Stuck Between a Hospital and Hard Place: How Risky is a Home Birth for a "Low, High Risk" Birth?

That title was a mouthful, and so is this story. This post has been one I have considered writing a long time, but it is difficult emotionally, so I have avoided it. It's time to get it out there.

In 2009, I had a simple laparoscopic knee surgery to correct an old sports injury. I was naive and foolish to think any surgery was simple. (I think that is why I get especially angry when someone says, "Just have a cesarean, it's so easy.") At the time, I was taking the birth control pill. My doctor never told me to stop it prior to the surgery. He didn't feel my surgery and birth control were counter-indicated. Two days after my surgery, I got an intense pain in my ankle, following by intense swelling and the worst charlie horse I had ever had in my life. I went to a massage therapist who thought I might have a blood clot in my leg, but gave me a massage anyway. I went on like this for a week before a finally went to the doctor. I couldn't find a comfortable position, sitting, standing, laying down. I had to leave work, went straight to my doctor, who sent me to the ER. I jumped into the ER on one leg (not yet knowing the gravity of the situation.) As it turns out, I DID have a blood clot in my leg. The massage had dislodged it from my ankle, but luckily it became lodged in the artery behind my knee, only a 3 small pieces breaking off and traveled through my heart into my lungs. (Which had explained some intense chest pain I had recently experienced. That my friends was a minor heart attack when the clots bounced around in there.) The ER doctors told me I was lucky to be alive. I was young then, and thought they were exaggerating. A week in the ICU, not being allowed to get up at all (not even to use the toilet) showed how serious it was. I know now, I really was lucky to be alive. But I was left with more questions than answers. I tested negative for any type of genetic clotting disorder. I think it was the birth control pill because the estrogens in it can thicken the blood, but my orthopedic surgeon vehemently denies this. "Millions of people get knee surgery on the pill and don't clot," he told me.

Well I guess that I am the exception. Now, I can't take the pill, and any time I get pregnant, I have to take two blood thinner injections to the stomach a day. There is a risk of clotting in pregnancy, which is many times multiplied over the pill. I cannot take a blood thinner orally, because they have been shown to cross the placental barrier. I was covered in bruises on my stomach during my pregnancies. A needle phobia didn't help this situation. My husband had to give me 99% of my shots, because I just couldn't bring myself to do it. I asked my doctor how dangerous it would be for me (and my fetus) not to take these shots. She likened refusing this medication to doing a road trip, driving 85 mph down the highway without a seatbelt. Maybe I'd get to my destination safely (clot free) or maybe not. There's a change I could clot again and have a stroke or heart attack that would be disabling or fatal, or my placenta could clot and kill my baby.

Because of this clotting issue, I am considered high risk. However, in all other aspects, I am considered a low risk patient. I don't smoke, I'm not obese, I'm reasonably fit, I don't have "advanced maternal age". One of the doctors I have interviewed dubbed me a "low, high risk patient". Talk about confusing and frustrating.

When I started having babies, I never thought of a home birth. Hospitals were "just where you had babies." However, my heart has started longing for a home birth, or at least something very close. Six months ago you couldn't have told me this is what I would want. I would have thought you were crazy. I have never wanted a home birth. However, the more I meditate on what I have read in "Cut, Stapled, & Mended", the more I feel like a home birth would be the most conducive to achieving my VBA2C. I'm beginning to wonder though, if I really have any choices in regards to my birth location. I feel like I am stuck between the hospital and a hard place.

• Where am I going to find a midwife that would take me on as a patient knowing that I have the potential to be a serious bleeding risk if things go wrong. ESPECIALLY after 2 cesareans. 

• AND where am I going to find an OBGYN that would co-manage me with a midwife so I can get my medications, blood tests, etc.

But most importantly is this dilemma in my heart: Am I putting myself, my baby, and my family at substantial risk by trying to birth at home. Am I being irresponsible, foolhardy? Is the risk to my safety so great that I am willing to leave my children motherless and my husband a widower? Is the danger even that high, or have my doctors exaggerated my clotting risk to scare me into submission? I'm feeling backed into a corner. I'm beginning to wonder if I am going to "be allowed" to have the birth I want. I'm starting to wonder if I am going to have to be satisfied with the birth "I get". This really saddens me. After reading "Cut, Stapled, & Mended", I was full of hope. Now I realize that despite how similar Roanna and I are emotionally and physically, medically we are completely different. I feel a lot of sadness, because I can't image a doctor on the planet would approve of a home birth in my circumstances. Most don't approve of home birth for people with immaculate medical histories. I feel like I don't have a snowflakes chance in hell.

If you're reading this and have any experience or suggestions, I more than welcome them. Please tell me what I can explore. Who I might see, what avenues might I pursue? What are your thoughts?

Ebb and Flow, Stop and Start, Sprint and Crawl

I've been meaning to write for days, but Valentine's Day has thrown me for a loop. My little home bakery (i.e. myself) put out over 10 dozen cookies over the course of 4 days. That is the busiest I have ever been. Hence, everything else fell off the wagon. Laundry, diet, gym, sleep, spiritual journey…sort of collecting dust. I felt like I was getting nowhere, when I did a quick visit to Curandera. I told her what I had accomplished (which felt like nothing) when she told me that progress sometimes comes in spurts and stops. She reaffirmed how proud she was of me for doing this work. She told me to be gentler with myself.

So, now that the rush is over and I can breathe, I can get back to the purpose.

Highlights on actions that I have taken so far since last we met:

• I am been working to touch my scar.
• Several trips to the gym, and some improvements in diet.
• Called the hospital in an attempt to get my medical records. Gotten a weird voicemail twice and no return call. Grrr.
• I have purchased all the ingredients recommended by my Urban Curandera to do castor oil packs.
• I did my first home castor oil pack last night. 

The idea and mechanism behind the castor oil pack is that it breaks up and softens the scars both internally and externally. They are really easy to do and relatively inexpensive. For an in-depth look at scar healing, you can check out Curandera's workshop here.

The pack itself was fine, again it was the after effects seemed to hit me hard. I have been chatting with Curandera to see what she thinks is going on.

I felt a real looseness in my pelvic floor, somewhat painful, but mostly just a feeling of weakness or low tone. Sitting up and standing up straight posed some difficulty, as well as lifting Lollipop out of her crib. Lifting my 40 lb toddler is almost out of the question. The best way to describe the sensation is that it feels like my uterus just might fall out of my vagina. Not in a bulging or pushing sort of way, but in a heavy weight sort of way.

Curnadera suggested that perhaps the castor oil is doing its job, breaking up the scar and adhesions that had been holding my uterus in its current position. As a result, my pelvic floor muscles (or lack there of) are having to take over, and they are showing me just how weak they are.

The feeling has persisted all day, and then as the day wore on a second symptom popped up: PHANTOM KICKS!

I had heard about phantom kicks before, but I had blown the idea off. Surely it was just mom's that missed being pregnant, or decided not to have another and trying to connect with a past fond memory.

I'm here to tell you they are REAL. Mine have been sporadic in both timing and activity I am doing when the occur. I was reading that they are thought to be the uterus having contractions, trying to get back into its normal shape. Again, the castor oil pack could have helped that, I'm sure.

I've been trying to take it easy tonight en lieu of how weak my mid section feels.

Tomorrow is the Red Tent in our area. I'm both looking forward to it and really nervous. I'm afraid about what might come up. Doula encouraged me to bring a notebook to draw or mediate on my labyrinth. A lot of birth traumas are sure to come up, and I am very sensitive to it. There could be women that talk about their births with a history of sexual abuse. I cannot even watch a movie that has a rape scene it without being upset about it for months. The small "PG-13" rape scene in the teen lit movie, Divergent, bothered me for weeks. I don't know how to explain it other than that I am very sensitive. My emotions are very close to the surface at all times. I can cry over a moving song or a poignant commercial. It's hard to strike them from my mind later. I replay them over and over in my head.

I'm hoping my determination doesn't waver. The weather is poor, and I'm looking for excuses not to go. I thought Doula was going, but she will be attending a workshop instead. We promised to meet up afterwards to discuss it. I'm holding myself to that. Time to take another step forward and breathe.

The Beginning of a New Birth Journey

If you are reading this, I am happy you found me. I am a woman, struggling to have a natural birth in a medically crazed society. A place where an intimate event that used to take place in the safety and quiet of our own homes has turned into an impersonal, fearful…and almost mechanistic act. As birth has moved out of the home and into the hospital, we have lost some of our rights to our own bodies. While one can argue that we can always have the "right to refuse any procedure", in reality women are coerced, lied to, acted upon without consent, threatened, and scared into accepting procedures that they otherwise would have, and arguably could have, done without. How do I know? It happened to me, and countless other women I have read about.

That being said, my two darlings, X-Man and Lollipop, wouldn't be alive today without cesareans. I developed cholestasis with X-man, a liver disfunction that can cause stillbirth in otherwise healthy fetuses. My doctor let me labor for 40 hours before he became distressed and was taken. He spent 4 hours in the NICU with respiratory distress before being returned to me. Lollipop's water broke and after 48 hours of trying to jump start labor with Pitocin, I would not dilate and she went into distress. My VBAC (vaginal birth after cesarean) had failed.

I'm not here to be a martyr for natural birth. If you had a cesarean, loved it, and would schedule another one for every future baby, that is your prerogative. This blog is not intended to shame, defile, or otherwise persecute c-section mothers. C-sections have and do save many, many lives. What bothers me is that c-section rates around the country have been on the rise for decades. In Texas, we are at 35% of births being via c-sections (according to ICAN network). Some hospitals have a 100% cesarean rate.

What are we telling women in this country when one third or more of us don't have a normal, uncomplicated vaginal delivery? We are telling women that their bodies don't work and not to trust their instincts. We are telling women that they need expensive, invasive procedures to insure that they do not kill their infants by entertaining the idea that they know what is best for their bodies and babies.

This is where I am…

Even though my c-sections were medically justifiable, I cry every time I think about them. I can't look at my scar. I can't touch it. My husband can't touch it. I get nauseous when I put the slightest pressure on it.

I feel broken. Lost. Physically in pain. My body is not my own…

This is what brought me here.

In one year, I would like to start trying to conceive (TTC) our next baby. I have a huge, what feels like insurmountable, obstacle in front of me. I started writing to help process my feelings about what has happened, and to hold myself accountable for the changes I feel need to happen to get me to my goal of a successful VBA2C (Vaginal Birth After 2 Cesareans).

If you are reading this, you are reading a part of my journey. You may be a mother or mother-to-be yourself, looking for answers. I don't have all of them. All I know is that I am in a vulnerable place, as are many other women in similar situations. I may write about things that trigger uncomfortable emotions. You may feel anger or sadness, shame or frustration. Do not take those feelings out on me. Trolling the wounded does nothing. I welcome your comments and questions. They may serve as inspiration for me to open, learn, and share more. To relax more, to trust myself more. However, under no circumstances will I tolerate shaming, cruelty, rudeness, or fear mongering. Perspectives are different, we are allowed to disagree, respectfully.

So…I guess let's get started with the backstory: X-man's birth.