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?

What Not to Say to Cesarean Mothers

After my first cesarean, I had to know what went wrong. I looked to every avenue as to why I did not have a vaginal delivery. My baby wasn't too big, I'm not ridiculously out of shape, I was generally in good health. WHAT HAPPENED?

In tears, I'm begging my doctor for an explanation. All she could say was, "You have a healthy baby, and you are healthy, too. If we had let you labor any longer that may not have been the case. Healthy mama, healthy baby. That is what I am happy about." I tearfully nodded as I left my postpartum visit with my husband and newborn. I tried to put on a brave face for all the soon mommies-to-be in the lobby. Big smiles! I have a health baby! I should be happy.

I would talk to my mom, my friends, my hairdresser, anyone who would listen and just cry about my cesarean. They all had the same thing to say:

"You have a beautiful baby, all that matters is that you are healthy, and the baby's healthy. Who cares how he got here?!"

My mother was also a little upset by me. "You were a c-section baby and it was SOOOO EASY!""I'd have a baby every time by c-section!" As if my disappoint was an affront to her delivery choice. She's the same way about formula, too, but let's not get ahead of ourselves.

I quietly accepted this, and stifled my grief as best I could. It's true. We are lucky. In other parts of the world, we both might have been dead. In another era, not too long ago in fact, we might be dead. I needed to suck it up and be thankful. After all, I have two friends that can't even GET pregnant. Surely I'm luckier than them. I had one friend miscarry; definitely luckier than her, right? I remember sitting in the speech therapist's office, waiting for our weekly oral motor appointment to help with X-man's nursing issues. I'd look around out the small children, so disabled from a genetic disorder or some other unknown circumstance. I cried and hugged my healthy baby. Surely, I was luckier than these mothers, right? How can my sadness even be justified by comparison to these other women? I felt guilty even feeling sad. I was disgusted with myself.

After Lollipop came around and my VBAC failed, I came to my postpartum visit seeking out answers. The OB that attended be in the hospital had mentioned that I had surgical adhesions from my previous c-section. Had this somehow caused a problem with Lollipop's position? I went in determined to get clearer answers this time around. Again, I was disappointed. "I know you were hoping for a vaginal delivery, but it didn't work out. As your doctor, I am just thrilled that we have a healthy mama and healthy baby! That's all I care about!" There is was. The number one sentence I loathed to hear.

We have to stop telling c-section mothers, "Who cares how the baby got here."

We hate it. Full Stop. Do Not Pass Go.

It makes us hate ourselves (We are selfish and ungrateful.)
It makes us hate our bodies. (We were too fat, too petite, too weak, too unprepared.)
It makes us resent our babies (They were too big, in a bad position, too weak, breech, multiples, had poor heart tones, broken waters, meconium in the fluid.)

While our rational sides can understand the facts of our birth, our emotional sides cannot.

Saying "Who Cares!?" completely undermines our grieving and healing processes. It marginalizes the loss of the birth story that we had written for ourselves from the moment we learned a life was growing inside of us. There are those who marginalize the importance of a birth story, but why is it that every mother whether 19 or 90 can so vividly describe her own? A birth puts a mark on your soul, and anything so momentous is worth value.

So to answer, "Who cares?"….Well, WE DO.

WE care that are babies were cut, wrestled, and separated from our womb.
WE care that we can no longer feel sensation in parts of our body.
WE care that we have a nagging sense of doubt.
WE care that we feel assaulted.
WE care that we are disfigured.

Most importantly…

We care that me missed out on a fundamental Rite of Passage. That's what hurts the most.

© Amy Swagman 2011

The Labyrinth of Birth, An Unexpected Journey

After plowing through my last reading assignment, I wanted to jump right into "Labyrinth of Birth" by Pam England. I was lucky to find Cut, Stapled, & Mended (CSM) in our public library, but was not so lucky with the Labyrinth. Before spending money on a book I wasn't sure I'd derive any value from, I confess, I read all the reviews on Amazon. Most seemed pretty crunchy with five stars praising its worth. Then there was the glaring single star review that said that the book was ok in the way of being arts fartsy, but was essentially a waste of money when it came to childbirth, spend your money elsewhere. Hmmmmm…I decided to try to keep an open mind, while quieting my inner cynic.

The mailman was knocking on my door the day I finished CSM, and I didn't want to lose any steam. I tore open the envelope and began reading what I expected was a mediative book on delivery; something to help me relax, go with the flow. The subtitle of the book says, "Creating a Map, Meditations and Rituals for Your Childbearing Year." I guess I thought it would be easy, if anything, easier than Cut, Stapled, & Mended. No graphic depictions of surgery or emotionally charged chapters. Just flowers and humming, swaying, and pretty pictures.

Boy, was I wrong. This book is hard. Not hard in terms of the words on the page, or the concepts put out. Hard as in real work. It is a book that is not meant to just be read, it is meant to be experienced.

Early in the book, you are asked to draw your own labyrinth, including foot prints, a threshold, and symbolic entry decor. Well…I decided I'd skip that part and do it later. I wanted to finish the book. Period. After that, I'd go back, do the drawings or dance naked in the backyard banging a tambourine or whatever.

Nope. Doesn't work that way.

WTF am I doing?!

Of course you can read on skipping the drawings part, which I did for a half a chapter. However, I felt like I was missing a connection I was supposed to be making. What Pam was talking about in the following chapters REALLY required you to not skip any steps. I soon realized if I tried to skip steps, tried to skip the work required to truly experience this book, I was missing the entire point.

Reboot to tonight, I did my first drawing and BOY WAS IT EYE OPENING. I actually started one and then scrapped it because I was pressing so hard when I drew that I snapped my crayon clean in half. Oops.

So here it is (don't laugh, I'm a crummy artist):

So many symbols, so many realizations

Okay let's talk about this. First things first, Pam recommends that you use a sheet of paper you can fold in your pocket to take with you and hang near where your birth journey will take place. I personally grasp concepts better when they are written large. I did my drawing on a giant post-it board, the kind that you use in meetings or to play Pictionary. She also recommends using pastels in case you make a mistake you can buff it out. Well, I hate pastels, they are messy and I had tons of other art supplies. Plus, I didn't want to spend more money. I am cheap. In hindsight, however, they were probably purposefully suggested. Looking at the illustrations in the book, the examples drawn by her students have this organic feeling; this smoothness and flow. I, on the other hand, used a Sharpie marker. While I was initially satisfied with it's clean, crisp look, I now feel that it looks very ridged and unforgiving. Hmmm….

(Inner thought to meditate on: The rigidity of the walls of my labyrinth. Is this symbolic of my anxiety and search to maintain control? Perhaps symbolic of my cesarean cuts, the tight line of the scar?)

This is a 7 circuit labyrinth, which is referred to as the "classic". It is the one that the book instructs you how to draw for your first. It is round which indicates it is feminine; a square is considered masculine.

Labyrinths can be left-handed or right-handed. The "handedness" refers to the first turn you make as you enter the "mouth" or entrance of the labyrinth. An initial right turn is associated with "Great-Feminine", while a left turn is associated with "Divine-Masculine".

I struggled with this initially, trying to decided if I wanted a masculine or feminine labyrinth. It seems like a person woman on a birth journey would naturally chose a the feminine. Honestly, I have never really associated with women, so I thought masculine might be a better option for me.

Then, I thought back to the times when I wanted women around me and how there were few, if any, present. I struggled to find women to be my bridesmaids, come to bridal and baby showers, and other traditionally female times. In a way, my journey mirrored Roanna Rosewoods from CSM, as she had the same difficulty of connecting with women. I feel really alone when I look back and realize that I essentially had good number of acquaintances standing with me up on by the alter when I should've been surrounded by my best friends. Roanna must have felt the same way at her blessing-way.

I didn't want this journey to be like that one. So, in the end I chose the feminine. Thankfully so, because that is the one the book teaches you step by step to draw.

Let's go, Ladies.

I tried to just draw and let it happen. You might ask why I chose the color blue for my lab when I was intent on trying to be more feminine. Truth be told, it's because I am hoping our next baby will be a boy. So, in honor of this symbolic journey to meet him, I chose blue. I also chose blue because I wanted the labyrinth color to be soothing like water.

The paths are supposed to be wide enough so you can trace them with your fingers while saying your mediations. Check. Before I added the other parts like the feet and vines, I thought my lab looked somewhat like a placenta. HARK! Am I on the right path?

Next you are supposed to add the feet at the entrance of your lab, about 2 inches from the entrance. I chose to make the feet red for multiple reasons. First, red symbolized the blood of the surgeries I have endured, and the hundreds of shots of blood thinners I had to take while pregnant. Red is also a powerful color, and I wanted my walk to be powerful and with purpose. After I drew them I noticed they were not square with the entrance to the labyrinth:

Which way are we going?

This WAS NOT done on purpose. I don't know what else to say other than my subconscious played its hand here. Shit is getting deep.

(Inner thought to mediate on: Does my feet not being square with the entrance symbolize that I am unsure I want to continue on the road of a VBA2C or to continue on the route of a scheduled cesarean?)

Next you are to draw a threshold, a symbol of transition and transcendence. I decided to draw a tangled vine of flowers. Firstly, because I feel I can draw a half decent flower. More importantly, I wanted the mess of vines to represent the complexity and convolutedness of this journey. The analogy of following a vine from root to flower rings very very true to me. One can easily be led astray by following the wrong curly-cue, and get tangled in a web of thorns, fear, and doubt. You're tempted to hack through to find the answers you want quickly, but that kills the vine. Your birth journey is both tangled and intertwined with other women and your care providers, whether they are doctors, midwives, or lay support. Sometimes your vine takes a divergent path than that which you or your provider wants. Are they going to force you to grow their way, pruning and securing you to the "trusted" path. Or are you going to curl off in a different direction, finding your own sun and soil? Yes, I feel a vine is apt.

Lastly, you are supposed to decorate the entrance of your lab with an image that holds symbolic meaning. I chose to draw an old-fashioned key. I chose an old-fashioned key because I feel like it symbolizes the wisdom of women who have already completed this journey, who can help us younglings to find the tools we need to be successful. I chose a draw a red ribbon on the key to again, emphasize the femininity of a beautiful ribbon and power in the color red.

Women are the key to finding the answers needed on this birth journey.

Once the lab is completed, you are supposed to trace it, slowly and purposefully. Again, in a rush to get an item checked off my list, I tried to race through to make sure I didn't make any mistakes. I got lost, the lines ran together. I started again. I moved too fast. I got lost again…and again…and again…………….and again. That's when I went back to the book to see what I was doing wrong. You are supposed to go SLOWLY with your non-dominant hand, while saying a mediation. I decided to reserve the mediation for later, but I proceeded with an eye roll and a sigh to use my non-dominant hand to slowly trace the labyrinth. "This is stupid," I was thinking. "What difference does it make what speed I go, it's all going to just run together anyway.""In, to the center, turn around back out again, right?"

Well, not exactly. What I found really interesting (and perhaps personally symbolic) is that I not only did NOT get lost when I went slow, but the path went differently than I thought it would. I mean intuitively, I thought I would enter, then sharply go to the outer most circuit, working its way to the innermost circuits and back out. What really happened is that you are almost tricked into thinking you are taking this shortcut to the center before you are swung back out into the outer circuit. This realization was probably the most symbolic discovery of this whole exercise. It was teaching me that I was looking for a quick answer to the middle, to the birth I wanted. But that is not how this journey works.

No shortcuts on a spiritual journey.

I truly have many things to think about.

The Seemingly Insurmountable Goals, The Mountain Before Me

Lai Tzu once said, "The journey of of 1000 miles begins with one step." Creighton Abrams famously stated that in order to eat an elephant, you must take one bite at a time. Why is that first step so hard? I've been procrastinating over an hour trying to even figure out how to start this very post.

Everyone seems to make New Year's resolutions that are tossed aside almost as quickly as they are formed. "This year I am going to eat better, exercise more, save more money…" they all say. By February 1, we are back to our old habits: eating ice cream in front of re-runs, paying for gym memberships we will never use.

When I got pregnant with Lollipop, I vowed to do better, to try harder. But somewhere in the middle of managing a very active one year old while feeling constantly exhausted during my pregnancy, I mostly gave up. I did some things better, but for the most part, I failed.

I FAILED. Full Stop.

I let my daughter, Lollipop, down. I let my husband down. I let my doula down. I let myself down. I gave up.

Now here from the ashes, we are brought to believe we can rise, be reborn. Be a phoenix. I'm no phoenix. I have the willpower and patience of most my generation, which is nil. At best I'm a one eyed, single eared, three-legged dog named "Lucky". Good things that happen to me, well they happen to me by good luck. Bad things that happen, well those things happen because I am lazy, slovenly. I want miraculous changes without miraculous effort.

For seven months I have had a list of things to achieve to attempt optimal conditions for my VBA2C. And what have I done…pissed away seven months.

Oh, now don't be gentle with me and make excuses:
"Oh you were recovering from surgery, you needed 2 months at least to get over that!"
"You have two children under two years old, you're doing great if you shower everyday."
"Once the kids are a little older and more independent you'll get on track fast."

Nope.Nope.Nope.

I'm so paralyzed by fear that I can't even write what my goals are. I'm sitting here quibbling over word usage and grammar. Sigh

Deep breath.

If you write a goal, it's out there for the world to see. If you write a goal, there's accountability. Just another thing to disappoint myself with if when I give up.

Deep breath.

After my VBAC failed, my doula came to visit me. She spelled out some things I should try if I were to attempt another VBAC. They are as follows:

1. Join my local ICAN support group and attend the meetings.
• To date I have liked their Facebook page and attended ZERO meetings.
2. Read the following books: "Cut, Stapled, and Mended" by Roanna Rosewood and "Labyrinth of Birth" by Pam England.
• To date I have successfully NOT lost the scrap of paper these titles have been written on.
3. Contact a local midwife that specializes in assessing pelvimetry to see if what my OBGYN said to me after my births is true: (that I likely had a small pelvis inlet, which is why my babies didn't "could not" descend into the birth canal.)
• To date I have followed the woman's Facebook page and checked out her website. Before I see this lady, I must obtain my surgical reports from my doctor. So this is a double demand.
4. Attend a Red Tent event hosted by our local midwives and doulas. A red tent is "a space where women gather to rest, renew, and often share deep and powerful stories about their lives." The Red Tent movement is changing the way that women interact and support each other by providing a place that honors and celebrates women, and by enabling open conversations about the things that women don’t want to talk about in other venues
• To date I RSVP'd for 2. Bailed out on the first one, the second one is happening soon.
5. Contact our local "Curandera". If this sounds like hippy dippy bullshit to you, allow me elaborate. Our curandera specializes in scar mobilization, Maya Abdominal Therapy, and postpartum support in the way of standard massage techniques, herbalism, spiritual support, and down right badassery. The goal being to help my scar to heal flatter, and promote internal relaxation of the pelvic organs by reducing surgical adhesions. 
• Arguably my most tackled step. To date I have listened to her give two talks. Liked her business page on Facebook, "friended" her on Facebook, spoken with her via private message and email briefly, purchased a massage certificate to redeem, asked her to meet for coffee. (unfortunately she was too busy :-/ ) AAAnnnnnddd, I told her about this blog when she checked up on me. She knows my PPD (postpartum depression has be by the throat.)
6. Find a new birth provider that supports me in having a VBA2C.
• This requires me to find a new doctor and a new hospital. To my knowledge, the only hospital that openly supports VBA2C in our city is the dreaded county hospital, Ben Taub. (more on this eventually, I'm sure.)

That's a tall order for an anxious, lazy ass like myself. These items are on top of my personal goals:

1. Loss weight to the tune of 20 pounds. *groan*
2. Exercise twice weekly. *Louder groan*
3. Talk to current OBGYN to assess my pelvic floor damage *Loud, painful groan with a bowl full of embarrassment*
4. Learn to relax, stop being hyper-vigilant ALL THE TIME. 
• This is arguably the toughest goal. I am high strung by nature, and probably should be getting some kind of treatment for my anxiety. I had my first panic attack in 3rd grade. How do you change something so ingrained in your personality? I used to take medication, but I didn't like the way it made me feel. I have a master's degree in clinical psychology, so I have the knowledge necessary to continue to skill build in this area. I work regularly to check in with myself to see how I am holding my body. I catch myself locked up at the shoulders and jaw almost every time I check. I am even tense while sitting on the toilet. I'm so locked up tight. My poor husband; my lady parts are essentially closed for business. It's just too painful.
5. Correct my separated Diastatsis recti. Which look something like this:

"Yea, a picture!"

I'm currently at a 2" separation (This is not me by the way)

I have been assessed, and have located a trainer. I have not joined the program.

As you can see, I have quite a list in front of me. Some of these steps are hindered by fear of failing. Will I invest all this time and energy only to end up on the operating table a third time?  Other hindrances come in the form of logistics (how on earth am I going have a pelvic exam with 2 little ones), and financial barriers (skills cost money, and they ain't cheap.) Is their such a thing as vagina scholarships?

In the coming weeks, I hope to explain to you why these goals are important for a VBAC journey. This post has already gotten out of hand in length. So I better call it quits for tonight.

The Birth of X-man: Unplanned Cesarean #1

X-man was my first pregnancy and I couldn't be more excited. I did everything most moms-to-be do. I read a million books, signed up for those ridiculous "your baby is the size of a lemon this week" newsletters, read all the safety product websites.

I had read a number of natural child birth books and knew I wanted a drug free birth. I had read that epidurals slow down labor, and can often make breastfeeding more difficult after the delivery. So, like many mom's to be, I wrote a detailed birth plan and made multiple copies so the nurses attending the birth would know my wishes.

Some might ask why I opted for a hospital birth if I wanted a natural, drug free birth. The answer is a complicated one. First of all, prior to getting pregnant, I really didn't think about having a baby anywhere else. I live a stone's throw from one of the country's largest medical centers. Houston is supposed to have the best hospitals in the country: MD Anderson Cancer Center, Texas Children's Hospital, Shriners Burns Hospital, TIRR. I can go on and on. I had done a little reading about home births, and at that time, they just didn't feel safe enough for me, even though their safety is on par with many hospitals, if not better. I had never really considered giving birth any place but a hospital. That's just what "you do". (I know now there are more options but let's not get ahead of ourselves).

Another reason I opted for a hospital birth was because I was considered "high risk". This to me, has been the biggest setback. About 8 years ago, I had a simple knee surgery. Later that week, I had a blood clot form in my leg, break off and go into my lungs. The ER doctor said he didn't know how I was up and talking to him, I was in critical condition. I spent a week in the ICU on clot busters. I was told "once a clotter, always a clotter."They warned me when I was pregnant, that the estrogen in my blood would cause it to thicken and possibly clot. The clot could kill me, kill the baby, kill us both. I would need to take Lovenox injections throughout my pregnancy, and at least 6 weeks postpartum. I met with a high risk OBGYN at the Baylor College of Medicine and started getting twice daily Lovenox shots to the stomach as soon as my pregnancy was deemed viable. They burned like fire, and my husband had to give them to me because I could not bring myself to. I was covered in bruises from them, but it was a small price to pay for my sweet boy.

X-man caused me other problems, mainly I was sick sick sick. I vomited so much for the first 5 months that I lost 10 pounds. Looking back, I'm surprised I wasn't diagnosed with hyperemesis gravidarum. I couldn't smell anything without vomiting. My poor husband had to eat half his meals on the front porch because the smell made me so violently ill. I vomited at home, I vomited at work, I vomited in the car, I vomited in the shower, I.vomited.everywhere. A shampoo, a perfume, all food, even my husband's breath would set me off. Even the sound of someone burping or making fake vomiting noises would set me off. It was awful. I was prescribed an anti-vomiting medication that was typically given to patients getting chemotherapy. I was scared to take it, I used it sparingly not only because I was afraid of the side effects to little X, but also because each fill of the prescription cost about $100. I was laid off at 5 months pregnant, on COBRA, and simply couldn't afford it.

At month 6 I was feeling better, I finally had "the glow". I was actually glad I was not working at the time so I could rest a little bit and recover from all the puke. We took our Lamaze classes and got an A+, same with breastfeeding and newborn care. We were prepared! We were going to do this!

The rest of my pregnancy was uneventful until about week 36. I started itching on my legs uncontrollably. I had had so many minor "pregnancy related" rashes, aches, and pains that I blew it off as just another normal pregnancy symptom. Since I was hitting the OB weekly at this point, I kept meaning to bring it up, but it slipped my mind until the week 38 appointment. My OB was literally walking out the door for her next appointment when I said, "Oh yea, my legs have been itching so bad! Pregnancy! Am I right?!" She almost literally threw down her clipboard and ran back into the room. She looked at my legs, saw no rash and immediately sent me upstairs for an emergent blood work collection. She feared I had a condition know as intrahepatic cholestasis , which can cause stillbirth in otherwise healthy fetuses. I was terrified. The blood test takes a week or so to come back and my due date was approaching fast, so my doctor told me to contact her immediately if the itching got worse or if any new symptoms came up. She also advised me to stop taking my blood thinners, in case we had to do emergency surgery.

Week 39 rolls around and I am still on edge. My doctor is still waiting on the test results but sends me for a for a biophysical profile to check how X-man was doing given that I might have this liver issue. During this profile he had to take so many " practice breaths" in a time frame or I would be whisked off for an emergency c-section. That turd held his breath until the last minute of the test and got his numbers in just in time. He appeared fine, so they sent me home with the same instructions: Any changes, worse itching, call immediately. The ride home was hard, so much worry, apprehension. When was he coming? Where they going to have to take him? Little did I know that I was already having contractions.

Later that day I was sitting at home and my hands just started to itch and burn. Burn like they were on fire. I told my husband, called my mother, and she told me to call the doctor. I left a message with the answering service and got a call from my doctor to come in immediately to be induced. She was not taking any chances.

We checked into the hospital at around 11 p.m. I was 2cm and 50 percent effaced. My contractions were mild and regular. They decided to augment with Pitocin, which I agreed to out of fear of what the cholestasis was doing to my baby. I labored an entire 24 hours without much progress. I was hooked up to so many monitors, including a balloon-like catheter inserted into my cervix to help open it, that moving around was difficult. I wish I would have moved more in hindsight, although doing anything with a giant tube jutting out your vagina is damn near impossible. That tube insertion was more painful than any of the labor I had had up to that point. At about hour 32, I had gotten to about 5 cm and the doctors thought that an epideral might help my cervix relax. I was exhausted. I had not been allowed to eat for over 24 hours, finally I was allowed a popsicle and some jello. Labor was starting to get much harder at that point, so I told the doctor I would think it over. Then the vomiting started. I vomited my jello and everything I had eaten prior to going to the hospital. The pain was getting pretty intense, so we flagged our nurse to check the status of the anesthesiologist, as we had agreed to move forward with the epidural. He came by, saw that I had a history of clotting, and put everything on full stop. He would not do the procedure because he read that I had been taking blood thinners. We advised him that it had been over 4 days since my last dose (this drug has a half life of 12 hours). He would not take our word for it, and demanded a blood test to be sure. So we had to wait over an hour for someone to get the blood and then get the test results back because we were on a weekend night shift. Talk about adding insult to injury. The contractions were very bad at this point, the old man was grumpy about being on call I suppose, so he fussed at me continuously to hold still and stop jumping. I don't know about him, but having a giant needle shoved in your spine while simultaneously having souped up Pitocin contractions, all without the support of your loved ones was not the easiest thing to have happen to you. The man was a total jackass. During this time, they had to insert a catheter into my bladder to help me pee since I would lose all sensation to go. They also tried multiple times, unsuccessfully to attach a monitor to X-man's scalp to watch him more closely. It kept coming out, and caused unreliable readings on the computers.

After the epidural I was finally able to get some sleep. Unfortunately, the epidural slowed down my labor, so they cranked up the Pitocin to the max dose. I was numb from the chest down. I hated it, I felt out of control, but what could I do? I was in a half doze when I rolled myself from my side to my back to get more comfortable when a team of medical people came crashing through my door. People were yelling out orders, checking monitors, grabbing my tubes. What was going on!?! Apparently, when I rolled over, he had had a massive deceleration in his heartbeat. It had come back up when they all came crashing in. No one was happy. My doctor came in and told me I had fought the hard fight, I had been in labor 40 hours with no real progress, and they needed to take him. I was devastated. My husband talked and I talked it over for about 5 minutes, called our families to let them know, and started to prepare for surgery.

The room was cold, I shivered so much. I was so exhausted, so ready to meet my baby. My husband was at my head so nervous; tears in his eyes after all that he had witnessed me go through for our son. The surgery was quick, they told me, "he was out." The doctor lifted X-man over the sheet, or at least tried to, I couldn't see him and I cried. Then I started asking, why wasn't X-man crying? I knew something wasn't right because babies always cry at birth to clear their lungs. When I said it twice more and nobody said anything, I started to panic. They had moved him over to a side incubator, and got him crying finally. Hubby was joyful, I was so happy I could finally see him, even if it was across the room.  I continued to shiver quite violently, despite having heaps of warmed blankets on me.

We were informed that X-man had to go to the NICU because he was having difficulty breathing despite being a good 8+ pounds. My husband was torn between leaving me alone, and going with our sick little boy. Our plan had been that he was never to leave me, but that all went out the door when I saw that little baby. I was able to give X the quickest of kisses and send him on his way with Daddy. I cried and cried.

They moved me into recovery and my mom was there waiting. I continued to cry for my baby, but I wasn't able to see him. My recovery nurse told me I had been through a lot and I should just rest. I was adamant, I wanted to see my baby. She very rudely told me that hospital rules said that I had to be 12 hours out of surgery before I could go to the NICU. For the first time in this whole ordeal, I stood up for myself. I ordered her to get my doctor on the phone to release me to my baby, or I was going to climb out the bed and cause all kinds of problems for her. She came back a few minutes later and said my doctor said I could go see him for 1 hour. The nurse went and got a wheelchair and said that I could go if I could get myself into the wheelchair. In hindsight, I can't even believe I am writing this. I just had major abdominal surgery and you are asking me to get out of bed on my own to climb into a wheelchair?! She was furious that I had put her out! At the time, it didn't sink in that this was a ridiculous request. I had mommy bear blinders on. I would have crawled through broken glass all the way to the NICU to see my baby. I guess she thought I'd give in and say I couldn't get up. Instead, I threw my legs out of bed and made an attempt to stand. She couldn't just let me fall, so she helped me get in the chair while exclaiming "Wow, you're strong!" I just glared at her. It had been 4 hours, I still had not seen my baby, and I had cried the entire time.

I met my baby in the NICU that evening. He had an IV in, and a little cast on to hold it in place. He had a heart monitor and a cute little crocheted hat. The NICU nurses said they had to really search for him a hat because they weren't used to having such a big baby. We finally got our skin to skin and I cried and cried. Everyone had met him before me. My inlaws were in the room, my best friend, everyone. I was so jealous they got to be with him before me. I tried to nurse him, and my husband tried to help by giving me my boppy pillow. When he shoved it in place, it hit my incision and doubled me over. I didn't care. I was holding my baby and he was hurt and scared. He needed me. I held him the entire hour until they took him from my arms. I cried all the way back to my room, like a broken human being.

X-man was supposed to spend 24 hours in the NICU but was able to leave after spending a good part of the night there. Our hospital had a policy of keeping baby with mama, so he was wheeled into my room. I was so relieved.

In the following days, he rarely left my arms. However, a dark cloud started to descend over me. What had gone wrong? Why did my body fail me? I had maintained a healthy weight. I had read all the books. I had a plan.

What was wrong with me...