Healthy Babies, Healthy Mothers

By Beth Townsend

 

My journey into motherhood began in late 2010, when my husband and I found out we were expecting our first child. We felt so excited; we’d waited a long time to have children, wanting to get school, travel and all of that ‘out of our systems,’ but now we both felt sure we were ready.

 

For the most part, the beginning of my pregnancy was fairly uneventful. We really thought a lot about our desires for bringing our son into the world. We took some birth classes at a local birth center, and shortly after we hired a doula, because once we started the classes we realized we’d like someone there to help us through labor. We also decided to take the Bradley Method approach to natural childbirth, although we still planned to deliver in our local hospital with an OB.

 

One of the things that sticks out from those classes was that there were three other couples - so four of us total - and someone, I don’t remember if it was the instructor or the doula, said “well, statistically, one of you is going to have a c-section.” I remember looking around the room and thinking ‘that’s not going to be, I’m not going to have a c-section.’

 

As time went by, complications appeared - I started passing out randomly and fainting, and eventually I had to go out on disability. I was already being closely monitored as a high risk pregnancy, because although I was only 34 at the time, my husband is a twin and his twin brother had a congenital heart defect and died at twenty-three years old. We were seeing a perinatologist often and they did quite a few ultrasounds, mostly to check the baby’s heart, and then also because I started having these strange episodes. At one ultrasound, it turned out that he (by now, we knew we were having a boy!) was breech. Everyone said “don’t worry, it’s still early,” but he stayed in pretty much the same position at every ultrasound, and soon I was on a mission to get him to turn.

 

That’s when Dr. Berlin first came in. I’d had my driver’s license suspended, because I’d fainted while driving and ended up in hospital for four days, and obviously it wasn’t safe for me to drive while I was having these episodes. So my doula and anyone else who could was driving me to my chiropractic sessions with Dr. Berlin, and I also tried swimming, walking on all fours, moxibustion, acupuncture, hot packs, cold packs - everything they suggest to turn a breech baby, you name it, I tried it - but as the weeks went by he still wouldn’t budge.

 

I desperately did not want to have a c-section, but as we went past thirty-something weeks my OB was quite insistent that the baby wasn’t going to turn and was ready to schedule my c-section. I was still holding out hope, and when he started talking about choosing the actual date I begged him to hold off a little bit and broke down in tears. He reluctantly agreed, so I went to see the perinatologist again, and that’s when they brought up my last-ditch option: an external cephalic version (ECV).

 

I was still determined to do anything to avoid a c-section, so I went to the hospital and attempted the version. It was very uncomfortable. Dr. Berlin could always get my baby to move and turn just a little, but soon after each session he’d pop right back. The perinatologist didn’t have any more luck, even though he tried so hard I remember that at one point in the whole ordeal he said he had to stop for a while because his wrist was starting to hurt. I remember thinking ‘well, if your wrist is hurting a little bit imagine how uncomfortable I’m feeling right now!’

 

So the version failed, but I was still determined to get him to turn or somehow birth him naturally – I called a doctor in Glendale who will deliver breech babies, but by then I was already 38 weeks, and they wouldn’t accept me as a new patient. Reluctantly, I let my OB put my c-section on his schedule.

 

At 39 weeks, I woke very early in the morning to my water breaking, five days before my scheduled c-section. That was a small silver lining for me, because at least my son chose his own birthday; I’d been having a really hard time mentally wrapping my head around the idea that we were choosing the time for him to come, it just didn’t seem right. It felt so unnatural. I started having contractions, but they were very mild, so I dilly-dallied at home for several hours because I knew once we got to the hospital I was going to be prepped and taken in for the surgery.

 

We eventually got to the hospital around noon. They did another ultrasound - yes, he was still breech - and I was told my OB would arrive around 4pm and my surgery would begin at 4:30pm. So I sat there and labored until the doctor came with my husband and doula, and they consented me, and I bawled my eyes out all the way into the operating room. I couldn’t stop the tears flowing, even as I lay there and they did my spinal, and my OB was actually very compassionate in that moment, and held me and wiped tears from my eyes and said it was going to be okay, but the tears didn’t stop. Once everything was ready, they brought my husband in, I had my section, and it was the complete opposite of everything I had imagined ‘birth’ would be. I was thrilled to pieces to have our son, Brycen, here, but they took him right away, he was screaming and I couldn’t even see him.

 

My husband even had to plead to bring Brycen in to me in recovery to let me see him and try to at least breastfeed him a little. The hospital staff didn’t want to allow it, because there might have been other patients in recovery, but eventually I got to see him for about twenty minutes and then they took him back. Thus began my journey into new motherhood and trying to breastfeed, with that awful incision, feeling a lot of pain and delirious from what had just happened. I had a really rough five days in the hospital – they actually said I could leave a day earlier, but I looked at my OB and started crying and said I couldn’t go home yet, so I was allowed to stay another day. But that was it - we had to go home, and somehow I had to get through the healing process and take care of my newborn.

 

In many ways, my emotional recovery was harder (and took much longer) than the physical recovery, although that was extremely painful and difficult. It was hard to accept that after everything I’d tried, I’d still ended up with the last thing I’d wanted.

 

For at least the year after Brycen’s birth, probably longer, I couldn’t think about it without crying. Whenever I heard that someone we knew had delivered their new baby the ‘old-fashioned-way,’ ugly feelings would surface - of course I was happy for them, but I was jealous, and envious, and I felt sad for myself and what was taken away from me and my son. I didn’t know why my body had failed me and couldn’t do it was supposed to do, and although I’m sure I didn’t always know the whole story, it felt unfair every time another woman seemed to have her baby naturally so easily when I’d wanted it so much, and so passionately, and I’d educated myself, I’d had a doula... I’d tried so, so hard.

 

My husband eventually got used to it - whenever someone we knew had a baby, I had to know: did they have a c-section, or did they deliver vaginally? Was it painful? Did they accept medications? I couldn’t stop thinking about my birth plan, what I’d wanted and didn’t get. It was painful every time someone else went through it and succeeded where I’d failed.

 

I also felt like - I still feel like - I constantly had to explain why I had the c-section. I needed people to know it wasn’t my choice, he was breech, my choice was taken away from me. Usually people responded with “at least you had a healthy baby,” or “thank god we have such advanced hospitals these days,” and while I know they were intended to be comforting words, really they just served to devalue my feelings, like I was selfish for wanting more from my birth. I’d even do it to myself, thinking ‘why can’t you shake this? Are you mental, are you crazy?’

 

The one thing that gives me just a little bit of solace was that the OB told me that Brycen had quite a short umbilical cord, so I try to tell myself perhaps it was the right birth for him, because although the risk was low, it could have been very tragic if the umbilical cord had come apart before he was born.

 

As hard as my birth and recovery had been, as soon as Brycen was born I couldn’t imagine having just one child. And I was only getting older, so we didn’t have a lot of time to waste… within 15 months we were expecting our second child. Brycen’s first year proved to be challenging in many ways and after everything we’d been through, when we told our pediatrician we definitely got some accolades for being brave enough to move on to number two!

 

This time around, I was about to be 36 and therefore of “advanced maternal age” and we still had the congenital heart defect to worry about, so from the beginning we were again monitored closely by a perinatologist. But this time I immediately began my quest to find a physician or provider who was going to allow me to VBAC; I knew the minute Brycen was born that if we ever had another child, I was going to be determined to VBAC that baby.

 

Thus began my research. I joined all the support groups and Facebook groups I could, I found ICAN, and interviewed doctors and midwives and all kinds of people, trying to find someone who would be able to give us the birth we wanted.

 

Somewhere around 18-20 weeks we finally found an OB near where we lived who told us that provided everything went as planned and this next baby was not breech, we would be able to VBAC at a local hospital. But as the pregnancy went on, I started to feel more anxiety whenever I went in and the baby was not in an ideal position, and eventually I found out that the back-up doctors for the OB I had chosen did not support VBAC. When I spoke to him about it he said, “don’t worry, I’ll be there, there’s no reason I shouldn’t be there, I’ll run it past them anyway, don’t worry.” As much as I wanted to believe him and trust him, in the end it just wasn’t enough - I couldn’t feel confident about what would happen if my OB wasn’t the doctor on call when I went into labor, and I wasn’t willing to leave so much to chance.

 

Then I went to the perinatologist – I was around 28 weeks by then - and my baby was breech. Although I knew it was early and she (yes, this time we were expecting a girl!) had plenty of time to turn, I still asked “if she stays breech, would you attempt a version again?” He said no, because Brycen’s version had failed, and I’d also had an early bleed with complete placenta previa in this pregnancy. He basically told me that in his opinion, I was going to have a c-section again. I walked out in tears.

 

That was when I told my husband that the only person I trusted, the only person I would believe 100%, was Dr. Stuart Fischbein – one of the few doctors in the greater Los Angeles area who frequently delivers breech babies vaginally. We had talked about Dr. Fischbein during my first pregnancy, but my husband wasn’t comfortable with the idea, because he doesn’t deliver in hospitals - our only options with Dr. Fischbein would be a home birth or a birth center. But after all my research, I knew more about his record, and I told my husband “I just want to hear it from him. If he tells me I need to have another c-section, it’s too dangerous to do it any other way, I’ll believe him, and I’ll accept it.” My husband heard me out and understood, and we made an appointment to see him when I was 30 weeks along.

 

In person, Dr. Fischbein was much like I’d heard - very warm, and very, very thorough. We had a long conversation about our medical histories, and he went through all the risks and benefits of VBAC and vaginal breech deliveries in great detail; he also explained that the risks of VBAC and the risks of breech are separate and not cumulative, which already made me feel a lot better. Finally he said, “There’s no reason I can see that you need a repeat c-section. To me you’re a good candidate for a VBAC.” It was the verdict I had been hoping so desperately to hear, but for some reason I didn’t really know what to feel in that moment. I wanted that VBAC so badly, but now we were talking about an out-of-hospital birth, and paying what was, for us, a lot of money out of pocket. Was I being too selfish? We’d been saving for a new house. Now I was thinking about taking that money from my family just to get the birth I wanted… was my VBAC that important?

 

We took a couple of days to talk about it and think it over, and in the end it was my husband that put me over the edge. He knew how hard Brycen’s birth had been for me, and how deeply it had affected me and our little family since. He looked at me and said “I give you a 10-15% chance of delivering vaginally if we stay where we are. I think our best bet is Dr. Fischbein.” He’d never been comfortable with the idea of me delivering outside of a hospital, so to see him make this huge shift, and not only feel at peace with it but believe it was what we needed to do, made it easier to stop feeling I was being “selfish.” At 34 weeks, we made the switch, and at that first appointment our daughter had turned transverse, so breech was no longer a factor.

 

At around 38 weeks I’d been having a week of prodromal labor - I’d be up all night. The funny thing was that Dr. Fischbein was out of town that week, so as annoying (and exhausting) as the prodromal labor was, I wanted my baby to stay in! Although my new midwives at the birth center we’d chosen had told me I no longer needed to see the perinatologist, I had an appointment booked, and I’m a people-pleaser, I follow the rules… he did an ultrasound and said she was occidental posterior (“sunny side up”), and that babies in that position are very hard and painful to deliver vaginally and, yes, I’d probably end up with a c-section. More doubt. More second-guessing. The next few sleepless nights were even harder. Had I done all this for nothing?

 

Two days after that deflating appointment, my husband and I spent the day out with my son. We went to the mall and walked around, and although I was contracting all day, I didn’t think anything of it because by then that wasn’t unusual. That night I took a Tylenol PM because I needed to sleep so badly, but as soon as I got into bed I had two strong contractions and I felt a pop and a gush of fluid. My water had broken. We called Dr. Fischbein, and he was on his way home from the airport - perfect timing! - but he told us to relax and call again when my contractions were consistently 2-3 minutes apart. About 20 minutes later I told my husband “you need to call him back,” because this was happening - it was as if my body went into ‘game on’ mode as soon as my water broke. Within an hour my contractions were 2-3 minutes apart, and within a few hours they were basically on top of each other, and with the back labor because of her position everything was more intense.

 

We got to the birth center, my doula met us there, and soon after Dr. Fischbein appeared. I labored most of the time in the tub, but then after some time, Dr. Fischbein did a check and said he thought he could help me out with the baby’s position and I could start to push down if I wanted. It soon became clear it was too hard for him to help much while I was in the tub, so I got up on the bed and started pushing there. It took a little time to get the hang of pushing effectively, but then Dr. Fischbein looked at me, grabbed my hand and said “Beth, you are having this baby, vaginally, today.”

 

Finally, for the first time in my entire pregnancy, I really believed it was going to happen. It all became very real in that moment. It was like the holy grail. It was the moment I had been waiting for since they wheeled me into the operating room to deliver Brycen. I got chills. I started to tear up. I believed him. I believed it. I believed in myself. He was right. We were there. We were at the finish line!

 

I’m a runner; I do distance races. The best analogy I can think of is that I’d been at that point where you think you can’t possibly go any further, you’re wondering what you got yourself into and how you’re possibly going to finish the race, and your body hurts and you’re exhausted - but then you see the finish line and the people cheering and they have no doubt you’re going to finish, and somehow you find that final surge of energy you didn’t think you had, that part that was locked up inside… that’s what his words meant to me. That was the feeling I had, that final surge of adrenaline.

 

It took one more push. Then I heard “reach down and pull your baby out” - was this real? It was. I was really experiencing that moment I thought I would never be able to have - only it was even better, because I did reach down, and I delivered my daughter Maiya myself. No one else touched her, the first skin she touched was mine. I pulled her to me still saying “did I do it?” and “I can’t believe it,” but she was there, and we kept her attached until the cord stopped pulsing. It was all so gentle and peaceful and exactly how I had envisioned, how I hoped my baby could come into this world, the way that nature intended. There was nobody poking her and prodding her, she wasn’t screaming her little lungs out, she was just at peace laying on me, she nursed right away, and just four hours later we were home.

 

In the end, I was in active labor for nine hours and pushed for thirty-five minutes. My husband said later, “There was no one in that entire birth center that was going to let you go to the hospital. You were going to have this baby vaginally and naturally and you were going to have it there. I knew you were doubting, but no one else was doubting it.” It was overwhelming to hear that.

 

Choosing to switch to Dr. Fischbein was the hardest decision of my life, but I truly believe that it was the best decision, too. I am certain that had I stayed in the hospital system, I would have had another c-section. The recovery after Maiya’s birth was nothing compared to the recovery after Brycen’s. Emotionally, I felt so high, and so much more even-keeled. I thought having two children to care for was going to be so hard, and yes, it was challenging, but I felt great. I was out and about around town with both my kids within the time period I was still in the hospital recovering after my c-section!

 

It was a healing birth in all the ways you can imagine. I needed it so badly in order to feel “normal.” It wasn’t until I gave birth to Maiya that I felt I could say those three words - I gave birth. I gave birth to my child. I can even say with a little more conviction that I gave birth to both my children now. I don’t know where I’d be today without Maiya’s birth, or even if I’d had a repeat c-section without hiring Dr. Fischbein, without knowing I had done everything I possibly could to VBAC. I can join the club I didn’t feel like I belonged to before.

 

For me, without doubt, there is more to a successful birth than “healthy baby, healthy mother.” Birthing is a process, a journey to experience. It’s all the benefits for the mother and baby, the hormones, the oxytocins, the experience of the child… there are studies now suggesting that how a child is born may affect them in the future much more than we think. You can’t just say birth is a means to an end. There’s so much in between - let’s say birth ends with a mother who is not emotionally healthy. That’s a “successful” birth to an OB, because she’s alive and physically well, but to me it’s not a successful birth. I was not emotionally healthy after my c-section and I believe it affected me, Brycen, and my husband in negative ways, how is that success? You need a truly healthy mother to take the best care of a child.

 

After my experiences, I would tell women to follow their hearts and their guts, because they’re usually right. I would tell them to educate themselves, learn the facts, and I don’t just mean talk to your doctor - go and read ACOG, join support groups, talk to other mothers, because not every OB out there is practicing based on what’s right and current. I do believe they all want to do the right thing and have the best outcomes, but sometimes other things get in the way of their judgment. Research for yourself. Learn as much as you can. Take it upon yourself to get the birth that is best for you and your family and your baby and really think for you, and that best birth could be anything, it could be the total opposite from what I wanted - but whatever it is, just make sure you have the facts straight.

 

For me, my best birth was delivering my baby vaginally with hardly any ‘intervention’ besides encouragement and care. And to everyone who said “you’re just going to have another c-section,” you were wrong. I told you I could do it. In that amazing moment - you are having your baby, vaginally, today - I finally knew I could do it. My body is not broken. It was never broken. The only thing that was broken, for two difficult years, was my belief in myself, and thanks to the people who did believe in me, now that is healed too. I am a healthy mother with two healthy children, and now I feel like a success.