around the web

I’ve posted links to awesome articles, photos and posts in the past, but I’m going to make it a weekly feature. This week, check out:

  • At Your Cervix: What I Wish I’d Learned About in School– great post about several things she wished she had learned in school about becoming a midwife. It’s not just about catching babies!
  • The Skeptical OB: VBAC birth story– Before you all flip out on me…this is an important story to share. In the natural birth world, there are not enough stories that talk about the things that can go wrong, despite everyone’s best efforts. What I mean by that is…it’s easy to become blinded by happy, perfect births. But the truth is, birth is not perfect. Anything can happen. At home, in the hospital… this story is just a testament to why being in the hospital for a VBAC is a good idea.
  • My OB Said What? You birthed like a warrior!– I’m pretty sure every mama wants to hear this! Even if she had a c/s.
  • With Woman, a Midwife on the Path: We Had Prepared– mixture of emotions surrounding birth center regulations and babies picking their birthdays, just in time before induction!
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Oliver’s Birth Story

This week, I am featuring a birth story that is not typical (or maybe it is and most chose not to share their experience?). While there is a happy ending, this is a traumatic birth story, both for mama and baby. Sarah is a dear friend. I saw her through her entire pregnancy from the day she announced she was expecting until the day she was 42 weeks pregnant and being induced. She is a very strong woman and I am honored to share her story here.

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I guess my story isn’t quite unique, maybe it is. Traumatizing, the doctor called it. A fiasco, I call it. From the day my son was supposed to be born and the weeks after he was, my experience as a new mother was one I will never forget, and one that I am terrified will happen again. From the moment I knew I was pregnant I knew it was going to be all natural, all the way for me. I didn’t want to be induced, I didn’t want any pain meds, and I didn’t want a C-section. I wanted to experience childbirth, test my strength, and give my son the healthiest arrival I could. I couldn’t wait to join the ranks of the millennia of women that have birthed children the natural way. I practiced yoga, deep breathing, relaxation techniques, researched pain management, took classes, etcetera. I did just about everything you can image to prepare myself, thinking that if I did enough, things would go my way. As they say, the best laid plans…yada yada.

Oliver, my beautiful son, was supposed to be born May 3rd. Days passed and No Oliver. 2 weeks passed and still no Oliver. No dilatation. No Braxton hicks. Nothing. My body was not doing what it was supposed to be doing. My body was not birthing my son. My doctor wouldn’t let me go past 2 weeks late, so on Sunday May 15th, my husband and I checked into the hospital for induction. I knew right there that things were not going to go the way I wanted. If only I knew now how wrong things were going to go, I would do so many things differently.

They started me on a drug called Cipro. It was supposed to make my body “naturally” start to dilate my cervix. Three or four rounds of this medication later, no dilatation more than ½ centimeter. The doctor on call thought that they would try a balloon. They inserted a little tiny balloon and tried to manually dilate my cervix, and then it would fall out and my body would continue on its own. Well, this was incredibly uncomfortable, made me feel like I had to pee every five seconds, plus I knew the more they put into my body, the higher the risk of an infection.

At this point I have been in the hospital for 24 hours and about 18 of them have been while having contractions. This magic balloon fell out prematurely, so that option was out. Sometime after the balloon fell out, my water broke. I continued getting stronger and stronger contractions. I became physically sick they were so strong. My breathing wasn’t working anymore, the ball didn’t work. I could hardly hold on. I told myself that if I didn’t have much more to dilate, then I could hold on, and I probably could have. However, the next time the nurse checked me I discovered that 20 some hours of un-medicated contractions and I was still only dilated to 1 centimeter. Right then and there I told them to give me an epidural. As fate would have it, that wouldn’t quite go right either. About 45 minutes after the anesthesiologist gave me the epidural, I began to feel my contractions again. I told my nurse and she immediately told me that “sometimes there’s a window of time and you just can’t get an epidural” blah blah blah. So I’m freaking out, thinking I’m going to have to endure another day or more, when she finally pulls her head out of her ass and looks at the tube and sees that it is kinked. So I got another epidural and it was wonderful. I was pain free and just waiting for my son.

Throughout the night, as they checked me, I wasn’t dilating. Nothing was happening even though I was having contractions. They said the word I was dreading; Pitocin. I knew that this was going to lead to a C- Section, or Oliver’s heart rate being affected, both things I wanted to avoid. But there weren’t very many other options.  They started a round of Pitocin as I slept. Nothing. They put a pressure catheter inside to feel how strong my contractions were; very strong but not quite strong enough. (Keep in mind here that a) I was exhausted and a little upset things were going so poorly, b) my water had broken several hours ago, and C) no one once mentioned infection risks, danger to the baby, or other options). Throughout the night the Pitocin had a negative effect on Oliver so they had to stop it. Later the next morning they tried two more rounds. I DILATED!! To 3 centimeters. This was Tuesday. The new doctor on call came in to speak to me. Oliver’s heart rate was going up, if it kept going up we might have to do a C-section, he said. Should have done one sooner, he said, since my water broke the night before. His heart rate kept going up. I had to be rushed to an emergency C-section. I had an infection, and Oliver got it.

I was terrified of the surgery, but thank god the staff was so wonderful. They kept talking to me, reassuring me, letting me know I wasn’t dying. My husband’s face was so terrified in the OR that I was being very strong for him, I thought. Olive was born on Tuesday may 17th, and at that moment I felt like it was all worth it. I was so sad that I couldn’t hold him, couldn’t meet him right away, couldn’t smell him and breathe him in. I had known him for nine months and now I was lying open on an operating room table and the first face he saw wasn’t mine, the first voice he heard wasn’t mine. But I finally HAD HIM. He was mine and we were a family. When my husband left the room I was all alone, naked, open and awake with a bunch of strangers. I know everyone goes through this, but it felt like my worst nightmare; this wasn’t what I wanted for me and my baby. This wasn’t how it was supposed to go.

I found out later, in the recovery room, that I had what they called a “tired uterus”. My uterus worked so hard and for so long that after Oliver was born it would not contract anymore, so my body couldn’t stop the bleeding on its own. They had to put another kind of balloon in my now empty uterus so I wouldn’t bleed out and die. I lost a lot of blood in the surgery, so I needed a blood transfusion. The bright side in all of this was that the minute I was allowed out of recovery, per my demands, I was wheeled into the NICU and got to try to feed my new son. He took to it like a natural. Even if everything else had gone wrong, we were breastfeeding off the bat. I felt like my body was FINALLY doing what it was supposed to.

The next day it was time for them to try and take out the balloon in my uterus. I had 2 blood transfusions, and was feeling a little better. They warned me that if this hadn’t worked, I might have to be rushed back into surgery. So I was officially freaked. Upon examining the balloon, the doctor discovered that my cervix had completely closed around it. So, fun fun, they had to pull it out through a closed cervix. It was the most painful thing. I had never cried like that before in my life. The last 4 days just came pouring out of my like a fountain. EVERYTHING I had planned went wrong. Nothing went the way it should have. My body was not doing what it was supposed to. But I was alive, Oliver was alive, albeit on oxygen and antibiotics and in the NICU for a week, and we were going to be ok.

I was discharged after 6 whole days in the hospital; Oliver was in for a few more than me. The hospital was wonderful and let my husband and I stay in one of the birthing rooms by the nursery until he could go home. Throughout the whole mess, my nurses were amazing. They made me feel comfortable and at home in a place I wouldn’t have, in a time I would have been freaking out. My husband was my savior;coaching my through my contractions, letting me know it was ok when things didn’t go perfectly, holding my hand when I was scared and telling me how proud he was of me, how strong I was. I wouldn’t have survived without him.

My experience wasn’t magical; it wasn’t special and the highlight of my life. It was painful, traumatizing, and just about EVERYTHING went wrong. But I have a beautiful son, and every single second I get to spend with him is the best part of my day. He is worth every moment of pain and stress and danger. He is what it was all for.

Mysoprostol (aka Cytotec): The Ugly Drug

Bare with me for a moment while I let the steam escape from my ears and the pounding in my chest subsides.

There.

Today, for the second time, I overheard an OB resident order Cytotec to induce a patient. In all of my reading and education thus far nothing pisses me off more than knowing OBs (and some midwives) use this drug on pregnant women WHICH IS NOT EVEN APPROVED BY THE FDA!! Yes. And maybe you were prescribed it. The more common name is Cytotec whose true name is Mysoprostol. This is a common drug used to minimize stomach ulcers as well as to help induce women for whatever reason (see the list below of the MEDICAL reasons for induction). The tiny white pill is inserted into the cervix to help it soften. This is usually followed by Pitocin once 1-3cm dilation has been achieved from Cytotec. It can take anywhere from 6-24 hours for the drug to work and usually around the 12th hour a 2nd dose is given.

I remember learning about this drug briefly in my Bradley class and if I had a choice of Pitocin or Cytotec I’d take Pitocin in a heartbeat. That being said, I’ve never been induced and the only experience I had with Pitocin was after I’d delivered Logan and I was given a small amount to help expel the placenta and minimize bleeding. Cytotec rarely is used after birth but that is not to say some OBs don’t use it.

As with any drug, there are risks and between these two most popular induction drugs their risks are similar HOWEVER Cytotec has had more complications and infant/maternal deaths than Pitocin. The most serious complications include uterine rupture and placental abruption. A women in labor is at an even greater risk of uterine rupture if she has previously had a c-section. The force and strength of the kind of contractions which both Cytotec and Pitocin create can cause the scar tissue to tear easily (hence why VBACs (vaginal delivery after ceceran) are still considered risky).

But why does it make me so upset? For several reasons. I don’t think that the women who are being given the drug are a)informed about the risks and b) told that it’s not even approved by the FDA and doctors still prescribe it. WHY?!! It’s so unnerving to think that the one person we put both our health and our baby’s health into the hands of is even suggesting that a drug is prescribed to “help soften things up” (my words). It’s relatively painless to administer, brings contractions on slowly, helps dilation–why not? Sounds like a nice way to get labor started. I wonder if the doctors who prescribe this know the risks and simply do not feel that there are enough numbers (aka: deaths) to sway them. Nor is the FDA cracking down and flat out denying it to OBs. Seems so upside down and backwards. I am eager to learn more about why this Cytotec continues to be used however I am not yet brave enough to ask the resident I saw tonight.

If you or someone you know is going to have a baby soon and an induction is on the horizon, PLEASE share this info with her. At the very least she will know the truth and can make a decision based on that and not “because my doctor said so”.

FDA link.

Real Life Story (plus many links within)