Monday, March 18, 2013

Robert's Birth

Hello Dear Readers!

Huh. I blog every four to six weeks. Which is funny - I talk MUCH more frequently than that... Is that too infrequent? Am I losing my dear readers? Or are my dear readers grateful that I'm not stuffing their in-boxes with EVERY random thought that hits my odd little brain? There are a lot of them...

So anyway. After the What You Need to Prepare for Baby post, one of my favorite people, Mama G.A., and I have been trying to convince each other to write essentially the same thing, but for birth. We also want to rope in Dr. Rachael, whom I introduced here, since she catches babies professionally in a total Midwife in Disguise way. But that feels like a huge, daunting project to us, and we're both scared of getting it wrong, forgetting something important, or in some other way messing up someone's birth experience. Birth is sacred, and as intimate as conceiving the baby in the first place. So we are understandably hesitant. And collectively rather busy, as well.

Well, while we work up the nerve to draft that post, I thought it might be helpful to outline my birth experiences here. I was going to try to remain objective and just compare and contrast the two. But then this post got reeeeally long, and I realized I just needed to write Robert's birth story, Meanwhile I'm imagining a nice, simple table for comparing the two models of care, via my experience.

So, spring 2008. (Yes, the stock market was about to implode. Every time I have a baby the market hits a bottom shortly after. And every time I go for a degree, the U.S. goes to war in Iraq. You will be relieved, therefore, to hear that I am done with both of these forms of creation, thank you.) Robert was conceived as soon as Matt would put up with when baby's birthday would be (he didn't want to stick the kid with a Christmas birthday) after we decided it was time to have kiddos. I had good but not fabulous insurance, an HMO plan. I like HMOs because they are simple and lower cost for the patient, and tend to generate less paperwork. But obstetricians do not like HMOs. So despite living six blocks from Huntington Memorial Hospital, and a mile from a fabulous Ob-Gyn whom I adored, I had to hunt and hunt for an Ob who would take this insurance. At this time in life, too, I was not as good at research (being, as I am now, a Research Analyst, when I'm not blogging or beating up big leather bags). And I was very anxious about the whole thing, convinced that the pregnancy would miscarry, or I would eat one bite of The Wrong Thing and permanently harm the child. So I piggybacked on Mama J.K.'s research and went to Dr. G.

Dr. G. was very well reputed among mamas and the birth community for his relatively low Caesarian rate, his openness to "alternative" practices such as natural childbirth, doulas, etc., and generally not being a pushy jerk. Luckily for me, he was also taking new patients, and my insurance. His practice was located right next to a hospital in a less glamorous part of town than that in which I lived (totally harmless, just cheaper and not all spangly new). He had privileges at one of the hospitals that would take my insurance, the  newer, nicer one with almost all single rooms (bonus!!!). I got an appointment fairly immediately, NOT because I was pregnant, but because I said that I needed a well-woman exam. The staff was not willing to book me for a pre-natal appointment because I was "only" four weeks pregnant. But once I got in there, two weeks later, Dr. G was very generous with his time, and even did an ultrasound even though technically I wasn't "supposed" to get one yet. He had an ultrasound machine right in one of his exam rooms, at which he seemed quite adept. (He got the sex of the baby wrong at 20 weeks, and the ultrasound tech who told me Jackie would be a girl scoffed that OB's don't know what they're doing with ultrasounds. But in terms of yup, that's a fetus, yup, that's a placenta, he did just fine.) Anyway he was able to show me the little, flickering grain of rice inside a thumb print, which would be Robert, inside his amniotic sac. "Oh, I'm going to cry!" I squealed. He looked mildly embarrassed, but said, "That's okay."

I received one prenatal visit per month until my third trimester, at which point they accelerated, I don't remember the exact schedule, I think twice in month seven, weekly after that, and twice weekly once the due date was nigh. (Due date. Tee hee!) The visits were something like 20 minutes long, and Dr. G was often running late but only actually cancelled when he was in the hospital with mamas. The staff continued to play roadblock between me and the doctor. It's difficult to know whether, when I called with questions, they were deflecting them on their own initiative or following his instructions. Sometimes a staff member called me back - she was often rather dismissive, seeming like I should know better than to call with this and that question, which irked me - how am I supposed to know what is a valid question? I'm an investment advisor, for Pete's sake. Sometimes the doctor called me back, and was much more patient with my questions. At least once, nobody called me back, not even the receptionist to say, "I relayed your concern to the doctor and he said not to worry." Again, I don't know whether this was a staff error or the doctor prioritizing his work.

Around month four (five?) I experienced what I thought might be leaking amniotic fluid. Of course I was freaked out. (I know now that pregnant women are just juicy, but again, how am I supposed to know?) After talking with the doctor on the phone, I was instructed to go in to Labor and Delivery at my designated hospital. My very patient carpool buddies/coworkers drove me to the hospital, which was about 2/3 of the way home on our 30-mile LA freeway commute (bleh). I went to admissions, and was sent to do all the admitting paperwork. This horrified me - if I was about to lose my protoperson, couldn't the freaking paperwork wait? It's not like I was going to run away, or could run anywhere, at all, at that point. Luckily the admissions clerk was a sweetheart. He had an accent, and when he asked my mother's maiden name, which of course a hospital needs in order to determine if a woman is leaking amniotic fluid, I said it and then started to spell it, but he interrupted me, "Oh, you're Italian!" Now he liked me even more, sweet little old fella. Even though I was crying through the whole thing. He probably wasn't allowed to just send me to L and D without the paperwork but come on, people, pregnant woman, freaked out and crying - let her go get some care for crying out loud.

Okay so finally I go to L and D. On the monitor, and thank Heaven, a very sensible nurse attending me. She took a big sniff of this suspicious emission and declared it not to be amniotic fluid. She said next time it happened, if I was brave enough to taste the fluid, I could tell myself, and described what it tasted like. I'm sure this is oogy enough for my readers already so the more squeamish should skip to the next paragraph, but she said it tastes like semen. I don't know if this is accurate, because with both kids by the time my water broke it was not necessary to try to determine if it was amniotic fluid, and even wacky crunchy mamas like me don't taste amniotic fluid just for kicks in the throes of labor. Anyway, I was, ultimately, fine, and sent home with orders to get more fluids and rest.

There were a couple more of these false alarm scares, mostly resulting in bedrest until you can get an appointment with the OB orders. I was mostly happy to comply, although I did sneak out to vote for the first African-American president in U.S. history. I had been voting at that spot for years, and this was the first time I had to wait in line. I had never seen that many citizens of color at that polling place before, and I was inspired. But I digress.

Regarding genetic testing, Dr. G just described what he would usually do, and let me decide. Since I was 35 (and bite me that is just not old, people) the standard of care is to do an amniocentesis. Wow, looks like I spelled that right on the first guess. Well, the heck if I was going to let anyone stick a huge needle in my belly and risk this kiddo for something that wasn't going to kill either of us. I told the doctor, look, the only way I will terminate this pregnancy is if my life is in danger. Is there anything you are going to learn from the amnio that you don't know now that would indicate that my life or fertility is at risk? No, he says. Is there anything you would learn that would change how you provide care for the rest of the pregnancy? No. Okay I'm not doing it. I went ahead with the "California genetic screening," a maternal blood draw and questionnaire, which said kiddo would be fine. Dr. G said he had seen one false negative off that screening in 16 years, which was good enough for me.

Dr. G was patient with my birth plan, and delighted to help me with my plans to bank cord blood (turns out he gets paid by the cryobank for each banking. Fine by me, I want the doctor to want to participate.) My "due date" comes and goes. (Funny story - eating brunch with friends on my "due date," young women at next table: "Oh, you're so cute!" "Thank you." "When are you due?" "Today." "WHAT! Why are you out to brunch?" "Because I'm hungry.") Now I'm three days "late" - which I would like to point out is within 2% of the average length of a pregnancy - who the heck thinks they can predict anything biological within 2%? Not me, thank you. I have another "what is this juicy stuff leaking out of me" moment, with no other symptoms of labor. I call in and am told to go to L and D. I was sure I wasn't in labor, but at this point I hadn't learned that as the patient, *I* am in charge, and I can say, "I don't want to go in, yet, let's wait a bit." I did have enough 'tude to take my time and eat lunch first, at least. I called my doula, Nancy (who also knew and respected Dr. G). and she told me to eat first, and to stay in touch. So we finally haul in to L and D, and I have an ultrasound. The tech said I had four units of amniotic fluid, and ten is the minimum. She also said it was all in his bladder, and if he peed I'd be fine. I know now that I had the right to say, great, let's wait an hour and do another ultrasound. But at the time I just trusted my medical professionals and played along.

Dr. G said I would not be leaving the hospital until I had the baby, and would likely need to be induced. I did not want to be induced. So I walked, and walked, and walked, and got thoroughly sick of walking. I had an enema (wheee!!!). The nurse heckled me a bit that I was being so high maintenance. "We only do this for very special patients, Suzanne." I got a vibe that the birth plan I handed them set off some "uh oh, one of THESE mamas" sort of alarm, but I was determined to be so sweet and wonderful that they would want to take great care of me. I'm good at that, and it worked. Eventually it became clear that I was not going to walk or poop myself into having contractions. Dr. G. and I talked on the phone, and he was recommending cervidil. This is like a tampon looking thing with synthetic prostaglandins on it, to soften the cervix. (Best prostaglandins in the world are free in hubby's semen. Who knows if we would have managed to have sex in the hospital. Suppose we could have snuck out to the car... anyway, I digress.) Dr. G. said if I wanted to sleep the night and use it in the morning he was fine with that, but that he was pretty sure it would be necessary. Knowing that, I was pretty sure I would not be able to sleep, and said, okay, just do it, but feed me first. The nurses were not thrilled with this idea - it seemed like they thought they would get in trouble, but they rounded up a sandwich for me (it was like 9 pm at this point).

My doula said I had to get rest once the cervidil was in. Well, I'm a chemically sensitive little creature, and four hours later I was at 4 cm dilated and the contractions were making me want to cry. So doula Nancy grabbed a quick shower and came in. Matt and I had few coping skills for contractions because the hospital birth class taught some useless breathing technique which irritated me so much to practice that I declared I would NOT do it during birth. Nancy showed up, asked me some questions, and said, "Let's get you in the shower." No birth tub in this hospital. Matt grabbed a few z's on the couch while Nancy fed me ice chips between contractions in the bathroom. At first the shower helped a lot, but then it didn't and I wanted out. Now the contractions are turning painful, and I'm having back labor. Real, natural labor with a well positioned baby doesn't hurt, I can now say from experience. Induced labor with baby sunny side up feels unholy, like being wrung out like a towel while something presses mercilessly on your spine. I tried squatting - felt best, but hard to maintain. We tried a squat bar in the bed. We tried standing, with Nancy doing counter-pressure on my back. We tried sitting in bed. Nothing felt good. Around dawn, Nancy said, "Oh, look at the sun." I said, "Fuck the sun." She looked at me with a sort of, "uh oh." expression. She started saying things like, "That contraction is done now, that's one more you don't have to do." She had helpful breathing and vocalizing suggestions, but this labor was beyond them, for me. She said something about the baby, and I heard a voice in my head say, "Fuck the baby."

SCREEEEEEE! All engines stop. I did NOT want this kid coming into the world to an angry mama. No matter what happened to me, it wasn't his fault, for crying out loud. "I want an epidural." I said to Matt. He looked worried. The nurses had asked a couple times, and I had said, "I don't want to make that decision right now." but now I said, "I'm going to be too exhausted to push." "Okay," he said. Smart man. We both really wanted a natural birth, and he probably though the was supposed to talk me out of it, but he also knows me pretty well, and knows that I would be really disappointed to make this decision, and wouldn't make it lightly. The nurses, meanwhile, were pretty relieved that I was being "sensible." Doula Nancy, I would learn later, felt guilty - I was suffering and she felt she should have seen that. I don't think that's fair on her, but anyway.

Well of course at this point anesthesiologist A has gone home and anesthesiologist B is stuck in LA traffic. WTH. Shouldn't a hospital not let A leave until B is on site? And of course then B has to attend a surgery. Stupid life threatening conditions. By the time Dr. B (not his initial, I can't remember anything about this guy except that I wanted to kiss him) arrives, I'm screaming during the contractions, which hurt worse than anything ever. He watches me do one contraction and says, "You waited too long." "I'm inclined to agree with you, doctor." "Here's the paperwork. The risks are that it won't work, that it will only work on one side, or that you'll get a really bad headache. But that's not going to happen to you." I have no idea if he knew I was a good candidate for an epidural or just says this to all the mamas, but it worked on me. I decided that I would believe him and that would make it work. It did work.

So to administer the epidural, mama has to be rounding her back to separate the vertebrae. Nurse Nancy, who wore the most elaborate eye makeup I have ever seen and very well, too, held me up while I held this position. I was seated at the edge of the bed with my arms around her shoulders, my forehead on her sternum, and my legs around her legs, like she was my teddy bear. She acted like this was the most unremarkable part of her day. God bless Nurse Nancy, she is an ANGEL. So first they shoot a local in your back. like you're at the dentist or need stitches. "This is going to burn," Nancy says. "Fine." "Okay, burning burning." "I don't feel it." "Wow, you're tough." "No, seriously, I don't feel it." My nervous system, in its infinite wisdom, decided that information was just not important and it would not relay it to my brain. So then in goes the shunt or whatever it's called for the epidural. I think maybe I kind of felt something weird or cold? Again, I just did not care. One more awful contraction. Then the next contraction was SO. EASY. This is the point at which I almost kissed Dr. Good Drugs. The relief was tangible. I had been suffering and scared and had no idea how I was going to get this baby out, and all of a sudden, I was totally fine. So then Dr. Good Drugs tapes the ever loving crap out of this epidural onto my back. "Hm. I think your skin is reacting to the adhesive. It's pretty red." "That's fine." "It's probably going to itch for a few days." "Really, That's fine." "Okay well don't get out of bed and I'll come check on you later."

So now doula Nancy and hubby are allowed back in and we're all instructed to sleep. HA! Are you kidding me? As Nancy observed, now that I wasn't suffering I wanted to process what I was going through. I couldn't have slept if they had whacked me up side the head with a brick. Which is not  the standard of care, anyway. I was reading the second Twilight book. Say what you will about cheesy teenaged vampire werewolf fiction, it's perfect for passing time while in labor. Meanwhile Matt and Nancy BOTH snored. I thought about kicking them out but I liked the company. Dr. Good Drugs came back to check on me. I told him my neck kept tensing up in a weird way. He explained that was "referred pain," that the contractions were being communicated to another part of my body so I would still know they were there. Bodies are fascinating.

I feel the need to stop at this point and insert a disclaimer. This is sounding a lot like The Case For Medicated Birth. It is NOT. I am so, so glad I was able to birth Jackie with no drugs. But what happened here, as I learned later, was that a medically unnecessary induction resulted in an unnecessarily difficult birth. Robert wasn't in position yet, my body wasn't ready to give birth yet, and that made the whole thing much, much harder and more uncomfortable than it should have been. Back labor SUCKS. BAD. So mamas, while I encourage you to educate yourself about birth and why hospitals have really messed it up, I will say, when there's a real medical reason for the interventions, they are a godsend.

Okay so back to the birth story. Other than a change in anesthesiologist to the tallest man I have seen in person, I can't remember much more of the sequence of events between the "sleeping" (ha) and the pushing. I know that there was a change in shift and our nurse left. I was so sad she didn't get to see the baby after all she had done for me. I asked who was coming on shift, and the answer was somebody, somebody else, and Joan. We had met Joan at a previous visit for one of the false alarms. "Oh, I hope we get Joan," I said. "Is that a Patient Request?" asked Nurse Nancy. "Uh, sure, why not?" I said. Again, in retrospect - this is weird. There has to be an Official Reason to let me  have who I want at my birth. After going through the midwife model of care with Jackie, this strikes me as bizarre. It's not open heart surgery, for heaven's sake. And nurses vary as much as any other part of the population in terms of likability and whether you want them around.

So Joan is awesome. At some point I start pushing, and Doula Nancy has me changing sides periodically. I'm allowed to lie on either side or my back. No squatting, no hands and knees, nothing helpful that would allow Robert to get out of sunny-side-up or at least ease the pressure on my spine a little bit. Now, given that my legs are fairly numb, I could see why they didn't want me going for a stroll. But hands and knees on the bed or squatting on the bed should have been fine - if I "fall," I'm just on my face on the bed. Nope. Hospital Policy. NowSuzi would say, "Allow me to demonstrate what the hospital can do with its policies." but thenSuzi was notably more obedient. (Chuckle.) And also scared that I would injure the baby somehow. (And as for that epidural shunt in my back, given how long it took them to un-tape it, it wasn't going ANYWHERE, no matter what position I was in.)

Pushing, counting, resting, on and on. For six hours. I'm pretty stinking tired by this point. Dr. G. has arrived, it's around 10 at night, and he looks pretty rough. This man was usually gentle, calm, and polite. He was cross and testy. I think he had been awake as long as I had. Now, I'm sympathetic to his plight. But I suspect it was part of the reason why I ended up with a surgical birth, and cutting a hole in my stomach so you can go to bed earlier is NOT acceptable. But there's no way to know that, now.

At some point the whole team shows up, baby nurse and some techs and bright lights and doctor, and I'm all excited, and then they go away, and I'm all disappointed. So Robert is, they tell me, stuck. I'm pushing and he comes out a bit more but when I relax he goes back in. Dr. G. takes Matt into the hall to tell him we might need to go with a c-section. (Because Matt's the one who's going to have a hole in his belly, right? No, because he's lobbying me. Why reason with an exhausted pregnant woman when you can just scare her husband?) (Okay clearly the whole objective retelling thing has failed. Raise your hand if you are surprised.) So Dr. G. comes back in and tells me I need to let him do a cesarean. Nurse Joan advocates for me: "But she's such a good pusher. Watch her do one push." So Dr. G. watches me push through the next contraction, and then says, "Yeah, no. You're going to rip your perineum and dislocate the baby's shoulders." Well obviously that scared me into allowing the surgical birth. In further discussions since, I realize there is absolutely no way for the doctor to know that those things would happen. They *could* happen. I also *could* have spontaneously combusted. The former is more likely than the latter, and that's about what we know.

Okay so they take Matt off to dress him in blue scrubs. Dr. Also Has Good Drugs cranks up the epidural to the point that they could have sawed off my leg. This causes me to shake and tremble, which doesn't hurt but bothers me - it felt out of control and scary. Dr. AHGD assures me that it's a normal side effect, and trying to stop it will just make it worse. I'm also freezing cold. So we're in the OR, and Matt and Dr. AHGD are up by my head, and there's a drape so I can't see my own innards. My arms are strapped down, which is weird, and I'm still cold and shaking. Dr. G. asks, "Can you feel that?" "Um, I'm not sure." "Well, it's pretty sharp. If you could feel it you would know." Next thing he says is, "Great abdominal muscle tone, Suzanne." "Oh, thanks." But then it strikes me that this is a little weird - he's actually looking at my abdominal muscle. It's sort of like, "Hey, cute liver," or something. It doesn't take long and he says, "Okay Dad, do you want to see your son?" Matt told me later he had a tunnel vision experience - he stood up just enough to see just the baby, managing to avoid seeing my innards, and then sat back down. I heard the baby cry, and I was soooo relieved. "Okay, everyone guess." And all the doctors and nurses start guessing how much Robert weighs. So this is like watercooler banter for them, while I'm strapped to a table with my belly open. Weird.

He had huge hands and feet, like me and my dad, and they were greyish (as most newborns' are) so they stood out even more. Before clearing Matt and Robert out to sew me up, they asked if I wanted to kiss the baby, which I did. Matt couldn't figure out how to get close enough to my face with the baby, so a nurse offered to help since she had more experience holding littles. I kissed Robert a bunch until she stepped back with him. I remember hearing them ask Matt if he wanted Robert wrapped up, and Matt saying, "Actually we're going to do skin-to-skin." Nancy had been to something like 350 births at this point and she said Matt was the second dad she saw doing skin to skin. Dad win for Matt.

The next thing I remember was Robert latching on to nurse. Which hurt. A nurse was trying to help us, but I was exhausted, Robert was tired from being born and all, and it didn't last long. They wheeled me (still lying on a sort of stretcher bed thing) into an elevator, got us up to the maternity ward, and then did a transfer by picking up the sheet I was lying on and lifting me onto the bed. Some nursing assistants cleaned up my lady parts with water and washcloths, and then we were left to sleep.

Robert was "rooming in," meaning he was in a hospital bassinet in my room. We had wrong information about cosleeping being dangerous, and also I was so tired from the birth experience that it actually would not have been a good idea at that moment. So every time he needed to nurse, someone had to hand him to me (I still had a catheter in and wasn't allowed to get out of bed yet), and Matt was doing all the diapers, with nurses showing him the ropes. I remember at one point Robert cried for food at like 2am and I was so tired I said, "let's just give him formula and sleep through this one." And then I heard those words I had said and woke up the rest of the way and said, "I feel guilty just saying that. Give him to me." After I nursed Robert, Matt wanted to put him back in the bassinet immediately, so I wouldn't fall asleep holding the baby. I instituted a rule that I got to cuddle Robert for five minutes after nursing, as my reward for putting up with the pain of nursing. (We had bad latches and yeast. Nursing does not have to hurt, mamas!) When I look back at this now, it seems barbaric. Babies belong on their mamas, and I knew that in my heart but I didn't know how to make that happen, safely, in a hospital, while exhausted, with neither parent having much idea what they were doing.

We had a reasonable share of help and attention from the nurses, but only a couple of them had any breastfeeding training. Several of them were pushing formula to one degree or another, expressing concern that he hadn't peed yet or over how much output we were getting from the pump we had been talked into using. I can't remember why, I think just to "help my milk come in," which at like 24 hours past a surgical birth is silly. There was a lactation consultant who worked a sort of standard 9-5 shift, and I had a number to call her at, but of course she would be busy with another mom when Robert wanted to nurse and it was therefore a good time to teach me latching.

After the catheter was removed and I was allowed to walk again, I was encouraged to exercise by walking around the ward. So we would take Robert's bassinet for a stroll. On one of these strolls I witnessed a formula saleswoman (who looked for all the world exactly like a pharmaceutical sales rep) talking to the nurses at the front desk of the ward. "Okay, and you know that Brandy Brand is the official brand for any WIC moms in your hospital, right?" AAAARRRGH! No, by the way, I did not see any breast pump reps or breastfeeding product reps, of course.

The pain was pretty bad the first day, but Advil took good care of it. When I had to sneeze or cough, that hurt rather a lot at the site of the wound. A nurse suggested that I press a pillow against the area and go ahead with real coughing, because if I didn't cough properly I might get pneumonia. She was weird. She wouldn't leave my Advil with Matt while I was in the bathroom because she had worked in psych wards where people tried to hoard their meds. Um. I'm not going to not take my pain meds, and for Pete's sake it's Advil. If I want to hoard it, I can go to the drug store... but the pillow trick helped.

When the Advil started to wear off, it would hurt pretty bad. The nurses wouldn't give me more 15 minutes earlier than the doctor's instructions, but they kept offering me narcotics. "I don't want dope, the Advil is fine, it's just wearing off." "Nope, have to wait." Yeah, that makes sense. Ladies? If you're going to give birth in a hospital, put a bottle of Advil in your bag. Oh and when the doctor did see me and I told him this, he just upped the dose of Advil so I could have more when I wanted it. I realize that the nurses aren't empowered to do that and they would risk their jobs by medicating me against the written instruction. But to me that says the system is dumb - they're allowed to give me a controlled substance but they could get fired for giving me an over-the-counter painkiller 15 minutes sooner.

When we were discharged, I was put in a wheelchair and wheeled to the discharge desk. Never mind that I had been walking around the ward, if I want to get from A to B outside the maternity ward, Hospital Policy says I have to be in a wheelchair. A maternity ward nurse makes sure we have a proper car seat and that we put the baby in it, and we are sent on our way.

After the surgical birth, I was instructed not to lift anything heavier than the baby, and not to drive. I was not to go out except to go see my OB. I became concerned that my uterus had prolapsed (it hadn't), and was having a really hard time with breastfeeding. I had cracked and bleeding nipples, and at one point it hurt so much to nurse on my left side that I was pumping exclusively on that side. Doula Nancy came over to check on us and help me work on my latch, which helped, but it still hurt, so I asked for a lactation consultant recommendation. I got an appointment to see her in a day or so, and she made some suggestions for the mean time. When we saw her, she immediately diagnosed the yeast infection on my nipples. Any time you have surgery they load you up with antibiotics (which makes good sense if you think about it) and I have always been prone to yeast, so we were doomed on that front.

I could go on and on about our breastfeeding struggles, but we have covered much of that material in earlier posts on this blog, and really my point here is the after care, for purpose of comparison to my second experience. The aftercare experience from the OB model is very "you're on your own!" It seemed to me like the staff at Dr. G.'s office became even less responsive to my freaked out questions, but post partum anxiety is probably coloring my memory.

Dr. G. told me I was okay to try for a VBAC on any subsequent pregnancies, but that probably it was just the shape of my pelvis that had prevented a vaginal birth, and it wouldn't work. "But you can try." (Turns out this is also nonsense.) As time went on I had ongoing pain, albeit mild, at the site of the surgery. The pain rated a 2 on that 1-10 scale, I told a friend, but the pangs of grief from how the birth went were more like an 8. I didn't understand why it had upset me so much - I hadn't done anything wrong, Robert was fine, and I would be fine to have another kid by the time I wanted one. Eventually I realized that there are very deeply programmed, natural processes in birth that were interrupted, unnecessarily, in this birth. Having learned through my experience with Jackie how it can go when it is handled well (assuming everyone is healthy and there are no serious complications), I see now that obstetricians are just trained in a manner that is going to utterly prevent the possibility of normal birth in many cases. They don't get the chance to let birth progress naturally. They are taught to view every event as a Possible Disaster, and of course as caregivers they want to prevent that disaster. They have to pay absurdly large malpractice insurance premiums, and regardless of how altruistic they may be, this is going to engender a cross incentive to make the most out of each patient that they can, either by spending less time with her or by charging more for their services - and you can charge the heck of a lot more for surgery than for walking in and catching a baby at the end.

I am not angry at Dr. G. I'm not happy with how things turned out, but I see that he really did what he thought was best. He was wrong, in my opinion, but he came by it honestly. And I'm grateful for my beautiful Robert, that there were no serious complications from the epidural or the surgery, and that now I am in a position to serve as both a VBAC victory story and as an informed consumer offering a comparison of the two models of care. Which I will do via my snazzy chart in another post. This one is long enough.

One last disclaimer - this is my story of one birth. Each mama must decide the right thing to do for herself and her baby.

Much love,
Suzi