Dear Jo, Thank you for posting the story. I wonder if the story could be posted somewhere for obstetricians to read and reflect.
Last night we had a twin mother admitted @ 33 gestation. The obstetrician did a VE and ARM at 3cm cervical dilatation. By the time I got to see her, she was contracting irregularly, weak. And nervous to say the least about Epidural which was imposed on her. Middle of the night she had syntocinon infusion. This mother is G4 with first babe forceps for failure to descent; second and third babe SVD. I feel very disillusioned that I cannot be an active advocate in her care. She was a Private Patient. No wonder midwife is a dying breed. Ping ----- Original Message ----- From: "jo hunter" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, March 27, 2003 10:40 PM Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial feeding > I give HAS' permission to post this story. It is quite long but worth the > read! > Jo > > Caesarean, Caesarean, Caesarean, Natural Birth > By Clare Colman > > I was 24, healthy, a newly admitted lawyer. I booked in to see a private > obstetrician in a large maternity hospital. I read pregnancy books. I > attended the hospital classes. I had complete faith in the system and knew > nothing of the politics of birth. > > The pregnancy went smoothly, until 38 weeks when my obstetrician sent me for > a pelvimetry. I'm now sure it had more to do with my size (a petite 150cm) > and my occupation than any health risk. The results had shown my pelvis to > be "inadequate" and an elective caesar scheduled. I was devastated, but the > compromise was that I could undergo a trial of labour, so long as I came to > hospital at the first sign of labour. I was told, since the baby hadn't > engaged, I could have a cord prolapse and then "we have 8 minutes to get the > baby out before it dies". So at 2am on his due date, I had the show and > rang the hospital! I was there by 4am. Labour hadn't even started but no > one suggested I go home. No sustenance, no sleep, on my feet till 6pm. By > then I was exhausted, starving, discouraged, only 2cm. I didn't even see my > doctor, who was not available that weekend. I agreed to an epidural and the > inevitable caesar. Andrew was born at 2.20am on 10.1.94, weighing 3.195kg. > > The operation itself was not physically painful, but I felt totally detached > from what was going on, as if I was an observer. I think this was a coping > mechanism at the time - I was hooked up to so much equipment - electrodes on > my chest, automatic blood pressure cuff on my arm (which cut off the > circulation every minute or so), electrodes on my thumb, cannula and drip in > my arm, oxygen mask on my face (nifty shower cap too), catheter in my spine, > catheter for my bladder, naked and numb from the chest down, belly swabbed > in brown antiseptic, and a screen between "me" and the surgery. My husband > was sitting beside me, and there was a team of 7 or 8 staff members. > > In recovery my body shook violently for about 15 minutes, which I was told > was a normal reaction to an epidural. I slept for a couple of hours and > woke to the most pain I had ever felt. I had never had any serious injury > or illness in my life before - it was like having been hit by a truck. I > spent that day in bed. I couldn't even roll over from one side to the other > without 2 nurses assisting. Pethidine shots in the thigh every four hours > made me feel dopey and sleepy, and helped detach from the pain, but also > made connection with my new baby extremely difficult. I didn't even think > he was really mine. I just wanted to be left alone to sleep and make the > pain go away. The next day I had to get out of bed, and walk to the other > end of the ward for a shower. I thought I was going to pass out with pain, > and kept apologising to the nurse for being so slow! > > Physically each day got a little easier as I became more mobile and the > intensity of the pain eased, but the thought of having to take a baby home > and care for it made me feel sheer panic. I felt like I had failed the > first test of motherhood in having not been able to give birth, > breastfeeding was not going well, I felt no connection with my baby and I > had lost faith in my body. > > Many of the feelings that flowed from my caesarean were gradual rather than > immediate, but they included a profound sense of loss, inadequacy, failure > and sadness, guilt that I was not more grateful for the health of my child, > and eventually anger at the circumstances which led to the caesar and the > way I was treated afterwards. (I was sent home with an infected wound, > cracked nipples, a thrush infection and no follow-up care. It was 9 weeks > before I was able to see my doctor for a post-natal checkup, because she was > fully booked!) > > The second caesarean 2 years later added a sense of powerlessness in the > face of medical technology and the doctor/patient relationship. I allowed > decisions to be made for me and my baby and things to be done which went > against my instinct and feelings. I had changed doctors (another female > obstetrician) and hospitals and made clear from the start my desire for a > natural delivery. But a long cycle meant my "official" due date was 3 weeks > out, it was Christmastime, and private hospitals pay triple time to theatre > staff. Surgery was scheduled, rather than wait another six days till after > the holidays, strictly for the sake of the baby of course. Stephanie > arrived on 21.12.95, weighing 3.259kg. > > Having a general anaesthetic after a failed epidural (and an encounter with > the worst anaesthetist I have ever met, who yelled at me for "failing to > co-operate" when he couldn't get the needle in my back) also created an > obstacle to bonding with my daughter - it was a long time before I felt she > was even mine, and there was no transition from being pregnant to being a > mother. > > I am sure my caesars contributed to PND during the first year after each > birth. It was also extremely hard for my husband (and others) to understand > why I felt the way I did when we had 2 beautiful, healthy children and I was > physically recovered from the surgery. Working through all these feelings > and their effect on my parenting was a long process. I learnt to accept > responsibility for my own part in what happened, and to take more > responsibility for my future care. > > Older and wiser, I approached the birth of our third child. I read > everything I could find on VBAC, attended excellent classes at Birthing > Rites, enlisted the skills of a private midwife (the one and only Maggie) > with a back-up obstetrician (Brian Peat). I learnt to swim (at 28) so I > could do laps and went to the gym throughout the pregnancy. > > Due date came and went, with contractions every evening that petered out > when I went to bed. Finally I thought it was the real thing, about 8pm > Friday, 41 weeks. I was so psyched up and ready to have this baby. I had > so much to prove, especially to myself. I called Maggie about 11pm and she > came over. It was still very early, and she suggested we all get some > sleep. I dozed between contractions, but I didn't feel rested by morning. > Maggie suggested we go for a walk around the neighbourhood as the sun rose. > Contractions were hard work. I was so disappointed that I hadn't even begun > to dilate yet. Maggie went home to vote (it was Federal election day). I > ate and walked and rested. Thought about voting, but every time I got to > the door I had another contraction and changed my mind about venturing out! > > Maggie returned later in the afternoon. I was beginning to wonder how long > this would go on. I was using hot packs, spent several hours in the bath, > did lots of walking and rocking and moaning. Eventually I felt I had come > to the end of my endurance, and knew I needed more help. I was about 8cm > when arrived at hospital at 1am Sunday, to be met by a security guard who > said I couldn't go to the labour ward because I wasn't booked in. Growled > at him that I bloody was booked in. Then the nurses kept waiting for the > contraction to end before they did this or that. I told them to just do it > anyway because there was no break between contractions. By 4am I at last > had an epidural in - blessed relief and sleep at last. > > I was fully dilated, but the baby's head was not engaged. By 10am baby was > still doing fine, but not engaged. No-one said the C word, but I had run > out of options. I needed to be upright and couldn't be with the epidural > in. > > So I bowed to the inevitable and was prepped for surgery. Tears flowed down > my face as I was wheeled to theatre. I had come so far. The disappointment > was acute, but the baby was beautiful. And big. David was born on 4/10/98, > weighing 4kg, which probably explained his reluctance to engage. > > All my preparation had not been in vain though. I recovered from surgery > much more quickly this time. I had taken responsibility for everything that > happened in the pregnancy and labour. Physically and emotionally I felt so > much better than before, despite the long and strenuous labour. > > Now, 3 years later, I have just given birth to my fourth child, Genevieve. > This time, I gave myself permission to fail. I planned to do my best to > give birth naturally, but I knew there was a high chance that I'd be having > another caesarean. One of the hardest things I had to do to prepare for the > birth was to write to the hospital director, setting out my wishes for my > care in the event of surgery, including not being routinely separated from > the baby, etc. The letter itself was an acknowledgement that I would > probably not give birth, and I cried and cried as I wrote it. > > Again my due date came and went, contractions came and went. Monday, 9 days > overdue, I felt something was different. After a couple of strong > contractions I asked Rod to stay home from work. I rang Maggie (my > labour-support person) and she suggested I go back to bed and get as much > rest as possible. Wise woman. Of course contractions petered out again, > but it was very reassuring to have my husband home, looking after David for > me. Late in the afternoon I went for a long walk around the neighbourhood, > with contractions strong enough to make me head back for home. Rang Maggie > again around 8pm to give her an update. Still early days yet. I went to > bed about 9pm, trying to rest between contractions. David was still > breastfeeding, and his sucking brought on strong contractions. Eventually > Rod moved him to another room because I needed some space to myself. About > 2.30am I began to feel alone and panicky. Rod brought me a hot water bottle > for my abdomen which really helped. About 3am we rang Maggie and asked her > to come. She arrived about 4am and promptly suggested a walk around the > neighbourhood. After once around the block we decided to go to hospital. > My mother-in-law arrived to mind the children. > > We arrived at hospital about 5am. After hours of strong contractions, > labour came to a halt again as I was put through the standard hospital > procedures. I lay down, strapped up to monitors, feeling my power slip > away. Lots of fiddling about trying to find the baby's heartbeat. Every > time the (student) midwife found it, the baby would move away. She insisted > we needed a 20 minute trace even though the machine wasn't even functioning > properly - it would record nothing during a contraction, then go crazy when > I wasn't having one. When the mid-wife left the room I stood up and > discovered I could find the baby's heartbeat myself when I undid all the > straps and just held it myself. Finally I'd had enough and took it off > completely. > > We asked where we could make tea, and I was told I could only have ice > water! I told the midwife my doctor was happy for me to eat during labour > if I wanted to, and to call him to confirm. She returned with agreement > that I could eat lightly, and the news that the resident was going to take > blood and insert a cannula; standard procedure for previous caesareans. I > told her I didn't want a cannula and would only consent to it when it became > necessary. I could feel myself taking back the power I had given away since > I arrived at hospital. I told her to check again with my doctor. Again she > rang and confirmed this. I knew she was feeling threatened by this naughty > patient, and I was feeling frustrated that I should be fighting battles > instead of being allowed to labour. > > Another midwife (who remembered me from Andrew's birth in 1994) gave me a > VE. I was thrilled to discover I was 7cm dilated. For the first time I > felt a glimmer of hope. > > We moved to a labour room, consented to intermittent monitoring, then set > out for a walk around Sydney Uni. We got some very strange looks from > people in the street! > > I ate toast, chocolate and fruit, drank tea and gatorade, went for another > walk through the streets. About noon I had a shower then lay down on my > side to try and rest between contractions. The baby's head was still high > and floating. > > From about 1-3pm labour was so hard. Every time another contraction began I > thought "I've got to get up", but I couldn't articulate what I needed. Then > it would end and I would lapse into half sleep again, until the next one > hit. I began to despair and just wanted to give up. I couldn't believe I > was going through all this pain when a caesar was inevitable anyway. I > asked if an epidural would help. No, said Maggie. Eventually she suggested > another shower and I managed to agree. From 3-5pm I used a handheld shower. > The hot water on my abdomen was fantastic. As each contraction came on I > would stand and rock, while Rod held a hotpack against my lower back. When > it ended I would sit on a plastic chair, Rod would kneel behind me, till the > next one came. We were in a trance-like rhythm, dealing with just this > contraction. Maggie brought endless cups of ice and gatorade, and cool > washers for my face and neck. > > About 5pm I started feeling the urge to push. I was making grunting sounds > and Kathy, the lovely midwife on this shift, suggested I go back to the room > for a VE before I did any pushing. Turning off the hot water was so hard. > It was my lifeline! I staggered back to the room and got onto the bed. I > was flat on my back but I absolutely couldn't move. My body felt as heavy > as lead. I was so glad to hear I was fully dilated. I gave a huge push and > my waters broke with a gush. Kathy said she could see the head. I didn't > believe her. I asked for a mirror, and found this was really helpful in > knowing what was happening. Another contraction and I pushed with a > strength I had never imagined. It felt really good to finally push against > contractions rather than surrender to them. Suddenly I could see the head. > For the first time it occurred to me that I might actually give birth. My > doctor arrived just as she was crowning. The head was born! It was really > happening. I tore a little as the midwife turned her shoulders, then she > was born. 5.24pm, Tuesday 18/9/01. > > She was passed into my arms, and I held a newborn baby for the first time. > She was warm and wet, bright-eyed and alert. I will treasure those moments > forever. After several stitches, I ate dinner and walked to the shower. > The next day we went home. > > Mentally and physically, I felt a thousand times better than after the first > three births. For the first time I was drug-free, no morphine or pethidine, > no catheters, no wound, no surgery or liquid diet. I could be fully present > to care for my baby. > > Genevieve was 3.28kg; with a head circumference of 35cm. Both measurements > were bigger than Andrew. So much for the technology which told me my pelvis > was inadequate to give birth! > > Thankyou Brian for allowing me to labour without restrictions or > intervention; your support in the face of hospital procedures made a huge > difference. Thankyou Maggie for your unwavering strength, your belief in > the power of birth, and your love and friendship. Thankyou Rod for standing > by me, for confronting your fears head-on, for spending 2 hours on your > knees in the shower, and for 4 beautiful children. And lastly, thankyou > God, whose power working in us, can do infinitely more than we can ask or > imagine. > > ----- Original Message ----- > From: "Mary Murphy" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Thursday, March 27, 2003 10:58 PM > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > feeding > > > > Jo, you wrote: > > "I have a great article that was published in the latest edition of > > Birthings (Homebirth Access > > Sydney Newsletter), written by a mother of 4 whom had a vaginal birth > after3 > > c/s - I can send it to you off list if you are interested." > > > > I would be very interested in this story. As it has been published it > isn't > > "private" Maybe you could write it up for all of us? with permission of > HAS > > of course. Cheers, MM > > > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.465 / Virus Database: 263 - Release Date: 25/03/2003 -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
