THIS ENTRY HAS BEEN EDITED TO CORRECT SOME FACTS RELATED BY “TRACY.” Yes, the stories you will be reading are true stories and experiences that occurred and are occurring.
The year is 1997. The place is Hackensack, New Jersey. A mother awakens in the early hours of the morning to go to the bathroom. She has spent the past two months with an uncomfortable ‘burn’ sensation whenever she rises from a sitting position. She is approximately 32 weeks into her pregnancy and out of habit she checks when she wipes. The paper is dark. She turns on the bathroom light and the amount of blood in the toilet alarms her. She calls her doctor’s office then 911 and then quietly awakens her husband not wanting to awaken her sleeping children. She calls a young woman who has babysat for her in the past. Her husband is trying not to panic but he runs outside waiting for the ambulance to arrive so he can direct them to the correct home.
Upon arrival at the hospital it is determined the birth is going to occur. This is her second spontaneous VBAC. The first occurred in 1995. She is advised by her obstetrician that a vaginal birth is the healthiest birth for her baby to receive every hormone he/she needs to signal to her baby that birth is imminent. Her obstetrician tells her matter of factly that she cannot be given pain medications as those drugs will depress babies’ respiratory systems.
Within hours a beautiful little boy is born. He weighs 4 pounds, 4.5 oz. He is the largest preemie in the NICU. She is pumping and bringing her breastmilk to the hospital for her son. She is there from 4am in the morning when her husband is home from work and she remains until late afternoon with him caring for their daughter until he brings her to the sitter and then comes to see his son and wife for a couple of hours before heading back to work again.
In those days while she is holding her son, singing to him, feeding him her milk and trying to coax him to breastfeed himself the nurses talk to her. It is during those days that she learns it is confirmed her son’s premature birth is due to a placenta abruptia and she learns it is common for pregnancies following cesareans. Two births earlier she had had an unnecessary c-section … they wouldn’t stop with the vaginal exams and fetal scalp blood draws …. she was in distress and her son made it clear he felt her distress.
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The year is 2002. The place is Connecticut. A mother dreams a foretelling of an appointment with her doctor where she asks her doctor to talk to her now about cesareans and epidurals. She wants to know ahead of time so she can make choices if there is an emergency. Her next appointment is a deja vu. She asks to speak to her doctor now about cesareans and emergency situations. Her doctor brushes her off and tells her she’s fine. Nothing’s going to happen. Just a few days later her water breaks prematurely at 26 weeks. She is at the hospital and she is told if labor begins attempts will be made to stop it. If the medications do not work the birth will proceed. Nurses come in and tell her to sign this form and that form … one form being for a c-section. She says she is not consenting to a cesarean right now. The nurse states it is only in case of an emergency and she won’t have time to sign a consent form. She asks to talk about the procedure and her options first. The nurse tells her someone will come in after the doctor is finished with his observations of the labor and will talk to her then. No one ever comes.
The labor is proceeding. Within a few hours she feels her child emerging. The doctor sees the baby is a frank breech and pushes the baby back in and up the canal. Her husband sees a lot of blood. Mom is scared and no one is answering her questions. An anesthesiologist shows up and gives her directions to position for an epidural. What epidural she asks? The epidural for her c-section anesthesia. What C-Section she asks? Also, if there is going to be one she wanted general. That’s not a healthy option the doctor says. An epidural it is and it is not until after that she sees she was given a classical T incision but the doctor tells her she is triple stitched.
In the postpartum check ups that follow she has questions about what was done and why. Her doctor responds that she is being difficult and she should be happy her baby is healthy and alive. She responds that she has had miscarriages, her baby was ripped from her body and is still in the hospital away from her so please excuse her for not being easier right now. Two years later she receives her hospital records as she requested and sees no one has written why she had a cesarean or any information regarding the surgery other than she has a classical incision.
The year is 2007. She is pregnant and she is joyful in her pregnancy. She wants to refuse a vaginal ultrasound on the grounds of the previous ones coincidentally preceding miscarriages. She is again accused of being difficult and her doctor is defensive of technology and it’s use is solely to know ahead of time if something is wrong with her baby. She dismisses any connection between ultrasounds and miscarriages. NOTE: “Tracy” miscarried twice, within five months of each other, since her cesarean. Her third miscarriage occurred two days after a more invasive type of ultrasound, a transvaginal ultrasound.
She is unhappy with how she, her thoughts, her research into her options and what is healthiest are dismissed. She wants to birth a different way. With someone who will hear her and who will read the research with her and who knows what normal, spontaneous birth looks like, feels like, smells like.
So she begins her search for answers and she comes across research that lists the order for the risk of uterine rupture based on type of incision as:
low transverse 0.5% [Haq 1988] – 2.0% [Clark 1988]
low vertical 1.3% [Enkin 1989]
classical and inverted T 2.2% – 4.0% depending on the study
upright T and J-incision may be higher; data needs to be found