On the Path to Birth

by Christine Strain

 

What drew me to birth work?

I’m not sure I know. I’ve been fascinated with birth for as long as I can remember. It probably didn’t hurt that my mom was the office manager for an OB/GYN office. They had a clear plastic uterus with a model fetus in the lobby, and I loved to play with it. I remember my mom telling me not to mess with the doll too much or I would break it. Now almost 30 years later, that is kind of my whole attitude towards birth!

In my pre-teen and teen years I was more interested in the sexuality side of the reproductive system, and my only focus on the reproductive part was how to avoid reproducing accidentally. Right after high school, though, a friend of mine got pregnant and I remember desperately wishing to be at her birth. I had never heard of a doula, I wouldn’t have known a single way to comfort her, I just wanted to be there. And she agreed.

Holding her newborn was the spark igniting my desire for my own children, but that was many years down the road for me. Finally, one marriage down and into my second one, when I was ready to get pregnant, I thought it would be easy. All of those years spent avoiding reproduction and watching plenty of my friends have “accidents” had shown me how easy it was to fall pregnant, right? Not so much. As my cycles turned from weeks into months and even quarters, I was thrust into the world of infertility, and desperate for answers I started reading everything I could get my hands on about fertility – learning things about my body they had never covered in health class.

That was my introduction to the idea that there were things involving female health that weren’t mainstream. Most people I met didn’t know anything about infertility. If I had a dollar for every time I heard “just stop trying and it will happen”. Thanks for your (highly educated) opinion, but if I had just stopped trying my husband and I would still be a family of two.

When I finally got pregnant, I wanted to learn everything I could about pregnancy and birth. Because of my experience with trying to conceive I had already started my education into how a woman’s hormones worked into cycles, and how those hormones changed in pregnancy. That naturally led me into how pregnancy progresses, fetal development, and of course – birth.

I wanted a medication free childbirth, I knew that. But not for any very “crunchy” reasons, back then. I had a HUGE needle phobia so an enormous needle in my back was just not happening. I would put up with any amount of pain to avoid that. And of course, a cesarean was right out. Not only would I need the huge needle in my back, they would cut me open. While I was AWAKE. No no no no no. Not happening. I was going to do everything “right” so that I would not end up needing either of those things.

I took prenatal yoga, with a wonderful instructor. Yes we stretched and we posed and we squatted, but more importantly, we heard birth stories, we discussed concerns and questions, and we laid on the floor relaxing while she took us through these wonderful visualizations. Imagine your favorite place on earth. Imagine that the people you love are there with you. Imagine your baby, feel the love you have for your baby already… sigh. It was wonderful. The same people that did the yoga class taught Hypnobirthing (the Mongan Method). This was going to be the perfect thing for me to learn to use these visualizations to have a completely pain free childbirth and avoid a cesarean.

I read about doulas, but we were saving all of our extra money, since I was going to become a stay-at-home-mom once the baby was born. I emailed some local doulas but I thought their fees were SO expensive. When I found out that my yoga instructor also did doula work, I knew I had to find a way to have her at my birth. We worked out a barter situation, I had my doula.

The journey to my perfect birth was already experiencing some bumps in the road, though. I had developed high blood pressure. I was put on bedrest at 27 weeks, my OB told us to prepare for a premature delivery. I had to leave my job early. I spent the days alone in my la-z-boy with my 2 cats, my laptop, and DVDs from Netflix. My only visitor was the UPS man, delivering all of the baby stuff that I was ordering online.

Still, I pressed on with my birth plans. We finished our Hypnobirthing class. I listened to my Rainbow Relaxation diligently. I typed out a “Birth Preferences” sheet, on pretty paper, in a pretty font, with positive wording. It never even made it to the hospital with me.

At my 38 week appointment (oh yes, no premature birth for me! I was GOOD at bedrest!) a routine cervical exam showed me to be 4cm and 80% effaced. The OB offered to have me come in the next morning for an induction. I refused. She seemed very surprised, and said that most women who had been on bedrest for months would be begging for induction. “It’s been 11 weeks” I said “what’s a few more days?” I knew that induction raised my chances of a cesarean, and at the very least would make labor hurt more. That wasn’t an option.

Then they took my blood pressure (which I had done at the end of appointments, because just walking in the building made it go up) and it was 160/100. I rested for 15 minutes on my left side, and they repeated it. 160/100. My OB came back in and said we were to go straight through the tunnel to the hospital for an induction. I asked “can’t we just come back tomorrow morning, like you said?” and she told me that if I went home I could come back at 2am seizing and lose the baby. She wasn’t going to let that happen. I had made it to 38 weeks but now it was time for the baby to be born.

My mind was racing with all that was going on. How was I going to preserve my natural birth? I debated internally whether I wanted to ask her if she would break my water and see if that would start labor, or if I should accept the Pitocin. I knew that Pit was “bad” but that laboring with your water broken could hurt more. Since I wanted to avoid an IV if possible, I decided to go for it. I figured I was already so close to labor, she would break my water, contractions would start, and we would have ourselves a baby in no time.

We went through the tunnel. We called our families. We called our doula. I got checked in and given a room, and my OB came in, and she broke my water. And that’s when it all went wrong.

With a funny look on her face, she said “I’m going to go get an ultrasound machine”. “WAIT.” I said, “what’s going on? Is something wrong?”

“I’m not convinced what I am feeling is the baby’s head” she said. She left briefly and came back in with a portable ultrasound machine. She put the wand on my fundus and there was my baby’s head. At the top. Where it wasn’t supposed to be. She said I had to have a c-section. My doula asked if breech always meant a c-section, and she said no, if a mom had a prior vaginal birth and no complications, they could try for vaginal. (Of course I know better now – both that she was wrong about who could have a vaginal breech birth, and that she would probably never let anyone attempt one!) I asked if I could have a VBAC next time – my friend, the one whose birth I had attended way back when I was 18, she ended up with a c-section and she had 2 vaginal births after that, so I knew it could be done. I thought she said “yes”. My husband says she said “we’ll see”.

So that was that. You know what they say about the best laid plans…

I got an epidural. I got cut open. I didn’t have an anxiety attack, I didn’t need to be sedated – I was actually pretty proud of that! A cesarean was my biggest fear, and I faced it. But I barely got to see my baby, and they whisked her away, and my husband went with her. I was alone in the OR while they sewed me back up, talking amongst themselves about vacations, and what they ate for lunch. Like I wasn’t even there.

When I finally got to recovery they had given my daughter a bath and they said she was cold. I couldn’t hold her, she had to stay under the warmer. I wasn’t in any shape to argue very much. I wanted my baby, though, I kept asking and they kept telling me not yet. Finally they said she was warm enough, but they were about to move me to my postpartum room and so they would just wait until we got there. I didn’t hold her for almost 3 hours after she was born. She had been washed off, I had never smelled her fresh-from-the-womb scent. She wasn’t interested in nursing when I finally held her. Luckily she did nurse a little while later, and we had a wonderful nursing relationship. But I knew that we were lucky.

After that I sort of withdrew from anything about birth. I didn’t even want to think about a VBAC. When I did think about it, I thought – why bother planning another birth? I may as well just hop up on the table and get it over with. I even tried to convince myself of all the positives of a planned cesarean. It would be fast. We would know exactly when the baby would come. I already had the scar there.

Anyway I was consumed with new parenthood. I joined playgroups and went to LLL meetings. My baby was high needs, and I was an “attachment parent” so I learned the art of babywearing. I found that there was a real lack of hands-on babywearing instruction, so a friend and I founded Koalamommas, a babywearing group. That was my first experience with teaching, with advocacy, with being the leader of anything. I didn’t think about birth much, but when I heard stories of awesome natural births I was secretly jealous and bitter. On the outside, to whoever asked, I was going to be very happy with my repeat cesarean when the time came. Birth had betrayed me, and I wasn’t going to let it do that again.

My daughter was over 2 years old when we got pregnant again. Though I had considered switching to a practice with some popular midwives, while visiting a friend at the hospital after her son was born, I ran into my old OB. I felt guilty. I told my husband “she was so nice to us. We should give her another shot”. So I scheduled my first prenatal appointment with her, and off we went. The night before I said “I wonder what she will say about VBAC. I don’t know how I feel about it anymore. Maybe somehow the decision will just be made for me.”

We went to the appointment, and though it was clear she recognized us (go team!), she didn’t remember anything about my previous pregnancy or birth, and she obviously hadn’t even skimmed the chart before coming in the room. She didn’t remember that I’d had a c-section, or been on bedrest – I realize that she sees tons of patients a year, but how many of them are on bedrest for 3 months and then end up with a surprise breech? Even if she couldn’t remember, that’s what charts are for. I felt like just another unit in a factory.

When I reminded her that I’d had a cesarean she said “well, then, we will schedule your repeat c-section at 39 weeks”. Not a word about VBAC. She scheduled me for some baseline tests because of my blood pressure (which had never gone down after my first pregnancy, I had been medicated for it ever since) and said she would see us in 4 weeks.

As we drove away, my husband said “I guess that someone made the decision for you after all”. “I guess so” I said.

But that wasn’t the end of it. I went on with my days, I was busy, we had just moved into a new house and I had a very intense 2 year old. At night though I would lay in bed and my mind would race…. Why didn’t she offer a VBAC? I know they are safe. Why can’t I have one? I am not sure I want one but I want the choice to be mine.

As the days passed my mind got more emphatic. My body was made to give birth. I dilated to 4 without even being in labor! Without even a head on my cervix! I bet I could have done it. I could have birthed that baby. I can birth THIS baby.
I needed a new doctor.

Again I considered the popular midwives. They were “the” natural birth midwives, and they even did waterbirths. But I had heard that they had to transfer women with complications over to the OBs in their practice, and since my last pregnancy had gone awry, I didn’t want to take that chance. I logged into the forums on Mothering.com and searched the local tribe for information on doctors. I found a thread called “Progressive OB/GYN in Atlanta?” where people discussed just a handful of birth friendly doctors and midwives. Two OBs were mentioned by a poster who also mentioned VBACs, and talked about the ICAN chapter in Atlanta.

I’d heard of ICAN before, but I assumed it was like the depression support groups my dad used to drag me to as a pre- teen. A bunch of depressed women sitting around crying about their c-sections (that wasn’t what my dad’s support groups were about – he’d never had a c-section. LOL). That wasn’t my style. But this woman seemed nice and mentioned a yahoo group, so I joined it. I made an appointment with one of the two OBs mentioned, the one who was closer to me.

He answered all of my questions with the right answers. He was a sole practitioner, so I knew it would be him at the birth. His office was very low-key, relaxing, not at all like my old OB’s practice. He was totally on board with VBAC. I had my records sent to him, canceled my other appointment with my old doctor. I thought I would get away without having to “break up” with her, but she called me with the results of my earlier tests, and at the end of the conversation she said “well… good luck with your new doctor.” Oh the guilt! Why was I so attached to this woman, this doctor who barely even remembered me and wasn’t going to give me the opportunity to birth my baby??

As I prepared for a healthy pregnancy and birth, I got bitten by the bug again. I started reading books on birth, spending hours on websites, devouring all the studies I could find on the safety of VBAC. I hired a doula. I diligently studied optimal fetal positioning – no breech baby this time!

I started posting on the ICAN of Atlanta yahoo group, slowly at first, and then more frequently. It was shocking to find out the reality of the VBAC scene in Atlanta. Very few doctors were doing them at all, and of the ones that were, most of them put extremely unrealistic limitations on them. We discussed not only how to get a VBAC but how to help people prevent a primary cesarean, because once you’re cut, that’s it. Your birth options are limited for good.

The other OB that was mentioned, the one I hadn’t chosen, was a regular participant on the group. He did vaginal breech births. Whaaaaat? I thought that wasn’t possible! He would do VBACs even if you had more than one cesarean, so when a friend from a mommy group asked me about that (she’d had 2 c-sections) I sent her right to him.

She had a successful VBA2C with him, and I went to visit her in the hospital, and that was the first time I met Dr. Tate. She introduced me to him and he said “Oh, I know who you are. I read your posts on the list.” I was impressed. “You’re going to stay with that other guy though, eh? Don’t want to be my patient?” Well, geez. No. Nothing personal, but I had a doctor, he was closer, he delivered at the hospital near my house. He was great.

A few weeks later, I woke up to a message on the ICAN list that my awesome doctor was joining up with another practice. The very same practice that the crunchy midwives worked for, in fact, but I hadn’t heard anything good about the OBs in the practice. My doctor ASSURED me that he would still be the one at my birth, he was going to stick with all of the patients that came over with him. It would all be fine. I wanted to believe him, I really did. I stuck around for 10 more weeks, but when they started pressuring me to schedule appointments with the other OBs, and told me that whoever was on call was who would attend my birth, I couldn’t take the chance.

I called Dr. Tate’s office and scheduled and appointment. I was 35 weeks pregnant. When he walked in and saw me on the couch he said “What took you so long!?”

Five weeks later I had a totally awesome, unmedicated, spontaneous VBAC.

The difference between this birth and my first was astounding. After I pushed her out she was placed on my chest and immediately started nursing. She never left my side. I didn’t let them wash her – I had planned just to delay the bath but they said I didn’t have to do it at all if I didn’t want to. I felt like I had just done the best drugs ever, like I could do ANYTHING. Twelve hours to the minute after I gave birth we were pulling in the driveway, and we spent the first night after the birth at home in our own bed.

I was joyous on my VBAC high. I told the birth story to anyone who would listen. I typed it up, I put in the pictures, I posted it on my blog and on message boards. And when I had told everyone the story as many times as they cared to hear it, and written about it on as many boards as I could find, I suddenly found myself faced with a very familiar feeling. The feeling you get the day after a show ends. One you have rehearsed and rehearsed for weeks, and then comes the Big Event, and then… post event letdown.

What now???

I wondered if I would fade away from the ICAN group but I found the opposite. I was even more fired up about spreading the word about VBACs and helping prevent cesareans. I felt really close to the women who had helped me achieve this wonderful healing birth, and I wanted to get to know them better, to hang out with them. The Yahoo list was kind of limiting in this regard – because the posts went right to people’s email inbox, the chapter leader was fairly strict about keeping discussions on topic. The leader and I had become “chat” friends, and I approached her with the idea of starting a message board so that we could have an off-topic area to discuss things like what we liked to do with our kids, whether or not we cloth diapered, what music we liked to listen to – anything not related to birth or VBACs.

She thought it was a great idea, but she said she didn’t know how to do that. I did, and I said I would, and that is how I became the Webmaster of ICAN of Atlanta. With the addition of the message board, the group started to grow even more and to become a very tight-knit community. We still talked birth nonstop, but we also had playgroups, moms’ nights out, and really got to know each other.

Every now and then someone would ask if I’d ever thought of becoming a doula, because I knew so much about birth. I thought the idea of attending births was pretty cool, but I didn’t think that was something that would be possible with young kids. I focused on growing the ICAN chapter and spreading the word. I also took a volunteer position with ICAN International as the webmaster for the 2007 conference that was to be held in Atlanta. I mostly did it for the free conference registration, but that was my first involvement outside of our chapter.

A friend planning a VBAC asked if I would consider attending her birth as a friend-doula. Nothing official – not for money – but just to be there and support her with my love and my ideas for how to help her achieve her goals. I agreed. The day before I attended her birth, I found out I was pregnant again. She had a wonderful VBAC and it was so amazing to be a part of. She seemed to think I did a good job and I had a lot of fun.

Still, it wasn’t something I saw myself doing on a regular basis. Pregnant again, and volunteering for the local chapter and on the International Conference Committee, I also was encouraged to apply for a position on the International Board of Directors. So I did. I took a position as the Subscriber Relations Director on the BOD of ICAN. I was working on the Conference, working on the Board of Directors, working on our local chapter, mom to two kids, and planning my second VBAC.

The doula that I chose for this birth – Nichole Feinauer – was a mom of 5, a doula, a childbirth educator, and homebirther. We quickly became friends on a deeper level than just a doula/client relationship. One night she was going to a doula mentorship meeting held by the Georgia Birth Network. She was bringing brownies. I said “I don’t want to be a doula, but I want brownies!” She said I should come anyway and just eat brownies. So I did. A few weeks before I was due, she got called to a birth as backup for another doula, and the mom happened to be planning a vaginal breech birth. I was jealous of that! I wanted to see a vaginal breech birth. My husband commented to me that if I were trained as a doula, I would be able to take a last minute birth like that. I said “yeah but who would watch the kids?” He said we could work it out. And he thought I would be good at it.

Oh, but I was 36 weeks pregnant.

A few weeks later I had my 2nd VBAC. It was even better than the first one. I waltzed into the hospital at 9cm, still able to walk through my contractions. Just like the last time, after I pushed the baby out, he was put right on my chest to nurse and snuggle and not be let go of. Again I felt like a million bucks, and again we left the hospital before 24 hours was up.

After that I was busy for a while, but a few months later Nichole and I were talking about some different things pertaining to doulas, and we came up with this idea for an on-call doula service. The doulas in the service would at least have gone through training, and would do births on an on-call basis for a reduced fee. I thought this would be the perfect way for me to attend births while still being a mom of young kids. I signed up for a DONA training in March 2010.

One of the requirements of certification was to attend a qualifying childbirth class, and though I wasn’t certain I wanted to certify, the class that Nichole taught was a qualifying one, so I decided to sit in on her series that January, so I would be finished with it before my training. When I got to the class and she started teaching, I had a shocking realization.

She got paid to talk about birth.

She got PAID to talk about BIRTH? But I did that for free all the time! Most of the people that I was interacting with already had some basic birth knowledge, but the people in this class had none. Though I was concerned with overstepping my boundaries or talking too much, Nichole let me be an active participant in teaching the class. She asked if I wanted to teach the cesarean portion of the curriculum, and I spent hours developing a presentation on the facts about cesarean – both the medical facts AND the emotional impact they can have.

That was when I knew that I wanted to teach childbirth classes.

A month later I took the DONA training. I quickly realized that I knew a lot more about birth than most of the people in there. My experiences, not only with my own births, but with all of the women I had worked with through ICAN, had really put me ahead of the game. I decided to go ahead with certification, even though the on-call doula service (that was still in the planning stages, due to Nichole finding out she was pregnant again shortly after we came up with the idea) only required me to be trained.

I started attending births while also looking into my options for becoming a childbirth educator. GBN was starting a new childbirth educator mentorship program, and it was after the first meeting that Nichole suggested I contact Baby Steps about teaching for them. I went home and looked on the website and lo and behold there was a page about the first ever Baby Steps teacher training. I was on board immediately, and the 6 month wait for the training was really excruciating. I busied myself with finishing my requirements for DONA certification, and in August 2010 I became a certified doula. In October I took the Baby Steps training, and in January 2011 I taught my first Intuitive Birth series.

So that, faithful reader, is how I came to birth work.

As far as my birth philosophy, it is pretty simple. I believe that women were designed to give birth. I believe that a woman who is educated and supported will be in an environment to have the best birth possible for her. And I believe that less is more. Less intervention (and I include my own doula work as an intervention – I think that any action towards a laboring mother is an intervention) is better. Obviously the ‘interventions’ that a doula uses are much lower risk than medical interventions, but I very much believe that the most important role of a doula is holding the space for the birthing mom to figure out her own groove in birth, and then acting within that birth space to support her in whatever way possible.

I hope that my passion for birth, my knowledge, and my own experiences will make me an awesome teacher. I look forward to helping other couples realize what an amazing, life changing, empowering event the birth of their child can be.