Thursday, January 17, 2013

Shridam's story

As told by his mother Dhanya.




















We wanted to have a homebirth with our first son but couldn’t afford it. He was a week late and we declined to go in for an induction that Friday but then non-stress testing said the amniotic fluid was low so we made an appointment to go in at 5am the next day to be induced. I went into labor Friday night and things were picking up steam when we got the hospital (My mom, husband, doula and myself). We labored pretty naturally for most of the day and didn’t get any pitocin until the evening. The back labor was pretty intense.

Then after a totally refreshing nap compliments of Stadol, the nurses woke me up and I hopped into the stirrups to push for about 2.5 hours. I saw baby’s head in the mirror! Dr.Koh came in and saw that the baby was OP so he got us all to prepare for a C-section. Dasaratha was 9 lbs 6 ounces, 21 inches and super awesome. Champion nurser.

 • Shridam was due September 16th, 2012. We didn’t want to have another C-section this go round and now we were in a position to afford midwives. We interviewed a few groups and went with the same midwives a couple people we knew had delivered with. We saw them for the regular checkup stuff, heart tones, measurements, weigh-ins, etc. and my seemingly endless list of questions about homebirth, pregnancy, transfer and nearly everything else under the sun.

 • For backup we saw some hospital midwives who work with M and R and take care of some of their transfers. I went to their clinic for all of the blood tests and ultrasounds. I had endless questions for them too. I was told by them and our homebirth midwives that we would transfer to that hospital in case of something like exhaustion or dehydration but that for an emergency emergency we would go to Heywood, the hospital 20 minutes from my house.

 • The pregnancy covered the best summer of my life, my husband, our toddler and everyone we knew was just so happy and excited that we would be getting a little baby boy. Stava and Dasaratha were able to accompany me to most of the prenatals this time which was really special. I was crazy healthy and felt great.

 

 • We went into labor Friday night but it stopped as soon as M got there. She left and told me to try to get as much rest as possible before things picked up again. I had light contractions until Saturday evening when things got hot and heavy and the two midwives came over again. We had my grandmother take Dasaratha to his Uncle and Aunties while we set to laboring. I see the hand of the Lord in that because we had considered having him babysat at our home but couldn’t think of anyone to watch him.

I labored leaning on Stava and moaning with him for awhile, at a certain point I was saying, "These contractions are stronger than me, I'm not handling them well," and I decided to get into the tub. What GREAT relief! In my first labor I kept wanting to take a shower but we couldn’t get the monitor wet so I opted for Stadol instead. Anyways no back labor this time, baby was in perfect position very low, NOT occiput posterior (I was super afraid he would follow suit like his brother and religiously did my positioning exercises while pregnant).

They checked his heart rate regularly the whole time and he was happy as a clam. We put on the birth CD my friend had burnt for us. The water made contractions so much more manageable, Stava was in there with me sometimes I would lean on him sometimes I grip the sides of the tub and stretch out. Eventually I felt the urge to push and started to do that. I was a little insecure thinking I didn't want to push if I had a lip of cervix so I hopped out of the tub and had my midwives gives me an internal exam (the first and only). I was 10 cm so I hopped back in the tub and began to push for all I was worth.

Pushing was about 2hrs but isn't seem very long at all, not like Dasa's. No one was yelling at me; I pushed not on every contraction but when I got a "good pushing one" I would say, “This is it!” and grip the side of the tub stand up on my knees and holler and push. I reached down and felt baby's soft head, it was awesome then I had Stava feel too.

The midwives were checking his heart rate with the Doppler pretty frequently now (I appreciate that now but at the time it was sooo uncomfortable!) and it was right where it was supposed to be. I vaguely remembered being blood pressure cuffed throughout the birth but I didn’t pay that much mind. Sometime during the pushing I felt the water bag POP and the midwives rushed over to the birth tub with maglights to check the amniotic fluid; it was clear.

At some point I felt like my pushing was becoming a little less effective and the midwives suggested I hop onto the birth stool. That REALLY directed the pushing energy, 2 or 3 pushes on that and I had his entire head out! I was done at that point, I asked if I still had to push because I had read birth storied where the midwives help ease the body out of the exhausted mother and though that sounded good I said, "Do I need to push anymore?" My midwife said yes, "You need to push with everything you have." Then they said, "You need to get on hands and knees."

*Sh*t* I had read enough birth stories to know that meant shoulder dystocia. I got onto hands and knees and pushed hard, thinking they would be able to hook him and pull him out. They told Stava to call 911 and then had me get standing upright to push. Then I was lunging, standing, hands and knees, on my back with legs pulled all the way back and supra-pubic pressure applied. We tried all these positions rapidly AGAIN and AGAIN. M and R were taking turns trying to hook the baby, and alternating putting the oxygen on his face and then on mine. I kept screaming, "I can't push anymore," because I was exhausted or "I'm still pushing!!!" because I WAS still pushing and felt no give from the baby.

I screamed a lot and there was blood everywhere, all over me, saturating the floor. Stava said, "They had to tear you apart to get to the baby." I didn’t know it at the time but Stava then left to flag the ambulances at the end of the drive. He feels like he didn’t do anything to help the situation but they may never have found our hidden drive on that dark and rainy night if he hadn’t gone out there. We just kept going in those positions. It was excruciatingly painful, I screamed and screamed and pushed and pushed.

Eventually the ambulance and EMTs arrived. I thought we were going to go to the hospital, I was screaming things like, “Can we got to the hospital now? Get him OUT!!! but the EMTS and midwives told me I had to deliver the baby first. I hadn’t expected that. The EMTS were really awesome; they took over the oxygen and focused the midwives saying, “You can do this, you can get this baby out.” FINALLY he came out, with me in the hands and knees position, at 1:42am on Sunday, twenty minutes after his head had been born.

He looked so small, and even though he was all pink and peach, without a tinge of blue on him I could tell he was lifeless. He was so limp and floppy. Shridam wasn't breathing and had no pulse. The EMTs began CPR and intubation immediately. I was sure that he was dead.

My own heart rate was at 200 and the EMTS were instructing me to focus take deep breaths, calm down. The midwives gave me two shots of pitocin in the thigh and some Chinese herbs to stop bleeding. We each got loaded onto an ambulance. I nearly passed out as they took me down the stairs, because my oxygen mask had fallen off. Stava and all but two of the EMTs (we had first repsonders from like 5 towns) piled into Shridam’s ambulance and R and two EMTS went into mine.  As I rolled past Shridam's ambulance they told me he had a pulse. I couldn’t believe it, I was so relieved. It came twenty minutes after he was fully born and they started working on him.

From there we went to the ER at Heywood, Stava was sobbing on Shridam’s side of the room and my heart was stricken fearing for the worst. They did all kinds of things for him, that I’ll never know the whole of, they managed to get an IV in his belly button.

They gave me three IV ports and pumped me full of blood, pitocin, morphine and two kinds of saline water. My placenta still hadn’t come out so two nurses massaged my stomach almost right down to the bed and Dr.R, come down from the maternity ward, reached in and grabbed it by hand, delivering the whole of it successfully. I had 3rd or 4th degree tears (I would hear from doctors in the next couple days) and Dr.R stitched me up into a, “patchwork quilt.” It hurt so much because apparently, like novocain, litocaine is totally ineffective on me. R was in with me but they wouldn’t let M in and I was so out of it I didn’t really care.

A few hours later we both transferred to a bigger hospital with a level 3 NICU, and they cooled Shridam’s body for 3 days to try to keep brain damage as low as possible, but his brain was just completely gone, 40 minutes of oxygen deprivation was too much.




















He was 23.5inches 10 pounds 15.4 ounces when the weighed him.

I finally got to hold him when he was 3 days old. He never cried and could only move his arms and face a little. The told us his EEG and MRI showed no brain activity and that he would not live for long. That Friday he managed to knock his arm into his ventilator tube, unpositioning it. We decided not put it back in and he breathed on his own until early Sunday morning when he gently died in my arms, one week old. There are many other stories and miracles that accompany his short week of life, but they are too numerous and hazily remembered to list here.

Friday, January 13, 2012

Magnus's story



As told by Sara, his mom, 9 months after his birth, “life”, and death.


With my first pregnancy we were seeing a local OB. The waiting room was full and waits were long. I felt more like I was part of a large herd of cattle than someone receiving personal, informed, nurturing care. I had no idea which of 10 doctors would show up at our birth. We decided to take classes to prepare for our hospital birth at a local birth center. We were welcomed with open arms and the feeling was far more personal in nature. We learned about many things there…among them. “Birth is as safe as life gets, birth is normal, and that babies know how to be born and moms know how to give birth.”

Likewise we were taught about the evils of the medical world, but in subtle ways. We learned about the, “cascade of interventions, the way doctors over use/depend upon technology for convenience and profit, and how their interventions were not in our best interest. Weeks before my due date, I panicked, terrified of having our baby at the hospital. We hadn’t planned on the cost of birth center birth. After three days of crying, my husband and I decided on a compromise, we would hire a doula from the birth center to attend our hospital birth. The difference was paying $800 instead of $3800. Things went fine and our first son was born without issue in 2008.

Upon learning we were expecting our second baby; we sought a different model of care. We wanted an environment that knew natural childbirth well and how to support moms during the course of labor. We wanted an environment and a staff that viewed birth as natural and normal first, knowing well that things can quickly change during pregnancy and labor, requiring a referral to an OB or the hospital. We liked the idea of knowing our caregivers well, and the fact that they knew our family well as opposed to being at a large practice like our previous experience. I wanted to know who would be present at the birth and I wanted it to be someone we knew well, a personal connection if that makes any sense.

We chose a freestanding birth center (meaning no oversight by a physician or hospital, although they did have an OB that they often referred to and often spoke of mom’s who transferred care to the hospital.) It was our impression that choosing the birth center was a “happy medium” between hospital and homebirth. Essentially what we had unknowingly chosen was a homebirth in someone else’s “home”. It never occurred to me that this was the case until too late and I never thought to research homebirth before our baby’s birth. We also found out far too late that none of our midwives are insured, something that would be paramount in trying to hold them accountable later.

At about 32 weeks we were told that our baby was in the breech position. We were given a list of things we could do to try to help the baby turn including homeopathic remedies, the pelvic tilt exercise, chiropractic care, and swimming. We did them all. As we continued to go to our appointments, each week we were told something different. One week Magnus was head down and the next he was not. It was an emotional roller coaster to say the least. I kept asking if there was something I should be reading to learn more about breech birth and I was repeatedly told not to worry yet as many babies turn, some even during labor.

At 37 weeks we asked for an ultrasound to see what position the baby was in. We had an appointment that day with our midwife S. and she was fairly certain baby was breech, but we wanted to see for sure since just days ago a different midwife thought he was head down. The ultrasound showed that he was indeed in the frank breech position. The ultrasound tech took some other general measurements, like the amount of amniotic fluid, but was not asked to estimate baby’s size or weight or check for cord or head positions, which we later learned would be critical information to have checked in considering candidacy for vaginal breech delivery.

At 38 weeks we knew we would be asked to make some decisions about our baby’s delivery. We thought our choices would be to schedule a c-section or consult with a well known midwife who had experience with vaginal breech deliveries at home. At that appointment with C., CNM, I was first asked if I had any thoughts about delivery for a baby in breech position. I had done a small amount of internet research on the topic just because I was nervous during all of the flip flopping this baby appeared to be doing.

I knew I did not want to schedule a c-section, that if I did in fact need one, that I preferred to go into spontaneous labor before the procedure took place, believing that would be better for both mom and baby. I also knew I did not want to try doing a version. We were surprised that C. offered us the option of having a vaginal breech delivery. I say surprised b/c leading up to this appointment it was always a given that they did not attend breech deliveries at the birth center, they would typically refer the client out. We had been told that they don’t take on high risk pregnancies and could spot trouble long before it was critical…that they would transfer if they needed more support.

At the time I was relieved at being given the option b/c we had went so far out of our way to seek their care and wanted to stay. At the same time, I expressed my biggest concern in all of this being the baby might be too big for me to deliver or his head getting stuck. I don’t know why that was my thought, but it was there. Her response was that she estimated Magnus’s birth weight to be about 9lbs and since I had delivered Jonah at 8lbs 12oz I would be a good candidate for a vaginal breech delivery. She also said that breech babies usually “fall out” once their bottoms had come out and that she thought the hands and knees position would be an important part of delivery.

I asked her specifically what she would do if indeed he did end up getting stuck and her reply was, “She’d have to get him out.” She told us that breech babies are, “Just a variation of normal and that as long as there wasn’t anything odd or troublesome that delayed labor, then we could have the baby there and not be transferred to the hospital.” That’s it. No discussion of what could go wrong, no indication that it could turn out in such a devastating way as it did. We did not know fully understand the severity of risk we were taking on.

I then asked about research and safety. C. told us about recent research from Canada that suggested that vaginal breech delivery was better for moms and babies, and just as safe as a c-section. Before our appointment, when I had done my bit of research on the topic, there did seem to be a trend in support for a comeback in vaginal breech delivery as well.

I asked about their experience with vaginal breech delivery and they had attended one birth in this fashion. She said that some of the midwives and staff at GBC had attended a conference in Canada about breech delivery and that they felt confident in attending this birth.

I asked if we should ask Pat (the aforementioned midwife who is quite experienced with vaginal breech deliveries at home) to attend this birth at the birth center, just to have someone else there who knew more about this sort of delivery. I was told it wasn’t necessary, but if we wanted to, we could ask her to come. Our impression at this point was that there were no more risks with doing a vaginal breech delivery than there would be with doing a c-section delivery. I asked about what I could be reading to prepare myself for this type of birth and I was told there really wasn’t anything available.

As we drove home, I asked Jarad how he felt about all of this. He said that we had chosen them to be our caregivers for good reason and they had taken excellent care of us up to this point. In essence we should trust their judgment being the professionals. And so, we let that be enough. In hindsight, we should have pushed more about specific risks involved, but didn’t really know what else to ask.

I knew from my little research that there were certain criteria that healthcare professionals use to even consider someone a good candidate for vaginal breech delivery, but I did not read about all of the things that could possibly go wrong. Being 9 + months pregnant, it was not a place I was mentally able to go. I put my trust in them as professionals, trusting that they would refer us if we were in any sort of danger. I have to also say that looking back, if we had any idea we were putting Magnus in danger we would have insisted on being transferred in a heartbeat. It never crossed my mind even for an instant that our decision to have a vaginal breech delivery could or would end like this. I feel like we were allowed, even led to feel quite comfortable in this decision, without any indication or education about the severity of risks we were facing

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At 3am on April 8th, 2011 my water broke. It was right on time, considering my due date was April 7th. I awoke from sleep realizing what had happened and called C. My contractions weren’t very strong yet or timely so I tried to go back to sleep. By 6am we were headed to the birth center. Things were becoming more intense quickly. I naively thought we’d be home by lunch time.

We got ourselves settled in at the birth center and tried to relax. Shortly after I was there they assessed baby’s position and thought he was head down. Relief! At about 7:30a I got up to go to the bathroom and came back reporting that there was some brown discharge. She said this was probably meconium and that baby could in fact be breech. We went along as planned and by 9am I was pushing.

I spent most of the time pushing on hands and knees on the bed with little progress. More meconium indicated that he was breech. I pushed and pushed for hours with no progress. By around noon I told Jarad I didn’t think I could do this anymore. C. decided to check me at this point and realized then that my cervix wasn’t completely dilated. I had been pushing against my cervix for at least three hours. She tried to manually help the “lip” recede and I tried a few different positions.

Our last effort was to get into the tub to help me relax. She said if that didn’t work that I’d have to transfer. At this point, I was so exhausted and focused on labor that I couldn’t have thought clearly if I wanted to. I got into the tub and it seemed to do the trick. My cervix opened fully and I could feel each contraction and push working together. Meconium everywhere, baby was on the way.

At around 3p, his bottom came out and legs. I could feel his legs moving around outside my body and said something to that effect out loud. I had been making good progress and could feel each contraction working with me as I pushed. After his legs and abdomen came out, my pushing changed. With the next contraction, I pushed, but I didn’t feel like I was pushing on anything or making any progress. His shoulders, neck and head were not coming, and certainly were not “falling out”.

After about two contractions like this, C. suggested that I change my position from being reclined in the tub to on my knees and upright (Definitely not on hands and knees as had been suggested earlier. I don’t know how much position mattered.), still in the tub and I pushed again, nothing. Then S. started becoming more assertive in insisting that I get out of the tub and into a deep squat. Things had suddenly become urgent. A. had just listened to his heartbeat again on the trunk of his body. They hadn’t in a while, I don’t know how long it had been because the philosophy was not to touch a breech baby as they are coming out b/c they could put their arms up and be in danger. I heard S. say we have to get him out.

C. pulled his arms out while I was still in the tub and they lifted me out and pushed me down into a deep squat. I could feel C. moving his body around trying to get his head to come out. When he came out, his cord was wrapped twice around his neck and he was not breathing. They milked the cord and immediately started resuscitating with chest compressions and a breathing mask/oxygen.

They called an ambulance and kept trying. The ambulance came in a matter of minutes and took him out of the birth center. Jarad was going to go with them, but they wouldn’t let him in the ambulance until baby was somewhat stable. He stood in utter shock outside the ambulance waiting, for at least 20 minutes while they tried to help Magnus. Finally they transported and Jarad rode along. S. rode along too to help in the ambulance while I had to stay and recover at the birth center.

In the meantime, C. gave the EMT’s her chart notes. When they stepped out of the room she told me she was telling them that she didn’t know the baby was breech until it was much later, close to time of delivery. I didn’t understand why she felt she needed to lie about this part of the delivery, but I thought it was strange nonetheless. I found out later through police investigation that she also told them that fluids were clear, no meconium present. She also reported without our knowing that we “declined transfer”. I spent hours at the birth center waiting for news. I had to wait until I could pee before I could go to the hospital to be with Jarad and Magnus. By 7pm I was anxious to go and they did a catheter to get things going. I packed up and they drove me to the hospital.

I found out later from his NICU doctor that took him in that night that they spent 45 minutes trying to bring him back, when normally at the hospital they would have given up at 20 minutes. He said he was essentially dead when he arrived and that he had never seen a baby that severely injured who came back.



We spent two weeks in the NICU grasping at any progress he made and at first he continued to surprise the doctors by even making any progress. After that long two weeks of watching him go on and off the vent, his belly fill with fluid, and organs gradually shutting down, we knew that further medical intervention would only prolong the inevitable. We were in agreement all along that we wanted to give Magnus every opportunity we could to recover, but when it turned for the worse we would not want him to endure interventions that weren’t going to support him in actually healing from this injury.

We decided that putting him back on the vent wasn’t going to help matters and so we knew we had to say goodbye to him. They walked us through the process of unhooking him from all of the machines and took us to this little room to hold him and be with him during his last moments here with us. There is nothing worse that holding your own baby, knowing he’s going to die and watching it happen. I never saw Magnus open his eyes, not until he took his last breath and they opened wide and froze. It’s an image that will never leave me.

This has been such a shock to us that it has taken me months to really start to see this in a different light. At first I was so protective of the birth center, always worried about how they were coping and not wanting anyone to know the details. At first I didn’t even really know what happened.

I asked for a meeting with all of the midwives and I met with them personally a few weeks after he passed away. I wanted to know what happened. Essentially they were surprised at his size at 10lbs, 4oz. and said the cord around his neck was probably pulled tight when his body came out before his neck and head, cutting off his oxygen supply. In my estimation it was a nice way of saying he had basically strangled himself in his own cord. I didn’t know that was even physically possible in choosing this route for delivery.

A., CPM asked me at this meeting if I felt they had given me enough information. I said, “I don’t know, you’re the expert, is there anything else I should have known going into this?” No one said a word. The truth was that we were grossly uninformed and I believe on purpose. They had been waiting to try this kind of birth and found people trusting enough to go along with it. C. told me on two occasions that she had replayed the events over and over in her mind and didn’t know what else she could have done differently. She told me she did her best. As it turns out, her best wasn’t quite good enough for the situation we ended up in.

It occurred to me one day as I was thinking about all of this that even in that meeting when I asked what had happened, they described what happened to Magnus. There was no sense of responsibility or ownership for what had taken place or for the fact that we even ended up in an emergency situation. In their estimation there wasn’t anything that they could have done differently, or at least that’s what they were telling me. I don’t know the ins and outs of birth, I’m not the professional, but I feel so strongly like they missed something. I didn’t know what it was, but nothing about what happened felt right.

After a few weeks had passed, C. came to our house for a postpartum visit which is part of their protocol. We didn’t have any specific questions, we were still so emotionally distraught and Jonah was present so we tried to keep emotions to a minimum.

Something she said that day was another haunting memory. She was talking to us about faith, almost like she was trying to make this right in her own mind and said, “Some babies just aren’t meant to live.” I was speechless and so angry I didn’t have words because I know there was nothing about Magnus that wasn’t meant to live. Again, she told us she did her best like that was some sort of consolation and said she hoped that we would have another baby with them someday.

This is one of the many moments that I can’t erase from my memory. I get flashbacks of certain phrases or images that haunt me and this was one of those moments. I kept waking at night with distorted images of Magnus walking around our house, but it didn’t look at all like him. In the medical records we not only read about the lies they told about us and the birth, we also learned that Magnus died from severe birth hypoxia, and asphyxia. He was entrapped for over 7 minutes, tangled, and full of meconium.

Learning they lied weeks after his death, we started researching furiously about breech birth. We learned just how grossly this labor and delivery were mishandled. If they had looked for size and cord placement in the ultrasound they would have known before labor even started that we were NOT good candidates for vaginal breech delivery. If they had read the Society of Obstetrics and Gynecology of Canada’s (SOGC) research they referred to before our labor, things would have been managed very differently.

Our baby was 10lbs, 4 oz, far exceeding the 8.8lb maximum the research suggests as safe. His cord was wrapped twice around his neck, both factors likely why he couldn’t turn into the correct position despite trying. I pushed for a total of 6 hours, almost 4 of which was without progress. The SOGC’s research says that a woman should not be pushing for more that 60 minutes without progress with a breech baby before it’s a sign of serious trouble. There were maneuvers that should have been performed in the heat of the moment that weren’t even attempted.

We found out that the research in Canada was written for doctors, NOT out of hospital midwives and explicitly explained that these kinds of deliveries should ONLY be attempted by very well trained professionals in a medical setting where immediate medical help is ready and present.

The study was initiated by Canadian leadership because women were having their breech babies with midwives, outside the hospital and the Canadian world of obstetrics saw the increase in infant mortality. They knew women were putting themselves in danger so they conducted the research and changed their practices around breech birth in the hospitals to create a set of clear guidelines and model of practice to offer women a “trial of labor.”

Our midwives also neglected to explain that Canada has now made it illegal for midwives to call themselves “midwives” or to practice as such with out a university degree. The actions of the SOGC are exemplary in many ways. Too bad our midwives didn’t read it or use it in the way it was intended, to keep women and babies safe. Instead they twisted it to fit their own agenda.

Our attention and effort turned toward accountability. We felt like we had been used as guinea pigs, as part of someone’s experiment meant to advance their own agenda, meant to make a statement politically.

We feel so much like this is fraudulent behavior, that they use the professional fa├žade of a business to lure people into feeling comfortable, pretending to have requisite skills that they do not have. We had no understanding of their extremist views and how they would influence our care in the midst of crisis.

Our midwives made a conscious decision to take a risk with our baby’s life, to adhere to their own philosophy with blatant disregard for our safety, to lie to protect themselves, and then to sell us the regurgitated line, that “some babies aren’t meant to live.” They hoped we would disappear under the rug of silence and sorrow as many families do. I was screaming inside a glass bottle where no one could hear. We will not be silent.

We reported this to the state, asking for investigation of the two nurse midwives, as did the hospital without our knowing. We asked the police and county prosecutor to investigate to see if criminal charges are warranted. We hired our own civil attorney and reported the incident to the North American Registry of Midwives for the CPM involved. (That’s another story of corruption and deception).

I don’t really even know what I’m hoping will come of all of this other than some form of accountability. I was taught as a child when you do something wrong, you don’t hide behind it. You face it, look the other person in the eyes and face the consequences. I feel strongly that families need to find a collective voice in the wake of all of this, a voice that demands that midwifery be practiced safely in America, with clear guidelines and responsible oversight.


Resources for breech birth:
1. SOGC’s research: http://www.sogc.org/guidelines/documents/gui226CPG0906.pdf
2. More Resources (at the bottom of this link):
http://www.sogc.org/media/advisories-20090617a_e.asp

Tuesday, August 30, 2011

Sheppard's story

As told by his mother Marlo.



I've always been afraid of hospitals. I hate needles. Nothing terrified me more than the idea of childbirth. My husband is the same way. But when I got pregnant in May of '09, after my first OB appointment and nifty ultrasound, we resigned ourselves to the idea that we would wind up at the hospital when the time came for me to deliver.

On my 2nd OB appointment, she asked me, "So are you interested in going all-natural? It made me feel better to think that a doctor was basically telling me that I could do it without all the scary stuff. My mom, an RN, had already scared me shitless about the whole process and I was filled with dread.

In my hormonal anxiety, I started "researching" natural childbirth. I watched the Business of Being Born with my sister-in-law and decided that it would be fine for me to go with a midwife since my doctor told me I was "healthy enough" that I should be able to "go all natural." That movie and all my internet reading suggested that home birth was a perfectly safe thing to do for healthy, low-risk women like me. My husband was on board, too.

The first group of midwives I hired were all about homeopathy, strange diet changes, and harping on people about their weight. They stressed me out tremendously, but I stayed with them because they understood the importance of all the prenatal tests, and I was able to go to the DLO (diagnostics laboratory of Oklahoma) to get all my testing done and paid for by insurance, and a local OB (who I found out later is quite quack-tastic and pretty shady) allowed these midwives' clients to come and do their ultrasounds at his office.

The midwives themselves, however, being CPMs, were not covered by insurance. They offered me a "discount" for paying in full before 35 weeks. The total fee after discount was about $2000. And in the end, I decided to change to a different midwifery practice because these CPMs were just too intense and I was having doubts... but of course, I wasn't refunded any money.



So long about 34 weeks, I hired my final set of midwives. I was in love with them-- every time I went, they told me I was beautiful. They seemed so knowledgeable, and had a huge library of books on natural birth, spirituality, and other topics which seemed interesting to me at the time. I was comforted by knowing that the lead CPM (her assistant was a DEM) had been in business for over 20 years. I figured she must have seen it all. They told me that they only had to transfer 5 or 6 women a year, so surely I wouldn't need to transfer, and the hospital they transport to was nearby and they claimed that they had a "good relationship" with the doctors and CNMs there. I still had no idea just how different CPMs and CNMs really were, and I had no idea that they were lying about having a working relationship with this hospital.

At 40 weeks and 3 days, I went into labor. I stayed in labor-- very irregular, very painful-- for a total of 3 days. The CPM never showed up, and instead, I was stuck with the DEM, who only showed up after I'd been in labor for 24+ hours (of course they said that it's fine to labor as long as it takes, because "your body knows what to do."). My doula had come in and out my house periodically the whole time, but she wasn't giving us any advice...

The DEM thought that I needed a rest at about the 30 hour mark (my hubby's estimate-- I was living out of time as we know it at this point...). She suggested that taking a benadryl would help me nap, and a drink would relax the uterine muscles and make the contractions space farther apart and lessen in severity. My husband didn't know any better, and despite my doubts, I took a benadryl with a chaser of TGI Friday's mudslide mix.

The contractions slowed all right, but I couldn't sleep. And very soon they picked back up with a vengeance. I spent hours on our pull-out sofa bed in the living room, vomiting, retching, curled up head-down butt-up because that was the only way I had any bit of relief... I tried to meditate on the Hawaiian music that we had playing on the stereo. I tried to think of our last trip to Hawaii where I decided that this music was what I wanted to hear during labor, since it was so relaxing...

My doula finally suggested the next morning that I get into the pool of warm water because I was completely distraught and she thought that it might alleviate the pressure just long enough to make some decisions about how to proceed. It had been about 48 hours, the DEM checked me and I was only at 1cm and change, but I was 60 or so percent effaced. Something was wrong, but she dismissed it at the time. I was delirious; neither my husband or I had slept (the DEM had taken a nice nap on our couch, however!). The DEM cavalierly said, "I had a 40 hour labor with my last child. It sucked, but you just have to get through it. The only way out is through. This is what gets your baby out."

I will never forget that as long as I live, how dismissive she was about my pain, fear, and exhaustion. I sobbed as I sat in the water, wearing only a tank top. My doula rubbed my shoulders, and began to explain to me how epidurals work, giving me the courage to shout, "I NEED HELP!!!!!!!!" and giving my husband the nerve to say, "We need to GO." The DEM agreed, reluctantly, and despite her promise to drive us there herself, she decided she needed to stop at her house first and had us drive ourselves.

When we got to the ER, the attending doctor was very brusque with me, slapping me on the back in the middle of a contraction and saying, "You're not in labor-- these are pregnancy symptoms. Get used to it." The MW came in with us, but she said nothing. She handed over my "records" which of course made no sense to a real medical professional.

The resident doctors knew something was wrong, they lobbied for me to be admitted for augmentation for failure to progress, they saw I was exhausted... but since my BP and heartrate, and Sheppard's heartrate, were stable, their protests fell on deaf ears with the attending. He discharged me and gave me Ambien.

We had to go back home, I took the Ambien the doctor gave me, tried to sleep... my water broke full of meconium. Back to the hospital we raced. I got an epidural in record time and was allowed to sleep since our vital signs were stable. The resident Family Medicine doc who would later deliver Sheppard assured me that most kids with meconium just have to be observed for a few days in the NICU, and that since we were stable, he wasn't too worried. I labored for 12 more hours, but was able to sleep and regain some strength from IV hydration and electrolytes. Then it was go time...

1. Jeremy called the DEM who came back when I reached 9cm, and was there through the delivery (30 min. of pushing).

2. Sheppard came out, they laid him on my chest for a moment-- he was beautiful, and smiled up at me. Then the neonatology/pediatrics team gently picked him up and said to me, "we need to help him now..."

3. Despite my skin/muscles being in great condition, I suffered a 4th degree perineal tear and a small cervical laceration. The attending doctor, an unflappable surgeon, was flapped-- he scrubbed in fast as lightning and shoved the resident who'd delivered me aside in order to commence what would become a 2.5 hour long repair. I was in the hospital for 6 days, got infected, all kinds of stuff... then I was so weak I couldn't walk for 2 weeks, I couldn't go see Shep for a week and couldn't hold him for 2 weeks... the doctor who did my repairs later apologized for not giving me a blood transfusion b/c I had lost so much blood...

4. Sheppard was taken to the NICU, but rather than being observed for a few days, he suffered there for a month. One of his lungs collapsed, necessitating a chest tube, he went into PPHN necessitating countless heart echos to monitor the wonky valve, he had: chest tube, UAC, UVC, PICC line, IV antibiotics/antivirals/nutrition/fentanyl and sildenafil ("viagra"), oxygen and NO2, and he was on a ventilator for 2 weeks.



Still, he had the strength to roll a bit to the side whenever we came into his room-- he recognized my voice and wanted me to pat his bottom and rub his back like I did when he was in my tummy (he'd press his little bum against my belly to have it patted!). He was given a 50/50 chance.

His doctors were amazing, though, and made us feel like he was a top priority for them. His nurses were wonderful. They sent every clergy-person (from every faith!!!) to our room to pray for Sheppard and sit with us. I will never forget the words of Dr. W the neonatologist-- "These little ones can turn on a dime. They can bounce back from almost anything, so please don't give in to despair-- there is every reason to hope. None of them blamed us at all for what happened.

We had Sheppard baptised and he had the Annointing of the Sick.

5. my parents blamed us for the whole thing, causing another layer of pain and drama... it didn't help that the ER doc that saw me on the first trip there was skulking around my room and telling them things like, "if these girls wouldn't try this homebirth stuff and work with midwives, these things just wouldn't happen... they bring it on themselves..."

6. The midwives didn't check on us



7. Sheppard had to take Viagra for 4 months, visits to the cardiologist, ended up back in the hospital for observation, had chest retractions for 3 months from breathing trouble, and now has a nebulizer and has to take Synagis shots during RSV season...

8. I realized more and more that the cascade of catastrophe began with the failure of the midwives to recognize that something wasn't right in labor, failure to consider the estimated size of my son from the ultrasound I had at 34 weeks, failure to get me help sooner... the DEM had the nerve to say to me, when I went to them a few months later to talk about what all happened, she said, "Hopefully next time you'll trust birth more, and it will go easier." UGH!

9. Recently I wrote a FB email to the CPM who never showed up, and she wrote me back an ugly series of notes accusing me of slander, harassment, of being crazy and "changing the story in your mind," and saying she would take legal action against me if I "continued to slander" because she would "defend" her "reputation of safety."

10. I was diagnosed with PTSD over everything that happened (flashbacks, physically feeling baby kicks and labor pains, random unexplained anger, paranoia, nightmares, intrusive thoughts of the labor & birth & mistreatment from my parents...)

11. I'm pretty sure that my husband became clinically depressed, although he refused treatment

12. I'm SO GRATEFUL to our amazing medical team, to my husband who stood by me, to Dr. Amy and all of you for giving me the permission to embrace what really happened and stop blaming myself for everything when I really had no control over it once it started and the mw's dropped the ball. Had I stayed with an OB the whole time instead of hiring a CPM (and then getting stuck with a DEM), all this might very well have been avoided entirely, or at least rendered not-as-bad. I trusted those midwives to act in my best interest, to recognize any problems before they went critical, to be there for me... but they don't have the knowledge or training to do that. I know that now.

Wednesday, May 4, 2011

Angela's story

As told by her mother Nicole.

Angela was born on 9/4/09 after 5 hrs of active labor and 29 minutes of pushing, a week late. She was born at home in my bed with 2 midwives attending, one was a certified nurse midwife. Angela was very active in my belly. She moved a ton compared to Kole, my first. I just knew she had the cord around her neck. During labor my water never broke and my CNM didn't break it until right before she crowned. After not being able to find her heartbeat my midwife broke my water and check her neck for the cord, while she was still inside. After she broke my water and being unable to get the cord off her neck they found her heartbeat and told me we need to get this baby out. So I pushed as hard as I could. It took her a few minutes after being born to cry. After a few minutes and oxygen she was perfect.

She was a very vigorous nurser and just wanted her mommy to hold her. I was so in love immediately. Everyone thought she was tiny but I knew she was a big girl. When the midwives weighted they were shocked. She was 7 and a half pounds and 21 1/4 inches long.

She was born at 12:30 PM. I spent the rest of the day holding and nursing her. Some friends came over and held her a little. And her daddy only held her a few times that day. Finally, when everyone left and my husband got our son to bed then we went to bed.

I laid her on my pillow so I could listen to her breath. She woke up and I tried to nurse but she wouldn't latch. So I checked her diaper and she was wet. I cleaned and wrapped her up and we went to sleep. She woke again an hour later and again wouldn't latch on. She went back to sleep only to wake an hour later. Around 11:30pm she nursed really good and went to sleep. But woke an hour later I checked her diaper she had a big wet fart. I cleaned her up she went back to sleep and did it again an hour later.

She was crying a lot so I laid her on my belly to get the gas out and she was gassy but hated laying on her belly. The night went on like that. Then around 6 am she was crying really bad and had a big bowel movement. It kinda of got stuck I cleaned her up but she continued to cry and hadn't nursed since 11:30pm. At 7am I called the midwife and she said she was probably tired and to get my husband to walk around with her so she could get a nap and the assistant would come over.

I took her to her room to put warmer clothes on her and noticed she had another bowel movement that was stuck again. So I cleaned her up and hand her over to my husband. That was the last time I held her alive.

I took my son down stairs and got him and I breakfast. My husband called down "how do you know if she is breathing?". I said her chest will be moving and thought he was being dramatic. Then I started freaking out and ran upstairs. He was looking over her in her crib and she was turning blue. I grabbed and started blowing in her mouth thinking that would help her catch her breath. My husband screamed call 911 and took her and started breathing in her mouth while I talked to the operator. The operated walked me though infant CPR.

The EMS got here and got her to the truck. My husband and I stood in the street praying. Then I rode with her in the EMS begging God to bring my baby back to me all the way to the hospital. When we were almost there I started thinking positive that she had to make it and be find infants are resilient. They let us in the room while the worked on her and we prayed.

Then the doctor came over to us and said after an hour there is really no hope. We freaked out. So they kept trying. After another 10 or 20 minutes I just walked over and told them to stop. She was gone. The guy making her heart beat didn't want to stop but I told him it is ok. They took out the tubes and we held her and talked to her for a long time. The assistant midwife came to our house too late and followed us to the hospital.

I totally blame myself. I should have know something was really wrong. I, as her mommy, should have been able to fix it.

Two months later the autopsy showed acute pneumonia, multiple lung lobes. Devastating. I hired the best a Certifed Nurse Midwife. Why didn't she see something was wrong?! The medical examiner's office did not culture the bacteria so I'll never know what or where or who it was from. I had a negative group B strep test at 35 weeks. But the midwife forgot to do it at that visit so she sent me the test to swab myself and send it in. Sometimes I think maybe I did it wrong. But from what I have read your water has to be broken for hours to infect your baby.

I miss her and love her all day everyday. I'll never forgive myself for not calling for help sooner and for having a home birth.

Sunday, April 17, 2011

Grant's story



As told by his mother Rachel.

My son, Grant was born on 6/30/2010 at 38 weeks gestation. 6lbs 9oz, 19 inches long. And perfect in every way.

My midwife was a fine midwife for perfect births, but I know from experience that you can have a perfect birth by yourself at home. My son Owen was born unassisted at home with just me and my husband. I take a lot of pride and it takes a lot of work to go against the grain. I believe in all things natural and holistic. It took the death of my child to no longer believe in Home/birth center birth.



A midwife should be there for you if something goes wrong. This is why I went to a birth center for this 2nd baby. I had a wonderful experience at home with my unassisted birth. I can't think of a more beautiful birth. My intentions for my 2nd son, Grant were that he would get that special and beautiful birth. But now having a son and knowing just how important babies are, we decided to do it the safe and natural way. I had all the confidence in the world in my midwives. I didn't even think I would need them. I first, never thought anything would ever go wrong and secondly, I figured this lady had birthed so many babies that she had seen it all. If by any crazy chance anything did happen. She'd have my back and take charge. I was wrong.



I'd been having terrible "Braxton Hicks" for 2 weeks before the day I went into labor. I told my midwives (I had seen 4 different midwives at this birth center) about the pain. I was told that it is common to have painful false labor with the 2nd child. I didn't push it, I'm tough. I can handle it but man it's starting to wear me down. I wasn't getting much sleep at night and they were very painful, like transitional labor contractions at times. I kept thinking that this baby was going to come any second. They just smiled at me and told me to hang in there. I did.

The day I went into labor was 6/29/2010. I was sick, flu like symptoms and a lot of painful contractions. I called the birth center and told them I think I needed to come in. I was told that the flu can give you false labor pains. I hung in there once again. I finally called at 6 pm and told them I needed help and was starting to feel scared. They had me come in. We dropped our 2yr old son off at a friend's house and we were ready to bring this baby into the world.

When I arrived the midwife on duty checked my cervix at 3cm and told me to lay down to see if I was progressing. They checked the heart beat every 10 minutes and told me the baby was great. My labor stalled. I was sent home in tears. I'd been in intense labor all day. I'd been in intense labor every night for 2 weeks. I wasn't sure how much longer I could take this. I was told to drink lots of fluids and take a warm bath. We picked up or son and headed home.

The bath seemed to help and relax me. I was tired, very tired. I fell asleep and awoke at 8 pm with very intense contractions. I was thinking it was transitional contractions and that the baby would be born very soon. We woke our son and drove in the car. The contractions were so bad I was vocal about it. Normally during contractions I would meditate until they passed but these were bad.

We arrived at the birth center but this midwife was running late. She showed up 10 minutes later. My husband dropped me off and drove our son back to our friends. We got into the room and I told her I was feeling scared. That something didn't seem right. She checked me and I was still at a 3. I started to cry. I told her I couldn't take much more and asked if I could get into the bath.

She poured the bath as I paced the room. She said to me, "I'll support you if you want to get an epidural." I remember taking a pause from the pain and thought... I really should go to the hospital... I'm scared. But at the same time I wasn't worried about something being wrong but she was telling me I couldn't handle the labor she would take me to the hospital.

I was then offered a back up doula. I wish I had accepted the offer. I wish I had had someone there that cared. The midwife wasn't in the room much while I was in the tub. I was mostly alone trying to get through the contractions. Thankfully my husband arrived to support me and help me. There were 4 midwives there at the time I was in labor and so far none of them had touched me or said a kind word. My husband and I were on our own.

My water broke. When my water broke the main midwife finally paid some attention to me while the others stood there with their arms crossed and waited with clipboards. So far up until the water breaking baby's heartbeat had been strong. When my water broke it hurt. The water was clear and everything seemed to be on its way. The midwives finally believed that I was actually in labor. I had to stand up... no I had to squat... or stand or kneel.

My labor was so bad that I couldn't even tell who was talking to me. There was no time at all between contractions. I kept saying, "I can't get a break... I need a break. A minute... something." For hours up until my water broke my contractions didn't have a pause. I don't know what time my water broke. I don't know what time they started to lose the heartbeat, but I know they started to panic.

My son's heart rate dipped when my water broke. The midwife said that was common. Things are adjusting and baby is getting ready to descend. I didn't feel ready to push, but I kept wanting and trying to push. The pain was so intense that I had to do something. I got out of the tub and while crying and screaming told them to leave. They were all just standing there. They hadn't even reached out a helping hand to me the entire time I was there. They were all standing around like I was out of control and they didn't want to set me off.

The pain was unbearable and they were cold and aloof. The main midwife told me she would be back in a few minutes to check on me. When they left, as I was naked I ran over to the corner of the room and cried. My husband trying to comfort me said, "something isn't right is it?" I told him I was scared. He held me while I contracted. He went to tell the midwife that I felt something wasn't right.

She came in and listened for the heartbeat and told me our son's heart rate was low and to push. All of the midwives were there now just standing there staring at me. I sat on the birthing stool and told her I couldn't push. I wanted to because I wanted this to be done and the baby to be here but I could barely talk I was in so much pain. She told me I HAD to push.

My husband asked her if I was completely dilated and she said I wasn't but that this baby needed to come soon or we would have to go to the hospital. My husband got down on his knees and was trying to help me as much as he could. But I wasn't dilated... I couldn't push. Still contracting... still in so much pain. No blood. Low heart rate off and on and still not dilated.

This went on and on. I don't even know how long. I'm trying to push. My husband is holding me and encouraging me and the midwife is panicking but no one, not any of the other 3 midwives is calling the ambulance. The heart rate is low... They all know this.

Let me remind you that when I first arrived at the birth center for the second time that evening I was offered a transfer for not being able to handle my labor. Why, now with my baby dying were they not offering us a transfer? Why were they trying to make me push when I wasn't dilated?

I was moved from the birthing stool to the bed… still not 100% dilated. I was told that I needed to get this baby out now. I'm still trying to push. I've never pushed so hard in my life. The pain is so bad that my vision is becoming blurry. I was given oxygen. When I look back at this scene I still wonder why no one has called for help. The baby has been in trouble and I'm having a hard time... why?

My husband and I were so focused on pushing this baby out as fast as possible and so focused on what we were doing that we couldn't stop and tell her to call 911. We weren't sane. We were relying on all of those midwives to do that for us if need be. We were counting on them to make the decisions that would need to be made when necessary. We were still all on our own as our baby was losing his struggle to breathe.

The main midwife could finally see that I wouldn't dilate and be able to push as fast as she wanted me to. She called 911 and told them she had a labor transfer… not a life threatening emergency. I'm still trying to push and the contractions will not stop and there is no break… I felt as if I was losing my mind.

One of the midwives had stayed with me to monitor the heart rate while all the others had left to call the ambulance. It was me and my husband pushing and crying. I looked at my husband while he is pushing my hair back and telling me to push. I ask him, "Why did they give up on us??" He keeps telling me we’re ok, just push. Another of the midwives enters the room and gets on the bed with us and my husband hears her ask the midwife that stayed, "Is it dead?" [Rachel asked to add this paragraph to her story a few hours after it was originally published.]

The ambulance arrived and they did not know or think this is any type of emergency. They are waiting in the lobby. My husband asks the midwife why they are not coming in and my midwife asks me what I'd like to wear. Can I stop here for a second and remind the world that my unborn child… my 38 week unborn baby is dying and she is trying to get me dressed? At this time I was wearing a robe and stood up and started to walk towards the door. My mind is fuzzy and my contractions are hard but I would have ran to the hospital if they hadn't of picked me up and placed me on the stretcher. I'm starting to feel at this point that the baby may be descending. I could feel him lower.

While being put into the ambulance my husband is told to ride upfront that the midwife would like to assist me in the back. I'm too busy to care and in too much of a hurry to worry. The EMT asks me which hospital I'd like to be taken to. I'm pushing and I yell, "St. Lukes Meridian" This hospital is only 5 minutes away. The midwife answers back, "St. Lukes Downtown" This hospital is 20 minutes away. I say again “ St Lukes Meridian” And she whispers in my ear, "They won't let me stay with you there. Lets go downtown." She answers for me again and we are finally on our way.

*****

I have stopped to take a pause in writing this story because it's too much. It takes me and puts me in such a numb state. Did this really happen? I think I'll write the rest later... and I think I'll lose all the sleep I had planned tonight and instead look at the very few pictures of my son that I even have in my possession and wish so much that he was here... That he was safe and that I hadn't let him down.

He was perfect. He had piano key toes… one up one down one up one down just like his big brother. He had the softest face and the slightest cone head. He had my hands. And he had arms to reach and legs to walk, lips to smile and eyes to shine. I never saw his eyes and I never saw him without the hospital plastics they tried to use to revive him. If you are a parent you know love. You know what it is to love and if you lose that… you could lose it all in a second… you can never be the same. You will survive it but you will never be the same.

*****

It's taken me 2 weeks to come back to writing this story. It's a hard story to write for me. I don't really want to complete this story. The story ends with me leaving the hospital with empty arms. It ends with a dead child.

While in the ambulance I was given an IV and oxygen, I'm continuing to push. I've not stopped pushing since the panic set it. I'm doing all I can. My vision is very blurry and I'm losing strength. I ask for water. I know now that these are signs of blood loss. There is no water. I keep pushing.

I'm yelling while pushing. I'm not fast enough but I'm trying to be fast. I ask her to check to see if she can see my son. She doesn't move. She hasn't touched me other than to check my dilation since we arrived at the birth center hours ago. I'm alone. I ask the EMT to tell my husband in the front that the baby is coming and that I'm trying.

I'm crying. I'm alone. He tells my husband. He comes back and tells me I'm crowning. I'm weak. He holds my hand. My midwife is sitting there ... silent.

We reach the hospital but I hardly even notice. I'm pushing and I haven't stopped. The ER staff reaches me and pushes on my belly. The baby comes about 2 minutes after we enter the doors. He is taken away. My husband follows. I'm covered in blood. They worked out my placenta and the bleeding stopped.

They keep checking me. I keep asking them where my baby is. My midwife still hasn't touched me or said a word to me. I grab her hand and tell her, "Go check on my baby and come right back. Tell me where he is and if he is ok." She leaves. I'm alone. Next… my husband walks in with tears in his eyes. He is broken. He tells me that our son, Grant has died. I will not see him alive.

The medical staff at the hospital surrounds me with love and support. What was all this I had heard about cold and sterile? I was hugged. I was handed my baby by a nurse with tears running down her cheeks with love and compassion. My midwife returns... She's been on the phone.

They ask why we are at a hospital so far away from the birth center. There are 2 closer hospitals. How long was the heart rate low? When did that first occur? My midwife pleads the 5th. My husband and I do not know and are not in the right state of mind to answer.

I was helped up and onto a new bed. My old bed, the EMTs stretcher, is covered in blood from the waist to the toe of the bed. All 3 EMTs are standing there in shock and silent. I see the doctor is talking to them. I find out later that they should have been told it was an emergency, not just a labor transfer. They would have been obligated to take me to the nearest hospital. If someone has a stroke, they don't ask them which hospital they prefer.

The ER doctor that assisted us while we were at the hospital told me: abruption. Hidden abruption is the diagnosis. Severe pain with contractions, contractions with no break. Loss of vision and weakness, thirst, heart rate lowers ... and if those are not enough symptoms and reasons for concern ... baby dies.

I am holding my son. He is warm and soft. He is perfect. He is beautiful. And he is dead.



How do I put him down? I can hardly come to terms that I will have to hand him back to someone and leave. That I will never hold him again. I hand him back. My arms ache. My heart aches. I can't leave the hospital. I stop almost 100 times on the way to the door and my husband and the nurses have to remind me that my 2yr old son is waiting for me at home and that I have to leave. My baby is dead. I feel like I am leaving him there. Who will hold him, "I will hold him," the nurse tells me with tears in his eyes.

Thank you, nurse for showing compassion and holding my son. The hospital staff later took pictures of my son. Hand prints and foot prints. They saved all his blankets and clothes. They have all written me heartfelt letters, flowers and mementos of a baby that should be in my arms. I got a tropical plant from the birth center 4 days after my son died 6/30/2010. And life changes...



I hear a baby cry in all the different rooms of my house during the night. I dream that I am holding him and that I lose him in my blankets. My mind races. "Where is he?! He was just here! I had him in my my belly, I held him in my arms how could I have lost him so easily??!!" I panic. I wake up I hear him crying and I start to tear the room apart. I'm sobbing as I'm realizing that I'm looking for a baby that is not here and never will be.

I'm not asking for homebirth to stop. I'm not asking for midwives to all lose their jobs. I'm asking for people to have the knowledge that your child dying because their midwife is scared to make the right decision. I'm asking that in the case of an emergency that they put aside whatever pride or whatever it is and kick into gear their life saving abilities. If they do not have this ability, get a desk job.

My son is dead. If I had been laboring in a hospital he would be alive. If I had been birthing at a birth center with a midwife with LIFE as her first priority… he would have had a standing chance. When you are in labor and you are in a the middle of a labor gone wrong you cannot act for yourself. You cannot save your baby. You have to have a midwife that is capable of making these calls before it's too late.

How will you know that your midwife has this ability? You won't know until it's too late. I stand by what I say... I'm not challenging anyone. I'm just missing my baby and my heart will not heal. He would have been 9 months old when I starting writing this story. I have been living for 9 months with a broken heart. I've got a lifetime to live with this broken heart. I have a lifetime of hurt.

And I can say I know now. I know now not to ever risk a home/birth center birth. What good does this knowledge do me if my child is already dead. The only good it does is that I can tell someone else.

Monday, March 28, 2011

Zen's story



As told by his mother Elizabeth.

Half way through my pregnancy, I made the mistake of watching The Business of Being Born. It absolutely terrified me. I was convinced that should I allow the hospital to be a part of my birthing experience, I would be given Pitocin. The Pitocin would make the contractions unbearable. I would then be given an epidural, forced to labor on my back with a fetal monitor attached to me, unable to move or feel my first child come into the world.

As a young, single, soon to embark on the greatest journey of my life, I was beyond concerned. Also, as a prior victim of domestic violence, all of my hospital experiences were very negative. I wanted the organic experience- as close to nature as I could, within reason and safety, get to. I wanted to eliminate the chance of succumbing to the temptation of drugs to bear labor, not just for the experience, but for the safety of my son. I wanted immediate skin to skin contact, the first crawl to the breast, and mother to mother support in an environment I was most comfortable with- my own room, my own bed, in my own clothes, on my terms. I had extreme faith that I was strong, young, very capable, and that my body would know what to do.

When I asked my obstetrician about natural, active childbirth, she said, "We'll see." That was not good enough for me. We'll see?! Was it the folly of youth that gave me such a strong desire to need a guarantee of safe passage into motherhood? The fear of the unknown? Being alone without a partner to ease into the rhythm of parenthood alongside me? I did not want whatever obstetrician who happened to be on call to deliver my child- I was looking for a wise, experienced shaman to guide me safely through the oceans of fear, pain, and uncertainty and dock me safely in the harbor motherhood- a journey, rite of passage, centuries of women took before me.

I transferred care to a midwife. Towards the end of an uneventful pregnancy, my midwife asked if I wanted to be tested for Group B Strep. She said not many midwives tested for it- that OB's had just begun, within the last 5 years to routinely test for it. Since my prenatal care had begun with an OB, I had been tested for everything under the sun and the results gave me a very a strong peace of mind. Knowledge is power- of course I would take the simple swab for more knowledge.

The result was more than a hiccup in my birth plan. I was GBS positive. Which meant, according to my research, that I would need at least four hours of antibiotics before the birth of my child. IV antibiotics my midwife could not provide. I was heartbroken and began mentally preparing for a hospital birth. My family was relieved. However, my midwife was unconcerned. She kept repeating over and over, "According to state regs, it does not rule you out of homebirth. So many midwives don't test for it- their clients have GBS and don't even know it. They still birth perfectly healthy babies. We can use garlic and a clorohexidine douche during labor. It just means after your water breaks, you only have about 12 hours to deliver the baby." After a while, the repetition of that mantra placated me. I trusted her deeply.

I was two weeks overdue and my midwife was stressed. She kept calling me to see if anything had changed. I had terrible Braxton Hicks contractions without progress or dilation for over 2 months. We had an ultrasound done to check the fluid levels to make sure the baby was still doing okay. She said she thought I was lacking oxytocin to progress my labor and she actually gave me oxytocin pills to take while she monitored the baby.



That night, I went into labor. When my midwife arrived, I was 5 cm. All I wanted was to be on my hands and knees, but she kept forcing me up, forcing herself behind me and pulling my belly up with her hands. It was beyond painful. After nine hours, she broke my water, something we had agreed that based on the GBS, she would not do. She told me there was "slight meconium," and I learned days later from my family who had witness the gush, that it was all meconium. She cleaned up the soiled Chux pads so quickly, I did not see them. We repeatedly did clorohexidine rinses.



I could tell she was panicked because she kept leaving the room to converse with her assistant. Upon returning, she told me we needed to get the baby out immediately and that I could start pushing. So I did. My midwife yelled at me with each contraction, that if I didn't push for 10 full seconds, I was wasting the contraction. She accused me of not wanting my baby enough, of not putting enough effort into labor, she even began separating my mother and sister (people whom I wanted with me!) from me, accusing them of "negative energy and keeping the baby from being born." They kept saying that the head was right there- but I couldn't feel it. I am 22 years old. Very fit. I danced classical ballet for 16 years. I practiced prenatal yoga every day of my pregnancy and walked two miles a day in my last trimester. I know how to use my body, and trust me, every atom inside me wanted to bring my son into the world.



After three grueling hours of being yelled into pushing every ten seconds, I was exhausted. I had not been offered food, water, or any breaks. I remember saying that I was going to pass out, so my midwife put oxygen tubes in my nose and left the room. I was thrashing around the bed, beyond frustrated and in extreme pain. "I can't do it...something is wrong," I remember saying. My mom looked at the oxygen tank. It was not on. When my mom told my midwife that she did not turn the oxygen on, she laughed and replied, "Oh, I forgot." At this point, I wanted to transfer to the hospital.



At the hospital, my midwife refused to give the nurses my chart. She was very combative and would not release any details of my labor or prenatal care. Upon being examined by two L&D nurses, a family physician, a resident, and an obstetrician, they all agreed that I was only 6 cm dilated. The "head" they saw was actually a blood clot on my bladder. An ultrasound showed that my son was asynclitic posterior. (Not only did my midwife constantly assure me that a doppler was very accurate, she told me that my son was LOA- the "easiest" position to labor in! Later she admitted that she should've known he was posterior because she was getting fetal heart tones from the lower left quadrant.)

I was so swollen from pushing that I could not urinate, although I desperately had to. It took two skilled nurses thirty minutes and several tries to insert a catheter because the swelling was so extreme. A fetal monitor showed that my baby was going into distress and an on call obstetrician asked if I wanted an emergency c-section. Although I know I had no choice, I will always deeply respect that he asked- he made me feel like being rolled down to the O.R. was my decision- that I had chosen to completely surrender to his medical care.



My son had to be resuscitated and he was jaundiced - he had a very low APGAR score. Because of the level of care he required, I did not get to see him until after I was done in recovery. Had he not been born in a hospital, he would not have lived. We were both under constant surveillance due to the meconium and the GBS. He had a ruptured membrane in his eye and a bruise on his eyelid and brow from slamming into my pubic bone. I thank the universe every day that my selfish desire to birth in an environment I preferred, instead of what was safest for my son, did not result in death - and I have so much empathy for the women who have lost their babies to homebirth. My son is almost seven months old now, still breastfed, and in the 98th percentile on the growth chart!

My body, however, is not unscathed. There is much internal damage from pushing for so long before being completely dilated. My OB told me that my bladder had prolapsed- that he literally had to pick it up and put it back where it belonged. It is tilted now, which makes emptying my bladder fully impossible without a sit down/stand up/sit back down dance every time I have to urinate! It can be fixed by surgery, but it's not advised until after I have all the children I desire, so it is currently monitored by my OB and a urologist. Due to the internal damage, I will never experience vaginal birth. I will never be a VBAC candidate. Every pregnancy from now on will be considered high risk.

I filed a complaint with the Colorado Department of Regulatory Agencies. The hospital staff, as well as my surgeon, also wrote in complaints against my CPM. The state board is currently investigating my birth and my midwife stands a very strong chance of losing her license due to negligence.

I only hope for the safety of future mothers that she will not be allowed to practice midwifery any longer. No woman should ever have to experience what I did, to know the guilt that I have, the permanent damage that I live with every day. And I was lucky. I know that every day my son wakes up, it is a day to be thankful for, a day that is thanks to an extremely remarkable staff at St. Mary Corwin hospital. I named my son Zen.

Homebirth changed my life forever. I am now currently getting my Bachelor degree of Science in Nursing, to help save women like myself. I can not only attest to the dangers of homebirth, but I will dedicate the rest of my life to telling Zen's story.

Wednesday, March 23, 2011

Thomas' story




As told by his mother Erin

Early in my pregnancy, I called Mrs. O, a midwife recommended by a friend, to see if she could care for me even with my history. I had a history of preterm labors, a cerclage in place and thyroid disease. She said that she could. She explained that she would draw my labs and send them to the endocrinologist as needed, and near the end of pregnancy she would have a doctor remove the stitches [the cerclage that another doctor had placed because of the history of preterm labors].

Mrs. O reassured me that if the baby had problems at birth, she had oxygen and was only 10 minutes from a good hospital. We made an appointment to meet and I saw her exclusively and regularly for the rest of my pregnancy. In addition, I met Dr. M, the doctor she recommended [one of the few doctors in that part of the country who is willing to back up homebirth midwives]. At my appointment with him, he did an ultrasound and we scheduled an appointment for the cerclage to be removed on December 17.

Shortly after this visit I went into premature labor at Bay Shore Hospital and they stopped it with 2 shots. Then I went into premature labor again and went to Christus Saint John Hospital, but the contractions stopped on their own and I was sent home.

When I was 33 weeks, Mrs. O said I was measuring an extra week at every visit and changed my due date from January 13, 2008 that was given to me by ultrasound by Dr. L on that first visit and an ultrasound with Dr. R at 16 weeks to January 05; the new date was consistent with my last period and the measurements at 34 weeks. So that day I went from 33 weeks to 34 weeks instantly.

Mrs. O said she could deliver me at 35 weeks and if I went into labor before the cerclage was removed she would remove it herself. I asked her to just remove it on December 17, as we had scheduled with Dr. M, but she said she would only do it on an emergency basis, because it was out of her scope and she had not done it before.

Mrs. O insisted that Dr. M remove the cerclage on December 2. She wanted to be able to deliver me the day I turned 36 weeks by new due date if I went into labor at that point, without having to remove cerclage herself. He did it reluctantly but said that I would probably make it until full term anyway. At that second appointment with Dr. removed a blue string with a knot at one end and checked me to be sure I had not instantly dilated. I asked him about getting a shot [of steroids] to mature the baby's lungs but he explained that they do not recommend them after 34 weeks. Even after I told him my history with my daughter Gabriella who had respiratory distress syndrome at 36 plus weeks, he said he was sure that something else beside having premature lungs caused her breathing problems.

After the cerclage was removed I had stabbing pain in my vagina with mild contractions. I had many episodes of contraction from then through December 11 2007. On December 8 I called midwife to tell her I lost my mucus plug but because I was not contracting at that moment she was not concerned.

On December 11, painful contractions began at 3:30, instantly one minute apart. I wanted to go straight to hospital because contractions were so severe, and tried to find a family member to watch my kids. I called Mrs. O; she said that she was on her way.

My family arrived at about the same time as Mrs O. She came into the bedroom, and as she got everything ready that I had better not be only one centimeter dilated. Then she checked me and said that I was one centimeter. Then I told her these were 8 centimeter contractions. She checked me again and this time she that the cerclage (which had supposedly been removed) was still in place, but she lacked the equipment to see clearly. I told Mrs. O that I would feel more comfortable going to the birthing center so that she could have a speculum to see better.

We got ready to leave. My mother told the midwife she thought we should call 911, but Mrs. O said that wasn't necessary since she could remove the cerclage herself. When we arrived at the birth center, she unlocked door and turned on the lights. When everything was prepared, she checked me and said she could feel the stitch but could not see it even using the speculum.

She began to try to cut the stitch, and that was very painful. She put a pink dish pan underneath me to catch all the bleeding. She insisted that she was not cutting me as her assistant and my sister took my legs; I had gotten weak from holding them. You could hear the cutting. She would close her eyes as she cut.

I was begged her to stop and she let me get in the tub for awhile. A knot from the cerclage came out in the tub. After awhile she said I was over heating and had me return to the bed. She checked me and I think she said I was 7 but the head was still bouncy, so I agreed to have her break the water so his head would drop down as it had with my previous labors.

After Mrs. O ruptured the membranes, I went back into the tub. She told me to stay on my hands and knees and to push to try to blow the cervix out. After awhile she checked me while I pushed and said she could feel something hard that must be another stitch.

I returned to bed and once again she tried to cut the stitch. She cut for a long time and I begged to go to the exam room because there were stirrups there and she would be able to see better. I knew the walk to the exam room would be a break from cutting me.

In the exam room she tried again to cut the stitch. I was screaming and in tears from the pain. I begged her to take me to the hospital. She said that the doctors at the hospital would have to do the same thing and would be mean to me because I had been seeing a midwife. She told her assistant to give me some the maximum dose of nubain to help me with pain. She cut again and when I was sure much more than ten minutes must have passed she said, "The baby is right here you need to push." I tried to push but the exam table was very uncomfortable.

After much pleading she allowed me to walk back to the bedroom and I lay down on bed and pushed with her hands inside me. After about 10-15 minutes my son Thomas Robert Williams was born she laid him in a towel covering him loosely and then put him on my chest. He was grunting and she rubbed him and suctioned his nose and mouth. She got oxygen for me to hold by his face. Occasionally he would make a fast gulping sound and when my sister told midwife she didn't answer. He tried to pull the oxygen tube away at one time. He made a one second whimper. Both Apgars that were done with him attached to placenta.



Mrs. O tried to get Thomas to nurse by squeezing some of my colostrum unto his lips but he would not suck. She tried to get him to suck by rubbing her finger in and out of his mouth but it did not work. She put a hot rice sock behind him, but it was too hot and I pulled it away. Next she clamped the cord and asked who wanted to cut it. my sister cut the cord.

Mrs. O started to diaper Thomas and he peed on her. Then I dressed him. He was still struggling to breathe. When we asked if he needed to go to the hospital she said he was transitioning. She said that she had delivered a 34 weeker who was on oxygen for 7 hours and did fine, and a 35 weeker who needed oxygen for five hours and was fine.

I went to bathroom and I was bleeding heavily. Mrs. O helped clean me up and I returned to bed. I held Thomas, positioned him upright and tried to help him breathe by stimulation. But when Mrs. O returned to the room she lay Thomas on the changing table and said it would help him breathe better. She taped oxygen by his face. She explained that he was being sluggish and lazy from the pain medicine I had received. I was able to get some sleep.

My husband arrived about 4:45. We looked at Thomas and I told Mrs. O that he sounded worse and asked if perhaps he was hungry. She tried syringing some formula into him but he started to choke. She sucked it back out and said, "No more formula because it makes you turn funny colors." He was gray. She rubbed him and laid him on his side with more oxygen and said we should let him rest.



My husband and I rested and I could hear Thomas breathing even though I was half asleep. After a while there were spaces in between grunting and I thought that he was getting better. When I woke up and lights were on and Mrs. O was doing CPR. She said that Thomas had stopped breathing. I wanted to call 911, but she said to call the ambulance transport company she uses. I found the phone and she called the transport team. My sister then took the phone and called 911.

The midwife asked me to hold the oxygen by Thomas' nose while she worked on him. I held it to my hand and it was not blowing at all. I checked the oxygen tank and it was on empty. Mrs. O had me look for epinephrine. I found it and Mrs. O may have given the shot.

The ambulance arrived and I started to pray. I over heard that his oxygen was 35 percent and that his heart beat was, I believe, 66. When we are leaving 20 minutes later the transport team that Mrs. O had called finally showed up.

At the hospital and they took Thomas while doing CPR. He started to breathe on his own and his color got better; then his heart stopped. I was asked to leave the room. After 30 or 45 minutes his heart started beating on its own again.

The Texas Children's Hospital transport team arrived and I hopped into ambulance. At hospital we were told that Thomas had gone for too long with low oxygen and that there appeared to be severe brain damage; any of his organs could fail at any time. We were told that he had high acid levels. He was diagnosed with Respiratory Distress Syndrome. Dr. G said that we might need to talk about turning off the machines.

Shortly after, Thomas' heart began to fail. When his heart beat was 22 I asked them to remove the machines and we went to the back room and they brought us our son. He died in our arms sandwiched between my husband and me.



After leaving I went to Clear Lake Hospital because I was bleeding heavily. They did one ultrasound. The technician said that there appeared to be a cerclage left in multiple places. A few hours later a doctor came in and said I that there was nothing that needed to be taken care of in the emergency room.

I went to UTMB on Monday December 17. I saw a ER doctor. He said my cervix looked badly damaged but that it was not severe enough to have an emergency hysterectomy. He removed the cerclage and showed me the blue long string with no knot.