giving us Grace. {Tampa Bay Doula}

Before I was even pregnant, I would drive by the birth center near my home and think “I need to have my baby there!”  I knew I didn’t want to have a hospital birth.  I had an irrational fear of having a cesarean.  It was a fear that became validated, but with time I’ve also come to understand the value of it as well.

We found out we were pregnant on November 14th and the very next day I began to bleed.  My husband and I went to the local hospital for answers and found that I had a sub-chorionic hemorrhage. This particular hospital was not equipped for obstetrics. The doctors explained that this was considered a threatened miscarriage and we had a 50% chance of carrying past the first trimester but if anything else was to come up to be sure to go to a different location. I spent the next few weeks in emotional turmoil while taking progesterone as prescribed by my midwife. Our first appointment at the birth center was at thirteen weeks gestation, my midwife was unable to find my baby’s heartbeat.  My husband and I were sent for an immediate ultrasound. That was a long drive, even though it was just up the road…the wait was even longer.  The Ultrasound technician found our sweet little baby, just fine with a strong heartbeat and the hemorrhage was gone. I had a feeling it would have been as I had passed a large, quarter sized blood clot the week before. I went on to have a pretty normal, uneventful, and beautiful pregnancy. 

I simply adored the care I received at the birth center, both prenatally and postpartum!  The entire staff knew my husband as well as they knew me! Most importantly, they understood my desire for a natural birth as most of the people around me didn’t have the same views. At my 38 week appointment, I came in feeling a bit run down, sweaty, and not really myself.  The midwife’s assistant immediately noticed that I wasn’t my “giggly” self and took note.  I had an elevated blood pressure reading that lead to the midwife suggesting I have a NST and drink some juice.  The NST looked great and we never had another high blood pressure reading, but to be on the safe side my midwife ordered a 24-hour urine test to check protein levels and make sure I wasn’t developing preeclampsia. I felt much better the following day, but when we got the numbers back from my urine test, the protein levels were elevated outside of the normal range.  What I didn’t know about the test was that the urine needed to either be kept on ice or refrigerated…a mistake on my end that I would grow to regret.

A few days later, the overseeing OB of the birth center gave an order for me to be in the hospital for the full 24 hours while I urinated in a container.  While in the hospital, I had a biophysical profile and routine blood pressure checks though never once was it alarming.  The nurses weren’t even sure why I was there, though they kept insisting that I would be back.  How I wish they had been wrong. 

When the urine test came back, the numbers were well within the normal range and I was sent on my way.  I thought things were over and I could continue on with my birth plan at the birth center.  A week later, while at my sister-in-laws house, I received a call from my midwife stating that the OB wanted another 24-hour urine test completed. During this call, there was some talk about a cesarean as the last ultrasound had determined that my baby was going to be over 10 lbs.  As I balled my eyes out on the phone, she assured me that she didn’t think that would be the case and to just proceed with the testing.  I came by the birth center that following Monday to get the urine collection container. At this appointment I also had a NST and a very painful and slightly bloody vaginal exam stating I was still at 3cm, as I had been since the previous week.  My midwife and I were hoping that I would go into labor soon. 

At 3:50 am early Tuesday morning, July 19th, I jumped out of bed as I thought I was urinating on myself! I didn’t bother to grab the container because it was flowing quickly and I wanted to get to the bathroom.  I didn’t have any more leakage after that, though I felt that was my water breaking.  I called the midwife's phone line as instructed and she told me to go back to sleep and get some rest.  How could I rest? I was so excited! I was excited that I didn’t need to pee in that stupid container AND that I was going to meet my baby soon! Not to mention I had only gone to bed around 1am as I was up with company, excitedly talking about how soon our little surprise would be joining us.

Around 6 am, contractions began and were consistent for the first few hours, about every 10 minutes or so.  They became inconsistent around 10am.  I had checked in with the midwife and she thought it best to stay at home at this point.  Not too long after we chatted, I received a call from her again.  This time, to tell us that the overseeing OB is offering an elective cesarean because my baby is measuring over 10 lbs and we had the possible risks of shoulder dystocia, broken collar bone, or damage to my tailbone, etc.  I burst into tears immediately. I was enraged and scared over this offer!  Once I gathered myself, I told her thank you for relaying the risks, but that I am declining his offer and would like to proceed with our original birth plan, as I trusted my body.  We had a few more conversations, but when 5 o’clock pm rolled around, we thought it best to head over to the birth center for the first round of antibiotics since my water had been broken for almost 12 hours. I agreed to antibiotics knowing that if we were to transfer, our baby may need to go to the NICU for prolonged membrane rupture and possible infection if we didn’t have the on-time antibiotics. We got to the birth center a bit later and never even saw the birth room.  My labor was still inconsistent and as we cried, we were told the OB was calling it at 18 hours, instead of the routine 24 hour rule, and I needed to transfer to the hospital.  At one point I was told that I should have never been taken on anyways due to my pre pregnancy weight. It was a hard transfer for my husband and I, and I knew my midwife was genuinely sad that it had to happen this way.  But, her hands were tied.  I was devastated.  I didn’t know that I had other options or that I could have possibly contacted a doula, since in this case the midwives don’t go with their clients.

I went home, ate a peanut butter and jelly, grabbed our “birth center” bag, cried while my husband and I held each other before we headed to the hospital.  When we arrived at the hospital, we were met with the rudest CNM I have ever met.  She was cold, forceful and made me believe that if I did not receive the Pitocin induction that instant that I was putting my baby in harm’s way, especially because it’s a “big baby”.  She made me feel like the worst person because I ate prior to coming in and that my midwife should have been clearer in relaying that I shouldn’t have eaten.  I knew that by eating, I might buy some time from an immediate cesarean, which I did as it was offered again upon my arrival. She repeated the words “rupture” over and over in reference to my water breaking.  Language is very strong and it twisted something serious within my husband and me.  My husband, already stressed out and overwhelmed, finally lost it and yelled at her to quit using that verbiage.  She calmed down a bit and got less aggressive, but not entirely.  I demanded an ultrasound as I believed that the last one saying that my baby was over 10lbs was inaccurate.  The technician stated that I had pockets of fluid and the baby was measuring right around 8 lbs.  That’s a big jump in size…never heard of a baby losing so much weight in a week while in utero.

My labor had become intensely stronger, but insisted on proceeding with the induction.  So there I was lying in a bed with monitors on, waiting for the induction to begin.  At 9 pm, they started the Pitocin.  That shit was intense.  I was yelled at by the anesthesiologist at one point to let him do his job when I asked him not to poke me on my wrist bone as the nurse had hurt me there before when he came to do my IV. The last few times the nurses had done it, they blew multiple veins; I was bruised for over a week.  That oh-so-lovely CNM at one point had one arm, blood trickling down onto her ungloved hands from her injection site, while another nurse had my other, trying to get the IV catheter in as well. I felt every contraction, as they were back to back almost immediately from the beginning of the induction, that I was urinating all over myself.  I wanted to sit on the toilet to labor, I felt more dignified there and protected by my husband as I labored holding on to him with a closed door.  The nurse didn’t feel this was a great place because they needed to keep me monitored.  So instead, she sat the bed up and put a bed pan under me.  Real classy. I felt like such an empowered woman…

I was told I was asking to go to the bathroom too often that I should really stay in the bed.  I wanted to move around.  That bed felt like hell.  My husband fought with the staff to get in the shower to try to manage my labor pain.  The nurse only agreed after getting numerous approvals from attending staff.  It was not comforting in the slightest.  The lights were bright; they were in my space trying to continuously monitor me.  It was frustrating. They kept asking me why I wouldn’t get the epidural, that I shouldn’t do this to myself.  I was just trying to give myself and my baby the best birth possible.  I didn’t want any more drugs.  Closer to morning I received another (upon the many, many random and unsolicited checks before) cervical exam.  The nurse told me I was at a 9, almost 9.5cms! I was elated! I knew I could do it! Shortly later, a different and much welcomed CNM came in and checked. According to her, I was only at an 8.  I felt beyond defeated.  I was done.  She suggested the epidural to get rest, I declined- but agreed to Stadol instead.  That did nothing but make me queasy. I had the incessant need to push, though I was nowhere near complete.  They told me to hold it, don’t push; do anything but push.  My husband needed a break at this point and fell asleep.  I remember grasping on the side bedrail, full fetal position screaming in pure agony as I fought my body’s desire to release the pressure. This felt like it went on forever.

 The sun was up and I was lost; I finally agreed to the epidural. I slept for a bit after the epidural and woke up with the urge to push. The CNM performed another internal exam that clarified that I was ready to. I asked if it was ok, then stripped myself naked and screamed to turn the damn epidural off. I don’t know if that request was honored, but I had feeling.  I pushed to the sound of them counting, to the feeling of my perineum stretching with the CNM’s hand, looking at my husband’s ghostly white face as he held a knee. I pushed. And pushed. And pushed.  My husband could touch and see our baby’s hairy head. But she wasn’t getting anywhere closer to crowning. The baby’s heart rate never dipped.  The midwife even cleared that with me in the immediate postpartum visit; our baby was such a trooper.  Three hours later, after they asked me to yet again stop pushing and put me in an exaggerated lie to try to get the baby to turn, I was vomiting with each contraction and fighting my body’s needs. My husband was crying to me, afraid and sad that there was nothing he could do for me. He was exhausted.  I asked for the cesarean as I felt like I was going to break, physically. I didn’t know that the nurses and CNM were already working on getting this ordered with an OB.  My husband tried to talk me out of it, but I told him it would be alright, that I was done and this needed to happen.  Shortly after that exchange, I found myself on an OR table, being yelled at to sit still or they would need to knock me out.  They were trying to get a spinal in as I could feel everything with only the epidural.  As I sat hunched over, baby in my canal and contractions on top of one another, I mustered as much strength as I could to hold still and on the third try they were successful. They laid me down, tied my arms down, and put the oxygen mask on. I could feel the warmth rush over me, the contractions fade and my body was no longer part of me.   When my husband came in I made sure to ask if he grabbed the camera! He looked so silly in his scrub outfit. The attending OB made the statement “Why couldn’t you birth this baby?”

At 2:26 pm on July 20th, my sweet husband announced to me that our little Grace was here.  We didn’t know if it was to be a boy or girl.  It didn’t matter.  I cried very briefly with so many different emotions.  She never made a peep.  They tried to get her to cry, suctioned her as routine, and even then there was barely a sound.  She was born with a peaceful demeanor, despite her birth journey. I saw her briefly.  They wouldn’t allow her on my chest, but my husband lifted her beanie so I could smell her lovely scent. And then she and my husband were gone as I was barking orders at him to not allow any tests, shots, or ointments.

As I lay there, unacknowledged, listening to Queen playing on the overhead and the nonsense chatter of the staff as they tried to mend my broken body, I remember thinking that this was the last place I ever wanted to be.  The OB told me when she was done that I was “skinny” again and come bikini time, the scar wouldn’t even be seen. I met my baby girl again in recovery, just for a quick latch close to 4:30 pm.  The lactation consultant basically shoved my nipple in her mouth because I was so swollen with fluids. Soon after, she was taken away again, with my husband in tow. He never left her, not once. The staff kept offering pain meds, and I had this odd container hooked up to my abdomen.  I wasn’t “allowed” to refuse the pain meds, but I could opt for minimal dosage and Tylenol 3.  When they took this odd container off, it ripped the skin off on my abdomen.  My husband helped with my first shower in the hospital that same night.  It sounded like he was murdering me, and it was only the water rushing over me.  Those fresh wounds hurt worse than the incision. I still have not one clue what that canister contained. The postpartum nurses were real angels and came whenever I needed and kept telling me that they heard my story and how brave I was.  That they were rooting for me. That some of them had heard me.  Hearing them share their own cesarean and induction stories while commending me on my efforts made me feel like a warrior for the time being.

Was she really mine? How could I be certain? She was taken from me. I didn’t birth her. These thoughts consumed me for many months, along with the long string of what if questions. We struggled with nursing for the first six weeks battling a few bouts of mastitis, thrush, split nipples, and latch issues. I struggled with postpartum depression in the first couple of months and though I tried to hide it as best I could, my husband saw through me and tried to get me help with my midwives.  I felt like a failure.  That I wasn’t even woman enough to give birth to this 8.5 pound, 21.5in long baby! Why did I deserve this, after all the preparation I had put forth during my pregnancy? It took many, many months and fighting to work on finding peace with Grace’s birth. 

When my husband so slyly called my midwives to set up a “breastfeeding” help visit, I had no idea that he had cried in fear to them on the phone because I wouldn’t get out of bed.  When we walked into the center, I seemed fine but my insides were crawling.  It was painful to be there, in a place that I didn’t have the dream water birth that I had so desired.  It was another knife to my heart.  Meeting with the midwife we started chatting about the many breastfeeding issues I had.  She then asked how I was feeling and that Will had called them.  I sobbed, telling her the horrible feelings of inadequacy, failure, and pain.  That I was NOT ok and I didn’t believe my baby was actually mine, though I knew that to be irrational.  She then pointed me to Healthy Start and suggested I find ICAN. I had heard about and attended an ICAN meeting before I knew I was pregnant. I didn’t think it was for me.  I wish that I would have stayed throughout my pregnancy; I may have been able to avoid the cesarean, but who knows.

I reached out to Healthy Start and was assigned a pretty awesome case worker.  As she and I chatted, I felt ok talking to her about my experience and being vulnerable.  She got how big of a deal it was to me.  She put me in touch with an in-home counselor and I set up a meeting for the next week.  When we began talking, she told me a bit about herself, one of the things being that she had no children.  When I was trying to explain to her my birth story and feelings surrounding it, I knew she didn’t get it.  “Well, at least Grace is healthy!” I immediately shut-off and sank away, knowing that this was not the avenue that was going to help me heal. At the end of the meeting, she gave me a ridiculous homework assignment and went on her way. I called and canceled the following appointment and didn’t see her again. 

I had attended the one ICAN meeting in very early pregnancy, but didn’t think it was something I would need because I was going to have a birth center birth and there was no way I was going to transfer to the hospital.  I just wish that when everything began going downhill around 38 weeks, someone would have suggested, or that I would have known, to call an ICAN Leader.  I attended my first meeting after Grace’s birth in September 2011, with my husband by my side. We listened to others share their stories, the meeting’s discussion topic, and my husband and I shared bits of ours. I noticed how angry we both were when we spoke about the birth.  It was an amazing feeling to have our feelings validated and to find that we weren’t alone.  Since that meeting, I have missed maybe two or three due to unforeseen circumstances.  ICAN has been my saving grace (no pun intended). I have learned so much about the different options that pregnant and birthing women have and through others sharing their stories, I have found bits and pieces of mine.  ICAN has allowed me to graciously re-enter the world of mommy-hood by knowing and acknowledging that I was not a failure.  I’ve since become an ICAN Leader and have used my experience and passion for birth to help other moms and moms-to-be have the best birth experience. Especially when things don’t go as planned, I can be there for support and help them find the resources before and after to make it as empowering as possible.  Whether a mom has a vaginal birth, cesarean, vaginal birth after cesarean, or a repeat cesarean, I know that I can help support her no matter the journey.  Two years ago, I would not have been able to see past the type of birth a mom had; that it somehow defined her as it had defined me.  ICAN has helped me to see past that and know that birth doesn’t have to define you, but it does matter.

I had attended a nighttime moms group at the birth center after went back to work. It turned out to be just myself and one other mom; a mom that became a very valued friend.  We shared our birth stories and she told me about this online group how it had helped her immensely and I should check it out.  That group, making those connections, and finding the group’s mentor is really where I found some amazing birth workshops and events.  I had attended a few birth movie screenings, an in-person moms group or two, and listened to all the stories shared.  The birth trauma workshops with this mentor were highly insightful.  It allowed me to step outside of the entire birth, and find focus on each individual major point during the birth that was difficult for me to bear witness to again.  But through these birth exploration exercises, I had found moments of empowerment.  Moments where I stood my ground and made decisions I didn’t realize I had, or how I was still trying to take care of my husband through it all.  Moments where I knew that no matter what, I loved my baby and was going to bring her into the world as safely as possible.

As I found healing, I got lost in the birth world.  For that, I am ever so grateful.  There was a post in a moms group for a Doula Training and as I had thought about becoming a doula for a few months at this point I figured this was the answer! I applied for the scholarship they were offering and along with one other amazing mama; I received it!  The training never officially happened unfortunately however, something even better occurred.  I received a call from a now very dear friend, mentor, and soon-to-be midwife extending an offer to come on board her birth team as an apprentice doula.  My heart was full and I jumped for complete joy! I found that helping friends and acquaintances who reached out with birth questions played an epic role in my healing and being a doula would provide so much more.  I attended my first birth on Christmas Eve, 2012 and it was ironically like the Grinch, my heart grew three sizes that day.  With every birth I’ve attended, I’ve learned so much more than I think I ever could have.  At one point I had a string of moms that needed necessary cesareans back to back for a time and I was feeling rather run down- that maybe I wasn’t cut out for this.  My doula sisters reassured me that the universe was trying to teach me something…. and it was.  There are true medical reasons for cesareans, and the key is to not fear or be naïve that it can’t or won’t happen to you, but to be understanding that birth is unpredictable and even the most educated and strong willed mamas may need cesareans.  It’s a beautiful tool we have that just like other induction medications and methods needs not to be over used and abused.

Without my husband all the moms groups, movies, workshops, ICAN meetings, doula work and healing that I found may not have come so easily.  He sat right next to me in these ICAN meetings, birth rallies, film screenings, and reading article after article.  He really is my greatest supporter. I know that I probably wouldn’t have been able to breastfeed, let alone still breastfeeding today, if it hadn’t been for him physically latching my daughter for every single nursing sessions for the first week of her life.  If he hadn’t made those calls to the midwife, taking me to appointments, ICAN and La Leche support groups, and just being my rock who knows what may have happened.  I know that because of him, the successful breastfeeding relationship I have with my daughter and the avenues of healing that I have found over the last two years. We have come so far and have a remarkable bond, in which I found my Grace.  She is my daughter, and I did in fact give birth to her.

We are extremely thrilled to announce that as we embark on our new pregnancy journey, we will be taking a much different path to ensure that we have the best opportunity to have an empowered birth experience.  We are currently planning our homebirth with a birth team that I trust deeply and this time around, I know all of my options, as does my provider. I know that with these choices that I’m making, I am giving myself and my baby the best opportunity for a natural and family focused birth. I have surrendered to the fact that birth is unpredictable and if this birth is to end as another cesarean, I know that it will not be of the same circumstances and that it can and will be empowering.  While I hope this is not the case and I do not know how I will feel if it were to happen again, I know that I have the support I need rallied behind me and within my community. I believe in things happening for a reason and I have been able to give reason to my daughter’s birth.  It has allowed me to find a community that I don’t know if I would have found otherwise.  It has allowed me to understand how important birth is, not only to mothers, but their families as well.  It has allowed me to find my calling as a mother, birth worker, and advocate for women’s rights.  I can only day dream now about what this next birth will bring us. My hope is that it will bring a feeling of full circle healing to my family. I am hopeful that it also brings awareness to friends, family, and acquaintances that may hold fear in their heart of having both a homebirth, a vaginal birth after caesarean, or even a repeat necessary cesarean if that’s how this baby needs to enter the world.   -Melissa