The On-line Journal of Mary Esther Malloy

When I first became pregnant, I knew very little about pregnancy and childbirth. One thing I did know was that when you have a c-section you are (usually) awake for the surgery. Being a person who is pretty afraid of even small needles, the thought of this frankly terrified me. So I started reading every pregnancy book I could get my hands on, and I learned that one of the best ways to avoid a c-section is to have an out-of-hospital birth with little or no interventions, attended by a midwife. And that was the path I chose. I was going to have an unmedicated birth at Brooklyn’s only free-standing birth center.

Unfortunately when I reached 16 days past my due date, I was diagnosed with low amniotic fluid, skipped right over the birth center, and went straight to the hospital for an induction. After 40 hours and every intervention under the sun, I had only reached 5cm.  The decision was made that my son would be born by c-section. This was a devastating moment for me. The exact situation I had worked so hard to avoid was now facing me, but it seemed like the only way.

The surgery was not easy. It left me emotionally and physically scarred. I felt totally betrayed by my body, and I questioned every detail of the birth. Why didn’t I go into labor on my own? Why didn’t my body respond to the induction? Did I take the epidural too early? Should I have walked more? Hired a doula? Refused the induction? What if…? Compounding all of this were people who constantly said to me, “Well, you have a healthy baby, and that’s all that matters.” This was so difficult to hear, because of course it goes without saying that the health of my baby was the priority. However, I was still trying to process my traumatic experience and mourn the beautiful birth I so desperately wanted for myself and for my son. These comments made me feel selfish and guilty for being sad. I felt so alone in this deep state of grief. I had no idea that these emotions are commonly felt by women who have had unplanned c-sections.

Years later as I considered getting pregnant again I knew I wanted to have a Vaginal Birth After Cesarean (VBAC), but I still did not trust my body and was really fearful of a repeat scenario. I heard about a Choices in Childbirth VBAC workshop and decided to go. I was so inspired by the stories of success, but most importantly the midwife on the panel simply said, “If you have a low, transverse incision and the will to do it, then there’s no reason why you can’t have a VBAC. You can do it!” It was such a simple yet totally transformative moment for me. I left that room feeling for the first time that this dream of mine could actually be possible.

Fast forward in time. I was finally pregnant again and determined to do some things differently this time. I decided that home birth was the best option for me. I didn’t want to be under the looming pressure of hospital policies and time limits. I wanted a care provider who would be completely focused on me throughout my labor as opposed to being one of many blips on a screen being monitored in another room. I wanted to be in the comfort of my home where my mind and body could be at ease. I went to the chiropractor and acupuncturist. I joined ICAN (International Cesarean Awareness Network) where I received amazing support and advice. I hired a doula. And then, defying all the doubts I had about my body functioning as nature intended, I went into labor.

Our doula arrived. We made the bed. We inflated the birth pool. I had my coconut water and my yoga ball. I was ready. I couldn’t believe it was actually happening! The next thing I knew, my water broke. There was a little meconium so my midwife arrived early to see that everything was ok, which of course, it was. In the wee hours of the morning I reached 10cm and I started to push. And push. And push. And push. After 9 hours of pushing, castor oil, black and blue cohosh, a catheter to drain my bladder, walking, squatting, hanging, and acupuncture my contractions had slowed way down, and I wasn’t making much progress. The baby would get to +2 station and float back up between contractions.

We decided it was time to transfer. This moment was extremely surreal for me. I felt I had been so present in my mind and body until that point, and all of the sudden I could barely remember how to put my shoes on. Because my transfer was not an emergency we decided to go to the hospital where my midwife had privileges even though it was an hour away. Somehow I made it out to the car and through the 1-hour ride trying not to push and actually dozing off occasionally.

At the hospital I received a light epidural, which relieved the back and hip pain I had been having. My midwife started a small amount of pitocin to get things going again, and before I knew it, I was pushing again. I pushed for another 3 1/2 hours. At some point during that pushing my belly changed shape. It had been full and round, and then it was lopsided with a dip in the middle. The attending OB suspected a uterine window, but she allowed us to continue on our own with careful monitoring. The baby was incredibly strong through all of this, for which I will be forever grateful to her. When I reached +2 again they agreed to do 3 vacuum attempts to try and assist my daughter’s descent on the condition that they would do it in a double prepped operating room. The OB said that if the vacuum didn’t work, I was going to c-section.

As they rolled me into the operating room with the harsh, bright lights shining down on me, I thought about how my water breaking in my bedroom seemed a million miles away. The threat of c-section was weighing heavily on me. I felt like it was “now or never.” I pushed with all my might three times, but the vacuum was not successful. As the staff started to mill around and prep for surgery I called out to my midwife, “Wait! Hold on! Why can’t I push more on my own? I’m not done yet. I don’t want to give up on this! Why can’t I push more?” I couldn’t just let the clock run out on this dream. I felt like I still had strength and my baby was tracing beautifully. My midwife consulted with the OB and they agreed to hand over the OR to us for more pushing. I was tapping some source of power that I didn’t know I had. People started coming back in to the OR to watch me push. I think they couldn’t fathom why I wanted to continue or how I physically could. Everyone was yelling and cheering me on. My husband standing next to me could see our daughter’s head coming out, but after each tremendous push she would float back in again. After 90 minutes I looked into my midwife’s eyes, and I knew it was time. We decided to have the c-section.

It was then that I remembered a conversation I had with my doula during my pregnancy. She asked what would be most important to me in the event of a repeat c-section. I almost didn’t answer her question, because I didn’t even want to face the idea of another surgery as I thought it would completely break me emotionally. At that moment in the OR I was glad that I did answer, because I remembered to ask for those most important things. I wanted double layer sutures on my internal incision in case I ever get pregnant again. I wanted to see my daughter all bloody and goopy before they examined her. And I wanted skin to skin contact and nursing in the OR. The surgical team was incredibly respectful. All of my requests were honored without question.

During the surgery they confirmed that I did have a large uterine window along my previous c-section scar. This thinned area was disabling my uterus so much that no matter how much I pushed my little girl just wasn’t coming.

In February of this year, I returned to a Choices in Childbirth VBAC workshop. Only this time I was on the panel of parent speakers. It was an incredible moment for me to be able to share my story looking back at the faces of so many women who were standing where I once stood. I felt so privileged to share the most meaningful and surprising aspect of my journey – it was not the success or failure of my VBAC that determined my healing, but the fact that I gave birth on my own terms, in an environment of knowledge, respect, and love. It was a big disappointment to not achieve this VBAC, but I still feel triumphant – something I NEVER imagined feeling in this scenario. My faith in my body’s ability to birth was restored. I feel if it wasn’t for the primary c-section I would have absolutely birthed this baby on my own. I am confident that I gave it my all and so did my daughter.

Suzanne Chesney