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was my c-section "necessary"? warning bad hospital birth  

post #1 of 11
Thread Starter 
I'm having some trouble still processing my birth, and I hear about how many c-sections are "unnecessary". I'd like to hear some opinions from birth professionals about my outcome, and if my c/s was or wasn't, so I'm going tell my birth story.

There was only one midwife in town, who canceled 4 out of 5 appt's with us (so unfortunately we couldn't keep her), and we wanted to homebirth, but not if we felt uneasy about it. We decided to stay home as long as possible, UC if the baby came quickly, and go to the hospital otherwise. I went to 41 weeks, my son "spun" often posterior to anterior. His head had been low since 33 weeks but at 39 weeks for some reason disengaged and mostly remained high in a OT position. I asked at every appt. that I did not think the baby was in a good position, and they said, oh well at least he's head down... was threatened with induction by my OB and had my membranes sweeped at 41wks, water broke the next day, and went into labor 1 hr. later. Contractions were irregular as in early labor but very intense in my back. I could barely move and spent the next 8 hrs. on my knees, drinking gatorade and rrl tea and vomiting. I thought I had to be in transition the whole time, but he remained high, under my ribs! and wouldn't turn. We ended up going to the hospital, they told me I was at 2 cm, and I was so frustrated by hearing that and worn out that I gave in to epidural and IV. I progressed quickly in a few hours, then they turned the epi off for me to push. He still wasn't descending or turning, and they told me not to push, just wait for him to turn, but he turned posterior. I tried pushing for 1 1/2 hrs. after that and I could touch his scalp. I asked if they had a squat bar, and the nurse said, yes, do you want it? I said oohhh i don't knoooww (during a contraction, that means yes!) she never brought it. They said he was still high and Dr. used forceps, but he couldn't get the baby past my pubic bone. He used the vacuum TWICE after that, the first one may have been broken but they knew I didn't want the c/s. His scalp came part way out but then the suction broke and he slid all the way back inside me (and my blood sprayed all over the room). The Dr. suggested a c/s after that and said the skull was not coming past the pubic bone (although I pushed his scalp out!). Is it likely that positioning i.e. squat or time could have made vaginal birth possible or not? I was weak and not pushing entirely effective, even though they allowed me free fluids and popsicles etc. I vomited everything, even ice chips.
post #2 of 11
I don't think there's anyway for me to go back in time and say...but it sounds rough - really rough. I'm sorry.
post #3 of 11
post #4 of 11
In my opinion, there are degrees of "necessary." In most cases of cesarean births, I think that if a woman had been on a deserted island with no medical professional, the baby would have been born vaginally and would have been fine. In your case, had your membranes not been stripped, *maybe* your water wouldn't have broken, giving the baby more time and cushion to change positions. If you hadn't been checked, *maybe* you wouldn't have gotten an epidural, and then *maybe* you would have been able to do more to encourage him to turn. *Maybe* if you'd been able to squat or get on all 4s, he would have been able to be born. These are lots of maybes, all just guesses of how things might possibly have been different.

This, to me, is where the subjective nature of "necessary" comes in. Posterior labors are hard. You tried to turn him unsuccessfully. You waited a reasonable period of time and went through a lot of intense labor before getting an epidural. You pushed for a reasonable period of time, and tried assisted delivery as well, and the baby didn't descend. With the way your birth unfolded, I don't think any of your decisions were unreasonable or incorrect. On a deserted island, maybe things would have been different, but we don't live in a vacuum, and we only do the best we can do with what we're presented with.

I hope you're able to feel good about your birth at some point. I know it must be very difficult to want a low-intervention natural birth and end up with a cesarean. Try contacting ICAN, and find some other women who have been there and can help you process what happened.
post #5 of 11
: The pp covered about everything. I do wonder about the baby going back up since you did birth part of the scalp. Posterior is a difficult position...but did anyone suggest shoulder dystocia? I wouldn't except that his scalp should have stayed there... or maybe you did just need a bit more time and a different position. KWIM So it's possibe that your cesarean was necessary, maybe not. But like the pp said, there were a lot of maybes. You sound like you did a great job with what you were given...and that counts for a lot. An empowering birth doesn't mean just birthing a baby out your yoni, it's taking responsibility and making good choices with the given knowledge at the time.

Congrats and enjoy your new baby.
post #6 of 11
maybe in the beginning --
the PROM most likely has a relationship to stripping membranes- and I say this because you were found to be only 2 cm when going in- a gentle stretch and sweep where a provider slowly works the cervix- wouldn't even be done unless you were already 2cm and head well applied to the cervix- and after a mom is usually 3 + the statistics on this are pretty good that stripping membranes can stimulate labor- -
vomiting- now this would probably be the thing that should have been addressed via- meds even before the epidural, short half-life as a med and could have dealt with a pretty destressing symptom- some CNMS will give this med and it will help mom sleep in early labor
someone not really paying attention to position -- which I notice you were aware of and concerned about I would like to validate the feelings you had about that as well the way your labor was happening and progressing in the beginning is very much like a labor where the baby is not well positioned- but despite that you were able to dilate well- doesn't that speak tons about how well your body works-- it really does-
turning the epidural down before having you push- and having a woman labor down before making pushing efforts - can be more effective or successful --more importantly you wanted to squat-- and what I have seen when babies do hang up bobbing above and then under the pubic bone is Mc Roberts- which is a lying squat and squatting- and for some it is standing and lunging -- pushing that comes from the inside is so much more effective than coached pushing for the most part-
lastly- if you were at home I would not have been able to give you drugs and what we may have tried in early labor for you may or may not have worked- but if you had gotten to the point of pushing and no progress we would have transferred care- and the hospital may have provided the same care with the same outcome- so no way to be absolutely sure but there are some things that could have been done differently
post #7 of 11
I just wanted to offer my , I know all too well the ?'s that are there after a birth like this and it may be that the answers will never all be known. Good support and help with positioning this baby of course "could have" changed things but we will never know for sure. The greiving and healing work that lays ahead for you can be life changing, please come onto the ICAN list here is a link to join the group: http://www.ican-online.org/community/emailsupport.php

It will take time, be gentle with yourself.
post #8 of 11
I would highly recommend that you read "Birth as an American Rite of Passage". I read it for my doula training and it helped me understand alot of what happened during my hospital births and why it didn't feel right. I would trust your instincts in how you feel and read, at least that's what made me feel better. Take the power back and research, that's how I veiwed it. Good luck.
post #9 of 11
Thread Starter 
Thanks so much everyone. I will read that book, and looking forward to joining the ICAN group soon. I'm just going to have to accept that my c-section was necessary with the circumstances and environment I was in. Hopefully I can face any emotional roadblocks and put myself with a knowledgeable homebirth midwife which will at least increase my chances for a successful VBAC/HBAC in the future. It's also sweet to see that some of you have overcome difficult births, it's nice not to be alone in this.
post #10 of 11

sorry

I am sorry you had such a hard time. I am a midwife and do both hospital and birth center birth. i know it seems strange to you that you could touch his head, but I wish i could draw a picture for you but anyway when you push so long the baby develops caput or soft tissue swelling and that came come through the introitus so you can touch it, but that doesnt mean the occiputal bones have come under the pubic bone, only the swelling has, which is also why you had an unsuccessful vacumm. I dont call for a vaccum assist unless the head is under the pubic bone and the mom is too exhausted to push any further. Had you been my patient I would of turned off the epidural, and had you squat. It is more difficult to push out a baby op but it can be done, its hard to make a judgement of necessity of a cesarean though unless your the one doing the examining. But anytime you have two popoffs the next step is cesarean delivery, which is why you can't use it too soon. I think your doctor really wanted to give your vag birth and you should still feel very proud of all of the effort you did. You are a good vbac candidate in the future, and I really want you to be proud of yourself.
post #11 of 11
I've seen ceseareans done MUCH quicker than yours and for some very questionable reasons. Like the pps said, no one can say exactly what would have happens if this or that but your caregivers where not JUMPING to give you one. Sounds like they worked with you, gave you time and tried other options. I'm actually impressed by their patience. You had a really challenging set of circumstances and I think you did great making some hard decisions.
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