do not want to be sued) and I was so stressed and worried I went along. I had all the interventions you can imagine stopping (very) short of an emergency cesarian... and the way they tell you "well you have a healthy baby at the end" is total and complete "b@**&!s" I had issues with bonding, breastfeeding and depression, I hated anyone touching me and sex was out of the question for at least 8 months postpartum - all caused by my birth experience. It took months to get over and at times I still get really angry and resentful when I think of it. I am now 34wks pregnant with my 2nd and planning a home birth, I am hoping this will bring the healing process to a close.
I send you all my hugs and good wishes, you will feel better about your experience with time and now you will also have more knowledge to deal with any bullying tactics if you decide to have more kids one day. There is nothing you could have done, you did your best in a very difficult situationand one day you WILL feel better about it.

[sarahn4639]

It certainly could have been different but I certainly don't blame you for doing what you did in the moment. Even when you are well educated and know what you want, there are times and situations where they can make you question yourself. Bullying happens, a lot more than I'd like to admit. When I say you were bullied I don't mean they were yelling at you but just with the urgency they used and not giving you time to do research they were telling you what to do and giving you no chance to make decisions for yourself. I agree that I would not use this midwife again, she does not have the same birthing philosophy you do, or the docs she works with don't and she did not stand up for you. I would do some interviewing of homebirth midwives and ask about intervention, transfer, and c-birth rates. Good luck, keep processing and learning, try to change your thoughts from what could have been or guilt to how much you've learned and what you know for next time. Pam England's book Birthing From Within may be helpful and I'd see if there is an I-CAN group near you. Visit their website for info.

[laohaire]

Yeah, OMG, you must have been so scared. I know I would have been. I don't know if I would have been able to push back, at least as a first time mom (I *think* I'd be able to now). And I'm not even that shy, and I'm well-informed. There's something about medical professionals - doctors and midwives in a professional setting - they say "we need to X" and it's like a command. Your mind is whirling and you don't have access to any resources (other than the professional) and of course you want to do the best thing for your baby. With that kind of pressure, it's so hard to stop and say "hey, is this REALLY necessary?"

I had a home birth so I didn't have that birthing experience - but my DD was hopsitalized for jaundice on day 3, and I was exactly like that. I let them give Hep B even though I wanted to research it first (yeah, I have to blame myself for not researching it first but I thought I had a couple of months and I was so focused on the pregnancy and birth and not at all on vax and stuff). Hello, she's a little baby and she's SICK right now, and you want to give her a Hep B shot? SHEESH. That was only a tiny fraction of it, along with the sugar water, and them taking her away from me and putting her in a box, and only letting her nurse every THREE HOURS even though she was newborn and was jaundiced precisely because she wasn't nursing well... but I won't bore you with the details, but you can see how when you're on their court, it's their ball game. I kick myself to this very day for allowing the things I allowed in the hospital. It was TERRIBLE.

So you're not alone, you are very, very, very far from being the only one who got pushed into something like that. I think 99% of moms get pushed into things they don't think are right around the labor and birth experience.

I don't know how you will feel better, so I'll just be honest. I think you COULD have changed the outcome by pushing back - "wait, this really needs to happen today? why? well, that doesn't make sense, is that really true? etc." but I also think it's ENTIRELY REASONABLE and UNDERSTANDABLE that you didn't, and I very well may have done exactly the same as you did in your situation. So - you ARE empowered for your next birth, if you have one, and you can use this experience to strengthen your resolve to ask questions, push back, demand an explanation, and walk out and do research if you're not happy. And I guess you and I both have to let it go that we didn't do that the first time - and it's true that we both have healthy babies and it turned out ok (though I don't say that to brush off your experience or feelings - but rather that it was something we can learn from and not need to carry a bigger regret than we do now).

[Kidzaplenty]

Sorry for your experience. It is wonderful that you have a happy, healthy baby to hold.

When in an unexpected situation, it is hard to know what to do. When everyone that you trust with your health is telling you do do something for "your" benefit, it is normal for you to go along and believe them and trust them.

It is also easier for you to look back on a situation after many hours or day or weeks and say, "I should have done...". Hind sight is 20/20. And you could never know at the beginning of your ordeal how things would have worked out.

You can not blame yourself, and you should not feel guilty for decisions made already. Nothing you do can change them. All you can do is look to the future and learn from them.

[boscopup]

Originally Posted by mamaginabean

At 37 weeks I started having prodromal labor, and was leaking what I thought to be amniotic fluid. She did an exam to check and see if it was in fact amniotic fluid, which it wasn't.

I'll bet it *was* amniotic fluid, and they just didn't use the right test to actually determine that. Did she just do nitrazine paper? I've heard that that one is really really really inaccurate.

I agree with everyone else - don't beat yourself up. You were in a vulnerable position, and they took advantage of that. I'll bet many (most?) of us have been there! I know I have! I had a hospital birth due to PPROM, and while things turned out ok, there are still things that I wish I'd voiced my opinion on, refused things, asked to be incorporated into the decision making process, questioned, etc. But I was a first time mom looking at a preterm baby, and I was just plain scared and didn't know what to do! Even though I'd researched natural birth and was seeing a homebirth midwife (who couldn't do anything for me except give phone advice once I was in the hospital), etc. I knew about *normal* birth, but didn't know about abnormal circumstances, and that's what I needed to be able to research at that point. Technically, I had an occasional Internet connection available, but it just didn't even dawn on me to do alot of research on my condition. Anyway, all that to say - don't blame yourself. Just do your research now to see where in the future you could stand up and say "WAIT". That really is alot harder to do as a first time mom, believe me!

As for your situation and whether it was an emergency... You can go for WEEKS with low (very low) fluid and have baby be ok. Since you PROM'd fairly late in the third trimester, the lack of fluid itself was not an immediate life or death situation for the baby. I know of women who PROM'd as early as 12 weeks, had little to no measurable fluid on u/s the entire pregnancy from that point on, and their babies went full term and were healthy. That's incredibly rare for such an early PROM (most of those babies don't make it because of lung development not happening), but it shows you how low fluid later in the pregnancy is not the dire emergency that your midwife made it out to be. Now with baby being breech and you having low fluid, yes there was higher risk for cord accidents, but they could have monitored you for that. I don't think the rate of cord accidents in that situation is huge or anything. It's just higher than it would be if baby was head down.

I am guessing that your midwife and/or OBs don't do breech vaginal deliveries period. That's pretty common. And if you have attendents who don't have any experience with breech vaginal deliveries, it's probably safer to go with the section. Otherwise, they're more likely to do something really stupid that could hurt the baby during delivery. So while a vaginal delivery of a frank breech is perfectly doable, it's not as safe if you have inexperienced attendents mucking with things.

Do alot of research on PROM, so you know next time how to handle that situation if it occurs again. Also, find a different midwife (homebirth type preferable!!!). Continue to read here on MDC. And if you ever find yourself in a situation like this again, remember that you have the right to say "STOP - I want to research this", even if you go to the hospital and get monitored while you pull out your trusty laptop and get onto MDC and start researching your situation. Having this previous experience under your belt, you're probably going to be alot stronger in your ability to say no to things and to ask questions. And hopefully you can have a lovely VBAC next time.

I'm sorry you went through what you did, but again, do not blame yourself or beat yourself up. You did what you knew to do at the time. And it's obvious that your first priority was your baby. It was a sucky situation, and you need to grieve the experience. PPs have posted some wonderful resources for you to help get past this experience and learn from it. Hugs to you, mama!

[roseq]

HUGS

I just want to say that I also chose to go to have the c/s when I found out my baby was breech (I was home, with MW, at 9 cm, planned HB). I felt strongly at the time I should go, but since then I've questioned myself a million times. I think one of the things about having the choice is feeling so guilty afterward. There are so many emotions mixed up in that. So many "if only..." thoughts.

It's been a year. I'm still working through it. Feel free to vent about it, and allow yourself to have your feelings. Don't let anyone tell you you should get over it, or that you did something wrong.

[kathan12904]

So sorry to hear your story. A very similar situation of coersion and scare tactics facilitated me ending up with a c/s almost three years ago. Looking back, I could tell that it was unneccesary, and the more I learned about birth, the more angry and hurt I felt. I did then and still do feel that a crime was commited against me and my baby. I struggled with my feelings of inadequacy and failure for over 18 months while the repercussions of losing those important early bonding hours with my daughter effected my relationship with her and my ability to breast feed successfully. I labored to 8cm without so much as a 4 on that stupid pain scale, and somehow ended up with a needle in my back and a knife across my belly. Of course, everyone's attitude, including mine was, "your baby is healthy and beautiful, just be happy" But that doesn't really cut it, does it? There is an excellent website www.cesarean-art.com It was really phenomenal to me as far as how well it depicted my thoughts and feelings. Also, an instrumental part of my healing was attending a doula training conference. Since my experience, I had decided that I wanted to make sure no other mama was left to suffer the injustice that I had, so I was learning to become a birth advocate and doula. The all female surroundings combined with everyones enthusiasm and knowledge about birth was exactly the environment I needed. Also, I went to one that was three states away from me, so the time away from family and on the plane was great for reflection, journaling, meditating. For the first day and a half, almost everything that was said about birth had me on the verge of tears, but when I came out of it, I felt rejouvenated and capable of dealing and moving on. I encourage you to pm me if you'd like to talk more, and rest assured that what your are feeling is valid and will take time to process, but it will get better. I believe the world doesn't inflict wounds upon us that we cannot heal.

[DayDreamer]

You did the best you could with the information and resources you had available at the time, in the situation you found yourself in. Part of that situation includes the fact that your MW said "we need to rush you over to the hospital for a c/s immediately!!" and not "let's schedual a c/s for next week."

I agree with this completely.

With my first baby, I read and researched and thought I was well informed. After having my DD and finding this forum, I realized my research and reading was all from mainstream philosophies (What to expect, etc.). So I can guarentee you if my MW (hospital birth) would have said I needed a c/s I would have went right along with it.

There are things from my daughter's birth that if I could do over again I would. However, I can't. I can only learn from it. And I did. I did have guilt and anger over the choices I made in her birth, but ultimately I decided that I had a happy healthy baby/child and that's what mattered. I just chose to learn from it and move on. We can kill ourselves if we let the "what ifs" get ahold of us.

Mama, I feel your pain, I really do. But please don't beat yourself up over this. Take what you've learned from that experience, and what you've learned since, and empower yourself with that knowledge.

[Phoebe]

Geez, I would like to think that if I was in your situation with a smack in the face with breech baby and low fluid at 37 weeks that I would stay calm and go home and research and find an alternative. But I know FOR SURE that I would have done exactly what you did. This sounds to me like it wasn't one of those situations where you were taken advantage of. It sounds like they really had your best interest in mind and it may have ended up a really bad situation if you hadn't taken care of it immediately. That would have just shocked me and I'd have gone right along with it too.
I am on my 2nd planned homebirth (first one ended in csection) and I feel like I'm pretty informed. If the exact same thing happens to me in 6 weeks, I'll be having a csection again I'm sure...ick...don't want think about that.

Don't beat yourself up!

[erin_brycesmom]

If the exact same thing happens to me in 6 weeks, I'll be having a csection again I'm sure...ick...don't want think about that.

Why would you have a c-section at 37 wks for low fluid? I'm geniunely curious.

[maxmama]

I don't think the low fluid was as much an issue as the fact that the OP said she'd been prodroming. If the fluid was too low for an ECV (and while you can try it, a 37 week ECV with low fluid in a primip isn't exactly a no-brainer), then I suspect the issue was more that the OP was potentially going into labor quite soon with a known breech.

Good, bad, indifferent, there are very few docs and CNMs who will vaginally birth a breech. I was offered a vaginal breech almost five years ago and given the data that have come out since then, my docs (same practice) don't do them anymore. They know how, they've done many, but there have been a few studies suggesting that the experience of the provider is not a determining factor in vaginal breech births, and they don't do them anymore because of that.

[wifeandmom]

Did you trust your midwife at the time?

If you trust whomever it is you are seeing for prenatal care, and that person looks you dead in the face and says 'You NEED an emergency section...NOW', I'd venture to guess most moms would have surgery.

I mean, really, what if the midwife is wrong and you really DON'T need a section? Ok...that would suck, and I can see questioning your trust in that person later, being angry, sad, upset, all of those emotions after the fact.

But what if YOU were wrong? What if you questioned the true necessity of what she was telling you, went home to do your research, and something terrible happened in the meantime?

This experience illustrates two things IMO. One is whomever we choose to attend our births, to give us advice, to tell us what they recommend, WE MUST TRUST THEM. If you don't feel confident in your provider, that is a terrifying thought really.

Second is we have to listen to our gut instinct in the moment. And if it turns out that our gut was perhaps 'wrong', cut yourself some slack. You can only make your decisions based on what information you have available at the time, and really, if you were told and believed that your baby was truly in imminent danger, how realistic is it to expect that you'd have gone home to do a quick Google search while the midwife is telling you that baby needs to come out NOW? That's not really much of a 'choice' if she was telling you your child was literally in danger right at that very moment.

[erin_brycesmom]

then I suspect the issue was more that the OP was potentially going into labor quite soon with a known breech.

oh well if that was the case then I definitely would have refused the c-section. I doubt that was what was going on here though. I would actually want to go into labor first (on my own) if I were going to have a c-section so that would be ideal for me.

wifeandmom - I have to disagree with you that we must trust our HCP, but I do agree that we need to feel confident with them (if we have one).

[wifeandmom]

Originally Posted by erin_brycesmom

wifeandmom - I have to disagree with you that we must trust our HCP, but I do agree that we need to feel confident with them (if we have one).

Please don't misunderstand me.

I feel it is crucial to trust your health care provider. NOT because of who they are though, but you need to be able to trust whomever it is giving you medical advice. Sometimes, that's all you're going to have to go on when making very important decisions, and if you do not trust the person giving you advice, you REALLY need to find someone that you DO trust.

I wouldn't go to a financial planner that I didn't trust. I wouldn't leave my children in the care of someone I didn't trust. When faced with your health care provider telling you 'This is life or death here', there's no time to go home and check out what your message board buddies think you ought to do, hence my strong belief that it is so critical to find a provider you trust, literally, with your life and your unborn child's life, as that may be what it comes down to in an emergency.

[erin_brycesmom]

wifeandmom I don't think I misunderstood you. I just don't agree with you and that is ok. I just felt the need to express my view in support of others who may be reading and seeing in all caps that we must trust our HCPs.

My goal is to be fully educated regarding childbirth so that I wouldn't have to go home and look up information on low fluid if that situation would arise. And FWIW I have never in my life asked online buddies what I should do nor do I really have any online buddies. I also don't trust financial planners with my money or non-family with my children.

I do think it is important, if you are having an attended birth, to find someone whose abilities you are confident in and whose practices you believe in.