VBAC Facts

My CS Birth Story

Disclaimer: As someone who loves reading birth stories, I like to hear the nitty-gritty. I do give some details about labor, so be aware.

• From the Beginning
• Breech!
• ECV
• Labor Begins!
• Hospital Time
• Having a C-Section
• Recovery
• Going Home
• Dealing with “Advice”
• What I Will Do Different
• Information for Every Pregnant Woman In Progress

From the Beginning. I laugh now when I think of how I felt “ready” to start a family. It’s very similar to saying you are ready to be shot into space. No matter how much you prepare, you will be utterly overwhelmed with the emotional and physical exertion as well as all the things that you didn’t prepare for because you just simply didn’t know. For example, I never knew I would have a c-section, how difficult recovery would be, how that would affect the first few months of my daughter’s life as well as my options in future births. I also couldn’t begin to comprehend how having a child would change my life, the dynamic between my husband and I, or how much love would swell up inside me for this little person. Now, it’s really hard to imagine how I lived almost 30 years without knowing my precious daughter K.

Even before I was pregnant, I was reading and researching. Not all OBs, midwives, or hospitals have the same standard policies and procedures so I wanted to find a midwife and hospital whose birth philosophy matched mine the best. As I read, I learned that every procedure has risks and benefits and that it is important when considering an intervention to assess on an individual basis whether that procedure would provide a particular woman in her specific situation a benefit that outweighed the possible risks of that procedure. I also learned how often interventions are performed due to convenience for the doctor. (One example: many women undergo induction without knowing the risks associated.) Even though I am a lover of technology, when it comes to birth, it is important to use technology when it was truly medically indicated rather than mandating a set of medical interventions as routine and performing them on every woman regardless if her case called for such care.

I was shocked to learn that despite all that Americans spend on health care and all of our technological advances, according to WHO/UNICEF/UNFPA 2000 estimates there are over 25 other countries with lower maternal mortality rates. How can this be? American health care is clearly missing something because we spend all this money and have all the “latest and greatest” technology, techniques and drugs, yet Australia, Austria, Belgium, Canada, Croatia, Czech Republic, Denmark, Finland, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Kuwait, Lithuania, New Zealand, Norway, Poland, Portugal, Qatar, Serbia & Montenegro, Slovakia, Spain, Sweden, Switzerland, and United Kingdom all had lower maternal mortality rates than the US.

Then I learned that according to the Centers for Disease Control and Prevention and the National Center for Health Statistics, in 2000 the US ranked 27th among industrialized nations in infant mortality rates. These facts shook me to the core and further encouraged me to really research and question the standard operating procedure that many OBs and hospitals follow during pregnancy and labor. Clearly, good prenatal care, access to health providers, and birth in a hospital setting was not enough. What was the US missing? (As of 2006, the US was ranked 29th in the world in maternal mortality rates, 42nd in infant mortality rates, and Save the Children found that we have the second worst newborn mortality rate in the developed world! Click here for an excellent commentary.)

I planned on interviewing several midwives (if you are interviewing OBs, here are questions to ask them) and visiting several hospitals. I went to my first hospital maternity tour at Saddleback at my mother’s urging. Little did I know that I would be the only non-pregnant woman my age in the room. To add insult to injury, I show up wearing a pair of trim slacks, accenting my pre-baby waist, and a very stylish pair of heels. Wow, where those ready-to-pop moms in their elastic waistbands and sensible flats not happy to see me. I felt horribly foolish. While it was a beautiful facility - was a palace in comparison to UCI where I would tour next - I was a little put off by the several hundred people attending this tour. I wondered if I would even be able to get a room if I came here laboring. I was also concerned about the nurse to patient ratio. In addition, they didn’t address the information I wanted to know: What was their c-section rate? What was their episiotomy rate? Did they routinely give pacifiers or bottles of sugar water or formula to newborns? Did they encourage rooming-in or did they automatically take the baby to the nursery? This was the information I came for and while the tour was nice, I left wondering if I was the only woman in the room who left with the same questions I came with.

I next visited UCI Medical Center and was even more disappointed. Not only did the tour reveal LDR (labor, delivery, and recovery) rooms that looked like former broom closets (very small, crowded, dark and no windows), but the nurse leading the tour had a very condescending tone.  She spoke to us as if we were a bunch of children, which really insulted me. I wondered if she spoke to us in this manner on the tour, what kind of treatment would I receive while in labor? Then the nurse informed us that “all babies would be removed from the mother for two hours after bonding.” No exceptions. I did not want my baby going to the nursery at all. Anything they needed to do to my baby would be done in my room or my husband T would accompany the baby to the nursery. I also did not want erythromycin put in my baby’s eyes. This is a procedure required by law in California in order to combat infection resulting from a vaginal birth in a woman with undiagnosed STDs. (However, you can refuse it “against medical advice.”) As I did not have any STDs, it was an unnecessary procedure in my situation and the nurse was not happy when I questioned her. If a hospital was not comfortable my wishes, I would not hire them. So UCI Medical Center was off the list.

I finally visited South Coast Medical Center in Laguna Beach and felt like I finally found a hospital that fit me. Their tour wasn’t a cursory cruise through the maternity ward. They actually talked about all the things I was interested in knowing. They didn’t even have a nursery. They encouraged rooming-in, but if you needed a break, a nurse would care for your baby. They were very supportive of breastfeeding and non-intervention during labor unless medically indicated. Did I mention that all the LDR rooms boasted wall-to-wall floor-to-ceiling views of the Pacific Ocean? I envisioned myself peacefully laboring in a warm tub of water overlooking the ocean in a hospital where I would not feel badgered, where our objectives were the same, so I could labor without battling. I was so excited.

While I was interviewing hospitals, I became pregnant, so I started was also interviewing midwives. After speaking to three, I hired a hospital-based midwife. The stage was set! Over the next few months, T and I took Bradley classes (was a better fit for us than Lamaze,) had reserved my midwife’s birthing tub (she didn’t permit delivery in the water, but she would let me labor in the water until my membranes ruptured), and studied various non-drug pain relief techniques. I read a lot, but Ina May’s Guide to Childbirthby Ina May Gaskin was one of the most influential books I studied. (I have heard that Journey into Motherhood is another excellent book featuring non-medicated births.) I gained such confidence reading the various birth stories in the first half of the book. All different women, describing different births, and different non-drug coping skills. It was a refreshing contrast to all the over-medicated, “over-interventioned,” over the top, screaming-all-the-way-to-the-delivery-room births I tortured myself with on “The Baby Story” and other similar shows. Reading Ina May’s book taught me that there was no Right Way to labor and labors can progress very differently. It influenced my expectations for what my labor would be like. I learned so much. I was highly motivated and committed to a unmedicated, vaginal birth.

Breech! My prenatal appointments were interesting and uneventful until 35 weeks when my midwife noticed my baby was laying transverse (sideways). She said it was very likely the baby would turn head down on her own. Only 3% of babies are breech at term. Surely I wouldn’t be in that 3%. I knew “doctors estimate that about 90% of fetuses who are in a breech presentation before 28 weeks will have turned by 37 weeks, and over 90% of babies who are breech after 37 weeks will most likely stay that way.” I asked her, “What if she doesn’t turn” and I was told that I would most likely have a c-section. I couldn’t believe it. I wanted to do everything I could to turn the baby because I desperately did not want a c-section. I wanted to labor in the water, overlooking the beautiful Pacific Ocean. I went to a chiropractor who practiced the Webster technique for several weeks. I did the recommended yoga positions, I sat on hard chairs versus our soft comfortable sofa, I tried everything I could think of.

At 37 weeks, the baby was frank breech (bottom down, legs and head up). We scheduled an external cephalic version (ECV) for the next week at Saddleback. I started to feel desperate and time was running out.

I borrowed some moxibustion from a midwife friend on April 13th (37 weeks, 6 days), but never had a chance to use it. Things happened really quickly over the next week.

ECV. On April 15th (38 weeks, 1 day), we went to the hospital for the ECV. We started off with an ultrasound to access the situation. They baby had moved to a footling breech position. The baby’s head is lodged under my right rib with the bottom down in my pelvis with one leg tucked beneath the bottom and the other leg pointing outward - a pretty complicated position. The OB said that there were three factors to determine the probability of ECV success - size of the baby (which was in my favor - he estimates the baby to be 6.5 lb plus or minus a pound), amount of amniotic fluid (which was not in my favor since he said I was on the low end of average), and the fact that this was my first pregnancy was not in my favor. So, he predicted a 50-60% likelihood of success in my situation. He said that if he felt the likelihood of success was less than 50%, that the risks of the procedure were not worth the potential success. With that information, T and I decided to go ahead with the procedure since what did we have to lose?

So, in went the IV in and they gave me Terbutaline to relax the uterus (keep me from going into labor) as well as Fentanyl for pain management and a few minutes later the doctor came in. They literally poured a cup, or even more, of mineral oil on my stomach and then the doctor cupped one hand around the baby’s head and the other around the baby’s bottom and turned. It was rather uncomfortable, but never painful - just did my slow deep yoga breathing and that helped me relax. The whole procedure was about 10 minutes. He tried three times to turn the baby and then said that the baby wasn’t going to turn. She was just stuck. Due to her position, the OB said that I was not a candidate for a vaginal breech birth. He recommended scheduling a c-section for next week when I will be 39 weeks pregnant. I asked him about waiting until I go into labor and he said that makes c-sections more risky and complicated - more issues with infection. (While the risks of infection are greater with an unplanned CS, I would rather get an infection than risk my baby be born to early with underdeveloped lungs.) He said that there was a 5% chance that the baby at this stage of the pregnancy could spontaneously turn head down. I stayed at the hospital for about an hour after the ECV for observation. It was interesting to watch how the drugs effected the baby. Before the drugs, the baby was very active, and then after the drugs, then the baby was just quiet and then “woke back up” about 45 minutes later.

My c-section was scheduled for April 22nd (39 weeks, 1 day). I was devastated. I remember going to lunch with my mom and mother-in-law afterwards and just crying. There are so many women in our society who think c-sections are just grand and even elect a cesarean when it’s not medically necessary creating significant risks for maternal and infant health. In this climate, it’s hard to find many people who understand the devastation of wanting a vaginal birth and instead laying on a table as you are cut and your baby is lifted out of your body.

Labor Begins!! We had dinner with my in-laws on April 19th. I had a full steak dinner with baked potato and a half glass of red wine. We didn’t get to sleep that night until 11pm. So of course, my water would break three hours later at 2am (38 weeks, 5 days). It felt like a river of warm water. So many things were going through my mind. Yeah! I went into labor naturally! Yeah! I’m so thankful for the waterproof mattress pad we put on the bed the week prior! Oh, need to wake up T! He later told me that he had thought I just peed the bed and didn’t believe that my water had broken, which is odd because I do not routinely pee the bed! I waddled to the bathroom with squirts of water flowing as I moved. I was so excited that my legs wobbled as I walked. I learned in Bradley how you can tell if it’s your water breaking versus urine: if you can stop the flow with your Kegal muscles, it’s urine. My water had definitely broke. I was not prepared for how much blood there was.

We called the OB who said to come into the hospital immediately and I would be the first c-section of the day at 8am. Of course, my bag wasn’t packed, because my c-section wasn’t for two more days. It was as if when I got my scheduled “due date” I didn’t believe I could actually go into labor on my own. So, we quickly packed our bags (T was going to stay in the hospital with me while I recovered), I put on a dress, wrapped a towel around my waist, grabbed a bunch of beach towels for my seat, and we hit the road. As we drove the 45 minutes to the hospital, I was having very mild contractions. I could feel my uterus stiffening, which is amazing to feel your belly as hard as a rock, but felt no pain. I called my mom, mother-in-law, and boss and left messages saying that today was the day. I was exhilarated.

Hospital Time… When we got to the hospital, T drove up to the Emergency entrance and ran inside. He said, “Wife… baby…I’m going to take this,” grabbed a wheelchair and ran outside. The nurse ultimately caught up with him and wheeled me up to Labor & Delivery as T parked the car. The nurse put me into the evaluation room, I suppose to confirm that I was actually in labor, which I was a little insulted by. I know a lot of women go into the hospital with “false labor,” but a few questions would have clarified that yes, in fact, I was in labor and not another naive first-time mom with Braxton-Hicks. It was a four-patient room, but fortunately, I was the only one there that morning. They gave me the fabulous blue gown to wear and hooked me up to the external fetal monitor (EFM), limiting my movement to the bed, and put in an IV. They told me to lay on my left side, despite all we know about gravity, balance, and the agility of a pregnant woman in labor.

By this time it was about 3:45am and my contractions were coming on faster - about 2-3 minutes apart. At one point I went to the bathroom so I was able to experience contractions in different positions and quickly saw why it is so important, and more comfortable, not to labor in bed. The contractions I had while sitting on the toilet were easily half the pain. As I walked from the bathroom to the bed, I had a contraction standing with my arms laced around T’s neck. Those contractions were not as comfortable as the ones I had sitting, but were still less painful than lying in the bed. (I had studied so many positions to labor in, but couldn’t remember many in the moment. For the next labor, I’m going to make flash cards of the various positions to bring with me.) I wanted to labor sitting on the toilet, but the nurses wouldn’t permit it. I had to be on the EFM. I wish I would have pushed the issue, asked if they had a telemetry (wireless) EFM unit (which I now know Saddleback offers) and gave myself the ability to labor comfortably, unmedicated and not in bed. There was no reason for me to be in more pain that I had to be if all I had to do was change positions. I wish I would have been less intimidated by the nurses. Better yet, I wish they would have offered a telemetry unit to me as it was clear I wanted to labor off the bed.

It is really the luck of the draw what kind of L&D nurse you get. Just like OBs, midwives, and hospitals, the birthing philosophy of L&D nurses vary greatly and depending how long you are in the hospital laboring, you could have several caring for you during your stay. Some will respect your choices, others, especially if you are a first-time mom, will laugh off your wishes and not respect your choices because, what do you really know? Despite the fact that my birth plan, which I gave to the OB and to the nurses when I was admitted to the hospital, stated “do not offer pain medications,” the nurses offered me pain meds three times that I can remember. Interesting how they push the drugs, yet limited my movement. This is like offering someone running a marathon a lift to the finish line. I wanted to see and feel what labor was like. I wanted to see my body do all the things and go through all the stages that I had read so much about. One of the reasons why I was so upset about a scheduled c-section is that I wanted to go through labor. I wanted to experience contractions and finally know what everyone was talking about. Through pure luck, my water broke two days before. I was actually there experiencing it. I did not want pain meds. I wanted to feel connected to the process, not like a bystander watching from afar.

Because of this experience, I plan to hire a a doula for my next labor to act as a buffer between myself and the L&D nurses. I know they mean well, but I wish they would have respected my desires rather than assuming that all women want pain meds during labor especially after I had expressed what I wanted multiple times. I envisioned T being a L&D nurse buffer, but he was so focused on me, and honestly probably a little freaked out. In addition, hospitals and their staff are intimidating, especially when you are in the vulnerable state of being in labor and pain. T was not focused on telling the nurses to read their monitor strip and get lost. Besides, it was unfair to expect that of him. I was not up for a fight. We both were focused on me laboring and the L&D nurses just got in the way with their constant interruptions, trying to talk to me in the middle of contractions, and offering pain meds when my birth plan clearly stated “no meds” and I told them several times “no meds.”

Despite that, it was great to see and experience my laboring body. Contractions felt just like a really bad leg cramp. My stomach was hard just as my calves got hard during my nightly leg cramps. (Maybe this is a way of preparing the new mother for labor? Constantly awaking her in the middle of the night in excruciating pain??) If only baby had been in the right position, I would have been able to see how my body would handle delivery. I am so hopeful that my next child will be in head down/blast off position and I will be able to experience labor and delivery as nature intended.

Labor is so primal and it was an incredible experience to share with T. There is a new dimension to our bond now that we have shared those few hours together. He was amazing. I remember feeling how disgusting I must have looked to him as I walked from the bathroom with blood trickling down my legs. I was a little embarrassed and wondered, knowing how squeamish he was, if he would find me gross. Whether he did or not, he supported me through my contractions and helped me visualize Kauai where we spent our second anniversary. We had such a wonderful time there and thinking of it helped me relax which made the contractions more bearable.

It’s about 4am now and the nurse checks to see how dilated I was - that was more painful than the contractions - and I was 3cm. So the nurses called the OB as I was progressing faster than anticipated and they did not think I could “hold on” until a more decent time of the morning. The OB said he would be right in. At that point, the L&D nurse offered pain meds for the third time and I consented. If she hadn’t kept offering them, I wouldn’t have taken them, but she was so persistent. I knew I was getting a spinal within the hour anyways and at that point I felt a little defeated as my evitable cesarean loomed ahead. Soon I was being wheeled into the OR.

Having a C-Section. The OB, hospital, staff were very respectful of most of my wishes. I wasn’t shaved or given an enema, my arms were not tied down to the table, I could wear my glasses, T was present the whole time during the surgery, and the OB closed my uterus with dual layer suturing rather than single layer.  (Update: It wasn’t until I got my medical records in 2007 that I saw I was closed with a single-layer suture.  There is much debate about which method of suturing is safer.)  However, the screen was above my breasts, so I wasn’t able to breastfed until I was in the recovery room and they immediately clamped and cut the umbilical cord rather than waiting until it stopped pulsing.

It was hospital policy for husbands to be out of the OR while the anesthesiologist did the spinal (similar to an epidural, but the needle goes in further and pierces the sac containing spinal fluid and spinal cord) but the he was running late. So there I was in the OR in full labor wearing a paper gown with everyone else in the room in scrubs and masks, waiting. I felt so disconnected, vulnerable, terrified, and alone. I was exhausted only getting three hours sleep, I was sad because I didn’t want a c-section, I was pain because the narcotics the nurse had given me had worn off, and all I wanted was to be with my husband who was just outside the door waiting to be let in. A nurse said that I could lean on her or hold her hand while I was having a contraction, but it felt so weird to be relying on someone when I couldn’t even see her face. This was such a intimate, private moment for me and here I was with a room full of people with masks on their faces. It reminded me of one of those alien autopsy movies.

After begging for T, they finally let him in and he was present when the anesthesiologist arrived and did the spinal. It was so wonderful to finally know someone else in the room and not feel totally alone. After the spinal was in, they laid me down on the table, put in the catheter, an oxygen mask was placed on my face, the screen was put up, and the music turned on. The anesthesiologist was sitting by my head on the right, T was sitting on the left and with the two OBs plus assistants crowded below the screen, I looked at the reflection in the lights above and saw red blood. They had begun the surgery. I was having a c-section.  And all my dreams of a normal, vaginal birth flew out the window.

I remember doing my yoga breathing trying to focus on my breath and not on the tugging I felt below. The whole idea of being cut was terrifying to me. The anesthesiologist was really nice continually asking how I was doing. I started getting a bad headache, so he gave me meds for that and then I got really nauseous so I got more meds.

Not long after the first cut, K was born at 5:50am, weighing 6 lbs 13 oz and 18 inches long. She was screaming and lovely.

T completely surprised me. During the ECV, they put in an IV in case I went into labor and they had to do a c-section. I wasn’t looking, but when the nurse put the IV in, I apparently squirted blood and T turned green and had to leave the room. I was fully prepared to have T sitting at the “pretty end” during the surgery. So imagine my surprise as I saw my husband rise and peak over the curtain - with the OB’s permission - and videotape the entire surgery! When I was pregnant, we both strongly expressed that we did not want to video the birth. When I was scheduled with a c-section, that started to change, but even as we grabbed the video camera that morning, I was still undecided. Looking back, I am so glad T recorded the surgery. I was drugged, totally disconnected from the process and while I could hear everything, I felt nothing. It is wonderful to watch that video - as I have many times - and associate all the noises I remember with everything I didn’t see, especially K’s cry. As the OB held her over the curtain, I felt as much joy as one can have after to many drinks. I was high from all the meds and it was hard to appreciate the profoundness of the moment in that state. I was in a drug-induced cloud and remained that way for a few days. It makes me sad to think that the first few days of K’s life, I was not fully present because of the pain meds I was taking. It was a hard choice, I was in so much pain for so long, and trying to chose between being in pain and being mentally clear is a very hard choice.

Recovery. After the surgery, I was moved to the recovery room. I was awake and very hungry, but wouldn’t be permitted to eat for many hours. They did bring K so she could breastfeed. I remember her latching on and I was so happy! It was very weird to not feel my legs and it took a while - I can’t remember how long - to finally feel my toes. Family came in and visited me and K for a little bit, but other than that I don’t remember very much. T said I slept for 9 hours while he played and slept with K on his chest. It makes me sad that I missed so much of that first day, but I haven’t slept that long since she was born! Later that day, I was moved to the room we would stay in for the next three days. It was a private room with its own bathroom, complete with shower and sink, TV, and reclining chair for T to sleep in. One wall was all windows overlooking a mall, so we got a lot of natural sunlight. As the spinal wore off, I began to feel more and more pain which I countered with a continual flow of Vicodin, which caused it’s own issues as I was continually thirsty and suffered from horrible periods of nausea. I had a slight cold, so was coughing periodically and that hurt so much. I held a pillow against my incision as I coughed which helped a bit, but I cringed before every cough. It also hurt just to move in bed. The most simple movement caused the most incredible pain. God bless the mechanical hospital bed. To be able to go from lying down to sitting up at the press of a button, without any assistance from my severed abdominal muscles, was wonderful. I didn’t fully appreciate it until I went home and had to figure out the least painful way to maneuver in bed.

Despite conventional wisdom, having a cesarean does not mean you will escape the pain of childbirth. With a vaginal birth, 90% of the pain occurs during labor which might last a day or two. With a cesarean, 100% of the pain occurs after the baby is born (and they don’t give you epidurals then!) and will last for weeks or months depending on the woman. Plus, you are in this great pain and caring for a newborn which is so hard and miserable. I took Vicodin for two weeks post-partum and was nauseous the entire time, but if I didn’t take it, I was in horrible pain. Cesarean is not the easy way. The surgery itself doesn’t hurt at all (provided your epidural/spinal works), all the pain comes afterwards. Post-surgery, you are in constant pain and discomfort for months. There is no comparison. It hurt to sit up or rollover in bed… I woke up countless times with jabbing, searing pain because I made the mistake of trying to rollover while sleeping. It hurt to go from sitting to standing. You don’t realize how almost everything you do physically relies on your abdominal muscles until you have abdominal surgery: peeing, pooping, coughing, moving, walking, bending… it is not the easy way.

24 hours after the surgery they removed the catheter and my wonderful daytime nurse got me out of bed for the first time to use the restroom. Walking for the first time after the surgery was so horrifyingly painful. I had the nurse under one arm and T under the other and I really didn’t think I would be able to walk the 5 feet to the bathroom. The pain was unbelievable and I experienced contractions for 2 hours before the surgery and those hurt like hell, but they only last for 30 seconds to a minute and then there is no pain. The pain as I walked the 5 feet to the bathroom was far worse than any contraction. It was the worse pain of my life. 5 feet never felt so long. I remember wondering how I was to possibly care for a baby and endure this pain. But with my nurse under one arm, and T under the other, I walked like a wooden solider to the bathroom.

The next day it was time to take off my bandage. I was terrified to see my incision. The whole area hurt so much, I couldn’t imagine how long it would take me to slowly remove the bandage that covered my abdomen. The nurse recommended I remove it myself in the shower because the OB would just “rip it off.” That meant walking to the bathroom again, and while it was far less painful than the day before, I walked unassisted very slowly and with great care.

That shower felt so amazing. It had been several days since I had showered or brushed my teeth. After my shower, I changed into my own pajamas and underwear that I had packed. Up to that point, I had been wearing a blue fabric gown with these horrible webbed mesh, stretch hospital panties. When you still look like you are 5 months pregnant, exhausted, and in pain, it just tops the cake to be wearing the one-size-fits-all hospital-issued underwear. What I relief to be clean and in my own clothes again.

That afternoon, the friends and family descended for a visit. I was so excited to see everyone and wished I had felt better so I could really enjoy the visit. Some side effects of the spinal reached a crescendo before the visit as I itched all over my body. In my groggy state, I didn’t realize how much I was itching. When it finally got to much, I called the nurse and they gave me benedryl and morphine via my IV. I now understand why people use morphine recreationally. My itching was almost immediately resolved and I passed out - despite fighting it because I wanted to be with everyone - within a few minutes. It was amazing to me how quickly drugs take affect when they are injected directly into one’s bloodstream.

The next few days I struggled greatly with breastfeeding and cried a lot as the hormones that make you feel so great during pregnancy left my body. I also realized how huge I was. When you are pregnant, and your cute tummy is center stage, you don’t realize how big the rest of you is getting because it looks small in comparison to your behemoth middle. Just wait until that tummy is gone my dear and you will see how you could take flight with your upper arms, and your thighs could easily feed a family of four for many weeks. Like most women, I have always struggled with my body imagine and gaining 40 pounds was very fun on one hand and very depressing on the other.

A couple days later, on Saturday, April 24th, we checked out of the hospital and started out life with K. Needless to say, with my next child, I am planning a VBAC.

Over the next few weeks, we received bills for the surgery and hospital stay. It was well over $22,000. Fortunately, we had really great insurance and we didn’t have to pay a dime.

Going home. I really didn’t get a taste of what life was like with a new baby until she was almost two weeks old. The first few days we were in the hospital. T stayed with us the whole time except Thursday night when he taught his class at the local community college. We didn’t have to clean or cook. The food at the hospital was surprisingly good, or maybe I was just very hungry. When we went home, T took a week off of work. So, that was pretty easy. He could hold K while I showered. While I was exhausted, it was fun to share those days with him. Everything changed when he went back to work. The exhaustion quickly took hold and it was very hard. Looking back, I wish I would have done a few things differently.

Dealing with “Advice.” I should have worried less about what other people thought and instead did what felt natural and obvious to me. I received some advice from well-intended people. As a new parent, there is so much you don’t know. I didn’t want to come across as arrogant, but there were a few things that seemed so clear to me that I really wondered if I was doing the right thing. Also, just because something worked for someone else, doesn’t mean it will work for you. Circumstances vary so much: your personality, your baby’s temperament, your spouse’s involvement, your family dynamic, and your parenting philosophy - it’s really hard to find one thing that works for all families. The most important thing is to find what works best for your family. Below is what worked best for ours.

The most important advice I heard on parenthood was “Follow your instincts. Don’t go by what you read in a book. If it feels wrong, don’t do it. If your baby is crying and you want to pick him/her up, don’t think, don’t analyze, pick her up!” It made me realize that I have everything I need to parent: my natural instincts and my love for my daughter. I realized that this philosophy was the foundation for a variety of parenting behaviors collectively called Attachment Parenting. Two years later, following this advice, I have no regrets about any of the choices I made.

“You shouldn’t sleep with the baby, you will suffocate her!” - The fact was, I struggled so much about K sleeping in a crib vs. a co-sleeper vs. right next to me. The deciding factor was sleep. Ultimately, everyone, K, T, and myself, all got more, higher quality sleep if she slept in our bed. For the first few weeks, I would wake up with K in the middle of the night, take her downstairs, turn on the TV, and nurse her. By the time she was done eating, I was wide awake, interested in a show, and would stay up a little longer. By the time I went back to sleep, she was waking up 30 minutes later. There is a reason why war criminals are tortured with sleep deprivation. It is painful. Once I learned how to nurse lying down, that rocked my world and changed my life. No longer was breastfeeding and sleep mutually exclusive. Now that I could do both at once, all I had to do is wake up just enough to pop K on the boob and then go back to sleep. Plus, she didn’t have to fully wake up enough to cry and get my attention as she slept down the hall. With her right next to me, I could feel her rooting and slightly waking up and I was able to quickly get her attached. It was less traumatic for both of us as neither of us had to fully wake up for K to eat. It was still exhausting, but not so much. Within a few weeks, I stopped worrying about where everyone slept, and concentrated more on how well everyone slept. I’m sure you heard about the AAP’s recommendation to put your baby asleep in a crib with a pacifier. You might find it of interest that the study they based that recommendation on was funded by pacifier and crib manufactures…. not exactly neutral parties. The fact is, co-sleeping is very safe and protects children from SIDS. Both Dr. Sears (pediatrician & author) and La Leache League have publicly disagreed with the AAP.

“You should put her on a schedule.” - Putting her on a schedule simply did not work with my overall parenting philosophy and would seriously interfere with breastfeeding as would giving her a bottle at night. Breastfeeding is based on supply and demand and especially in those first few weeks when your milk supply is getting established, it is very important to feed on demand, not on a schedule. This will ensure that you make enough milk. It is no surprise that “not producing enough milk” is commonly cited as a reason to stop breastfeeding when we live a society that loves putting babies on schedules and getting them to sleep through the night ASAP. If I hadn’t done my reading beforehand or joined La Leche League, I probably would have thought how wonderful it would be to have K on a nice little schedule. Who wouldn’t love more sleep? But the fact is, I just needed to power through those first few months. They are brutal, but co-sleeping and learning to breastfeed lying down, made it easier.

“If you hold her to much, she will become clingy.” - At the time, when I was filled with so much doubt, I wondered if this person was right, but looking at the wonderfully independent, confident little girl K has become, I realize how much that advice was rooted in not being inconvenienced. Babies in the womb are in continual physical contact with their mother. To go from that to post-birth reality is quite a shock. Babies love to be held and parents should enjoy that time as much as possible. Soon your  kids will be dating and most likely won’t be into hugs. I am a huge advocate of babywearing and recommend it to all new parents. My Wilkinet and Maya Pouch were the two best investments I made. I would not live without my Pouch whereas I could easily forgo my strollers (except maybe my BOB Sports Utility Stroller.) I use the Maya Pouch, almost daily, to this day and K is 22 months old. It’s excellent for shopping - no pushing around a gigantic bulky stroller. If K wants to nurse, she can discretely. If she wants to sleep, she does. It’s a great way to give baby what s/he needs (physical contact with you) while freeing up your hands to do things that you need to do (grocery shop, clean, cook, etc.) A sling is the one thing I could not live without. All the other baby do-dads are superfluous.

“You should let her cry it out and sleep train her. It will teach her how to sooth herself.” - Sleep trainers make tons of money because new parents are tired, desperate and are looking for an easy solution. Even so, I knew from the beginning that I was not going to do this. There is a reason why babies cry - they can’t talk yet. It is their only mode of communication and the whole point of “cry it out” is to reduce and/or eliminate crying thus eliminating a baby’s ability to communicate with you. This makes no sense. However, I did give it a try a couple desperate nights. As I sat downstairs and listened to her shrill, I thought back to “Don’t analyze, pick her up!” and I ran upstairs and did. First, it’s very important to understand that babies sleep differently than adults, so it’s unrealistic to expect them to sleep 5, 6, or 7 continuous hours like an adult. Second, there are also other less painful, more logical methods for getting your baby to sleep longer. Third, excessive crying can be harmful to babies. Fourth, there is a reason why babies cry, they are trying to communicate something to us. So even if we can’t identify the cause, that doesn’t mean we should ignore the message. Finally, I reflected on the evolutionary truth of “cry it out.” While we are sophisticated technologically savvy people now, our bodies are the result of millions of years of evolutionary fine tuning. Imagine being on the savannah and consider “survival of the fittest:” those that manage to survive, live to reproduce. Would a baby permitted to cry, unsupervised on the savannah, survive longer than a quiet baby who is held and comforted? I imagine crying babies attracting predators and the quiet satisfied babies surviving. We are now safe in our homes, with no natural predators stalking us, but those ancient behaviors - a mother’s natural immediate response to pick up her crying baby - are hard wired into our being.

What I Will Do Different. I will feel more empowered during labor and question the L&D nurses and use more positions. Hopefully baby will be head down, so I will labor at home for as long as possible. I will hire a doula to keep a timeline of the labor and to act as an L&D nurse buffer. (A lady from my Bradley class had a timeline from her labor and it is so cool to read. It’s really hard to remember the spacing of your contractions at a particular time and how dilated you were, etc.) I wish I would have joined ICAN because that is one group of smart, confident women. (If you want an unmedicated, vagainal birth, it’s important to surround yourself with people who support that decision, rather than trying to tear it down.) I will set up people to come stay with me in my house. I’m hoping since I have more local friends now then I did at the time of K’s birth, that I will have more social support, but I also know how hard those first couple months were and it would be so great to have people around. I will be more confident about my instincts as a mom.

Information for Every Pregnant Woman

The World Health Report 2005 by WHO. Selected indicators related to reproductive, maternal, and newborn health.