Choosing an experience: My journey to VBAC

Today's post is written by Pamela Candelaria who writes over at Natural Birth for Normal Women. 

I’m going to come right out and say it: The single biggest reason I wanted a VBAC was because I wanted the experience, magic-filled and complete with angelic music and ethereal light. Well, yes, I had romanticized it a bit, but I had a very clear vision of my ideal birth before my firstborn was a twinkle in his daddy’s eye.  I believe giving birth is a rite of passage, and the actual physical act of giving birth is the highest expression of feminine power.  I was shocked when I ended up having a c-section to deliver my first baby, and it was an enormous struggle for me to work through my feelings of failure. There was never a question that I would pursue VBAC when I had more children. Or at least, there was never a question until I got pregnant again. 

Then it started. I knew I had to be better informed this time, make better choices to have a better birth. My starting point for research was the internet, and it was absolutely filled with horror stories about VBACs gone wrong, catastrophic uterine ruptures that killed babies and left mothers hemorrhaging and facing hysterectomy. If only they’d chosen another c-section, their babies would be alive and they would be able to have more children. My conviction began to falter. I kept reading. I read the derision heaped on VBAC moms, the accusations that we were trying to get a “vag badge” or would rather have a vaginal birth than a healthy baby. I wondered if I was putting my own desire for an experience above the health of my baby. If that was the case, I needed to re-evaluate my priorities make peace with having c-sections for all my children.  

In the midst of my searching, something wonderful happened. I found an online support group full of women who not only knew absolutely everything about VBAC and repeat cesarean (RCS), but were able to direct me to the sources so I could learn it myself. I started reading studies- actual studies that looked at thousands of births. I could see the biases and flaws in the research, and I was able to critically evaluate how the conclusions of the studies were affected by those biases. I had support, I had encouragement, and I had resources- and this is what I learned:

VBAC is safe. Let me say that again: VBAC is safe. That is not to say it is without risk, but any pregnancy following a c-section carries greater risk than a pregnancy with an unscarred uterus. On the whole, VBAC provides better outcomes for mothers and babies than scheduled repeat cesarean.  VBAC babies have higher APGAR scores, lower rates of NICU admission, less need for supplemental oxygen, and shorter hospital stays than babies born by RCS. VBAC moms have less time in the hospital, too, and they also enjoy significantly lower rates of infection, hemorrhage, transfusion and hysterectomy. Repeat cesareans are 2-4 times more likely to result in maternal death than VBAC, but death related to uterine rupture in a VBAC attempt is unheard of. Because I wanted a large family, it was critical for me to learn that risks in future pregnancies dramatically decrease with multiple VBACs, but dramatically increase with multiple c-sections. Having this information renewed my confidence in my decision to VBAC, but it left me with questions, too. Why was the obstetric world so against VBAC? And why do only 10% of women choose VBAC? 

The answers to those questions are multifaceted. The factors influencing modern obstetric care in general, and VBAC specifically, are complex and interwoven to the extent that it’s nearly impossible to separate them. Medical malpractice suits are a huge part of the equation, and there are lawyers ready and waiting to vilify OBs who support VBACs. It’s estimated that 30% of OBs have stopped supporting VBACs solely because they fear malpractice liability, and another 29% have increased their c-section rate for the same reason. The ACOG issued guidelines requiring “immediate” availability of emergency c-section for VBAC moms, and as a result nearly 1/3 of hospitals stopped supporting VBAC labors. But with the majority of OBs and hospitals still allowing VBAC, I wondered, why do women choose RCS in droves? 

It is common (though inaccurate) knowledge that VBAC is safer for mothers and RCS is safer for babies, and there is a strong social expectation that we as mothers should be willing to sacrifice our own safety to ensure the safety of our babies. We fear we’ll be held responsible if a VBAC goes wrong, but choosing RCS makes the OB responsible for the safety of the baby during birth. Many OBs provide misleading information about the risks of VBAC, guiding women to “choose” RCS because it is falsely presented as risk-free.  Other OBs claim to be VBAC-supportive, but have a laundry list of criteria that virtually guarantee no one will ever achieve a trial of labor. VBAC is no longer a mainstream birth choice, and when faced with unsupportive providers, misinformation, scare tactics, and a constant need to be vigilant and advocate for ourselves to ensure we’re given an opportunity to birth the way we want- well, is it any surprise that most of us opt out? 

After all my hours of research, I felt vindicated. Not only was my desire for a birth experience okay, but going ahead and having that experience was going to be better for me and my baby and all my future babies too. I was also lucky; my OBs never questioned my decision to VBAC and they were supportive and encouraging throughout my pregnancies. I have now had three VBACs, and oddly enough, there wasn’t a single one marked by angelic music or ethereal light. I never had that ideal birth I’d envisioned. It was just me, birthing my babies, having that experience, doing a little part of God’s work. And I wouldn’t trade it for the world.  

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Pam is a mother of 4 who found a passion for birth through her cesarean and 3 VBAC journeys. She believes the best way to improve maternity care is to empower all women to make fully informed decisions, regardless of what type of birth they choose. She resides in Denver, Colorado. 

J Lo tells us the reason we should all get our pre-baby body back...

Recently, Jennifer Lopez was interviewed for  US magazine. Not the most intriguing of magazines, I know, but they do have (what I am assuming is) hundreds of thousands of subscribers, and many, many more pick it up while waiting in line at the grocery store. The cover screams, "MY BEST BODY EVER" and provides us with an eyeful of the celebrity looking happy and sultry. A look all of us mothers are apparently dying to achieve. (Insert eye roll). The article quotes Lopez as saying,"You get to the point where you're like, Where am I? What happened to me? I got to get myself together for my kids, you know? They need to know what I really look like."

Don't get me wrong; I love me some J Lo. Many times I've been running, listening to her music, shaking my butt, trying to tap into my inner Latina. But, Jesus H. Christ. "They need to know what I really look like" ?? What she really looks like? I can guarantee, that what she really looks like is not some perfectly lit, posed, professionally make-up'd, airbrushed and photoshopped celebrity. And what kind of message does this send to her children and to other mothers? Call me completely bananas-gone-crazy, but this is the message it sends to me as a mother: 

Mamas: If you've got a little or a lot of belly fat, perhaps some pesky cellulite on your thighs,

 some sag on your butt cheeks after having those babies, don't you think it's about time you show 

your kids what you looked like BEFORE you had them? So what if it's been several years and you're

 not 20 anymore. Do it for your KIDS! Get yourself together for your them. 

Clearly, I jest, and who really takes J Lo seriously anymore. But, this is nothing new. We see it and hear it daily. The "How I got my body back after baby" article is a pretty constant bombardment to us mothers. So how do we ignore it? How in the world do we squash just deal with the body image pressures after having babies? 

There are many things a woman can do about it, and it really depends on the severity of her issues. I will say a couple of things. First of all, remember this: When you decide to have a baby, your life will change permanently. Forever. For the rest of your natural life. So, count on the fact that it's pretty likely that your body will change too. For-ev-er. Am I happy about the fact that my body is different now after having 2 babies? No. By no means do I give myself a wink and a thumbs up in the mirror when my eyes fall on a part of my body that is different than it used to be. But, I'm learning to live with it. Sometimes I just sigh and have to say, "It is, what it is", then go chase my toddler or nurse my daughter (which by the way I'll take my not-so-perky-anymore breasts as a trade off for breastfeeding both of my children). Just try to keep it in perspective. We chose to have the attitudes we have about certain things. Body image is no different. We can choose to be in a place of "Oh-my-god-I-need-to-get-my-body-back-or-else-(insert worst possible fate)" or we can choose to just accept it for what it is.

Your kids don't care if you have some belly fat. They don't care if you have some cellulite. But, they do care (and listen) about how you think and talk about your body. I vowed to do my best to heal my body image issues and to not pass them on to my children, especially my daughter. I do the best I can. Sometimes I feel like that clown at the circus who spins plates on both hands, one foot, his head and his nose. Some fall off, sometimes he looks silly, but, hey, at least he's trying, right? We have a lot to deal with as mothers. Let's not beat ourselves up by comparing our bodies now to what they looked like before we had babies.

Thanks anyway, J Lo. Please don't comment anymore about that. Just keep making great movies making music that we can shake our butts to. 

Things you shouldn't say to a pregnant lady...

...Or one that just had a baby

“Don’t be a hero, just get the epidural.” 

Plain and simple- Women who don’t get an epidural during childbirth are not trying to be a hero. They’re not trying to prove anything to anyone. They don't want a trophy, a medal, or a "congratulations". Their reasons may vary, but I can almost guarantee that they are completely annoyed by the “Don’t be a hero” statement. 

“Women that have natural child birth are crazy!”


We are trained to think that childbirth is hidiously painful and should be avoided at all costs. Childbirth is a right of passage and many women embrace it, pain and all. 

“VBAC is selfish. You should just do the safest thing for your baby and have another c-section”


This one makes my head spin. If anyone was truly educated on both the subject of multiple cesarean and VBAC, they would never say this ridiculous statement. I can only assume this would be said by someone that doesn't have a clue about both subjects or does not have a vagina. If someone does have the balls to say this, ask them where they got their medical degree. 
VBAC is not selfish. 

“Having a healthy baby is all that matters. It doesn’t matter how he’s born”

There is someone else involved in the birth and caring of that baby- and it’s his mother. Her physical health is important, but also her mental and emotional health. I am so tired of hearing this. It does matter how the baby is born! It goes without saying that the health of the baby is most important, but it's entirely unfair that the mother's feelings are simply pushed aside. 

“C-section is the way to go. No contractions, no pushing, you’re in, you’re out!” 

If you’ve never had a c-section and you say this to someone, shame on you. You have no right to impose this type of advice. If you’ve had a c-section and your experience was pleasant, I ask you to STOP telling pregnant women this. The process of labor and delivery is actually healthy for mother and baby. Most women grow up hearing nothing but horror stories about labor, so they learn to fear labor. I mean really FEAR labor. But women's bodies are made for labor. We're made to be able to take the pain and the contractions. 

“Well, it could always be worse”

I'd like to think that this statement is said when there is absolutely nothing else to say. Perhaps out of desperation to fill the silence or say anything to make the mother feel better. But, I urge, you...don't say this! Obviously, it could always be worse. But, someone who didn't have a great birth experience does not need their feelings to be made less. 

And lastly, I hesitated to write about this, but I wanted to make the point. (Another great post about this is here). If someone has had a traumatic c-section, or even a non-traumatic one but has ill feelings toward it, I think saying the following can be hurtful:

“Don’t worry, next time you can just have a VBAC!”

It can be negative for two reasons. First, she may not be a good candidate for a VBAC or she may attempt and not succeed (or she may be done having babies). Secondly, having a VBAC doesn’t automatically erase or “fix” the feelings of a previous traumatic birth experience. In some ways, I expected this to happen to me. Although my VBAC was great, and I encourage all women to try for one that desire to, I’m still sad that my son came into the world in a way that I feel was not the greatest. It’s out of my control, I’ve come a long way with the feelings assocaited with it, but like any traumatic experience, happier ones in the future don’t make it all better. 


Photo courtesy of Shutter Daddy

Caveat Emptor: The Real Risks of Cesarean Section

Today's post is written by Pamela Candelaria who writes over at Natural Birth for Normal Women. 

Over 1.3 million babies in the US were born by c-section in 2008, accounting for 32.3% of all births. The most common reason for cesarean delivery is having had one before, but the reasons for a cesarean can vary widely. Sometimes there are medical reasons for planning a c-section prior to labor, and emergencies during labor make other c-sections truly lifesaving. For a huge number of women, though, the picture is less clear. They are told they have small pelvises, or big babies, or their labors aren’t progressing fast enough. Many women are told cesareans are a safe way to avoid the risks of vaginal birth, and an increasing number of mothers are choosing c-sections with no medical indication at all. Whatever the reason for the c-section, though, one thing they almost always have in common is a lack of truly informed consent. Let’s look at the risks listed on a fairly typical consent form—what isn’t on the form may be surprising:

The consent form says:

Infection in the skin incision, usually this is controlled with antibiotics. Sometimes it can require you to be re-admitted to the hospital, but in most cases antibiotics are taken as an out-patient.

In reality, you are twice as likely to be re-hospitalized following a c-section, infection is almost five times more likely to occur, and infection can extend to the uterine incision. Taking antibiotics while breastfeeding contributes to thrush, adding another challenge when breastfeeding is already less likely to succeed following a cesarean. 

The consent form says:

Development of heavy bleeding at the time of surgery with the possibility of hemorrhage which could require a blood transfusion.

Transfusion is required in up to 6% of cesarean sections. If your c-section goes perfectly, you’ll lose over twice as much blood as you would during a normal vaginal birth- and even that number may be grossly underestimated. It is interesting to note that “normal” blood loss during a c-section would be considered a hemorrhage during a vaginal birth.  

The consent form says:

Injury to the bladder and/or bowel which could require surgical repair (this occurs in less than 1% of all Cesarean sections)

True- but mild bowel paralysis occurs following up to 20% of cesareans, and some women have bladder injuries that don’t require surgical correction but do require use of a catheter for weeks following delivery. Even if only 1% of women require further surgery to correct these injuries, that is almost 14,000 additional- and largely preventable- surgeries per year being performed on mothers who should be happily caring for their newborns.

The consent form says:

Injury to the ureter (a small tube which passes urine from the kidney to the bladder)

While this injury is unusual, occurring in just 0.1% to 0.25% of cesareans, it often goes undiagnosed until the mother returns to her doctor with symptoms including pain and fever. Another surgery is then required. 

The consent form says:

Developing a blood clot in the leg veins after delivery

This occurs in ½% to 2% of c-sections- somewhere between 6,900 and 27,000 women- and can be fatal; yet many women are never told what symptoms to look for or how to reduce their risk.  

The consent form says:

Risks for subsequent pregnancies include: placenta previa (where the placenta lies wholly or partly in the lower part of the uterus)

Shockingly, this consent form fails to list any other risks for future pregnancies. Reproductive consequences of a primary cesarean include a risk of uterine rupture that is 12 times higher than it would be with an unscarred uterus, even if a repeat cesarean is scheduled. A woman also faces increased risk of placenta previa, more severe placenta problems like abruption and accreta, miscarriage and unexplained stillbirth, unexplained secondary infertility, and dramatically increased risk of surgical complications in future c-sections. If that is not enough, the scar tissue and adhesions left by cesarean surgery can cause chronic pelvic pain and sexual dysfunction, and in rare cases can cause intestinal blockage that can be fatal.

The consent form says:

Cutting the baby during the incision into the uterus (this occurs rarely).

About 1-2% of babies are cut during c-sections- that could mean over 25,000 babies, every year, receiving anything from a nick to a severe laceration at the hands of the delivering OB. While the consent form ends here, a slippery scalpel is not the only risk babies face when delivered by cesarean. Babies born by elective cesarean are up to seven times more likely to have respiratory problems at birth, and are up to three times as likely to die in their first month of life.  C-section babies have lower APGAR scores, higher NICU admission rates, and they are more likely to have ongoing health problems like asthma. It’s important to note, these are low-risk babies, not babies who are delivered by emergency cesarean who may have been affected by complications of labor. No, these babies experience these issues as a direct result of the way they were born. 

I’ve talked with hundreds of women about their cesarean births, both online and in real life. There is a pervasive belief that c-sections transfer the inherent risks of birth to the mother, providing babies a safer and lower-risk entrance into the world than they’d have with a vaginal birth. Many OBs perpetuate this myth, but it’s clear they aren’t telling us the whole story. I don’t think I’ve met one woman- not one single mother- who was told up front that in some respects her c-section put her baby at greater risk than vaginal birth would have. Even though many women seem comfortable with the increased maternal risks of c-sections, few are truly aware of exactly what those risks are, how much they are increased, or how they can be reduced. OBs are selling c-sections as a safe and easy way to deliver a baby- and women are buying. 

Buyer beware.

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Pam is a mother of 4 who found a passion for birth through her cesarean and 3 VBAC journeys. She believes the best way to improve maternity care is to empower all women to make fully informed decisions, regardless of what type of birth they choose. She resides in Denver, Colorado. 

Sources:

2008 Birth Data

http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_16.pdf

Cesarean Section Consent Form

http://www.awomansplaceobgyn.com/PDF/CONSENT-FOR-CESAREAN-SECTION.pdf

Risk of selected postpartum infections after cesarean section compared with vaginal birth: A five-year cohort study of 32,468 women

http://www.informaworld.com/smpp/content~db=all~content=a913514882

Cesarean Fact Sheet

http://www.vbac.com/pdfs/CesareanFactSheet.pdf

Neonatal Morbidity and Mortality After Elective Cesarean Delivery

Caroline Signore, MD, MPH^a and Mark Klebanoff, MD, MPH^b

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2475575/

Thrush in Breastfeeding Moms

http://www.babycenter.com/0_thrush-in-breastfeeding-moms_8486.bc

Cesarean Childbirth

http://www.emedicinehealth.com/cesarean_childbirth/page9_em.htm 

Estimates of cesarean-related blood loss shown to be too low

http://findarticles.com/p/articles/mi_m0CYD/is_13_38/ai_105514154/  

Urologic Injury at the Time of Cesarean Delivery

http://www.femalepatient.com/html/arc/sig/obsF/articles/034_08_023.asp

Uterine Rupture in Pregnancy

http://emedicine.medscape.com/article/275854-overview

Deadly Delivery Summary

http://www.amnestyusa.org/dignity/pdf/DeadlyDeliverySummary.pdf

Fetal Injury Associated with Cesarean Delivery

http://www.ncbi.nlm.nih.gov/pubmed/17012450

The Easter Bunny meets Cesarean Awareness

April is my favorite month. Probably because it's my birthday, Spring, Easter and Cesarean Awareness Month. So guess what this post is about? Yes, another topic that gets my panties in a wad: Cesarean section and VBAC.

Fighting for my own VBAC has changed my life. I don't use that term very often, only when I truly mean it. It opened my eyes up to the world of American obstetrics, and how far we've come away from birth as a natural process. In my opinion, we've shoved a big, fat middle finger in Mother Nature's face.

So, why do I care? Isn't it none of my business how another woman gives birth? What she chooses to do is her perogative, isn't that why we're so lucky to live in America? So, shouldn't I just sit back and not judge? Well, yes and no. Yes, I shouldn't judge, but realistically, we're all human and we do it every day. And no, this is my blog and I feel it in my bones to speak out about this. So, if you don't want to hear me rant about birth, unnecessary cesarean and VBAC, you are welcome to stop reading now and for the remainder of the month of April.

Congratulations if you're still reading, you might get your mind changed, help someone else change their mind, or just plain hate me later. I'm okay with any or all of those.

I have come to realize that birth is hands down the most natural, beautiful, organic process in the entire world. It's been happening for billions of years. And it's changing for the worse. We are backpedaling when it comes to nature. Once we figured out we were destroying our planet, we all jumped on the bandwagon to fix it, right? And when we realized how many hazardous chemicals are in our foods and  household products we try to make changes to keep ourselves and families safe, correct? But, here we are, destroying the one thing we all have in common: Birth, and year after year it continues to get worse. In the U.S. the maternal death rate has nearly tripled in the last decade and the cesarean rate has continued to rise for the last 11 years, and if the trend keeps going, it may reach 50% by the time my daughter is ready to have babies. There are many reasons for this sharp rise, but that's not what this post is about.

I feel if I sit back and say nothing, I perpetuate the problem. What has me so upset, is the lack of information women have when they are pregnant and give birth.  When pregnant with my first, I was one of them! I sat back, let my doctor talk at me and hardly questioned him. My instincts told me to do something, anything, ask questions, go against his word, call his bluff. But, I didn't. Years and years of wiring were engrained in me. Things like: Doctors know everything. Doctors always have your best interests at heart. Hospitals are the best and safest place to have babies. Birth is scary, painful and dangerous. These are all things I thought were true, never trying to find out if any of it was factual or not. Guess what? It's all bullshit.

(Note: Not all doctors are bad. There are some great obstetricians, ones that support VBAC and will even wait it out on a long labor. But, this post is not about that either. Moving on!)

So, what is this post about? Basically what I stated before: I feel that many women lack important information when they are pregnant and giving birth. Some patients rights include:

• Women can refuse to be examined or treated by anyone.
• Pregnant women have a right to refuse any medical treatment or drug, including a cesarean section, episiotomy, anesthesia, and pain medication.
• A woman has a right to change her mind about any decision made before or during labor or childbirth.

Those are just a few. For a full list and other great information, click here. I hear story after story of women who are pregnant that didn't know they could refuse treatment, cesarean deliveries, vaginal exams or other interventions. It's up to us to know our rights and be able to ask or question our medical professionals. 

One of my favorite birth bloggers, Barbara Herrera, wrote a post entitled, "When you buy the hospital ticket...you go for the Hospital Ride." She says, "If you want control, why go where egotistical birth is the norm? If you want autonomy, why go where lawsuits and defensive medicine are the rule?" I'll be honest. I was scared shitless that my baby might be in danger during labor. Why? Because I was fed the absolute worst possible scenarios at each and every one of my OB appointments. If you know me and/or read my blog you know that I encourage and teach people to listen to their intuition, their gut instincts. Mine was telling me everything was fine, myself and my daughter were healthy and safe and that I should trust my body. But, as mothers, as incubators of these precious creatures it's very difficult to ignore modern medicine and not place our utmost trust in our superhero medical birthing system. After all, hospitals save babies. They save mothers birthing babies. In very, very rare instances they do this. But, you have to wonder: Is a hospital the safest place to birth? Is it the best place to bond with our babies? Are we just too scared and maybe uninformed to do it anywhere else? Do women really think they can't or don't know how to birth? Is it just a coincidence that as maternal mortality is rising so is the rate of cesarean sections?

The month of April will continue with birth and Cesarean related posts. Here are some references if you are pregnant, wanting a VBAC, or thinking about either one. Or if you know someone who may learn something about birth, these would make an excellent gift. Birth is the first major event your child experiences. Inform yourself to be able to make the best choices for yourself and your baby. Empower yourself to take control of your body and your birth.

"Ina May's Guide to Child Birth" by Ina May Gaskin
"The Thinking Womans Guide to a Better Birth" by Henci Goer (this one is great if you like scientific research to back up all the things you're reading).

"Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience" by Ricki Lake and Abbi Epstein.
Also, visit the International Cesarean Awareness Network, VBAC Facts and The Unnecesarean websites.

Photo courtesy of Thomas van Ardenne

Beautiful Blogger Award

I am so honored to have been giving the "Beautiful Blogger Award" by none other than Julie Parker, author of one of my favorite blogs: Beautiful You by Julie. Thanks, Julie!! To claim this award I have to regift it to 15 blogs I love and read and so the awards go to:

Voice in Recovery

Authentic Realities

Natural Birth for Normal Women (aka Use Your Vagina)

Life After College

May the Beauty

More To Love by Elizabeth Patch

Venus Vision

Beautiful Women Project

Motherhood Reinvented

Jess Weiner's Blog

Revolution of Real Women

Woman Uncensored

The Feminist Breeder

The F Word

You'd Be So Pretty If...

To claim my prestigious award I also have to tell you seven things about me, so I'll try to tell you seven things that may surprise you. Or maybe not? Drumroll please.....

1. I was a painfully shy child. The kind that hid behind my mothers leg if someone said hello to me. Quite the opposite now.
2. Having children deeply changed who I am. I was a conservative republican (okay, I just heard some jaws hit the table) and some of my views still stay there. But, as a feminist, well, you can figure out the rest.
3. I hate 2 things that are very "American". Snickers bars and Barbeque sauce. Both disgust me.
4. I have a phobia of drains. A serious one. Sink drains, shower drains and especially pool drains. I have near panic attacks when swimming near the huge deep-end pool drains. Even just typing this makes me uneasy.
5. I can do a beer bong. I haven't done it in a few years, but I've won a few contests. I'll sign autographs later.
6. I am a whiz at remembering people's names, but not at remembering faces. So, it rarely comes in handy. But, I am notorious for thinking I know someone and I'm wrong.
7. The worst physical injury I've ever had was knocking out 3 teeth when I was 7 years old. No broken bones ever!

I hope all the blogs I have given this award to enjoy it. To claim your award you need to:

1. Thank the person that nominated you and link to them.

2. Pass the award on to 15 bloggers you’ve discovered and think are fantastic.

3. Contact said Blogs and let them know they've won!

4. State 7 things about yourself.

Happy blogging all!

My amazing body

Today's post was inspired by another blogger and what she entitled, "MY perfection". I encourage you to click on the link and read her short view of what her perfection is. And here is mine.

This week is National Eating Disorders Awareness week and leading up to it was racking my brain thinking of something amazing and inspiring to write about regarding body image or eating disorders. But, truth be told, I just don't have it in me. Maybe I'm taking a break from writing about my own struggles, maybe I'm so far into recovery that my mind refuses to go back there and dig up the old painful memories. I'm not really too sure.

But, here's the honest to God truth: Every morning I turn the shower off and open the shower curtain. Directly in front of me is a large bathroom mirror, so I get to see myself naked everyday. It's not the same body it was 10 years ago, 5 years ago, or even 3 years ago. Three years ago today I was almost 3 months pregnant with my son, my first child. My disordered eating and exercise behaviors were ending. I don't think I knew it then. I wanted it to be over, but wasn't sure if I would relapse after my son was born. I'm proud to say I didn't. I kept going forward with giant steps, steps bigger and scarier than I ever imagined.

So back to the mirror. I heard once that if you can hold a pencil under your breast, you need a boob job. (Whaaat?) I'm pretty sure I can hold an entire pack of pencils under mine, and I still don't "need" a boob job. I have belly fat that spills over and my son loves to poke it and say, "Squishy belly mommy!" There are veins on my body that look like road maps, I have stretch marks, and even cellulite on my thighs. I am reminded every day of my sons birth from my pink, uneven cesarean scar. But, I ask you, someday at my funeral, will anyone say, "Such a pretty face, too bad she didn't lose that baby weight." or "That cellulite and stretch marks were a real eye sore."

No.

Because at my funeral, I hope to have touched enough lives that people will tell stories of what I meant to them, how I bettered someones life, how the values I instilled in my children's have helped shaped their own lives. That's all.

I'm not saying let's all throw away any notion of wanting to look good and feel our best. I know it's important, I get it. But, what's amazing to me now, today, isn't the same amazing it was even 5 years ago.

So, bring on the cellulite and stretch marks. I got the privilege of pushing a baby out of my vagina! Now, THAT'S what I call an amazing body. I love my body now, with all of it's so called "flaws and imperfections". It's pretty awesome to me...and for reasons that might not be what others think.

Photo courtesy of author (that's me!) taken by Kristina Chartier Photgraphy

Oh my gosh, my life is over!

Todays post is written by Pamela Candelaria. She and I have become "cyber-friends" through a VBAC support group and Pamela herself has had 3 VBAC's!! Please enjoy this beautiful ode to motherhood. Thanks to Pam for letting me re-post this.

Every time I've been pregnant, I go through a period of blissful happiness, envisioning the sweet tiny newborn I'll be holding, the quiet moments we'll share during 2 a.m. feedings, the soft innocence of that new life cradled in my belly. I close my eyes and breathe deeply, and I swear I can almost smell that precious new baby, so new to the world.

And then at some point, the pregnancy becomes real. The sweetness does not go away, and I'm not unhappy, exactly, but I find myself longing for my life before. I think of all the changes this baby is going to bring- and it's number four for the love of God, not like I haven't done this before- but I think of the changes and I have some kind of premature need to reminisce about my life as a mother of three. And two. And one. And, of course, none. I think of the freedom, the spur-of-the-moment trips, the parties, the concerts, the smoking and drinking and laughing and sex and spontanaeity and overall coolness I had. I think of the career I gave up to stay home with my kids, the financial sacrifices my husband and I have made, the difficulties we've had in our relationship as we've adjusted to our roles as parents. I realize we haven't even found our groove after adding our daughter to our family, and yet we thought it was a good idea to go ahead with another baby- what were we thinking?!?

I remember when I was pregnant with #3, I had left the kids at home with my husband and was driving to the library to check out some baby name books. I was stopped at a light when a song came on the radio- I don't remember which one and I guess it doesn't matter all that much- and in the second it took me to reach for the volume knob and start turning it up, I was overwhelmed with the realization of how much my life had changed, and was about to change again. I ended up pulling into the library parking lot and sitting there in my minivan- so not my Miata- crying my eyes out because this was "me" time. Getting baby name books at the library without having both my boys with me. What had become of the woman I'd been? I felt so lost, so uncertain about the new role I had taken on. Motherhood is so much more than having a child, it is a soul-deep shift that forever changes how I view myself, and the world. Every child I have has increased my capacity for love and learning and life- but every child has taken me further and further from my life before. Every flutter I feel in my womb is a reminder that my potential is being passed down now; the future will soon enough be in their hands and not mine. One day they will exceed my ability to shelter them, and one day I will look into their faces and see all the things I used to have.

So I sat in that parking lot and cried. I cried for the woman I had been, and for the woman I am, and for the woman I will become. I went inside and got my baby name books and drove back home. I pulled into the garage, reached over, and turned the radio down so it wouldn't be too loud when I got in next time, with the boys. When I walked into my house, I was greeted by their little voices shouting "Mama!" and asking what I'd brought them.

And I realized then, as I will again soon, that my life was not over. It had really just begun.

Birth Story, Part III

September 15th, 2009 was by far the most adventurous day of my life.

If you've read the birth story of my son, you'll hopefully understand my thoughts and feelings concerning the upcoming birth of my daughter. I was in personal predicament, being pulled in two different directions; on one side was my obstetrician strongly recommending I have a repeat cesarean section due to "risk factors" and the other side were my instincts telling me myself and my daughter were healthy enough to handle labor and that a natural vaginal birth was best for both of us rather than a surgery, given before she was even ready to be born.

That morning I had an appointment with my obstetrician. I brought my husband Jason with me because I knew it was going to be tense. The week prior, I had agreed to tentatively schedule a repeat c-section for Thursday, the 17th, which was one day before my due date. My OB and a perinatologist recommended I not go past my due date because of risk factors I mentioned in my last post. During the appointment as my OB is telling me he really doesn't think I should push the date back to wait until I go into labor on my own I broke down in tears. I was hoping to not get emotional, but at that point I was tired. Tired of fighting, tired of arguing with a medical professional, tired of unsolicited advice from others telling me what I should do. I felt my body and my daughter were telling me something: That everything was fine. All the recent tests (including one that morning) showed she was healthy. But there was a little part of me that felt compelled to listen to this man who had the medical degree and 25 years of experience. My husband asked him, "Are my wife and daughter in danger?" and my OB replied, "Well, there's always the possibility of sudden stillborn."

As below the belt as that comment was, I still knew, I just knew that we were okay. I went home and cried my eyes out and trying to come to terms with the fact that I should just give in and have another c-section. My doula, Linda, said we didn't need to make any decisions today, and that I had until Thursday morning to decide. She said to do my best to relax. That was much easier said than done.

At 5 pm I went in our back yard to sit with my son while he played. As I tried to get comfortable on an uncomfortable wooden patio chair I felt some movement down below and a warm trickle. I told myself not to get too excited that my water broke and stood up. Sure enough, warm clear fluid raced down both legs and if you've ever had this happen before (the same thing happened with my son), it's pretty obvious that it's not pee. I was in somewhat disbelief. But OH MY GOD IT HAPPENED! All the tears, all the worry, stress, indecisiveness and frustration, all came together and this was it. I still didn't know how it would all turn out, and there was still worry that my daughter wouldn't handle labor well, like the doctors warned me she may not, but at least I was going to get the opportunity to try to labor like my body was meant to.

Jason got home from work about 10 minutes later, we scrambled to eat and get some last minute things together. I called my doula, Linda and she was ecstatic. She said to call her when we got checked into the hospital because it would most likely be a while before my labor began. And away we went.

In the car the contractions started. They were uncomfortable, but bearable and I could still talk through them. But pretty much all I was saying was, "Ouch, this really hurts." They were steady at 5 minutes apart. We got to the triage floor and I approached the front desk where there were 3 nurses there. No one looked up for several seconds and that, for some reason, really irritated me. I suppose I expected them to see me, throw all their papers in the air and start yelling, "Oh my God, she's here!! The girl that wants a VBAC is here! Everyone get ready!" No such luck. They were very busy, but got me checked in and into a room. At that point time started to go really, really slow and I was very impatient. They took entirely too long to do everything, (which in hindsight they weren't, but in my position it was taking too long to do anything). My contractions were getting noticeably stronger and I felt like I had to go to the bathroom (yes, poop). This happened twice and both times I had to unhook myself from the monitors and tip toe across the triage room to the only bathroom. I had to stop a couple of times for contractions to pass.

The nurse came back and checked my cervix. I was 2 cm dilated and 90% effaced. So, no big emergency. Yet. She said they were really busy and would check again for a room. At this point time seemed to go as slow as molasses. People could not move fast enough. The only thing that was moving fast were my contractions and I really, really, wanted to get to a delivery room. Now, I don't consider myself a high maintenance kind of girl, but I told the nurse I needed a room, NOW. The next thing I knew I was getting into a wheelchair (which before then I thought only sissies had to be wheeled from triage to labor and delivery. I thought for sure I would be walking. Insert hysterical laughter on that thought). I asked the nurse to stop twice on the way while I had a contraction.

When we got to the room, I immediately had to throw up. I was trembling and shaking like I had never experienced before and began to feel like I was completely out of control of my body. Like it wasn't even my own. I made it to the bathroom and told my husband and Linda that I wanted some privacy. I sat on the toilet and caught a glimpse of myself in the mirror. I had one hand on the wall and the other clutching the safety handle bar. I was pale white, sweating, and a little confused. Was this early labor? If I was only 2 cm dilated, didn't I have possibly hours and hours before I even make it to 4 cm, when the active labor stage starts? I left the bathroom and the obstetrician was there. For some reason I was relieved to see that it was a woman, perhaps I thought she would be more supportive that I wanted a VBAC. I managed to make it into the bed and the OB began asking me question, after question after question. About my health history, about this pregnancy, about my previous c-section, about my pain. I couldn't talk through contractions and even in between was difficult because all I wanted to do was be still and not utter a sound in fear that my voice vibrations may conjure up another contraction. I finally said, "I'm sorry, I don't mean to be rude, but isn't all this information in my file or on some computer here?" With that, the OB said she wanted to check me again. Perhaps they know when the laboring mother gets feisty, things are moving pretty quickly, who knows. I finished a contraction and told her to hurry and check. I had my eyes closed and heard her say, "She's a seven".

Excuse me? Seven centimeters? I immediately thought of a book I had read, Your Best Birth where Ricki Lake describes the transition phase of labor going from seven to ten centimeters as something like, "This is the part where you're not fucking around anymore!" And boy was she right. I have also heard women say that at this point you sort of leave your body. It was like that for me. It was all happening so fast I could do nothing but think of how to stop the pain. I had previously decided to have a natural child birth. (Again, insert hysterical laughing here). However, when given the option to have an epidural when my head was spinning around, guess what I said? I would have taken a shot of tequila with a hit over the head with a frying pan.

The anesthesiologist arrived and I had to sit through transition contractions while he administered the medication in my back. He kept saying, "Don't move!" Ummm, okay. As soon as he left the room the OB checked me again and said, "She's complete." I heard the nurse tell me she was sure I was complete before he even started the epidural and that I had just gone through what takes most people 10 hours of labor in one hour. I've mentioned in other blog posts that I've always been the type of person that does things in a hurry. Apparently this was no exception.

I kept asking if the baby was doing well and the nurse told me (after I asked her for the 10th time) that she was doing better than a lot of babies that come in with no "risk factors" like mine. After the epidural kicked in things were a lot more peaceful. They left me alone with my husband and Linda so I could "labor down" and just let the baby come down naturally. After more than an hour the nurse said I could practice pushing and I said, "Like a dress rehearsal?" It was a little strange to push with no feeling down there, but practicing did help. They said they could see her coming. I was impressed with my husband who previously said he wouldn't want to see her come out at all, but he did in fact look. Part of the baby's head showed and I asked him if she had hair. He said yes. The nurse decided to call the OB to deliver. I was ecstatic!

It was 10:30 when the OB came in and sat down. I did about 4 sets of pushing and her head was out. One more push and Sydney Marie was born at 10:37. The OB put her on my chest and it was totally quiet. I didn't cry like I thought I would. I didn't say anything. I was stunned. Stunned that I did it. Stunned that she was here, finally and she was fine. Stunned at how beautiful she was. And stunned at how beautiful labor and birth are.

They let her stay on my chest for at least 30 minutes, I can't remember how much time passed. I think I finally cried, as did Jason. The placenta was delivered with no problems and the scar tissue was still attached to it. I didn't have any tearing. I kept thinking it was too good to be true, that everything went so well, even with the fast and furious labor. I said a few times that I felt like I was dreaming and that I would wake up and it would be earlier that same day. Linda pinched me and said, "You're not dreaming, you did it!"

I want to close this post by saying that the reason I wanted to share all of this was to emphasize the importance of listening to your body. Sometimes it's easier than others, but if we try and open ourselves to it, our bodies will communicate with us. I never once felt like anything was wrong during this pregnancy. There were times when I had to stop and ask myself, "Am I lying to myself?" and the answer was always no. I spent time alone, relaxing to become in tune with the mind/body connection and my body responded by opening up and communicating with me. I had to trust it and let go of fears which was probably the hardest part. In all that I have been through over the last several years, doing this has been the most empowering and healing reward I have been given.

Sydney Marie- 2 days old

*I also wanted to give a special thanks to the staff at Sharp Mary Birch Hospital for Women. The nurses and obstetrician were so helpful and played a major role in the safety and smoothness of my birth. Without them and their support that night, I'm not sure how it would have turned out. I don't believe there are enough words of gratitude.

Photos courtesy of author. Please do not duplicate without my permission.

Birth story, Part II

I've been putting off writing part 2 to this trilogy of my birth stories, only because the last couple of weeks has not turned out exactly like I had planned it. I'm not sure what I was thinking; pregnancy and birth can never be planned, many times there are bumps in the road and sharp turns need to be made. But if you read my last post, you know that I didn't have the best experience with the birth of my son and that my cesarean section left me feeling, well.....scarred for life.

With this pregnancy I had planned on a vaginal birth. My situation is called a Vaginal Birth After Cesarean, called a VBAC (pronounced "vee-back"). There has been much controversy over the years about VBAC and I won't spend time going over all of the research I have done, but in a nutshell, I felt that a vaginal birth was completely safe for me and my baby and my obstetrician was in agreement and supportive. I was ecstatic to be able to have a baby the way nature intended.

At 18 weeks things began to go slightly downhill. I was told I had what is called a uterine synechiae, basically scar tissue on my uterus connected to the placenta. Basically it was caused by my previous c-section. Another thing to add to my list of "why my c-section sucked". They said they are usually harmless, but weren't going to say a for certain "yes" to my VBAC until they checked it again, at 34 weeks. So I had to wait until then for them to not only check that, but check the baby to make sure she wasn't harmed by this and for them to tell me what they thought about the safest way for me to birth.

Week 34 came around and the synechiae was almost MIA, apparently it's typical for it to get pushed aside at that point. So, my VBAC was agreed by the perinatologist that I would be a good candidate. Hooray!!! I was so excited! I hired a doula and threw myself into researching about VBAC, natural childbirth and just birth in general. I couldn't wait to experince the magic of childbirth. Of course I knew that there was always a chance of another c-section, but I was content knowing that I would be able to allow my body to do what it was meant to do: Give birth.

At that appointment, I was told that my daughter was measuring small for her gestational age. She didn't seem too worried and asked about my son's size at birth. When I told her she said, "You're probably just one of those women that have small babies". Okay. She told me to come back in 2 weeks to monitor her progress. They don't mind if she's still small, but they want to make sure that she's growing adequately. For some reason I wasn't worried. Something told me it was fine and that my baby was growing as she should be and there was nothing to worry about. So I went to the next appointment feeling confident that they would tell me she was still small, but okay. They didn't. The doctor came into the room and said, "Last time you were here your baby was small, now she is officially small, in the 8th percentile for her gestational age. And your placenta is showing calcification, a sign that it's aging".

Time stopped. My mouth feel open as if to say something but nothing came out. I promptly burst into tears.

My head was spinning. Thoughts flooded: "What did I do wrong? I'm 34, I'm too old to have a baby. Why isn't she growing? What is wrong with my placenta? IS SHE DYING???"

I think I asked a question or 2, but the doctor might as well have answered in Chinese because I wasn't listening. I did ask what her recommendation of birth was for me; a vaginal birth or a cesarean section and she said I could go for what is called a trial of labor, they will monitor the baby the whole time, if she's fine I can go ahead with labor, if she seems stressed they will take her via c-section. Fine by me. I drove to my husbands work to tell him the news in person.

So for the last few days I have been going back and forth from being a complete mess about this, to feeling confident that everything will work out fine. The reason I wanted to share this is because of this:

I have learned (a little late) that opinions on this topic vary greatly. It's one of those things that if you have never been there it's impossible to say how you would feel and what you would do. It's a highly sensitive matter. Backing up a little, let me share with you my personal feelings about this. Keep in mind; these are my feelings, and I am not speaking for all women here.

I have come to the conclusion that women are given vaginas for 2 reasons: To make babies and to birth babies. We are put on this earth to reproduce and as a female, it is our inherent right to give birth. Modern technology has given us the gift to make sure our babies are healthy in the womb and have saved many, many lives of both mother and baby. If I had had the same pregnancy I had with my son 100 years ago (breech position and severe hypertension), there is a good chance I would have died during childbirth, as well as my son. I do think the best decision was made when it was decided to have a cesarean section. It goes without saying that I am grateful for modern medicine.

That being said, it still doesn't take away the feelings of failure that a surgical delivery brought to me. I feel like a natural child birth is something I was meant to do and it was taken away. My mother did it three times, and her mother did it 11 times (all at home by the way). I can't help but think: What is wrong with me?

At this point I have no idea how I will end up birthing this baby. The constant back and forth of decisions, feelings and emotions is almost too much to bear. One minute I think I should throw in the towel, schedule the cesarean and deal with the emotions later. The next minute my instincts say, "Wait a minute! I can do this! I was meant to do this! She is healthy and will be fine." Whichever voice is louder at that moment wins, and the process starts over. Sometimes it's unbearable. This is not how I imagined my last few weeks of pregnancy to be. Worried sick about my daughters health and doctors telling me different things about how I should birth. Not knowing what's best and running out of time. The whole time thinking how powerful it is to love someone so much that I haven't met yet. That there are so many people fussing over her and she is blissfully unaware of it all.

Then there's the question of selfishness. Why is this birth so important to me? Is it really best for both me and the baby? Is natural labor really just as safe? Biologically and scientifically I believe yes, I have done the research both ways to come to this conclusion. Sometimes it's not, and in my situation as I type this, I'm not sure what the right answer is for me, if any. I suppose I will find out within the next 2 weeks.

I think as women, many of us put a lot of pressure on ourselves to have the perfect birth, the perfect magical experience, blissful breast feeding, etc. And when it doesn't go that way, combined with all the hormones, it's the perfect storm. I can only speak for myself in that sense, but I beat myself up a lot over those things. This time I am working on letting it go.....I can only control so much and most importantly I can control my emotions, my reactions and leave the rest up to God.

In closing, I have had to ask myself why this birth is so important to me. For me, I am at the end of my child bearing days. Pregnancy is beautiful and I have never felt anything so alive and amazing as having my child grow and thrive inside of me. I am very lucky to have experienced this. I have always imagined what it would be like to be in labor, to feel my uterus actually contract and begin to push my baby out of me, a new life ready to experience a life of his or her own. For me, this is the essence of womanhood.

*Note: Although I love comments, due to the sensitivity of this matter, please do not comment if you are going to tell me what you think I should do or to be snarky. I posted this because I feel there are other women who probably can relate to these feelings and that it's normal to feel them.

Photo courtesy of soartsyithurts