I promised I would post on my blogs the full story of our natural childbirth, in the hopes that this account will encourage mothers to explore their alternatives and beware of the medical establishment's malpractice-avoidance agenda.
The background: My wife, Susan, had 2 boys in 2001 and 2002. Both were born in Newport Beach, CA and both were delivered via cesarean section in a hospital setting. Our first experience was soured by a prognosis of "failure to progress" by our OB which led to the operating table. With Daniel, our second, we had made a (flimsy) effort to learn natural birth principles because of our disappointment with our first unplanned c-section. We did not, however, attend any formal training and (looking back now) were not ready to tackle any snags in the birth process. Eventually we were at the hospital again and the spectre of "failure to progres" loomed over us, deflating Susan to the point of another surgical option for Daniel, our second.
Fast-Forward to 2007 and our third child, a girl. Susan & I spent twelve weeks doing 12 classes in intensive training with the Bradley Method of Husband-Coached Childbirth. The classes were taught by Kelly Cassidy in Lancaster City, and our class consisted of 4 couples. Susan & I were truly empowered! We learned time-tested ways to jumpstart labor, control pain through deep breathing and massage, how to understand and interpret medical birth protocols & terminology, and much, much more. I was certified by the Bradley people as a birth coach. Susan was set upon a positive, healthy diet & exercise plan.
We completed our training in mid-March of 2007. Our due date was June 26th. We had called many friends and contacts about selecting an Obstetrician who would support our right to a natural childbirth. By the way, the term VBAC is used to describe the process of having a non-surgical birth after one or more cesareans. We found that the overwhelming majority of OBs would not support this choice, but would urge us to have the third c-section planned. The reasoning was that there is statistical evidence that the uterus could rupture in labor, and the doctors were concerned about "the safety of the mother & baby". We heard that a lot. When we asked about the actual numbers, we got different answers ranging from .5% to 3% probability of uterine rupture. Obviously, the medical establishment was managing to the risk...to the malpractice, that is. Well we found a Dr. who was in private practice after becoming sick of the politics at the biggest birth hospital near us. Apparently he received flak for allowing VBACs and other "high-risk" patients. He had priveledges at Ephrata Community Hospital and told us that they would allow us to labor there. We were preregistered in March 2007 and visited the hospital for a maternity ward tour. So far so good...
Then, in early May, our OB dropped a bomb on us. He had decided to close his practice by the end of May, electing to return to his home state in the south to practice medicine. The reason? His annual malpractice premium of $80,000!!. I couldn't argue with him on that one...but he knew we would have trouble finding another OB who would support our right to a natural birth experience. Susan suggested another OB, a woman at another small practice nearby. The doctor agreed that she would be the best option for us and arranged the transfer. We met for about two months with this new OB, who was supportive but cautioned us to keep "the safety of the mother & baby" in mind. We had developed a written birth plan which outlined our preferences, which the OB signed off on.
All this brings us to the last week of June. We were understandably nervous, but confident. I had packed the car and my coaches bag - ready to go. I got the first inkling of trouble when my email request to Ephrata Hospital for confirmation of our preregistration status went unanswered for a few days the prior week. A representative finally got back on Monday the 25th to tell me that we were good to go.
I was at Party City on June 26th, about 2pm getting a "welcome home" banner when Susan called me to say that our OB had called. Ephrata Hospital had contacted her THAT DAY to tell her that they had reviewed our file, and realized that we had 2 c-sections, and that their policy did not allow them to admit us for a non-surgical birth! I was stunned, to say the least. Susan said that our OB had been very apologetic and would try to get us into Womens & Babies Hospital at the last minute. She had said that, worst-case, we could go into W&B emergency room if we went into labor! I continued to be stunned by this turn of events. I kept thinking "how could Ephrata Hospital do this to us without so much as an apologetic phone call?"
We felt our world closing in around us. Susan expressed her deep frustration at being marginalized by the medical establishment, not because of her condition (which was perfectly normal) but because of a malpractice-centered risk aversion mentality. That night, I fired off a testy but polite email to Ephrata Hospital's staff, asking for an explanation of their abandonment of us right at the threshold of our birth. Why had no one offered to help us find other accomodations? I put myself in the maternity director's shoes - what ever happened to customer service? I was (and am) perplexed at the poor response on their part.
Well, on the morning of the 27th we had other things to worry about. Susan began early first stage contractions about 5am. By 10am, we had still not heard from our OB about getting into another hospital. Then, just before noon, she called. No other hospital would take us given our "situation" - especially on short notice. She suggested a few out of the county hospitals, but the only viable option was Lebanon Hospital. When I called them the OB group there informed us that they would not even do a VBAC! We were crushed. I'll never forget noontime on the 27th. We were having a perfectly normal pregnancy & birth, even better due to Susan's top physical and mental readiness. Yet no medical facility would accept us.
Our OB suggested that we come into Heart of Lancaster for an exam to see if we were actually in labor with our water broken. I knew, I just knew in my heart that if we did that we would go down the same road we did with the first two, that the establishment would jam a c-section down our throats. Yet, we saw no options and set up the visit for about 2pm.
At that point divine providence stepped in. About noontime I had put out an email requesting prayer to our church group of families that we belong to at Calvary Church. At about 12:30pm, while Susan was getting ready to go, I received a call from a "friend of a friend" who had heard about our situation and offered the name of someone who had had a VBAC with a local midwife. (I should point out that we had explored the midwife option 2 years ago and found at that time the same resistance to a VBAC home birth, which led us back to a doctor/hospital paradigm). I called the contact, and made about 3 more referral calls to people who were suggested to me. Each time I explained our predicament and asked for help. My calls took me from Lancaster to Missouri, to Chester Springs and back to Lancaster.
Finally I got a name of a local lay midwife who might be able to help us. At this point I was desperate for a second opinion and some sort of option! The midwife, who is well-known in natural birth circles it turns out, was completely free that afternoon - and her attending nurse was with her! What a miracle. They were at a party in their honor, put on by some Amish families near Strasburg. She conferred on the phone with us and agreed to visit. We decided to put off the hospital visit until we had the midwife's opinion.
At 4pm the midwife was at our home and examined Susan. Turns out she was 90% effaced and the baby had dropped down into station. We were excited! This was way further than we had gone in the last two births. The midwife then said that, although she never downplays risk, that there was no reason she could see why we could not have this baby at home! She had a connection at a Harrisburg hospital if we wanted to go that route, too. We talked about it and the decided to go with the home birth. In her over 5,000 births, she had never had a uterine rupture from a VBAC, and she'd done natural births for women with 5 c-sections! That was enough for me - we would go forward. We told our OB, who cautioned us against using an "unlicensed" birth attendant.
Our new midwife left us with some exercises and positioning to do to help the baby rotate naturally inside Susan. It's not a "complication" to have a slow or stalled labor with a baby out of position - for centuries midwives knew the body could use some help aligning the baby for best position to give birth.
The day progressed slowly with no increase in labor, and I dozed off in the late evening. Susan woke me, however, about midnight to say that the baby had indeed moved and contractions were coming hard. Our Bradley Method training went in action for about 2 hours of active labor and transition stage. When the midwife returned with her nurse Susan was ready to push. At 2:35am Carys Victoria Geoghan was born without incident. The midwife and nurse were a blur of activity, multitasking on a level I could appreciate from my real estate business. As I coached Susan through pushing, they prepared the area, took notes for documentation, massaged Susan and held a mirror for us to see. Incredibly professional. The actual birth and following hours seemed anti-climactic after the stress of the preceding days...
...The rest of the story is still happening, as Susan, Nathan, Daniel & I enjoy our new addition and get used to a new routine in our home! We owe a huge debt of thanks to our midwife (whose name I am not publicizing because she is busy enough already and only needs to work with referrals). They put the medical establishment to shame, in my humble opinion.
Shame on Pennsylvania for not doing something about malpractice reform - its a scandal that is driving good doctors out of the state. Shame on Ephrata Hospital for dumping a patient along the side of the road - get some training on what constitutes good customer service. Shame on all the hospitals and OBs who won't take the time to open their eyes to the natural childbirth revolution that's sweeping the nation.
I hope you've learned something from our experience - that was my goal in writing this. If you are pregnant, don't accept what your doctor says at face value. Do some research. Consider taking the Bradley course. Above all, don't allow yourself to be labeled "high risk" without a good explanation based on facts. Consult a midwife - ask questions. Remember, you have a choice! Thanks.