Tag: vbac

Share or not to share?

Anonymous BirtherLeave a comment

During my first trimester, I was researching, interviewing, and coming to terms in my own soul with what was right for me in terms of a provider and birth plans, I chose to not share my home birth considerations with basically anyone other than my husband and support groups online. I highly highly recommend this. During a time of decision making, it is important to not be subjected to a million opinions OR other people’s negative, traumatic experiences with birth and their own fears. I have spent a lot of time growing into a person who can stand on her own two feet and not give a shit about what other people think about me or say BUT, when in a vulnerable space such as being pregnant…and making these personal choices, I believe it’s important to protect that space spiritually and mentally. The use of DISCRETION is key. Even throughout the second trimester I chose to not tell people because…well, it didn’t feel necessary and I was still moving through some tests and things that could’ve risked me out of prepping for a home birth so I didn’t think it felt “real” enough to even share.

I’m 31 weeks pregnant and I feel differently. I made it through the decision making process of the first trimester as I gained tons of information and I spent the second trimester settling into it all myself, and in the third trimester now, I feel confident in my choices and am super excited about birth! I also want to normalize my choices (as a home birth plan is new for me given my first was a desired natural birth turned c section due to frank breech at 37 weeks). I do want to share all this info I have learned as well to other women but also know that might not be my place, or the time yet. Another place to use that lovely word DISCRETION. Other women may want a scheduled c section, an induction, etc. and that is cool, more power to you. I’m not trying to push for all women to have natural births. I just hope there is more real informed consent happening around all of it one day…for example, every women actually being told the risks of an epidural to mom and baby or how inducing labor changes labor and has a high rate of leading to c section or how our posture affects baby’s positioning the whole pregnancy.

Off on a tangent again…So, I am now openly sharing my home birth plans to people if 1. they ask specifically, and 2. I feel capable of detaching from their reactions. Being in the preparation phase for birth now, I do mostly feel able to detach from others’ reactions because I just don’t care what others think but…I’m not about to get into debates about it or try to justify my choices to skeptical, fearful people. There are still some people I won’t share it with because, well it’s a personal healthcare and family choice that really isn’t anyone’s business. But just like everything on the pregnancy journey, my perspective has now shifted and Im in the space of being excited for our plans, super happy with my provider (a home birth/birth center midwife), and wanting to normalize the process for myself, because, contrary to our culture, it is normal and I believe in physiological birth.

What are your experiences with this? Sharing or not sharing birth plans (whatever they may have been) and what worked for you?

Posture…Who would’ve thought?

Anonymous BirtherLeave a comment

Jan. 17, 2020.

I’m now almost 29 weeks pregnant with baby number two and I’ve been writing about the differences in care I’ve received this time around (because of my choices) and how I’m prepping for my vbac home birth. Today I’ve been thinking about how my previous experiences with OB’s and CNM’s in a hospital group (at great hospitals in major cities) compare with my care under a midwife now. I am not blaming previous providers as I konw to take responsibility myself to gain information now in regards to birth within our healthcare system BUT in all honestly, they were not great at teaching how to take “preventative” measures for concerns such as breech positioning or nutrition or exercise stipulations in general. Which probably doesn’t come as a shock as these are things they don’t really emphasize in their studies. This pregnancy, besides just taking responsibility myself to gather all the information I can, and I have, I have also been with a provider, a licensed midwife (LM) who practices in out of hospital births (home births or birth centers) who has put emphasis on measures to be taken EARLY to prevent the whole, “oh fuck, it’s now 37/38 weeks and baby is… or mommy is…what can we do to change it?”

Here’s a quick list of things I am now grateful to be more aware of because of both my own research being stepped up about 100 notches and my midwife’s thorough care. (She provided me with a thick binder with info to read before each appointment that carries me through to the end). Right away, first section of the binder there was an emphasis on how to achieve optimal fetal positioning for a smooth birth. FETAL POSITION DOES MATTER if you are trying to have a smooth, natural birth. It’s important even if you aren’t trying to have a natural birth but are trying to avoid an unnecessary cesarean or just a labor that might qualify as a “tough one.”

  1. POSTURE

I was never aware how much my posture and slouching in a chair or a couch could contribute to less than ideal positioning of the baby for birth. I think I was more aware of it at the very end of the pregnancy the first time but now I know it is something to consider from the beginning and one in which I believe has helped position my little guy in the optimal fetal positioning (LOA) since at least 27 weeks. I am going to keep paying attention to posture and although it feels like a pain in the butt sometimes to not just slouch into the couch, I understand and believe the importance of it now. I feel a bit awkward sometimes sitting with such good posture as everyone around me rests into the back of a chair…but hey, you gotta do what you gotta do. I do want to slouch sometimes and sometimes I do briefly, but I’ve now developed a good amount of muscle memory with good posture or choosing to stand (as I am now) so when I do slouch, I can feel it my lower back and how my hips aren’t tilting forward anymore. The Spinning Babies website labels this as “Maternal Positioning.” Which leads me to the number 2 thing I’m most grateful for being more aware of now…

2. SPINNING BABIES

The main homepage of this website says “Easier birth with fetal positioning. Use this site and videos to improve fetal position (breech, transverse, posterior) and birth. Reduce the chance of cesarean.” I won’t copy and paste their knowledge here but go to the site and read read read! In my first pregnancy, I was made aware of this website from my prenatal yoga teacher and my doula at the time. My OB’s and CNM’s never directed me to this information except at the very end the CNM’s mentioned it with trying some exercises for how to flip a breech baby. It is much more effective to just be knowledgeable and practicing some of these exercises/suggestions EARLY on in the pregnancy and throughout, and not just at the end when it’s like…”oh shit…” 🙂 Before I also didn’t take it as seriously as I do now. I thought it could be used more as a measure taken if something went wrong as opposed to just optimal health for the pregnancy.

3. Acupuncture

I have seen an acupuncturist 3 or 4 times so far and I swear it is the best stress reliever I’ve ever experienced. You’re basically forced to rest and meditate for an hour without moving much so it is super super helpful to me to get some self care rest time as I have an almost 1.5 year old AND I believe the practice really works to prepare the body for birth. My body needs to be in balance and without tight muscles and ligaments obstructing or hindering baby’s positioning for birth. It was highly suggested to seek acupuncture from numerous Licensed Midwives I’ve met on this journey. Again, it was not suggested in my experience with OB’s or CNM’s until again at the very end last time when my CNM suggested I do that to try to solve the issue. I’ve found it to be helpful as a preventative measure so far.

4. Webster Certified Chiroporactic Care

This time around I’ve been seeing a chiropractor since the beginning… before, I tried to go 2-3 times around 38 weeks…which… when your body is out of balance, super tight, etc. a few times aren’t going to help. (First pregnancy I was probably the fittest I’ve ever been leading into it and had very tight ligaments around my pelvis and abdomen (and everywhere).) I love getting these adjustments and yes, I do think they have been helping enormously.

There you have it… The top 4 things I am grateful to be aware of during this pregnancy and doing things differently.

Please follow my blog to stay tuned and please reach out if you have any questions, are in the same boat, etc etc. I’d love to hear from you!

Finding the Balance. When is it too much info?

Anonymous BirtherLeave a comment

January 3, 2020. I am now 27 weeks pregnant with baby number two.

Around six weeks ago I filled out a questionnaire for my midwife which we will review this upcoming Tuesday. The first question was “What are your top fears about this pregnancy/birth?” I knew right away. 1. That this baby will also be breech and I will not have any choices (like my first) except to have a c section.

My first ended up in a cesarean section due to late finding of frank breech positioning and “low fluid” (I put this is parentheses because this is kinda in line with the whole “big baby” fiasco going on in maternal care, typically being an unnecessary (lack of evidence) cause for intervention. (see earlier posts about my first pregnancy and look up the ACOG’s new position on the big baby thing: stating that ultrasounds can’t accurately depict size. Yes. thank you for all the unnecessary surgeries due to your earlier position on it. lordie.). Sidetracked there… I now know SOOO much more about optimal fetal positioning and the need to look at pelvic alignment and balance and relaxing the ligaments surrounding the uterus to give baby optimal space to turn and the various ways to do that. (A topic that isn’t fully addressed in 10 min prenatal OB appointments or CNM hospital groups in my experience. They very lightly touch on things AFTER the less than optimal positioning presents itself. Teaching optimal fetal positioning and ways to prevent variations that aren’t medically supported usually isn’t a part of basic prenatal care in the first and second trimester especially. (Over my two pregnancies so far: I have experience seeing a top OB at a major “good hospital,” a CNM group with a smaller but good hospital, a private practice OB known to be “natural” and vbac friendly, and a regular midwife. By far, the midwife has been the most holistic and knowledgeable and presenting me with all my choices and giving me preventative care as opposed to “let’s fix this” afterwards.)

I’ve been seeing a regular chiro and then a Webster certified chiropractor since 7 weeks. We just started doing twice a week actually around 26 weeks. I have gone to acupuncture with a guy who specializes in pregnant women around three times so far and plan to continue every few weeks. I’m doing a handful of Spinning Babies exercises/stretches daily at home, such as the forward leaning inversion, and focus on just walking and caring for my toddler as my exercise. I’m seeing a supportive provider, a midwife. I joined ICAN and my local chapter. The more I learn, the more passionate I become about the need for changes to women’s rights and choices with maternal healthcare in the US.

Now… at what point is too much? or too much focus on this breech prevention? or wanting to become an activist as I am prepping for this birth?

Well… As I near third trimester, I think I’ve hit my self imposed limit of research for now. I just deleted the Facebook App from my phone so I don’t read posts so often from my support groups because I find it just makes me think about it more. In the last 6 weeks since I’ve answered that question about my fears, I’ve concluded that if I end up with the circumstance of baby presenting head up towards the end (like 35 weeks), that I would first try more things to turn (but not an ECV bc of prior experience) and seek out a vaginal breech provider who does attend home births if not and if he thought I qualified for a vaginal breech birth. (If an OB would attend my birth at a hospital near me I’d do that instead but they don’t exist where I live unfortunately. I’ve looked into it.). After all my fact finding, I now believe having a csection just because baby is breech is not usually a necessary csection. (sometimes it does necessitate one… but it’s not a black and white, always needing one.) My first baby never showed any signs of distress while in breech position at the end. I have felt that truth. It’s more a lack of skilled providers being “allowed” to attend the vaginal breech birth which is a recent phenomenon in our history. I think I would have a hard time consenting to something that some providers will do and others won’t. That lack of continuity makes me see it as a policy issue and not a health or safety issue, or what’s in the best interest of mom and baby. However, me dwelling on this limitation in our health care system keeps me in a “fight or flight” stance because I get angry. I know that being in fight or flight is ANTI optimal baby positioning and labor. It’s like me being in defense of the giant bear outside my cave when I am preparing for birth, the modern day threat: the healthcare system. It’s not what my mind or body needs. This also brings me to the conclusion that although I want to begin advocacy work for more options for breech birth as well as vbac and home birth in general, I think being in “fight or flight” with the system, as it gets me all riled up to think of our current state of options, isn’t the best for me while preparing for this next birth. I will jump on board more post birth to do my small part in making some changes. Even just sharing my experience now feels like a bit of a contribution.

So, I’ve done a LOT of gathering and now it’s time to have faith that baby will be head down and try my best to let go of the outcome. I will only do more research now when a new decision presents itself. I have enough facts and information about my birth choices and breech in particular and have taken a lot of action.

My third trimester mantras: Think positive. Be present. Safe to soften. Take the actions for body balancing for baby as I have been doing, but trust it is working. Talk to baby. Relax. Limit my Facebook group time. Protect my mental and spiritual space surrounding this with healthy boundaries and discretion. Have faith and surrender.

Co-Care: What a concept!

Anonymous BirtherLeave a comment

Oct 23, 2019: 16 week appt with OB

I saw my OB today (one of three main male doctors recommended for vbacs in the area) for the 3rd time (8, 12, 16 weeks) and discussed my plans for transferring to a midwife for the rest of my care for planning a home birth. I was very happy with the experience and his willingness to meet me where I am at, be honest that I have a very “uneventful” pregnancy going on (a good thing), and he said I can come back and see him towards the end, before labor, perhaps at 35 weeks if I wanted. ( I had asked him if he’d be open to that should I want to.) I was super happy with this “co-care” methodology and I believe it’s how all maternity care should be which is: flexible and going with the needs and desires of the mother as well as treating the pregnancy as it is, a low risk, normal pregnancy (regardless of one prior c section due to breech). He gave high remarks about the two midwife groups I told him I was considering and spoke highly of his hospital which is five minutes from my house should I have to transfer there during birth. He said it was the best hospital around for taking homebirth transfers. He shared how some other “good” hospitals around would not be so open and ok with it. You would be met with a tone of “oh another one of those homebirthers are here” kinda a reaction at many hospitals which is obviously not cool. I wouldn’t be able to cal him in labor, but if later in the pregnancy things change and I am high risk, then I’d switch back to seeing him or see both him and the midwife. He normalized the whole thing for me which in my head I can sometimes think, “I’m the first to be doing this.” Absolutely not. I am a normal, pregnant woman, with nothing showing up of concern. It is natural for me to not need medical interventions. It’s just against our cultural norms now of everyone going to an OB and all births “needing” hospitals.

Prior to my experiences in the last four months, I never even realized I could have co-care, which essentially means I can see who I need to see without an “allegiance” to one provider. Call me crazy…but that sounds like how it should be. I’m hoping we can see a shift to more of this in our country to lessen the amount of unnecessary interventions, which lead to c sections, and trauma many women experience with birth… midwifery care for most pregnancies unless/until the pregnancy necessitates medical interventions, and therefore an OB. Medical interventions and good OB’s are gifts to this world for the moments that are actually necessary.

I’ll see where I’m at by the end of this pregnancy. Perhaps I’ll actually need an OB or a hospital, and I will then seek it out. But for now, it appears that all is well with my pregnancy, and I believe in normal, healthy physiologic childbirth.

Have anyone else had a positive experience with establishing co-care with a midwife and an OB?

Quick reference: The following is an excerpt from the Journal of Perinatal Education.

“A normal physiologic labor and birth is one that is powered by the innate human capacity of the woman and fetus. This birth is more likely to be safe and healthy because there is no unnecessary intervention that disrupts normal physiologic processes.17 Some women and/or fetuses will develop complications that warrant medical attention to assure safe and healthy outcomes. However, supporting the normal physiologic processes of labor and birth, even in the presence of such complications, has the potential to enhance best outcomes for the mother and infant.18–,21

Normal physiologic childbirth

  • • is characterized by spontaneous onset and progression of labor;
  • • includes biological and psychological conditions that promote effective labor;
  • • results in the vaginal birth of the infant and placenta;
  • • results in physiological blood loss;22
  • • facilitates optimal newborn transition through skin-to-skin contact and keeping the mother and infant together during the postpartum period; and
  • • supports early initiation of breastfeeding.1

The following factors disrupt normal physiologic childbirth:

  • • induction or augmentation of labor;23–,25
  • • an unsupportive environment, i.e., bright lights, cold room, lack of privacy, multiple providers, lack of supportive companions, etc.;26,27
  • • time constraints, including those driven by institutional policy and/or staffing;28
  • • nutritional deprivation, e.g., food and drink;29
  • • opiates, regional analgesia, or general anesthesia;30,31
  • • episiotomy;32,33
  • • operative vaginal (vacuum, forceps) or abdominal (cesarean) birth;6,34
  • • immediate cord clamping;35–,37
  • • separation of mother and infant;38 and/or
  • • any situation in which the mother feels threatened or unsupported.39“

Home Birth or Birth Center?

Anonymous BirtherLeave a comment

Oct 22. 2019: 

I originally thought a birth center must be an “in between” option for a hospital and home birth, but with further research, it’s basically like a home birth, just not your home and without the drive in labor. It’s like going over to your friend’s house to give birth or to a nice hotel. So the question becomes, which one is more comfortable for me? I asked the midwife who gave me a tour today of a brand new birth center that accepts vbac patients (the first that I know of within 30 min of me).  We discussed how we live in a culture that makes it “normal” to go to an institution to give birth so it may feel more comforting to go to a birth center than stay at home for some women. So, it’s basically just the mental element. My issue here now (as I am again debating my choices since my first midwife may not be able to take me on) is that how the hell can I know what’s going to be more comforting to me when in labor since I’ve never experienced it before? 

I am going to make a pros and cons list to help me decide. Here it is:

Mental PROS for home birth: 

  • no drive anywhere 
  • my son can be at home and can meet baby right away and have dad at least check in on him while someone else is his caretaker during labor so the home is more family centered in that way. 
  • I’m most familiar with my home therefore I am going to be comfortable there 
  • memory of birth in home
  • 6 min drive to good hospital that midwife said was a good one to transfer to should I have to
  • No abrupt changes during labor to help my odds of staying in labor without setbacks. 
  • No one else laboring in rooms nearby possibly. 
  • All my stuff is there and can have lots of food/drinks etc./ no packing of goods

Mental PROS Birth Center:

  • Our culture has ingrained “going somewhere” as the normal thing to do so this could perhaps feel comforting
  • no prep in my house
  • They are pretty, calm rooms, a deck/tub/bed and bathroom all close to one another, everything is set up already once we’re there. Terrace for night air laboring outside.

Mental NEGATIVES for Home birth:

  • Managing dog and other son too in small house with multiple midwives/students attending the birth (issues that can be solved though with boarding dog near due date)
  • Getting someone reliable to watch my son while we’re laboring at home, and who I am comfortable with as anyone who is in the home has to be a “safe” person to me and someone I am very comfortable with

(both of these seem like logistical issues that can be figured out closer to birth: board dog, hire a doula in training or something to be a sibling doula)

Mental NEGATIVES for Birth Center: 

  • other people around besides birth team
  • potentially other laboring moms in rooms next door
  • seeing people out in public in general in active labor
  • My son won’t come there
  • mental prep of driving through 5 contractions car in active labor, could cause setbacks to labor

My CONCLUSION:

Seems like home birth is the better option for me.

Something Different

Anonymous BirtherLeave a comment

Oct 20, 2019 : 16 weeks pregnant with baby boy number two. (I posted it on Nov 9 shortly after starting the blog).

Giving birth is probably the most basic human truth and experience. Somehow, the US has managed to get in the way of that (not really a shocker) and over time women have been taught to fear birth, and be led to believe that we need lots of medical help to give birth (myself included, until recently as a 37 year old woman.) I have learned that that is not the case. I am going through the journey of trusting in myself and mother nature to have faith in the process of birth. I do wish that I had started to research our climate of birth well before getting pregnant…but I did not.

When I was pregnant with my first son in Chicago, I remember talking to my doula about home births and how they aren’t even “allowed” in Chicago. (Which, first off… let’s think about that word “allowed.” So as a woman, my own body, I need to get permission from someone in how I want or need to give birth to my baby? Hmmmmmmm… something’s not right here. We hear this phrase all the time… “my Dr wouldn’t allow me…” ) EDIT: So I guess CNM’s can attend a home birth in IL but other midwives (like the ones in 35 other states) can not, so it is still extremely limiting. https://www.nprillinois.org/post/illinois-rules-leave-mothers-little-access-experienced-midwives#stream/0 Anyways, my first doula shared her positive experiences giving birth at home in Chile and how it was “the norm.” At the time I thought, “well I for sure want a natural birth, but home birth…now that’s too out there for me. Doesn’t everyone go to the hospital? Just in case?” I just didn’t want a c section. I was at least knowledgeable enough to be aware of the c section crisis in our nation with my first pregnancy and how the typical cascade of interventions tend to become c sections. I didn’t want to become a part of the statistically alarming over 30% cesarean rate in the US. I had the opportunity to witness this through many of my friends’ experiences who had kids before me as well as have some time to research all these stats, but that knowledge still didn’t save me from it. Knowledge only gets you so far. It’s only a part of the equation. I am however extremely grateful to this experience which taught me a healthy dose of acceptance and mental strength because it started me on this path of discovery that I am now on. I did the best that I could with the information I had at the time. Now, I am in the midst of my journey with my second pregnancy. We moved to California from Chicago 4 months ago, and I’m 4 months pregnant. You can do the math. Apparently the salty ocean breeze and our anniversary weekend in July evoked baby number two from picking us from the heavens. He liked our situation down here and wanted in! This time around I have been like a freaking detective (slightly obsessive mom) gathering all of the facts surrounding a vbac (vaginal birth after cesarean) and my options both within and “outside of” the hospital/OB system. I spent all of pregnancy number #1 preparing for a natural, unmedicated birth which ended up being a planned c-section due to frank breech and now I’ve spent 4 months REALLY putting in the time to make my first important choice: choosing my provider for care. 

This time around I know I need more than knowledge to move into this second birth. I need:

1. Knowledge: evidence based facts. 2. Empowerment 3. Support (or a “crew” if you will, and access to the right kind of crew for that matter). Now living in southern California, I am grateful to have many more choices than I did in Chicago. I am also in a position to be able to afford some of the different options I have here as many women are not, and therefore very limited to their healthcare options for their most basic human experience of giving birth. Since insurance is a huge pain in the ass, most holistic care providers, such as midwives, are “out of network” so I need to pay out of pocket and hope to get some reimbursement afterwards. (Again, not surprising in our climate today where women have to fight for their rights STILL and many think that a woman’s body is open to debate). I hope one day pregnancy will return to being seen as a natural, physiological event and not a medical emergency or something that laws/insurance can dictate how a woman chooses her birthing options. Let me be clear that I am not saying that every woman should be doing a home birth. They shouldn’t. It’s not a one size fits all situations. My issue is how our culture tries to force the hospital birth with an OB (who is a SURGEON) as the norm, for low risk, healthy pregnancies.