April was Cesarean Awareness month and it got me thinking a lot in regards to how I talk about this subject. I read a blog post recently that talked about the beauty and strength of women who have given birth by cesarean. It made me stop to think that I never speak of it in this light. It always comes up in a negative way. Often rightfully so, as too many women are being convinced that they are in need of a cesarean when in fact they are not. I have always said that I am not anti-cesarean. I am anti-cesarean when it is unnecessary. But this blog post made me stop and think, am I acting this way about all cesareans? Am I treating their births as sub-par? I was convicted. Maybe I had. All three of my cesareans were unnecessary, but I know many women who have had necessary cesareans. I am so thankful that we have this option as a life-saving procedure!
I teach my students in my birth classes all about how to avoid an unnecessary cesarean. I do this by teaching them the red flags to look out for and educate them about interventions that may be unnecessary. This is one of the biggest reasons I started teaching Birth Boot Camp classes. I think this program does an amazing job to prepare couples to make educated decisions once it comes time to give birth. I have peace of mind knowing that when I send my students on their way, they will only end up with a cesarean if it was truly needed. I wanted to share a series of three beautiful births that ended up in a cesarean. I hope you enjoy them!
This first of three stories comes from one of my earliest couples from my class. I loved getting to know them. Both chiropractors, both very committed to having a natural birth. Here is their story:
We made that
(Jessica and Hans Mohrbeck)
(Jessica) I got pregnant. I got very pregnant. I had visions of being pregnant once, it involved a small, basketball-sized tummy and skinny ankles. I don’t recall wearing my husband’s clothes in that vision, nor it necessitating a wheelbarrow, but there I was using a pack and play box as a makeshift walker rushing at a snail’s pace to reach the bathroom in time, cursing my pelvic instability the entire way!
We were ready for this baby, took our Birth Bootcamp with Caryn, read all the books, did all the research. We had four more weeks to go but we were ready. Soon I made it across our tiny apartment living room and into the bathroom, relief set in and I wiped the sweat off my brow. Oh how I wished it were that beautiful pregnancy glow, but then my stomach turned and my dream of being the most beautiful pregnant woman was destroyed by the lurching noises coming from my being that would put a drunkard to shame. I’ll spare you the rest of the details but it must have been food poisoning, I was certain of that. The day turned into night and my already anxious husband, Hans, urged me to call Jenee, our midwife. It was nearly 11pm but I sent her a quick text telling her that I was having a bout of food poisoning and was finding it difficult to keep water down. I may have also noted the excruciating back pain causing me labored breathing. She called asking more details and then as matter of fact told us that I was in labor and that I should begin working with each contraction and get comfortable. She urged me to take a warm bath and then try to get some rest and to keep her updated if any changes were made. I thought this woman was a professional! If she had memorized our cliche birth plan she would know that it entailed music and candles and not labor 4 weeks early while making mammoth sounds while the contents emptied from my stomach. “I’m not ready!” I’m fairly certain I yelled at her. She very calmly, Jenee-style, told me it didn’t matter we may have a baby soon. “We’ll see about that”, I protested. If there is one thing people learn quickly about me its that I’m very decided, my husband calls it stubbornness but I’m sure he’s wrong. Giving up on trying to squeeze my whale of a body in a kiddy pool size tub I made my way to bed and managed to drift to sleep. The next morning I woke a bit sore from the violent heaves of my body, but otherwise I felt pretty good. No contractions, no baby, we were back on schedule. I had an appointment on Monday for a checkup with Jenee and I looked forward to proving her wrong. The rest of the weekend rolled by uneventful and I continued my nesting ritual of making my husband rearrange every room several times insisting I could still see dust on the baseboards. Monday arrived, I would be attending this midwife appointment alone for the first time. Hans had an exam and felt guilty for missing. I’m sure I graciously eased his guilt by pointing out that he was going to let his very pregnant wife drive to a town she had never been to and miss the sound of his precious baby boy’s heart. On my way the “contractions” began again. I don’t know what right a contraction had to be so strong in the back and certainly not while I was driving. I knew something was wrong, but I was obstinate and in denial. I would get there and rest and all this would go away. It didn’t, and very quickly Hans was on his way to take me to the hospital. I was to be assessed for pre-eclampsia though it was unnecessary. I knew I had it and I wasn’t ready. I wasn’t ready. No cute first baby outfit, no cute receiving blanket or baby booties or hat. I didn’t even have a tooth brush! This was most certainly not in our birth plan.I don’t remember much and probably for the better. I remember being told I would need an emergency cesarean and letting one mournful tear drop, oh how I wanted a natural birth. Ok, maybe it was more than one tear, maybe it was more like wailing banshee, I was never a pretty crier. I thought about holding back the emotions but then again, how could I? I was stripped of my obligation to bring this baby into the world naturally, healthily, beautifully. I had made it my mission in life to disprove people, doctors, and naysayers. I wouldn’t get married, I was told, who would want to marry someone with my conditions knowing I would be a burden the rest of their life? I wouldn’t accomplish a degree I was told, no one could accomplish a degree with the level of pain I suffered. And children? Forget them because even if I wanted them it would be impossible to conceive. But here I was, a Doctor of Chiropractic, a wife to an amazing man who knowingly took my hand and stood by me. A mother—the ultimate impossible. I remember a short argument with a disgruntled nurse, something about signing a waiver to remove my uterus. I hoped she knew I was just having a C-section and nothing more. I was concerned about leaving with all the parts I entered with.
(Hans) So there I was, waiting for my exam to begin, I had been studying at school all morning because I finally had some free time while Jess was at her midwife check-up. Twenty minutes before my exam my phone is ringing, it’s Jess, and all I could think was “doesn’t she know this test starts in a couple minutes?” I was wrong, it was Jenee, and after a greeting she dropped the bomb on me. “Jessica needs to get to a Hospital, ASAP” she said. “But I have an exam…” I mumbled, completely taken by surprise and as if the thought of the exam wasn’t terrifying enough. It was go time! My wife in her most demanding state of need, an experience that I swore to be present for and to assist her with. “Not anymore you don’t. You need to get here and get her to a Hospital. Something is wrong” Jenee demanded. “Ok, let me go talk to the professor and I’m on my way!” I exclaimed. Yep, this was happening. I can’t believe how worried I was about the test and how quickly it became the least of my concerns. When I arrived Jessica was sitting inside and Jenee was greeting me. She had started our other car to get the A/C running, it had the carseat so it only made sense. “Jessica is having contractions. You need to get her to a hospital, she might have pre-eclampsia. The two docs we planned for in case this happened are on vacation. You have a couple options but if I were you, I’d take her to Cleburne” Jenee advised. Jenee squared us away with directions and off we went. At the time I was terrified, Jess was having contractions in the passenger seat of one of the most rough riding vehicles we’ve ever been in, and she could have pre-eclampsia! Whatever the hell that is! I know they mentioned it at the classes but come on, that stuff doesn’t happen to us, certainly my life wouldn’t be affected by something so sinister and… what the hell is it? How could Jess have it? “I’m hungry but I don’t want to eat” Jess whined. “So eat something, I grabbed some crap at the store” I said as I motioned to her side of the car where I had tossed a bag with some juice, Cheez-its, almonds and some other stuff in it. She managed to get down one Cheez-it before she declared she didn’t want to eat and now she felt ill. I offered that perhaps it was because she hasn’t eaten. When we arrived at the Hospital we didn’t know where to go. We knew Dr. The O.B.’s office was with Labor and Delivery so that’s where we went. Jenee had already called over to a resident midwife on staff who was awaiting our arrival. She didn’t waste any time and was in our room assuring us how smoothly it would go. She mentioned how Jess looked fine and this is probably just precautionary. Nothing to worry about. They’ll just take some blood and we’ll make sure everything is fine, and be on our way. I was pulled in two directions, one direction was occupying half my mind with terrifying thoughts of what might happen. Of course only considering the worst case scenario, whatever it entailed, it was bad though. The other half of my mind was stuck on what a waste of time this is, how expensive it was going to be since we don’t have insurance, and how late we’d get home when we had to drive all the way back to Dallas. The certified midwife on staff was named Sharon*. She was the one who came to deliver the news. She stumbled over her words for a moment and then said “I don’t know how to tell you this. You’re going to need an emergency C-section. I don’t think there’s any way to even try a vaginal birth.” I’m not going to say I was stoic when this news was delivered. I was heart broken for my wife. She wanted nothing more than to deliver this baby on her terms. I teared up pretty bad but thought I’d be able to hold it together, until she started sobbing uncontrollably. I failed. I did what I could to console her. Sharon* reassured us that we were in good care then asked if Jess had eaten anything on the way, perhaps we could do the C-section now. We told her about the Cheez-it and she said “ok we’ll wait for tomorrow. We can’t do it if you have had anything to eat.” We notified Jenee as soon as the tears slowed and sat and waited. Sharon* came back and gave Jess some pill for some reason. I’m not good under pressure like this, so I can’t really recall what it was for, but I do know that shortly after she took it she just spaced out. She was high. I was jealous wondering if I’d get one. She seemed so carefree. I wanted that. Instead I finished up the conversation with Jenee. Called my brother to let him know he needed to handle the pups and that we wouldn’t be coming home. I sent some texts to family and then decided I better get a few things from the store. I waited for Jess to fall asleep and ran out to Walmart to prepare for the next day. My clothes were filthy, I was ravenous and my mind was too damn busy for sleep.
The big day. The day all of this crap will be behind us! Dr. The O.B. showed up to clue us in to what was going on. He informed us that Jess was in fact pre-eclamptic and more than that was suffering from some terrible thing called HELLPs. More like UN-HELLPS. When we asked what HELLPs was we were just bombarded with a bunch of doctor words that meant nothing to me. All of it sounded terrifying however that’s probably because it was all wrapped in in a nifty box called syndrome. I’m not sure but I don’t think there’s such thing as a good syndrome. Jenee arrived and we filled her in. She didn’t say much, but she did a great job of making it feel like everything was normal and that this was just a bump in the road. Not a big deal. Dr. The O.B. came back to the room with an IV bag of platelets, and some medication used for the pre-eclampsia. He informed us we needed to raise Jess’ platelet count before we could even attempt the C-section. After administering a couple of bags of platelets she was prepped and ready, even though they still weren’t pleased with the count, they needed to move fast to make sure they could at least contain the pre-eclampsia. This is where I was left out. Jess was moved to the main OR at the hospital so that they had immediate access to any equipment that may be needed and Jenee and I were sent to the waiting room. We sat and talked for a while, about 30 minutes and then Jenee started to pace. I had no idea how long it should take so I assumed she just didn’t want to sit. Forty-five minutes went by and Jenee mentioned that it’s taking a little long but perhaps there was some politics in the OR that have lengthened the process. We didn’t hear anything until just after an hour passed. We were notified that the baby was born and he’s doing great, just working on Jess. Jenee seemed relieved about that and so I was too. They brought my baby to me and handed him to me with a big smile and said “he’s so precious! The most adorable baby I’ve ever seen!” “What the f#$% am I supposed to do with this thing?” I wondered to myself. I stood there and held him up awkwardly. “Where’s Jess” I asked. I mean I heard so many times how she couldn’t wait for him to be born and hold him skin on skin, and nurse him, and cuddle him. I don’t remember having to hold my son in front of random strangers, under their scrutiny, as though they were testing to see if I would be a good single father. It was almost like I was shopping for lingerie at Victoria’s Secret without a woman. I was being watched like some weirdo. Seriously… what the hell am I supposed to do? Jenee and Sharon* said some things to me to bring me to ease but let’s be realistic, this wasn’t part of the plan. This is Jess’ thing. My plan was to watch and shed tears of joy. Not be the sole caregiver of a newborn. I can’t nurse him. This doesn’t even make sense! Sharon* assured me Jess would be out in a few minutes and to head upstairs. So Jenee escorted me upstairs where instead of Jess getting to experience the first moments of skin on skin, it was me. I was thrust into this awkward moment by myself, without my support, with the one person in my life who I needed to prove myself to, my son. Jenee urged that skin on skin with me was almost as good as with Jess so I peeled off my shirt, felt awkward and self-conscious and realized the only judging eyes in the room were my own. So I unwrapped Hansi and placed him on my chest where we just sat and he looked up at me.
This was heavy. This might be my reality. I could be the only one there for my son. All I could think was “this kid is doomed…” Time went by. At first I was counting the minutes. Staring at the clock. Then I just stopped. A watched pot never boils… you know, that kind of thing, so I just sat there with Hansi and Jenee assumed my role. She began calling downstairs every 10-15 minutes inquiring about Jess. Finally after some ungodly amount of time they said “we’re having difficulty stabilizing her. We’ll move her to ICU as soon as she’s stable enough to move.” Call me crazy, but I was always under the impression that ICU was where unstable people were sent. It seemed like my worst fears were getting closer by the minute, this kid was doomed, I will be a single dad, and Jess wouldn’t have been able to realize the skin on skin contact of her own creation. We took a lot of bold chances but perhaps they finally caught up to us. I had sent texts to inform family about Jess going in for a C-section. We had prayers and wishes for luck. I texted my in-laws, and as the time passed my mother-in-law continued to inquire. I responded a couple of times, I even sent pictures of Hansi. This of course was not the news everyone was awaiting and soon texts were going unanswered. Eventually we were given the fantastic news that Jess was moved to ICU. It’s not very often that your loved one in ICU is good news, but I must say it filled me with hope. It was a step in the right direction because I’m pretty sure there was no room for a step in the other direction. Jenee told me to go downstairs and see her, she’d watch Hansi for me, and so that’s what I did. I ventured down to the ICU as soon as I could. I found Jess’ room and crept in. She laid there. She was motionless, frigid cold to the touch yet wrapped in blankets. Her skin was nearly translucent, her heart rate was low, blood pressure dismal. It looked as though she was dying and this was their attempt to let me see her one last time. She was unresponsive. It’s probably obvious how I reacted. I went back upstairs to see Jenee and told her about how Jess looked down there. She said she wanted to go check on her. I sat there with Hansi again, the gravity of the situation seeming to have acquired much more pull than earlier. How do I do this alone? When I married Jess it wasn’t for the thought of children, it was for a future with her, and this reality didn’t seem to have room in it for her. Jenee came back upstairs and told me to call her family. She informed me she couldn’t find Sharon* and that her parent’s have a right to know what’s happening. She was right. I went back downstairs to see Jess and find Sharon*, I found Sharon* first. I told her I was going to call my in-laws and needed to know what to tell them. I asked her “can I tell them that Jess is going to recover and that everything is fine, or do I tell them they need to get out here as soon as possible?” Sharon* tried to respond while I was talking but I hand cut her off with my questioning and her response was “tell them to come out here.” I did just that. I walked outside and made sure to get away from the entrances and sidewalks. I called my mom first, hoping that I could release enough sorrow on the phone that I could have a reasonably collected conversation with her mom. All it did was convince my parents to get on the road. I didn’t protest. After I hung up I immediately called my in-laws. My mother-in-law asked how Jess was doing. Asked why I wasn’t responding. I told her we had not been receiving any updates so I didn’t have anything to tell her before. I told her about the conversation with Sharon* and that they should get on a plane and get here as soon as possible. They did just that. Jess finally came to in ICU where they were routinely changing out IVs of blood. I witnessed them change it 8 times, however I do not know how many units she received. She was coherent though after a while, and although there was some moments that seemed like they’d be her last, that team never stopped fighting and neither did Jess. I spent a lot of the day between being in the ICU with Jess and giving Jenee a break.
(Jessica) A few days, or hours who knows, I awoke. I was alone and empty and so I let the medication drag me back under. I woke again but this time my husband was at my side begging me to hold on, to not leave him alone, that he couldn’t do this without me. I didn’t understand. I tried to talk some sense into him, to tell him I was ok and that we would be home soon, but all that came out was a few squeaks. It had taken the anesthesiologist eight minutes to intubate me, normally a 30 second step, and in the process scarring my trachea making it difficult to talk and swallow. So I weakly whispered affirmations of love and healing and that I felt great, but only terrified doubt lay in his eyes. I remember waking again later and asking for Hans but I was told he was with our baby on another floor in the hospital. They weren’t allowed to leave that floor and I was still too sick to return to the maternity ward.
(Hans) Jenee stayed with us that day. It was much needed. I couldn’t have done it without her. She was a blessing and I wish there was some way I could thank her. I wish I could pay her for her time, or return the favor. She made sure to acquire donor breast milk and took the responsibility to feed my baby. She changed his diapers. I was clueless. That night the head nurse said she would be taking Hansi downstairs to see Jess. He was going to nurse one way or another. I mentioned something I had heard in passing about the doc not wanting Hansi down there yet and her response was “I don’t care what anyone says, she’s going to nurse.” I knew Jess would be pleased, because I was, and she was right. She brought Hansi downstairs and Jess was given the opportunity to nurse him on his first day of life. It may not have been in the plan, but her wish was still granted.
(Jessica) I argued with the doctors that I was strong enough to at least nurse my baby. Concerns flooded through me, would he know me, remember me, feel safe and loved in my embrace? How coldly he was torn from my body, so soon before our due date. I had lost the chance to birth, to become a real woman, to understand my body. But my pleas were heard and my baby was brought down. I was complete again, my worries quickly melted away, of course he remembered me and we nursed and fell in love all over again. I looked to my husband and said “We made that, a miracle baby.” Hans Wulfric was born June 11, 2013.
We just want to extend a special thank you to Jenee Ohrvall w/ Sacred Path Midwifery for everything that she did for us from the start. Thanks to Caryn Westdyk for being such a fun and knowledgable Birth Bootcamp instructor. Thanks to Dr. Jim Bob Haggerton for providing fantastic Chiropractic care. Finally,a big thank you to the team at Texas Health Harris @ Cleburne for everything you did for us.