Several months back, I had the pleasure of meeting Alisha at the Baby Expo event at Reblossom in Athens, Ga. I struck up a conversation when she came down the isle very pregnant and wearing one child with another little one walking along side. It was obvious to me she was a strong mama who wouldn't be held down and knew what she wanted. Alisha shared, "This time, I want the opportunity to choose labor and I sought out a doctor who would agree to let me try." I said, "Good for you! Many have no idea that skipping labor and going straight into surgery denies baby meaningful stimulation that preps baby for the best start to life."
We instantly bonded. Her smile was infectious! We ended our conversation that day with a fun selfie, after she shared she would be attempting to VBAC after two prior c-sections. Her previous OBGYN had convinced her to skip labor and simply schedule a c-section at 39 weeks. The second time, he convinced her to skip labor again and schedule surgery at 42 weeks bc she had no signs of labor. The catch 22 for most VBAC scenarios (vaginal birth after caesarean surgery) is the doctor typically will not induce a VBAC. Therefore, you can see real quick how women feel defeated from the old concept, "Once a c-section, always a c-section" because that is often how it plays out. If you can't get yourself into labor within their time frame back in surgery you go. I, too, experienced lack of support and disparaging comments from my former OBGYN and I rose above it. I made good decisions and now my team and I are birth advocates for all couples, despite their choice to utilize pain management or not but particularly for clients who desire to labor and birth free of routine interventions or drugs unless medically necessary.
I shared with Alisha that Dr. Tate had caught both my girls back in 1990 and 1992. I elaborated that I started out with an OBGYN practice in Snellville, Ga. They were trying to force me to induce at 40 weeks, but I was smart enough after my twelve week Bradley Method® birth training to stand my ground. If mom and baby are okay, what is the problem? Just being overdue based on an estimated due date is NOT a medical reason for induction. Even when my doctor pressed to bully me into induction or I quote, "Go find you another doctor!" I replied boldly, "No problem, where do I get my refund check?" I was young 21 yrs old, married my high school sweetheart and planned both my children, but I could've easily fallen into the category of "FAILURE TO PROGRESS" c-section, had I not invested into birth training. The knowledge and education of informed consent empowered me and so I took my out of pocket money from that practice at nine months pregnant and paid it to Dr. Tate (who agreed to not mention the word, induction). It is important to cooperate with your birth team and allow them to explain why they prefer a certain way of doing business, however, we do not always have to agree with them.
WE STILL HAVE A VOICE. If there is no immediate danger or emergency, YOU STILL HAVE OPTIONS. One of the biggest issues we face today is expectant COUPLES ARE NOT CHOOSING CHILDBIRTH EDUCATION and unfortunately that one decision often lands them in the "I didn't know I had a choice" box. And, worse in addition to not knowing better the unknowing couple also gets the bill, all of it. Regardless of whether you understood what or why you experienced whatever intervention, procedure, surgery, etc. The irony, people research their next cell phone or tablet, their next gadget or car, often in great detail, yet when it comes to their most prize possession, their own child, people seem to decide real quickly childbirth education doesn't fit their busy schedules so they don't make time. Also, they either don't know what a doula is or does or that hiring a doula doesn't really fit into their budget or even care to research where they birth or with whom, as important at all. Yet, couples GET THE BILL at the end, Mothers refer to their birth as traumatizing and on top of it all they often experience a much more challenging nursing relationship, recovery time and even postpartum depression. In addition, once you experience a typical hospital induction, medical vaginal birth or c-section, your out of pocket costs FAR EXCEED on average what you would have spent in adequately preparing and even utilizing prenatal consulting, childbirth education, labor assistance, lactation support, etc.. Mind blowing!
Alisha would tell you the opposite. That it is important and valuable. That education is power. She would impress upon you knowledge matters, informed consent, where you birth and with whom matters and not just a little, but big time, because even in the event of a bad outcome, you are left to recover on your own, take care of and raise your own child and get the bill.
Alisha's Birth Journal for baby #3 reads:
Being able to experience labor without pain medicine was such a great experience! While many people desire "healing from unscheduled c-sections" by simple scheduling a subsequent surgery, it was the opposite for me. Having an OBGYN like Dr. Joseph Tate who allowed me the opportunity to labor, to attempt a vaginal birth and even encourage me to try rather than immediately scheduling another simply because of estimated baby weight and my history of surgery meant the world to me! Though I was sad I did not get the vaginal birth I had hoped for, this c-section experience was so much better in so many ways than my previous two and allowed my baby to still come into the world safely and much stronger because I chose to labor. Nothing is better than that!
Induction vs. Scheduled surgery ~ Alisha's Recorded Timeline of Events:
Monday, April 2, 2018 (41 weeks and 3 days):
Non stress Test / Internal Exam (cervix thick, 1cm dilated, -3 station
Hike ALL THE WAY up Stone Mountain, GA wearing her 2nd child. Then hikes all the way down in an attempt to bring on labor.
Lost mucous plug late same night.
Tuesday, April 3, 2018 (41 weeks 4 days):
Listened to relaxing music to go to sleep- per my Doula
Wednesday, April 4, 2018 (41 weeks 5 days):
Spent the day with my Doula Pam trying interesting foods at Taqueria Tsunami, hiking up hills @ M2b Farm and ending my day
with a relaxation session/ pressure point work to bring on labor. Left having contractions.
Thursday, April 5, 2018 (41 weeks 6 days)
Spent the day shopping at my favorite places and relaxing with the family in hopes that "not trying" to be in labor would take my mind off things.
Friday, April 6, 2018 (42 weeks)
Receive a call from Emory to arrive around 8pm / start with NST in triage
We pack up, stop for food on the way (Outback my favorite blue cheese wedge salad, cheesy bites and my favorite potato soup).
Around 6 p.m. entered triage and began the questioning process.
Change into hospital gown/ grippy socks and answer more questions.
Hooked me up to the EFM (monitor) for the initial strip to get a base line of baby's heart rate. Contractions had commenced and were being picked up by the monitor despite not having began the induction process yet.
An influx of women arriving in active labor that a room for induction still unavailable.
Met the student Doctor, Parks.
IV was placed to speed up the process while still in triage waiting on a room.
Saturday, April 7, 2018 (42 weeks 1 day)
After midnight made a pallet and slept on the floor in triage.
Enjoyed my soup, salad around 2:30 a.m., removed from monitors.
Slept till around 5:30 a.m, five more women enter and bed still unavailable, monitors re-attached for 30 minutes.
6:30 a.m. off monitor on birth ball
8:00 a.m. Foley Bulb inserted
9:00 a.m. first round of antibiotics started (Group B positive) Dr. Tate reminds nurse of cold induction method. Only raising pitocin 1 every 45 minutes and holding there for 2 hours. Then raising to 2 every 45 minutes and holding to re-evaluate.
1:30 p.m. Dr. Tate comes in to check progress and the foley bulb is out. 4-5cm dilated, 50% effaced. Pitocin is being held at 4 until 3 p.m.
2:10 p.m. Nurse shares Alisha is in the sweet spot with contractions coming every 2-5 minute so pitocin is being held.
3:15 p.m. First sign of bloody show (positive changes in cervix happening).
7:42 p.m. Up to 8 ml of Pitocin, cervical check 5-6cm 70% effaced, starting to become more uncomfortable.
8:27 p.m. Nurse informs Dr. is coming to discuss internal monitor being placed to monitor baby's heart rate variables. Pitocin at 10.
9:31 p.m. Amniotomy (bag of waters broken) Internal Monitor placed. Since Pam was already in Charlotte for a mom who went early, Nikki Reeves, YBH Doula Apprentice was in route and would collaborate to assist under Pam's instruction.
10:42 p.m. Pitocin is turned down to 6
11:00 p.m. 6-7cm dilated, 70%, -2 station
Midnight: Ultrasound to check baby's position, baby is posterior presentation.
Sunday, April 8, 2018 (42 weeks 2 days)
Nikki (present) and Pam (consulting) guide me through multiple positions to try to get baby to move down.
- Inverted all fours
- Raising Bed pillows on top leaning over
-Sifting with rebozo (Matt her husband on bed)
- Hip Sways
-8th grade dance
-Sitting on toilet with Matt in front leaning into him
-Squats
-Birth Ball exercises
-Penny Simpkins
-Sitting in Recliner soles of feet together/ Namaste
2 a.m. No cervical change, baby's head starting to mold, elevated heart rate for baby several hours now saline has lost its effectiveness to eliminate baby's tachycardia.
Dr. Tate explains options and advises he believes its time to get the baby out safely to avoid emergency surgery. He did advise the final decision was up to Alisha & Matt of whether to continue or make decision to move forward with c-section. After a few moments of crying to mourn the loss of her vaginal birth she had hoped for, Doula Apprentice Nikki politely asked Dr. Tate to come back in to re-explain how he arrived at this decision and protocol to follow. Once again they agreed their ultimate priority would be to avoid an emergency c-section. Alisha decided to opt for the spinal block for her anesthesia and the anesthesiologist was delightfully surprised at how easily she could assume the position. Alisha explained in her previous two surgeries they rolled her into the position like a sack of potatoes and how nice it was to be asked to assume the position all by herself. She also noticed that only one arm had been strapped down and pointed that out to the nurse who advised that wasn't necessary and freed her left arm instead. Alisha was pleasantly surprised when she mentioned she was cold they added a drape over her chest that pumped warm air in through a tube.
A few minutes later her husband, Matt was brought in and encouraged to get some photographs of the birth. Every time Alisha felt tugging her excitement of meeting her daughter grew. Dr. Tate joked that since this was her 3rd c-section she could probably do it herself at this point. Alisha found comfort in being included in the conversation rather than ignored while a surgical team discussed their current events and their own lives as she experienced in her two previous c-sections with her former OBGYN. She found the experience to be so much more pleasant indicative of a proper happy "birth" day despite repeat surgery. A few more tugs and the medical team advised it was time to meet her baby. Matt stood up with his camera and little Miss Astrid Josephine Berkland was born at 3:17 a.m. After hearing baby's first cries, moms tears weren't far behind. Alisha asked if she had hair and what it looks like? Dad continued to capture the precious first moments of her new life outside the womb. Alisha inquires of her apgar scores and is told 8 and 9 and baby was already smacking her lips, which excited mom that she was already signaling she would nurse. To further evaluate her elevated heart rate she was taken to the nursery to ensure everything was okay.
Matt accompanied baby Astrid as Dr. Tate and his assistant resident doctor put Alisha back together again. When the curtain came back down, Alisha was the one doing the joking as she laughed and asked, "Did you two make me all pretty? And, how does my abs look?" She had experienced some separation last pregnancy. The resident replied, "They look beautiful" and Dr. Tate added, "Well, you do still have some work to do." Alisha laughed. Once she was ready to head to recovery and observation, Dr. Tate advised the tubing attached was called a Q-ball with pain relieving medicine and not a drain tube.
Welcome to the world Miss Astrid, no doubt you are loved! Special thanks to Doula Apprentice, Nikki Reeves. She was instrumental in assisting the couple through late labor positioning, progressing and empowering Alisha to run her labor marathon making the decisions best for her and her baby by utilizing only medically necessary interventions or what we like to call, #SymbioticBirth. Our goal, as Your Birth Helper Doula/ Labor Assistants, is to help our couples PLAN, TRAIN, APPLY & EXECUTE what they have learned TO HAVE A HAPPY "BIRTH" DAY no matter how their baby enters the world.
Your Birth Helper offers scholarships each year for 4-6 couples desiring Doula assistance in the Athens, Ga and surrounding counties who can not otherwise afford help or do not have someone to support them during labor & birth. Couples must have either a financial need for free / reduced services or meet other criteria in exchange for training opportunities for new team members.
Email Pam @ YourBirthHelper@gmail.com for more details on one day workshops, 12 week traditional birth prep in The Bradley Method®, doula services or information on applying for our Doula scholarships or Doula Training Candidate Program.
Each YBH Doula Contract comes standard with Free Labor and Birth Photography. The photos in this birth story compliments of the awesome Nikki Reeves.