My journey on the C-section express
by Denise Iskiw
 This
is my story of the journey I traveled, the obstacles I faced
and the heartbreaks I endured to finally have my dream of
a VBAC come true on January 1, 2003, after three Caesarean
sections.
All aboard
I underwent my first C-section on July 16, 1987, at the
age of 23 years to deliver our stillborn son. I was approximately
33 weeks into my pregnancy. This was a most devastating experience
that was going to alter my life forever.
I recall that my blood pressure was up around my 28-week
prenatal check-up. I was told to relax and watch my salt
intake. I was an elementary school teacher at the time, and
my place of employment was out of town, and I drove one hour
to school in the morning and drove one hour back home every
weekday. Relax was not in my vocabulary. At the 32-week check-up,
I remember telling my doctor that I felt that something was
wrong and that my tummy didn't seem to be getting bigger.
He laughed at my concerns and told me that everything was
fine and that I was experiencing first-time pregnancy jitters.
A week later my baby died inside my uterus.
On the Monday morning I was not feeling my baby move as
normal so I drove myself to emergency. A nurse tried to find
the baby's heartbeat with a hand-held doppler but was unsuccessful.
I had an ultrasound performed immediately and was sadly told
that there was no fetal heartbeat -- my precious baby had
died. The following morning I saw my doctor and was admitted
to the hospital. My blood pressure was elevated and my face
appeared swollen. I do not know if this was a symptom of
the high blood pressure or from my hours for crying. A p-jell
was administered to soften my cervix. We waited. During the
wait nursing shifts changed numerous times. With each change
I had to face an onslaught of ridiculous questions and hurtful
comments such as, “Why are you crying? Do you always look
like this? My goodness you have such bad veins.” Don't nurses
look at the chart before approaching a new patient? Where
was the compassion for someone who was experiencing a tremendous
loss?
My blood pressure continued to climb and the p-jell was
ineffective. My doctor thought it best to deliver the baby
by C-section. Was I toxic? Had I developed pre-eclampsia?
Eclampsia? Was the section necessary to save my life? I was
never told. An autopsy was performed on our baby boy and
the cause of death was ruled as unknown. The following day
my doctor at that time went on his summer vacation. My husband
and I felt abandoned; we had no one to talk to about what
happened.
The physical pain I experienced after the anaesthetic wore
off was excruciating to say the least. I remember thinking
that I would have been better off dead. The feelings of loss
and failure were overwhelming. Not only had my body failed
to nurture my unborn baby, I had failed to give birth to
him the way I had wanted. I did not leave the house for three
months after returning home from the hospital for fear of
meeting people that knew I had been pregnant and having to
explain my failure. I felt so ashamed. I never did return
to teaching. I was so depressed and I had thoughts of suicide.
The positive result of this tragic event in my life was
that I became a Christian, but that is a whole other story.
Little did I know that the stillbirth of my first child and
my first Caesarean section was going to be the catalyst that
initiated me into becoming a repeat passenger on the “C-section
express.”
My second ride on the C-section express
I wanted a baby so badly that eight months after my loss
I was pregnant again. I changed obstetricians and promised
myself I would do everything right this time. I was sure
to have a good experience. Boy, was I ever wrong. I was in
the doctor's office every week to have my blood pressure
monitored. I underwent many ultrasounds and stress tests
throughout my pregnancy. Needless to say, I did not enjoy
this pregnancy very much. I was made to feel like there was
something wrong with me instead of having a baby. I had expressed
my desire to have a VBAC. My doctor said we would talk about
it later. Later turned into never.
At 24 weeks I was diagnosed with gestational diabetes, but
this was controlled with diet and insulin. A week prior to
my due date, which was Dec. 25, my doctor strongly advised
me that we should induce labour because we knew for certain
that the baby was healthy and that at 39 weeks was mature
enough to be born. I had put my total trust in my doctor
and agreed to the induction. So on Dec. 21, 1988 I was induced.
I was not aware or informed of the risks associated with
inducing a woman with a previous C-section. Needless to say
the induction failed. I was not ready to give birth and my
baby was not ready to be born. I only got to 1 cm dilation.
I expressed my desire to go home and wait for labour to start
spontaneously. I remember crying and telling him that it
was important to me to birth my baby naturally. His reply
was, and I quote, “You really don't want to go through that.” Yes
I did. How dare he tell me what I did and did not want to
do. This doctor became hostile and actually raised his voice
at my husband and myself. He proceeded to make horrible comments
such as, and I quote, ”Your first baby died, do you want
it to happen again? This baby could die too you know!” What
a cruel thing to say at such a vulnerable moment. Of course
we did not want to lose another baby. I was coerced into
agreeing to a C-section. My doctor used fear to manipulate
my decisions.
The next day, I was informed that my doctor's partner would
be examining and discharging me because my doctor had left
on his Christmas ski trip. My husband and I were stunned.
We are positive that the C-section was not performed for
my well-being or that of my baby but purely for the doctor's
convenience. I had to recover from major abdominal surgery
while my doctor was enjoying himself on the slopes. To this
day I have regretted my decision of undergoing the C-section.
The diabetes was under control and I was not experiencing
any other problems. I believe that I could have given birth
vaginally to my beautiful 7 lb. 15 oz baby boy. I had my
live baby so why was I so angry, disappointed and sad?
Third C-section express ride
My third pregnancy was terrific and I had no complications
whatsoever. I was seeing a different OB again and from our
initial meeting I told him I was determined to have a VBAC.
He agreed to support me although he seemed reluctant to talk
about it. I was told not to worry and that everything would
be taken care of. I should have recognized this as a warning
sign. At my 36-week prenatal appointment my OB started making
comments about the size of my baby and my lack thereof. He
asked me how tall I was and what size of shoe I wore. The
alarm bells should have gone off. Did my short height and
small build make me a prime candidate for a C-section? I
think it did.
Ten days after my due date I went into spontaneous labour
at home. Things went downhill the moment I set foot into
the hospital and it was discovered that I was a VBAC mom
with two previous sections. The next thing I knew I was strapped
to an EFM, had a catheter inserted into my bladder, my waters
were broken and an internal monitor attached to my baby's
scalp. I labored this way in a semi-reclined position for
approximately 12 hours.
You would never have known that I was having a baby by the
atmosphere that the doctor and nursing staff created in my
labour room. I did not get one smile or hear one encouraging
word from anyone. No one said, “Hey Denise, you're doing
great! Or “Maybe you should try this . . . .” No one asked
how I was doing, they all just walked over to the EFM and
then left the room. My husband and I got the impression that
everyone felt that I was wasting their time. “Have a section
and get it over with,” the expression on their faces seemed
to say. Giving birth to my baby was not a waste of time.
During labour I was not allowed food or drink because of
the nothing by mouth policy for VBAC moms. After my water
was broken for the internal monitor, my contractions were
very strong and on top of one another. My OB strongly encouraged
me to take some Demerol. I recall how parched my throat and
mouth felt and the drug seemed to compound the problem. I
could not swallow and my tongue felt too big for my mouth.
I felt very distressed and almost panicky. What effect was
this having on my baby? This was torture! Having my basic
need of water withheld was purely inhumane!
The last internal exam I had my doctor told me that I was
8 cm dilated but felt that the baby was too big for me to
birth vaginally. I said that I wanted to keep trying. My
doctor propped himself up against the wall with his arms
folded across his chest. He continually looked at his watch
like there was somewhere else he needed or wanted to be.
The pressure to perform was on. Was there a 12-hour time
limit to give birth that I didn't know about?
About 30 minutes later I was told that the baby's heart
rate was showing signs of distress. I was told that I needed
to have a C-section. Was this true or was I being deceived?
I felt that I was. I believed that all the interventive procedures
that were used on me were deliberately done to set me up
for a C-section. Being strapped to the fetal monitor and
expected to stay in one position for so many hours more than
likely affected my baby's heart rate. Breaking my water probably
affected his heart rate and the use of Demerol most likely
affected his heart rate. Why was I not encouraged to move
around to get the baby in a better position for birth and
to open up my pelvis? Should I refuse the section? Could
I risk my baby's life? At this point I completely shut down.
My labour had stopped. I gave up. I had my third Caesarean
birth on June 3, 1992. We were blessed with a beautiful 9
lb. 4 oz. baby boy.
I left the hospital feeling very angry and disappointed.
I felt that I was alone, working very hard for a VBAC, but
that everyone else was against me. The 100% commitment I
expected from my doctor was not there. I was angry at my
husband. Why didn't he do or say something?
I felt so frustrated. I could not get rid of the label I
had been given. No matter what I did the doctors always found
an excuse to perform a Caesarean. I believe that the doctors
had predetermined in their minds that they were going to
section me and I didn't stand a chance of having a successful
VBAC.
Stopping the C-section express in its tracks
Ten years had gone by since having a baby. We had two healthy
boys and I felt outnumbered with all that testosterone around.
I wanted another baby. I prayed for a girl and a natural
birth. I recall the Lord speaking to my heart and promising
me a daughter and a natural, vaginal birth. I did not know
how this was going to come about but I trusted and believed
in the Lord to bring this miracle to pass. Six months later,
spring 2002, I was pregnant with my fourth child.
I was on a mission. I was going to get off the C-section
express and no one or nothing was going to stop my successful
VBAC! I discovered that VBAC was much better for myself and
my baby. There was much less risk and complications involved
with a vaginal birth. The VBAC success rate for women with
two or more previous C-sections was 75% or higher and that
sounded pretty darn good to me. I made sure that I was well
prepared this time. I contacted and joined the Edmonton VBAC
Support Association. Meeting other VBAC moms let me know
that a VBAC was possible and that my dream of having a natural
birth could become a reality. I read everything I could get
my hands on about VBAC, Caesarean avoidance and natural childbirth
so that I could make well informed decisions. I started reading Birth
Issues magazine and hired a doula (Suzanne Moquin of
Gentle Touch Doula Services). My husband and I wrote up a
birth plan. In my previous pregnancies, I made the big mistake
of believing that my doctor and hospital staff would assist
in creating the type of birth experience that I desired.
I finally realized that I was the one responsible for the
type of birth experience I would have. I was finally taking
responsibility for what happened to me. I also became aware
of my rights. No medical procedure can be performed without
my consent. I succumbed to medical intervention in my pregnancies
because I thought I had no choice.
I got the names of several OBs that were considered VBAC-friendly
and made an appointment with the one I heard much about.
The appointment was a disaster. Not only was I labelled high-risk
because of my three previous sections and stillbirth, I now
was over 35 years old. I was only given a 50% chance of having
a natural birth and was lectured on the risks of uterine
rupture. I tried to explain that I had done my homework and
the occurrence of a uterine rupture was rare. I recognized
this “fear” tactic for what it was, and I refused to be moved.
I have adopted a zero tolerance for the use of fear tactics
and deceit to manipulate my decision-making. The doctor interrupted
me numerous times and grabbed my question sheet from my hands.
He told me that if I went over my due date that he would
section me (not without my consent, buddy) and that in hospital
I would require continual fetal monitoring, an IV, etc. Sorry,
been there done that, no thanks! From my own personal experiences
the hospital guidelines for the care of VBAC moms consists
of procedures that actually increase the risk of Caesarean
section. I was going to avoid these interventions like the
plague. My husband and I left this doctor's office feeling
very depressed. I didn't let the tears flow until we were
in the car. I knew that if I went with an OB and a hospital
birth, I was going to be guaranteed a surgical birth. I could
not go through that again. I needed a positive birth experience.
I deserved a positive birth experience.
Now what?
Now more than ever did I believe in and value the natural
process of birth. I had experienced first-hand the enormous
negative impact created if the process is interfered with,
altered or taken away. Even though I had three C-sections
under my belt (so to speak) I knew that my body had not forgotten
how to labour or give birth normally.
I chose a midwife-assisted home (water) birth. I felt that
this was my only safe option to have the type of birth I
wanted. I wanted to be the primary decision-maker in my prenatal
care, labour, and birth. I wanted to give birth in a place
where I felt safe and where I could avoid procedures that
are known to increase the risk of Caesarean section. I desired
to give birth without intervention. I would not allow myself
to feel like a victim of the medical system again; after
all, birth is a beautiful, natural, and normal part of the
life cycle and not a medical event.
I received several names of midwives from my doula. Noreen
Walker was my first choice. I remember waiting in my car
before our appointment feeling terribly anxious and trying
to relax and fight the fear that she would not accept me
as a client because of my birth history. I was feeling so
desperate that I was considering an unassisted birth if I
had to. To my relief, Noreen was just what I needed. She
did not hesitate one second to accept me as a client. She
was so positive. Noreen had no doubt in her mind that I could
birth my baby vaginally. Her belief in me reinforced the
confidence I had in myself.
I was blessed with a beautiful 7 lb. 12 oz baby girl
and a vaginal birth on January 1, 2003. I received the professional
and supportive care I needed from my midwife, my doula and
the loving care and support of my husband Tim. They believed
in my ability to give birth vaginally. My daughter is my
proof that “once a Caesarean, not always a Caesarean.” My
VBAC experience was very satisfying, empowering, positively
beautiful and extremely healing. New Year, new baby, new
me. I gave birth without intervention. In spite of the long
labour and challenging work, I savoured every moment of my
daughter Alysha's birth. I would not have changed a thing.
(Alysha's birth story was previously published in Birth
Issues magazine Volume XVII Number 4, Summer 2003 titled “Our
New Year's Baby.”) Finally, with a joyful heart, I had gratefully
disembarked from the C-section express.
Article from Summer 2004 Birth Issues magazine,
published by ASAC in Edmonton. Denise Iskiw is part of the
2005 Executive of the Edmonton VBAC Support Association.
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