Posts Tagged ‘ C-section ’

Birth Stories: What It’s Really Like to Have Twins!

Monday, September 15th, 2014

Alesandra Dubin and TwinsThe day I delivered my babies is both completely blurry and seared indelibly into memory.

After a long, surreal lead-up to my scheduled c-section, there was nothing left to do but deliver some twins. On July 22, at 38 weeks, we were actually sleeping when the alarm sounded at 4 a.m. For the last time, I peeled my enormously pregnant body from the bed and got in the shower, following with my full hair and makeup routine. My husband, David, couldn’t understand why I would bother, but of course I knew 1) there would be pictures! And 2) it might be a very long time before I managed such a feat again.

For the last time as a family of two, we left the house with our bags packed. It was a warm, beautiful early morning, and we snapped a picture of the moon over our house. Minutes later, we arrived at Cedars-Sinai Medical Center where we had our pick of prime parking spaces at 5 a.m. — a dream for a Los Angeleno, and an auspicious beginning to a big day! I noticed a sign that advertised discounted parking at a weekly rate, and as I shuffled into the hospital, I asked the parking attendant how to get the weekly pass, which would save us $10 over the course of our four-day stay. David couldn’t believe I found the energy to focus on such a pursuit, but I reminded him that every dollar counts with two babies on the way! And I’m nothing if not a hustler for a great bargain.

We made our way inside to check in for labor and delivery, at the same desk we had seen on our maternity ward tour when the reality of this day seemed infinitely far off — as if it were actually on another planet instead of just weeks away. This time, it was we who were checking into the hospital to deliver babies, and it was still too enormous to process.

We met our wonderful nurse, Griselda, who would be with us for 14 hours that day. She got us all prepared, running my IV line and strapping on two fetal monitors, one in blue and one in pink. She’d be my guardian angel — among many — during our stay.

Eventually, it was off to the operating room, where TLC’s “No Scrubs” was playing; the anesthesiologist had apparently honored my preference for ’90s hip-hop when he selected the Pandora station. I remember registering the neat play on hospital scrubs as the terror set in. I was most worried about this part of the day: David would have to stay outside in the hall as the team administered my spinal. It was the only time we’d have to be separated. As I sat sideways on the operating table with my legs dangling and my back exposed, Griselda squeezed my hands as she leaned into me, forehead to forehead. I’ll always remember her caring support.

Soon, the anesthesia began to take effect, and I didn’t like the feeling one bit — the feeling that my body had vanished from the boobs down, and there was no guarantee I’d be able to feel it again. I panicked.

The team let David come in early, and they also ran Propofol into my IV for the anxiety. David used the tools in his tool box to calm me: He rattled off a list of words that corresponded to my favorite images and memories. “Our first dance… Bora Bora honeymoon… scuba diving Belize… the beach in Rio…” He named as many of my favorite things he could think of in the moment, before, owing to his own nerves, he just repeated the list.

I heard my obstetrician say, “We’re down to the uterus now,” but I was less concerned about the progress of the surgery and more eager to feel my body again. Soon, I heard the cry: My son was out in the world. David’s face was hovering just over mine, and though his mouth was covered with a green hospital mask, I could see that his eyes exploded with emotion. Our son.

Someone announced the weight: six pounds, six ounces. Then another cry and another weight: five pounds, 12 ounces. My daughter was on the outside too. Both were whisked to the other side of what felt like a very big room for their initial medical attention. I heard someone tell David, “…other than that, she’s great.” I called out to try to understand what that meant. It turned out my daughter’s body temperature was low, but she was quickly warmed up. And beyond that, they were perfect. I felt rhythmic tugging as the doc stitched me all up. And then someone (was it David?) brought the babies over to my chest so I could hold them for the first time, one nestled under each arm. We’re a family of four now — imagine that.

From the operating room, we moved to the post-op recovery room, where my parents came with pink and blue balloons and held the babes. We shared their names for the first time: Maya Zoe and Jordan Oscar. Jordan was platinum blonde like me at birth, and Maya had dark hair — something she got from her dad that I never expected. They were devastating in their sweetness, too precious for words. How improbable and magical that we actually made them and I carried them inside!

From there, we moved to what was supposed to be our room for the next four days. It turned out, we’d move again.

As the team of nurses was transferring me from the gurney to the hospital bed, I noticed a lot of blood. I said, “That’s normal, right…?” There was some focused silence and then a second nurse said to Griselda, “It’s just that I’ve never seen a clot that big.” Quickly, the babies vanished out of the room on their way to the nursery, and our tiny room filled with people. David said he counted nine in addition to us. One of the doctors was really young and I called him Doogie Howser. I was high on Propofol. And I was hemmorhaging: My uterus had been so distended from carrying 12 pounds and two ounces of baby to full term that, like an overstretched rubber band, it could not contract.

In another far-off era, or in another part of the world, that might have been the end of me. But with access to such quality health care and thanks to modern medicine, I didn’t worry about my mortality. I did however, feel anxious for the team to resolve the situation, and I thought the thermometer bouncing up and down in my mouth was a physical manifestation of my anxiety. In reality, I’d later learn, the shaking was just a standard side effect of narcotic drugs.

Griselda pressed repeatedly on my post-op stomach; it’s not the relaxing spa-like treatment I’d pictured when she’d said she was going to periodically “massage the uterus.” Doogie Howser administered a bunch of drugs including Pitocin. And within a few tense hours, my bleeding issue was resolved.

For the first night, we moved to an acute care wing of the hospital, instead of the standard labor and delivery ward, and the babies rejoined us, sleeping serenely most of that first day — hazy, as it was, for all of us. Apparently, my situation warranted some attention, with the head nurse coming to check on me as the first stop on her shift later that evening. I told her she was stunning and looked like Nia Long because I was still high on Morphine and Propofol, and was, apparently, without filters. (And because she was and did.)

Outside the window, I could see that night was finally falling on what was, without any question, the most intense and wondrous and magical day of my life: the day my twin miracles came into the world.

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Photo: Courtesy of Alesandra Dubin

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Could Your Age Determine How You’ll Deliver?

Monday, August 11th, 2014

While some recent studies have brought good news for women hoping to get pregnant after 35, this latest research isn’t so rosy.

According to a new study published in BJOG: An International Journal of Obstetrics and Gynaecology, older moms-to-be are at increased risk of requiring emergency measures to give birth, whether that’s a C-section or an “operative vaginal delivery,” which includes forceps or ventouse. In fact, the study found that women over 40 had triple the rate of emergency C-sections, and nearly double the rate of operative vaginal deliveries of women 20 to 24. Women over 40 had a 22.4 percent emergency c-section rate, and a 23.7 percent rate of use of forceps or ventouse. And those rates aren’t just for high-risk moms-to-be: That’s the rate for healthy older moms.

But maternal age wasn’t the only risk factor for these emergency interventions—using an epidural, induction of labor, large birthweight or a gestational age over 41 weeks were also factors.

Long story short? If you’re an older mom, your doctor should be aware of the likelihood that intervention may be necessary—and you should be realistic about your odds of requiring a little help to bring that baby into the world.

Tell us: If you’re an older mom, did you have an unexpected C-section or another emergency intervention? How did you handle it?

If you’re getting ready to give birth, consider these birth plan strategies to ensure that your wishes are met. And don’t forget to like Everything Pregnancy on Facebook to keep up with the latest pregnancy news.

Beyond the Birth Plan
Beyond the Birth Plan
Beyond the Birth Plan

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Hospital Bans VBACs—Could It Happen to You?

Thursday, August 7th, 2014

Some moms-to-be like Laura Nelson picked Hudson Hospital in Hudson, Wisconsin, because of its VBAC (vaginal birth after C-section) friendly policy. But now, just weeks before she’s due, Nelson is looking for a new hospital (and new ob-gyn) to assist in her attempt to have a VBAC, because the hospital has banned this option after August 31st.

In a written statement to local news station WCCO, the hospital stated, “We support VBACs as an option for women, but at this time we cannot provide this service due to human resource constraints.” And it seems, according to two ob-gyns we heard from, that recommendations from the American College of Obstetrics and Gynecologists (ACOG) requiring anesthesiologists and ob-gyns to remain in hospital for the entirety of a VBAC patient’s labor could be to blame for this.

“Most hospitals across the country will not offer VBACs to their patients if there is not 24 hour obstetric and/or anesthesia personal available to perform an emergency C-section or surgery,” says ob-gyn Michele Hakakha. “Budget cuts and poor funding are main reasons for hospitals not having 24-hour in-house care. Other reasons may be lack of specialized caregivers, or too few caregivers to warrant many days of in-house call per week.”

And unfortunately, money may be at play. “OBs who do VBACs and anesthesiologists with a VBAC in labor know that they are required to be ‘in house’ for however long it takes the patient to deliver—and they are NOT able to bill for their time in doing this,” says Marra Francis, ob-gyn and author of The Mommy MD Guide to Pregnancy and Birth. “Hospitals can choose to reimburse physicians for the time they are at the hospital providing care or they can decline to reimburse them. But if all three entities (hospital, OB, Anesthesiology) can not come to an agreement on how providing VBACs will be done in order to provide the safest care that meets ACOG’s regulations, the hospital will not allow VBACs because of the liability they assume.”

This comes at a time when many experts are concerned about the growing number of C-sections, despite the fact that VBACs have a 75 percent success rate—and moms who give birth vaginally have a much shorter recovery time than those who have a C-section.

In a statement, Hudson Hospital said its working with the affected patients to help them find somewhere else to try their VBAC. But let’s hope the policy changes soon as well, so moms-to-be have more options.

Tell us: Did you have a VBAC? Was it difficult to find an ob-gyn or hospital who would accommodate you?

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Birth Stories:
Birth Stories:
Birth Stories: "My Labor Stopped"

Image: Mother and Newborn by ChameleonsEye/Shutterstock.com

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Could Labor Be Considered Child Abuse?

Wednesday, July 30th, 2014

That’s the scary implication behind one hospital’s attempt to keep a mom-to-be from trying a vaginal birth after previous C-sections (VBAC). Mom-to-be Jennifer Goodall received a letter from the hospital where she planned to give birth, Bayfront Health Port Charlotte in Florida, stating that “because she decided to have a trial of labor before agreeing to cesarean surgery, her prenatal care providers intended to report her to the Department of Children and Family Services, seek a court order to perform surgery, and to perform cesarean surgery on her ‘with or without [her] consent’ if she came to the hospital,” according to a press release from the National Advocates for Pregnant Women.

Goodall tried to fight it in court, but was unsuccessful—the judge said that she had no “right to compel a physician or medical facility to perform a medical procedure in the manner she wishes against their best medical judgment.” (And that’s despite the fact that Goodall herself said she wasn’t adverse to having another C-section—but just wanted the chance to try laboring.) In the end, she gave birth to a healthy baby boy last weekend, at a different hospital where they were willing to allow her to labor—and had a C-section.

But this wasn’t the first time that a woman reported being bullied into a C-section. We reported about a woman who was suing a New York-area hospital for forcing her to have a C-section against her will.

VBACS aren’t right for everyone. But at a time when the American College of Obstetricians and Gynecologists is expressing concern over the startling numbers of C-sections (one in three babies is born via C-section now), why are so many hospitals still pushing for surgery? And why are they using scare tactics like reporting parents to Child Services for questioning the hospital protocol?

Labor & Delivery: Unplanned C-Section
Labor & Delivery: Unplanned C-Section
Labor & Delivery: Unplanned C-Section

 

Image: Rissy Story/Shutterstock.com

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The Final Countdown! What Did You Do in Your Last Days Before Baby?

Tuesday, July 22nd, 2014

Surely there is no better word to describe the final days of pregnancy than “surreal” — in particular for first-time parents with no idea what to expect.

Because I’m carrying multiples who have pretty much been breech (or in other funky positions) the entire time, I always knew I was a likely candidate for a scheduled c-section. (However, I was still fully prepared for the possibility of going into the hospital any day, given I knew my risk for pre-term labor.)

Now here we are at full term, just hours before I’m set to check into the hospital for the big day. Knowing exactly what time your babies are slated to come into the world is a very strange limbo.

Anticipating a Tuesday morning surgery, I knew this past weekend would be my last before babies come. The last Friday, the last Saturday, the last Sunday…tick tick tick. I could almost hear a clock ticking out loud everywhere I went. I felt like we should do something major, something thrilling, something to really take advantage of our last moments as a family of two with proper pomp. Skydiving? Probably out of the question. But at least a last dinner out or grown-up movie in the theater, right?

As it turned out, I wasn’t really even up for those things. Physically, I’m super limited now—everything hurts. And my husband also didn’t relish the visual picture of racing to the car in a crowded parking structure in a desperate panic after his wife’s water broke in the concession line at L.A.’s crazy-packed the Grove shopping mall. (Fair enough—it was a very real possibility.)

So what did we do? Well, we rested mostly—surely something equally as important as any other of my big-plan ideas. (And, hey, in the second trimester, we fit in more babymoons than we ever thought possible, so anything else would have been icing anyway).

Here’s a partial summary of our actual (underwhelming) last days as a kid-free couple:

  • We’re Type-A organizers, and we put all our ducks in one hell of a row. That meant lining up things like cat sitters, and people to move our city trash bins in and out during our planned four-day hospital stay. It also meant preparing for weeks away from work during leave.
  • We watched a bunch of movies from Netflix
  • In solitude, in a tepid Calgon-filled tub, I read both Travel + Leisure magazine and the book Twelve Hours Sleep by Twelve Weeks Old. I call that the wishful-thinking reading list. Hope springs eternal!
  • I got an epic Biogel manicure, with pink and blue nail art in honor of my boy-girl twins’ arrival. The goal was to get the longest-lasting look possible… because getting back into the salon won’t exactly be as easy to fit into my life as it’s been before! And come on: There will be pictures.
  • We set up a few last things in the nursery—and ordered a few things online to fill in some gaps. (How—after three baby showers and what I thought was such a carefully crafted registry—were we without bouncers?) We made sure the kitchen was stocked with non-perishables and paper plates. And we packed and repacked our hospital bags.
  • And today, we’re both working. As you can see, I’m writing this last blog post before babies. And I even participated in a HuffPost Live segment talking about the content of a post from last week—the idea of drawing up a pre-baby contract with your partner. Some people might think we’re nuts, but from where I sit, work seems a lot more relaxing and therapeutic than the alternative: waiting and worrying!

So, did our final countdown before babies turn out to be some big blowout? Hardly. But after a few days like this, I actually sense a new feeling creeping over me, and I like it: I feel like I’m as ready as I’ll ever be.

How did you spend your last days before baby?

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Pregnancy Month by Month:  Preparing for Labor
Pregnancy Month by Month:  Preparing for Labor
Pregnancy Month by Month: Preparing for Labor

Image courtesy of Shutterstock

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