The Business of Being Born

Before Shepherd was born and I was toying with the idea of having a VBAC instead of a repeat c-section, I had heard of this documentary "The Business of Being Born".  I was really interested, but Justin was pretty much like..."Do not watch this".  I figured, God gave Justin to me to take care of me so I submitted and didn't watch...and I am pretty glad I didn't.

This was put together by Ricki Lake after having a less than desirable hospital birth and then a "life changing" home birth experience.  I am going to try to be really objective and not judge-mental either way...that being said I have had 2 very different birth experiences and will be drawing from that and God's truth in my critique of this documentary.  In full disclosure I have had 2 hospital births.  1 emergency c-section.  I also had a medicated VBAC.

There is very many stats that are alarming. There is a huge increase of c-sections in the US and also maternal/infant mortality rates in the US are the highest among all developed countries and also have the least amount of births attended by mid-wives...however.

However, my problem with this documentary is how it seems to judge others who don't chose a home birth/unmedicated/natural birth or as the documentary calls "normal". I think its because they have had wonderful birth experiences, and I am so happy for those women. But it leaves you thinking that you can't have a wonderful birth experience in the hospital or be medicated and that those experiences are "abnormal".  They do seem to want the best for women across the country, but they assume the best for most women is unmedicated/natural/home birth.  Here is a direct quote from the documentary:

"I have so many friends who only want the end result of the healthy baby in their arms, and they don't care how it got there.  They are missing an amazing opportunity for a life altering experience.  So much of who I am today comes from that experience". She then goes on to say "nothing compares, nothing".

This quote (in my opinion) is the problem with this documentary.  It is said sooo condescendingly.  As if those women who don't care about their birth and only their baby are to be looked down upon and "missing out".  This is exactly the lie I believed with Inara---I didn't get my "normal" and "life altering" experience.  This lie I believed led me to be so depressed over what I "missed out on" and seriously obsessed with my abnormal experience...so much so that it was hard for me to enjoy my perfect, healthy, wonderful, miracle of a baby.  Which if you didn't know...having a baby is the goal of pregnancy. Period.

Here is another quote from the movie:

"The best thing to do is to get the hell out of the hospital".

I will say they have valid points in the documentary, but they take their points to the extreme by making it seem their experiences/facts apply to all women.  One example is the example that one intervention (using pitocin), leads to another intervention (epidural for too strong painful contractions), leads to another (slowed labor), leads to another (c-section).  You know what, that is how it goes sometimes....sometimes.  But not all the time and not all interventions are bad or end badly.

I have a friend who is wanting a home birth.  She said the stress of a hospital scenario she feels would make the pain worse for her...all the beeping...staff...interventions.  So for her a homebirth seems to be the best option.  It isn't for me....and that is OK!  For me it would be the opposite, the thought of not being right next to an OR where my baby could be delivered via emergency c/s in 7 minutes would stress me out.  Not having a ginormous 18 gauge IV in me in case I need blood stat...that would stress me out. I know that for me a home birth would not be something I would be able to relax enough to actually do...and it is OK!

I trusted all the OB docs in my office.  They were supportive of me wanting a repeat c-section but told me the risks and then continued asked me at every appointment if I wanted to try a VBAC.  They were supportive when I wanted a non-traditional induction but always reminded me the health of the baby is the number 1 priority.  And after having a real scare with Inara and almost losing her, that was my priority too.  I didn't care how he got here...just as long as he arrived safely.  But the point is I trusted them with one of my most precious lives.

I think as women we do need to be informed about what the labor and delivery experience could be like and ultimately we need to be trusting our providers...whether is be a Midwife or an Obstetrician.  Any my problem with this documentary is it leaves you feeling the only one to trust is a midwife for a home birth.  I know there are some OB doctors out there who aren't trust worthy.  Hearing how some friends have essentially been forced into having a c-section by their OB for silly reasons, is seriously a major bummer.  But the problem isn't hospital births or interventions, the problem is they had a provider they couldn't trust. I have also read stories of home births gone bad--really bad (I would encourage you to follow the link as another source of gather information).  In most cases, the midwife was unconcerned and/or uneducated about newborn hypoxia, chose to allow a homebirth even though the mom was a high risk and not ideal home birth candidate, or simply unforeseen circumstances that would have been caught and treated at a hospital.  But once again, the problem (in most cases) wasn't home birth, but rather providers who shouldn't have been trusted.  

So here is my advice (if you really even care), whatever method of birth you choose be educated.  If its a homebirth then ask your midwife if they are actually a certified nurse midwife? (apparently some midwives have minimal medical training) What is the emergency plan?  Do they have a working relationship with an OB office? How quickly can they get you transferred to and OR?  What supplies do they bring in case of an emergency?  Have they had infant/maternal deaths in the home?  What were the circumstances?  How many babies have they delivered?  If you choose an OB at a hospital...ask them questions too.  What is their c-section rate? Do they allow VBACs?  Can you labor out of bed?  If you want is their a tub available for delivery?  Are they comfortable/supportive of your preferred birth plan? (whether its medicated or unmedicated)  How often to they use a vacuum or forceps?  Do they do an episiotomy routinely?

*Also side note, I don't understand why every home birth the women are naked? :-)

After I watched the movie and wrote this post I found there is a "More Business of Being Born" which is a little mini-series of 4 episodes.  They said they received so much feedback and more questions from viewers they really wanted to expand on the topic which they simply couldn't do in a 90 minutes.  I would say they are not quite as judgmental  as the movie, it has a lot more helpful information, but I would still watch with caution.

The first episode isn't as "emotional" as the movie and they seem to have a lot more information.  The episode is about Ina May Gaskin's Farm Midwifery Center. The midwives they interview absolutely agree that you should be prepared to ask you potential midwife about how they handle emergencies, if they have a working relationship with an OB, etc. I was really excited about the second episode because it was all about a bunch of celebrity births (Cindy Crawford, Alyson Hannigan, Gisele Bundchen, Melissa Joan Hart, Laila Ali).  A homebirth, hospital birth, medicated, unmedicated, c-section all different stories. The third episode discusses doulas, hospital birth centers (which I had never heard of but sounds amazing) vs freestanding birth centers, and c-sections. The last episode is all about VBACs and HBACs. I did a lot of VBAC research, but they cover it much more in depth than I could find. I would say episode 4 is a great resource. (It also made me so happy my OB office supported and brought up the VBAC option for me, apparently its actually illegal in some states!)

Here are some links regarding homebirth : The Daily Beast, The Farm Midwifery Center, Slate, BMJ research article, Skeptical OB with CDC statistics (although I was unable to find ANY statistics on the CDC website), True Midwifery, Homebirth Death Statistics (lots of articles citing other studies), Mayo Clinic.
Here are some regarding VBACs: American Pregnancy Association,  Woman's Guide to VBAC, Mayo Clinic,  Consumer Justice Group.

But the truth is, there is no one size fits all birth plan and as women (and especially Christian women) need to support our friends in their decision. Because although we can help our friends be educated in their choice...it is their choice...not ours.  Shepherd was born and I got my birth experience I thought I missed out on.  It really was so wonderful.  I started crying as soon as I saw him and was so instantly in love and got that "high" everyone talks about. I am so incredibly thankful for the chance to have a VBAC! The memory of his birth brings such joy to my heart.  BUT, was it life changing...NO.  Life altering...NO.  Am I who I am because of my delivery...abso-freaking-lutely NOT.  Christ is my hope, he changed my life, I am a daughter of the King, redeemed, restored, and forgiven.  That is so much better than the "perfect" birth experience...I guarantee it.  

So here is my advice.  You should watch it. It does have some valid points.  Use it as a piece of your research as you look for what is best for your family.  And most importantly I urge you to hold your birth plan loosely remembering the goal of pregnancy is having a baby.  Do your research as cling to Christ (not your birth plan) with all you have.

Happy Birthday Shepherd Justin Duke!

*I wrote this the night Shepherd was born, and just have been adding things here and there*

So here I am at 4am less than 24 hours after Shepherd was born. I should sleep because its dark, I have had 5 hours of sleep in 24 hours and there is a sweet cooing/sleeping baby next to me. But I can't because I want to remember every perfect moment of this day. So warning long mushy post ahead! And for dude readers...just read this....I had a baby! :)

January 26th at 5am, I woke up to pee and surprise! My water broke. I called my OB on call and they told me to come on in. After about 10 minutes I still hadn't had any contractions, so I woke up Justin. I had him call my parents who were coming over to stay with Inara while we left. I hoped in the shower. I wasn't sure if my water had broken, but once the contractions started coming on I was sure that was what happened. I made it through the shower and my contractions were about 2-3 minutes apart. I told Justin to tell my parents, they might wanna hurry up.

On our way to the hospital I told Justin to stop and eat because it would be a while before he could.  I knew once I arrived I would be NPO, so I got a little something for me too. Just a V-8 fusion. I figured if I was going to be in labor for 24 hours I needed at least SOME energy.  With every contraction in the car I wanted an epidural. Then it would subside and I would think Its ok, I got this.  I told Justin I didn't want an epidural until I was 5-6 cm (I have no rational reason for choosing those numbers). I remembered to try and relax to let my contractions do the work, but it was so hard. Justin was awesome and very quick to remind me to relax and that I could do this.

We arrived at GSH triage a little after 6. They got me changed, started and IV and talked a little about an epidural.  I told them I would like to go natural because of a previous bad experience with my spinal with Inara. They said that was fine, but they would put the order in "just in case I changed my mind". I was then checked at was 4 cm dilated! I was only 2 at my OB appointment on Thursday, so I was VERY happy with this news. Mentally I was still preparing for the worst- a long hard labor.

By the time I was transferred to my labor & delivery room I was feeling REALLY bad. The contractions were just as close as they were at home, but much more intense. A few times I freaked out and told Justin I didn't think I could do it...not the go natural part...I was talking about having a baby. They were so intense it seemed impossible to make it work.  I tried to pee in the bathroom and ended up getting sick and throwing up a few times. Secretly I was excited hoping that I was in transition, but still preparing for a long hard labor. But it was then I asked for an epidural. When I wasn't actively contracting and in my right state of mind, it still seemed like I would need one.  About 30 minutes later and a few really awful contractions the CRNA arrived. It seemed like it took forever to get it in, but once it was and I had some relief I told her that she was my very best friend!

Very happy (and obviously tired) after my epidural :)

She said she would come back after a few contractions and see if I needed a bigger dose. I had some hard ones and I could breath through them, but I also wanted a little more relief, so she re-dosed me..and it.was.wonderful!  They checked me at 9am and I was 8cm! I honestly couldn't believe it, but oh my! I was so happy :) They then decided to put in internal monitors to monitor the pressure on my scar. I had a few more REALLY intense contractions and baby did NOT like it.  They turned me on my left side and game me some oxygen. They were super calm about everything and neither Justin or I felt uncomfortable or scared.  After a few minutes they checked me again and I was fully dilated! Miracle!

Then I was sat up high in the bed to let gravity do some work of getting baby down, so I didn't have to push as long.  About 2 hours passed and a few cat naps for both Justin and I (who by the way was a total rock start and I KNOW I couldn't have done it without him), and finally they said I was ready to push. At this point I really couldn't feel anything, so I was a little nervous how the pushing would go.  Justin stayed back but visible, Katie was on picture duty, my awesome nurse counted for me and I pushed!  At first it didn't seem like I was really doing anything because like I said I couldn't feel anything. But my OB is wonderful and kept encouraging me and reassuring me that I was being a great "pusher".  In between contractions it was totally clam and relaxed. I rested, chatted, and tried to relax for the next one.  I pushed with each contraction for about 30 minutes, and still couldn't feel a thing...not even pressure.  Then about noon I was able to tell he was really close.  And everyone's excitement really helped me push even harder! 3 contractions and 9 pushes later and he was out!

Fresh new baby!

I heard the most amazing newborn cry, he was put on my chest, and it truly was love at first sight. I couldn't stop crying and was just staring at my perfect son.  My son whom I thought might not make it this far. My son who I kept waiting for a disaster...was here. He was perfect and mad...and did I mention perfect :)  I got to hold him on my chest in awe for about 15 minutes, stare at his beautiful face, squeeze his chunky arms, and then I got curious. I wanted to know how much he weighed and wanted to give Justin a chance to hold his son too!

Love at first sight :)

They took him away to get cleaned up and weighed and I heard his weight: 8lbs 8.9oz.  I couldn't believe this monster of a baby was A) actually just inside of me and B) came out of me. The doctor even couldn't believe I had that big of a baby inside.  They stitched me up and Shepherd was so content to be held by his Daddy :) He was so happy in his arms.  I was able to nurse him and was am seriously so much in awe of this little perfect human that God had blessed us with.

LOVE!

Big boy!

First time with Dad

So thankful my BFF could be there and take some pics for us !

Just relaxing

After I was transferred to the Mother Baby Unit my parents arrived with Inara. I could not have asked for a sweeter daughter or be more blessed by God to witness their first encounter. She was so interested in him and apparently at home when she saw his picture said "Awe, I love him. He is so cute. And then kissed the screen".  During his bath when he was crying she was singing him a song to help calm him down, was trying to soothe him with some shushing noise, and kept saying "Its ok. You're ok". I know it won't last forever, but their first meeting is one of my favorite times in my life :) Here is a video of her when she first came into the room to meet him. Be prepared for some serious cuteness!

I seriously had never had a "love at first sight before", until I met him :)  Later on the in the evening when it was just the 2 of us, we just gazed in to each others eyes and I couldn't help but cry! He is already awake so much of the time, is a good little eater, and seems to be pretty content. I just love him so much and it was so wonderful for him to finally be safe in my arms after so many uncertain things about my pregnancy.

Why I chose (at the last minute) to try for a VBAC

*Warning: Long post ahead*

After Inara was born I had some major hormonal issues. This led to me feeling like I was "robbed" of a "normal" birth experience. When I was pregnant with her, I wanted a natural birth, absolutely NO c-section, and to breastfeed for at least at year. When those didn't work out, I felt ripped off kind of.  I was so very happy for friends who had a good experience, but I felt sorry for my self that I didn't. It took a while, but I finally got to the point where I trusted in God's plan and was just happy Inara was here. It didn't matter to me anymore how she arrived, only that she arrived safely.

Fast-forward to this spring.  I find out I am pregnant again. My high-risk doctor says I can try for a VBAC! *Cue angels singing* But then a bunch of little things came into play and I figured I would just go for a planned repeat c-section.

Then a few weeks ago I began toying with the idea again. At first I was still REALLY aprehensive about it and the reason why I wanted a VBAC. I felt like every time I told someone was wasn't going to try for a VBAC but get a c-section, I needed to justify my actions.  No one ever made me feel that way. I realized that it was because I (so shamefully) had previously judged other women for not at least trying.  I quickly realized that having a VBAC to make other people happy was not really a wise choice. So I set out to do some research.

I found this really great website (that is pro VBAC, but not in a preachy way) that has the NIH statistics for readers and helps make some sense of them.  This website was really great in getting down to the nitty gritty. Even though they said no one can guarantee you any specific outcome of your chosen delivery, I wanted that.  I think since the beginning of this pregnancy I have been waiting for something to go wrong. And since nothing has at this point, I kept thinking that delivery must be where disaster is waiting for me.  And since disaster was on the forefront of my mind, I thought the OR must be the best place for me to be when my impending disaster should happen. (Not saying I was rationally thinking, but it was how I was thinking none the less).

But talking to Katie and Justin really helped set my thinking straight.  So Justin and I decided to just ask my doctor this week if it was too late to change our minds.  I met with the NP this week and she was wonderful. She was actually interested in why I changed my mind which was kind of nice for her to care.  She said it was no big deal and laid out a few options for me.  She didn't make me rush and said to go home and talk it over with my husband and just call up there and let them know what I chose.  I am so thankful the group is so supportive of whatever we want (c-section or VBAC)

So the new plan is to see if I go into labor and give it a try. They will let me go 41 weeks before they can see if they can "induce" me (must be at least 2 cm dilated). They can only use some medicine in a VBAC. If they can't induce me then I'll just have my c-section as planned.  So Shepherd will definitely be here by 2/1/13! I know I am going to have to fight the mental battle since I thought I only had 4 more shifts of work, 3 more NST, and less than 2 weeks before I got to meet my sweet baby.  Knowing that it could be more like 4 weeks (oh goodness!) is a little daunting as I feel so huge/can't sleep/can't move, but I know it will be worth it if I can have a chance at not recovering from a c-section....last time it was really awful!

A few nights before I talked to my doctor and officially decided to have a VBAC I slept really awful. I kept waking up with worry and anxiety about all the new unknowns...when will I deliver? will it work out? can I actually do labor and not scream like a maniac? Am I going to freak out if I get an epidural?  Will he be a beast of a baby and huge? All the new unknowns had me really worried.

Then while I was at my NST I was reading my bible and read this passage from Matthew:

While walking by the Sea of Galilee, he saw two brothers, Simon (who is called Peter) and Andrew his brother, casting a net into the sea, for they were fishermen. And he said to them, “Follow me, and I will make you fishers of men.”  Immediately they left their nets and followed him. And going on from there he saw two other brothers, James the son of Zebedee and John his brother, in the boat with Zebedee their father, mending their nets, and he called them. Immediately they left the boat and their father and followed him.

This passage was so powerful to me.  Peter and Andrew didn't ask Jesus any questions, they didn't know what would happen when they left everything to follow him, they simple followed Jesus and obeyed.  That is the situation I am in Jesus hasn't told me what life will be like when Shepherd is here, only that he is coming.  He hasn't told me how  Shepherd will enter this world, but I do know God has his days numbered, God has plans not to harm us, and to work everything for our good.  Really there is nothing I can do about any of the things I was worrying about. There are no questions that I can ask that God will answer. I can only do as Peter and Andrew did:  leave all the worry and questions behind me, love the Lord, and follow him completely.

Please know that God has really changed my heart and my attitude. I will not be disappointed or feel like a failure if I get a c-section. I really don't care how he gets here...just as long as its safely :)  Whatever choice you and your family make regarding how you labor, deliver, breastfeed, raise your kid....is fine!  We chose this (and how we parent Inara) based on what we feel is best for our family.  It probably looks different than what you choose, and that is ok and wonderful.  I am thankful I have friends with differing opinions that me, it helps me to really think about why we do what we do.

So...how did you deliver or plan to deliver? I loooove me some birth stories of ANY kind. Post a link to your story, or leave it in the comment section!





Due date

So today is my EDD (estimated due date). It is so funny to think I would still be preggo. So weird. I was thinking yesterday about everything. Yesterday Inara turned 2 months, and today is my EDD. How different things could have turned out. I have been so thankful that we both ended up healthy and alive! It is crazy to think of the potential that Justin could have buried his wife and daughter. Praise God for his plans for us. With all that being said, I have been wanting to write down the birth story of Inara. I think it would be so great to share it with her every year, as a constant reminded to us all of how blessed we are by God. And I also figured there may be some peeps out there that would like to know the whole story. So here it goes...it's pretty long. So if you know the story...no need to continue reading (unless you wanna thank God for saving us both).



Sunday, November 15th we had some friends over to watch football and clip coupons together (well the girls couponed). Around 8pm I started getting a headache and blurred vision, which I know is a sign of high blood pressure or preeclampsia . I took my blood pressure at home and it was like 150's/90's, which is bad. My pre-pregnancy BP was like 100/60. So I proceeded to freak out. I checked it in a few minutes and it went up (I'm sure my stressing made it go sky high). It was now 170/100. So I called my OB on call and he told me to go to the L&D triage. There they laid me down and checked her heart...she was fine. And seemingly so was I. They drew some labs and everything came back normal. They sent me home on bed rest and told me to follow up Tuesday with more labs and my OB at the office.

Tuesday I get my labs done and go to my OB. All my labs came back fine. They were only waiting on one more. My doctor said he was sure the other would be fine, so I could go back to work and be off bed rest. So as soon as I left, I called my office and told them I was back in the game for the rest of the week. As SOON as I got off the phone with my boss, the doctor called me and told me he got my other lab report back and surprisingly it was no good. He wanted me to go to the hospital right away and get a steroid injection. I knew from nursing school that this medicine helps the baby's lungs mature faster in case the baby needed to come early. I really wasn't that worried because I felt fine. So back to bed rest it was. I had another follow up appointment with my OB on Thursday November 19th.

Thursday morning my dad drove me to the hospital to get my labs done (again). We decided to stop by First Watch for some breakfast. By the time I ordered I started feeling really crappy. I thought I was gonna either throw up (which I had never done in my adult life) or I just had really bad gas. I went to the bathroom, but started to feel worse and neither one of those was the problem. I went out to the booth where my dad was sitting and laid down in the seat. I am sure the people around me thought I was crazy, but I felt horrible. I just knew something wasn't right. I called my awesome hubby, who said I should call the doctor. So I called the office and spoke to a nurse to describe my symptoms (epigastric pain and shortness of breath). She told me to just wait until my appointment at 2pm that day. I said no way Jose, and told her I either needed to see a doctor right away or go to the L&D triage. So she got me an appointment right away :)

My Daddy drove me to the office where Justin met me. I was SOOOO uncomfortable, I couldn't sit still. Pacing didn't help...nothing did! Finally they called me back and I saw one of the Physicians. He looked at my labs from just a few hours prior...he said I would be having this baby soon, probably in the next couple of days. I started to cry. I knew it was too early for her to come. I wasn't ready...she wasn't ready. But the pain really kicked in and I couldn't even focus on worrying because of the pain. They sent me to St. Elizabeth, where a different doctor checked me out. They gave me some medicine to keep my BP down and to keep me from having a seizure (which is a risk with preeclampsia). St. E doesn't keep babies born under 32 weeks (I was 31 weeks 1 day), so they sent me to Good Samaritan Hospital. God was so great to me in the ambulance ride. It was very bumpy and cold, but it was the ONE time where I was pain free.

We arrived at GSH triage and they hooked me up to monitors and drew more blood. Basically they thought I was going into HELLP Syndrome, so they were checking my labs frequently to see if it was getting worse. The only "cure" is delivery. Since I was so early, they wanted to keep me preggers as long as possible. I met with the OB at GSH, he was SO great- Dr. Voss. He was VERY reassuring about their NICU, and had the best bedside manner. They were gonna do a BPP to check on her and see how she was doing.

Well on the way to get the U/S, I started puking my guts up. It was horrible. I was in the hallway in the wheelchair when I got sick. But the staff was so awesome there! They were fast to get me a garbage can and some water to rinse out my mouth. Even the U/S tech was great. She gave us the pics and let me lay in the bed until the transporter came back. So they took me to a room...semi-private might I add. As soon as I got in the bed...puking again. I felt so bad for my roommate, I'm sure she didn't' wanna hear me yakking and moaning from the pain. The nurse brought me in medicine for my nausea, and TYLENOL for pain. If I wasn't so sick I would have argued, because Tylenol is metabolized in the liver and I was having liver problems so shouldn't have had it. Oh well...I was too sick to fight back.

The residents came in and said they will be drawing my blood a few more times to see how things are going. I think I dozed off for about 5 minutes, when they came back. They said my labs have gotten a lot worse and I was gonna have to deliver that night...they were calling in Dr. Voss. Once again tears came, but they left just as fast this time too. I had to sign consents and get prepped. Justin was so great to remind me things would be fine, God was in control.

So into the OR, I went for my emergency C-section (hilariously I wanted a natural childbirth, OH WELL!). I don't remember much because I started to freak out because I wanted to move my legs and I couldn't because of the epidural. And I was shaking like a crazy woman. So the Anesthesiologist gave me Versed which I know would make me go night night. I do remember they were listening to Christmas music, and "Sleigh Ride" was playing when she was born (fun fact). Next thing I remember I am in recovery and SO parched. The nurse said I could only have ice chips, but being the wonderful nurse/patient I am, I ignored her rule and took a few drinks of Justin's drink.

Phew! What a day it was. I went from hoping to be off bed rest at 7 am, to delivering our little lady at 7pm. I did get to see her in the NICU that night. They rolled me past her incubator on my way to my room. I remember she was holding my finger. It was great. So much to be thankful for. So much to remember and praise God for.