Still Birth Day Certified Doula
My journey into doula work started with my first birth. I come from a long line of natural birthers. My mother, grandmother and great grandmother all had unmedicated, vaginal births. So when I got pregnant, I thought it would go the same for me. It was in my blood, right? I researched about all kinds of birth, I took a birth class and made a natural birth plan.
At 38 weeks, we discovered that my baby was breech. I cried in the doctor’s office because it felt like my birth plan went out the window. I was terrified of having surgery. I asked my doctor about all of my options because I wanted to do everything I could to avoid a cesarean. He said they could try an external cephalic version the following week but if it didn’t work, they would have to do the cesarean immediately after. I spent the week at the chiropractor and using Spinning Babies exercises to change baby’s position, but none of it worked.
The day of my ECV had arrived. As they tried to flip my daughter around, her heart rate dropped. I remember how everyone held their breath in the OR waiting for her heart rate to return to baseline, but they determined a STAT c-section was necessary. I was able to get skin to skin with her in while in the OR, but I was in shock from the whole experience. One minute I was pregnant and the next I was handed a baby. I felt so disconnected from it all.
This led me into a deep postpartum depression. I was so full of anguish over my birth and how people kept telling me “once a c-section, always a c-section”. I was fed up with the lack of support for the birth trauma I went through and the feelings I associated with it. This is what led me to pursuing doula work.
I live in a pretty rural area, but found an agency of doulas in the city about an hour away. I didn’t care that I had to drive a long way, I needed to become a doula. I felt this calling. I began training and shadowed another doula for a birth. She was a first time mom who had a fast, unmedicated labor. I stood in the corner of the room, wide-eyed. I watched how the doula comforted her. I had heard so many stories, seen so many birth videos, but I had never seen it happen in real life. It was amazing! I continued doula work with the agency for about a year until one day the owners up and left. No one knew what happened. It broke my heart. The other doulas and myself had become like family. It was an all-around hard time. I had also been struggling physically with abdominal pain that was determined to be related to scar tissue from my cesarean. I sought out physical therapy and was able to get some relief from putting in the work. After all of this, I knew that I still wanted to be a doula so I chose to become certified through Still Birth Day. Learning about the bereavement aspect of birth was life-changing.
While I was working on getting my certification I was simultaneously working on trying to reverse my local hospital’s VBAC ban. I called the hospital, left them reviews and wrote a letter asking to reconsider changing their policies. After two years of not giving up, they listened!
I found myself pregnant again and it seemed like things were going to work in my favor. It had been five years since my first cesarean. I felt like I had a good team lined up for my birth and everyone was incredibly supportive. Halfway through my pregnancy, the pandemic hit and there was a lot of stress. My last client before my own birth was my best friend. Luckily being in a rural hospital, they still recognized doulas as essential members of the birth team. Despite all the craziness involved in the pandemic, my friend had a positive, natural birth experience. We had the same care provider so it was nice to see him in action. What a gift it was to be a part of her birth story, I couldn’t wait for mine.
You know how it is with the best laid plans. Not long after, I found out that this baby was also breech at 34 weeks. My doctor had mentioned that he was trained in vaginal breech birth, but it was against the hospital’s policy. I asked him what he would do if I refused the cesarean? He said, “well I wouldn’t be mad. It’s your right.” I wanted to try another ECV first. I felt that it would work this time around since we found out earlier than the previous time. My doctor did not waste any time setting up the procedure with someone who had a high success rate. He told me again, that if it wasn’t successful that he would have to recommend scheduling a c-section. That’s when I flat out told him “I am not scheduling a c-section.” I was determined to do everything in my power to avoid it.
Once again, I found myself walking in for an ECV and once again it failed. It felt like everything was playing out in the exact same way. I didn’t have to have an urgent surgery this time, but I spent the last few weeks of my pregnancy scared, crying and not enjoying it at all because of what was looming over my head. I tried all of the things to flip him around. And I mean everything! I researched vaginal breech birth and searched for a provider who was willing to take on a VBAC breech. It was met with a bunch of “absolutely not(s)”. But then I got a call back from someone who was willing to discuss it with me. Sadly, I wasn’t able to make it to that appointment.
A couple of days later I woke up feeling very off. My doctor wanted an ultrasound to check my amniotic fluid level since they were on the lower side at my ECV procedure. I had been having contractions for days already, but this particular day the contractions seemed more regular. I went about my day trying to ignore them. After the ultrasound, I stopped in at the chiropractor and then went to work. By the time the day was over, I felt like I couldn’t focus. The contractions were getting closer together. My husband was going to get some food while I jumped in the tub to try to calm things down. My contractions became stronger. I got out of the bath, scarfed down my sandwich and told my husband we needed to head to the hospital because my contractions were 4-5 minutes apart. There were so many emotions coming over me. I was excited that my body went into labor on its own but scared because I knew my baby was breech. I still did not want a cesarean. My doula was coaching me through contractions over the phone on the drive to the hospital. It was so hard to breathe through them!
When we got to the hospital, the nurse checked my cervix and said I was 1cm dilated but my contractions were coming consistently every four to five minutes. I cursed through them for hours. I screamed at my husband to turn off the music and stop touching me when they got stronger and closer together. The nurse and physician thought I was only having uterine irritability and they were probably going to send me home. However, when she saw that I was acting like I was in active labor she decided to switch out the contraction monitor. She seemed to be alarmed when the new monitor showed I was having contractions every two minutes. I was checked again, but I was only about 1 to 2 cm dilated. I continued laboring like this for hours. At one point I felt like I was going mad and I screamed at my contractions “go away!” I just knew that I wasn’t making any progress and all of my efforts in getting this baby out naturally were in vain. Eventually my water broke and my contractions did not let up. I reluctantly pushed the call light because I knew it was time to get this baby out. My doctor came in as I was on the floor next to the bed having another contraction. He waited patiently for it to be over before recommending the c-section again for safety reasons. All I could do was stare at him as I went back and forth in my head on what to do. I had labored for 24 hours and I was too exhausted to continue. I consented to one more exam after all that time. No cervical change. I cried in frustration. Why wouldn’t my body deliver this baby? I told them I was ready to have the cesarean, but made it very clear of the things I wanted to happen. I handed my doctor the cesarean birth plan I had made and he went to discuss it with the anesthesiologist.
Before I knew it, I was being wheeled to the same OR again while getting a second dose of terbutaline to slow the frequency of my contractions. I screamed as I was given the spinal. After hours of back labor, the last thing I wanted was to have a needle shoved in there. I was laid on the table and the drapes were lowered as I watched as my son was born. His head was difficult to get out. He was in a posterior, breech position (which is apparently not a good combination). He was given to me shortly after his initial checks. We were never separated from the OR to the recovery room to the room we stayed in. Even though it was a repeat cesarean, this time around I felt like I had actually given birth.
The hospital staff apologized that I didn’t get my VBAC and truth be told, it started to annoy me. I felt embarrassed. I couldn’t do it. Not only did I want to be an advocate for increasing access to VBAC in my area, but I wanted to be successful to prove that it was a safe option. My baby is three months old now, but I still have very complicated feelings about it all. I still have no answers as to why my babies are breech and I have been obsessively searching for reasons. I did all of the body work, I was healthy, I ate right, there was plenty of time between pregnancies and this still didn’t work out for me. I have been working on healing with talk therapy, but I continue to be frustrated. I have been in physical therapy as one of my biggest worries was having the same issues with the pain and scar tissue. So far I feel that healing is easier this time.
I’ve always been told that breech is a variation of normal, but almost no one treats it that way. I’ve been continuing my search for future pregnancies that I may have a VBAC breech provider. Statistically speaking, now that I have had two breech babies, I am likely to have more. And believe it or not, I found a supportive provider. The doctor has forty years of vaginal breech experience. We spent half an hour on the phone talking about my options for the future. He ended it by saying “when you get pregnant again, come to me. I will help you.” I hung up the phone and thought “what the heck just happened? Did I really find a provider who was willing to deliver a vaginal breech after two cesareans?!” While I haven’t fully come to terms with my first two births I do feel that I made the right decision with both of them. I’m relieved to know that I have choices and support for the future because that’s all I really wanted in the first place.
Initially I wasn’t sure how I was going to feel returning to my work attending births. Would I get sad? Would I show biases because of my experience? But everything that has happened has lit a new fire inside of me. Both of my cesareans have sent me on a journey of self-discovery. I may never have been brave enough to go on without them. I’m even strongly considered becoming a midwife now. I don’t ever want a mother to feel like she doesn’t have choices and not enjoying her pregnancy because of fear. Even though I have not achieved my VBAC, there is a reason for my story and it’s not over yet.
Do you love birth? Heck yeah you do!
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