#220 | Catrina's HBAC: A Mother's Triumph Over Medical Intervention

July 5, 2023

Catrina's first pregnancy was labeled high risk when a routine ultrasound revealed a two-vessel cord, leading to repeat ultrasounds and a diagnosis of IUGR (intrauterine growth restriction) and low fluid at 35 weeks. Her doctor immediately sent her in for an induction, and because her baby was still breech at that point, she ended up with a C-section. Catrina felt completely "checked-out" during the whole experience, as this was the exact opposite of the birth she had planned for. Her baby ended up in the NICU for five days and over 24 hours of time passed before she held her newborn.  After this experience, she was sure she would never have another baby. Just over a year later, she was pregnant again, chose home birth and had the HBAC (home birth after cesarean)  of her dreams.
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View Episode Transcript

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

As far as I know, no grandmother of mine, great grandmother and my mother, no one ever had a C section. I felt like I did everything right. I drink green juice every day. I had no coffee. I did all the things I ate healthy. I had no sweets. Why me? What did I do wrong? But of course, I trusted the doctors. I didn't know better. I was a first time mom. I just it was like my worst nightmare come true. I hate hospitals. I hate everything about that. And I had asked my OB GYN, you know, way before prior to that, you know if in the event I didn't need a C section being that I am high risk now. Can I have a gentle cesarean? And I remember him laughing in his office going up? No, they don't. They don't do those.

My name is Catrina. I live on Long Island in New York. Born and raised somehow ended up back here after thinking I would stay in Hoboken forever but here I am love Hoboken.

So here we are. And yeah, got married. 2016 we got our house 2017 2018 pregnant with our first child both had teaching jobs in you know Public Schools life was perfect. Right picture perfect storybooks. dream wedding Dream House dream jobs right. got pregnant first try with our beautiful baby. I thought I had a great pregnancy. I think it started going downhill when my OBGYN sent me for I believe it was a level two sonogram because my husband was born bilateral clubfoot ID. So I guess they're they wanted to make sure that our baby didn't have the same issue. And during that time, they found that I had a single umbilical artery.

How pregnant? Were you at this time?

Maybe at the end of the first trimester. Okay. I believe. So they informed me that there was a risk for restricted growth and preterm labor. And I didn't think anything of it because my OB GYN was like, oh, yeah, it's fine. Don't worry.

You had a single or two vessel.

Right? So single umbilical artery, meaning I had one artery and one vein to vessel cord.

Yeah, right. So a to vessel cord, a single would not single would not work, single artery, one vein, one artery, right talking about, whereas normally we have three vessels in the court. So it's a variation of normal, it's not that uncommon. It's a good reason for providers to get all worried about growth, restriction or complications in pregnancy. And while those things can sometimes be associated with that, more often than not, they mean nothing, it means nothing.

Right. And I've heard stories of moms having no issues and I've my own another doctor, and my practice told me her child had it there were no issues. So I was trying to be positive, they felt good. I really didn't have any, you know, illness come along, or bad feelings I was, I felt like I was glowing every day. My My job was quite stressful. It was very demanding. I had a couple of rough patches, a couple of fears of me losing my job that I thought I would return to after becoming a mother. So there were days where I was crying in the bathroom at work. It was a very emotional time as far as my career and I was feeling very worried about that. On top of, you know, after hearing all of the potential issues with my pregnancy, and in my heart, I knew I didn't want to work till the end. I wanted to take my maternity leave early and just rest and relax and nest. But my OB GYN reassured me that I can work up until the day I deliver. So I took his advice because he was the doctor instead of listening to my instincts. So I did work up until the day that I was admitted for delivery. I was at my 30 Five weeks sonogram which I had many, many ultrasounds during my first pregnancy to check the growth because of the cord, right, so I was going, maybe maybe weekly by my third trimester. And she was monitoring, you know, she said baby is at 13 percentile if baby drops 10% or below, we're gonna have an issue.

Just just to be clear, this 10 percentile is the threshold for the intrauterine growth restriction criteria. Yes,

yeah. But it's not justified, Trisha. Right. I think we want to make that point clear, right?

Well, yes, there's so every baby born under the 10 percentile is not necessarily IUGR.

Because one in 10 babies will be right? And is that ug ours? Well, if it's a 10 percentile, it has to be we're talking a percentile chart, one in 10 will be under 10% 10, out of 100 will be 10% or under. So they're taking the lowest 10. First of all, they're basing this on ultrasound, which is a very poor indicator of fetal weight. But they're just taking this big fishing net, and gathering all these babies under 10%. And stressing out the moms. But that isn't what that isn't really indicative of IUGR. It's just saying all these babies on the small side? Well, yeah, because there are small babies, just as there are large babies, and as Trisha said, has said before, you don't really know if a baby has IUGR until after they're born. But I would think, Trisha, isn't it more indicated by like, a failure for the baby to continue growing?

Right? So there's no lack of growth slow there slowed growth, lack of growth. And then there's ultrasound Doppler measurements that can help evaluate whether the placenta is getting properly perfused. But the first marker is that 10th percentile and a lot of people are pushed into intervention, just because they fallen below that 10th percentile. That does not necessarily mean you have true IUGR. So keep going.

Yes, yes. So I, I suppose the fact that according to ultrasound, baby went from 13th percentile to 10th percentile. You know, she called me in the office, she told me, I'm sending you to labor and delivery, you're going to have your baby now. I sat in her office chair and cried for about two hours with my husband. Because all I wanted was a natural, physiological, you know, birth. That's all I wanted for my baby. I wanted everything in my power to not have a C section. I didn't even know at this point that I was going to have a C section because he was breached. So I didn't even realize they wouldn't give me the option. And she also said my fluid was low. So So due to the low hormone and my placenta, the low fluid, the growth restriction, and my baby being breech at 35 weeks, I was sent to labor and delivery. I didn't even know what was going on. I was so distraught. I like didn't even feel alive during all of this. You mean, you felt checked out? Yeah, I just it was like my worst nightmare come true. I hate hospitals. I hate everything about that. So then they told me they were going to give me steroid shots for the lung development. So that would have to be done 24 hours apart two doses, because the baby would be born prematurely. Right. So I was 35. And two, maybe.

So they determined that the be the risk to the baby. Of us staying pregnant was greater than the risk of a 35 weaker who potentially wouldn't have functioning lungs. Yes. Based on one slowed growth measurement, and a little bit of low fluid.

Yes. And you know, for this appointment, I was all about letting baby come when baby's ready. You know, never trying to force anything or intervene with the natural process. But of course, I trusted the doctors, I didn't know better. I was a first time mom. So I did whatever they said. And I ended up you know, after the 48 hours passed, I was in the hospital bed sleeping with my husband. It was maybe like, one, two or three in the morning, all these alarms and monitors started going off. You know, I was sleeping with the monitor around my belly. I was all hooked up to all these machines. To monitor the baby. A whole crew of like five doctors and nurses ran in in the middle of the night, telling me oh, you might need an emergency C section right now the baby's heart rate stopped. Again. I didn't even know what was going on. I couldn't even process what they're saying. And then they're like, Oh no, it's fine. It's fine.

So it's not that the heart rate stopped. It's that the electronic fetal monitor failed. And no one was there taking care of you. They were down the hall leaning back watching a bunch of monitors. Yeah, and rather than thinking that these monitors slip all the time and move all the time, they went and scared the heck out of you. It just feels that way. It just feels like it's nonchalant. For hospital staff to not be with a woman. And it just feels like there's this vibe of let's Let's just hang out. Watch these monitors mean women are supposed to be tended to and loved and cared for. At one thing is causing me confusion. Here. You are in a apparently very high intervention traditional New York Hospital, your baby was breech. I'm not understanding why they were not sending you straight to a C section. Or she goes on waiting for the steroids to work out to give the steroids to the mother then pass on to the baby to rapidly mature the lungs so that they can be born. Hopefully with functioning lungs.

I didn't even realize after you know, they came in. They scared me then they said nevermind, the baby probably squeezed the cord with his hand. And don't worry, go back to sleep.

Oh, the baby probably squeezed the cord with his hand. No.

She's right, Trisha. Probably, I mean, let's not blame the baby here.

Yeah. So then they said don't worry, go back to sleep. So I'm like, Yeah, right. Okay, go back to see if you just told me my baby's dying. But go back to sleep. Right. Right.

Right. Right. Nothing to see here. So that was that. So I was so exhausted. The next day, I believe my C section that I didn't even know I was having until probably a few hours before I didn't even realize. So I didn't even think of it didn't explain the plan of care that they were going to give these steroids and that you're going to just remain in the hospital until until your scheduled C section because your baby was breech. They just didn't even share that with you know, I didn't know I was getting C section until like maybe the morning up. And I had asked my OB GYN, you know, way before prior to that, you know if in the event I didn't need a C section being that I am high risk now. Can I have a gentle cesarean? And I remember him laughing in his office going oh, no, they don't. They don't do those.

So nice.

There's that. Yeah. So, you know, the nurses were very kind. I had all women. I remember one nurse coming in and telling me oh, we're going to try to get you in on time for the female anesthesiologist, you don't want this guy. So just tell them that you want the female and I was like, Okay, I don't even know what that meant. But I said okay. And I made sure I had the anesthesiologist, the nurse told me to request so C section was very quick. I don't even remember what I do remember is they were playing Christmas music. It was November 30. singing Christmas songs. And I remember the smell of my skin burning once they cut me open. Yeah. Oh my god. So. So Christmas music, bright lights and the smelling of my skin burning. They took the baby out, weighed them, clean them, you know, cut the cord right away, put him cheek to cheek with me for maybe seconds. Then took him to the NICU because he was small. He was four pounds nine ounces, I guess I must have must have fallen asleep. Because I woke up however many hours later, with a breast pump on my lap. Not even my baby. I didn't even know where I was where my baby was. I didn't know my baby was in the NICU. But I remember the lactation consultant telling me okay, just pump every hour or two or whatever it was. So here I am. All I want is my baby to hold my baby and I just I had this pump on my lap I'm like,

so that you really hadn't even seen your baby yet. At this point. You had a moment of Cheek to Cheek you probably hadn't even seen your baby on rap to seen.

I remember. I remember looking at him when they were weighing him when I saw these two huge dark brown like black eyes looking at me, that's my memory and then the cheek to cheek and then they took them away. I don't really remember. The first time I touched my baby may have been the next morning. My first time I tend to breastfeeding him was probably the following morning. Obviously trouble latching because without my permission or without my consent, they gave him a bottle of formula before I even helped him. And mind you this is a breastfeeding friendly hospital.

So they broke the rule. Yeah, and can I just we just need to re emphasize the point that in premature babies, colostrum and breast milk are so incredibly important. So to give your baby formula without your permission is it's so wrong It's harmful, it's harmful. It is it is going against first do no harm, it is intentionally harmful. Yes.

Was that a Baby Friendly Hospital? Are you saying a baby friendly certified hospital? Yes, then they should be reported for that. I can't get it every day they have 10 criteria that they have to adhere to. And that is the most important one. That should be reported for the sake of everyone for their sake for every woman and babies sake that should be reported.

Yes. So my story is not the only traumatic story that I know from there. So. So that happened, you know, fast forward, baby was fine. He was in the NICU for six days. I think he maybe just needed oxygen the first day he was born, but no health issues. They kept in the NICU for six days. I don't know why. But it's felt like the longest six days of my life. We got home. I couldn't I tried breastfeeding him for about three months, I was doing the triple feeding for three months, pumping, trying to latch bottle feeding nipple shields. After three months, I saw another lactation consultant who came to the house and she helped me and once I got him exclusively breastfed, I never went back to pumping again, I had a little celebration, I threw away my pumping parts and continued to breastfeed him for three and a half years. And that's beautiful. It's not easy with a baby born at 35 weeks and of that size to breastfeed. Those babies are not capable of breastfeeding exclusively, which is why you were needing to do three part feedings. But that's one of the one of the serious consequences of preterm birth that nobody talks about is what your breastfeeding journey is going to be like. And you know, three months of triple feeding is major dedication. And so I'm so happy to hear that you persevered and made it to three and a half years it was I'm sure well worth all those difficult days and weeks in the beginning. Yes, you also were recovering from major surgery when this was going on? Yes. It's worth asking. Are you aware if you had postpartum anxiety or depression because you suffered a few risk factors of that?

Through. Yeah, it was just it's all a blur. It was going through the motions. I just remember the sound of my pump in the middle of the night. You know, I remember being really upset that I always just wanted to hold my baby, but I would have to put him down and let someone else hold him so I could pump and that crushed me because I just wanted to nurse him. I know. As far as I know, no grandmother of mine, great grandmother and my mother, no one ever had a C section. Everybody breastfed without an issue. So I felt like I did everything right. I drink green juice every day. I had no coffee. I did all the things I ate healthy, I had no sweets, why me? What did I do wrong. And even though, thankfully, I breastfed him for, you know, natural term. I just I can't help uh, keep thinking back. Now I realized perhaps if I got a second opinion, perhaps if I met with another provider, things could have been different. I understand C sections are unnecessary for some cases. But I also understand that, for example, in my hospital, women giving birth for the first time, there's no reason for 50% of them to be having C sections. And I didn't even know these numbers until after I gave birth. And I became aware. So had I known that before I gave birth, I probably would have seen a different provider. And or at least given it a little bit more time. There really wasn't. There really wasn't in that moment. On that day, there really wasn't an urgent need to give birth to your baby.

Yeah. And I wish I would have just been in the right mindset to know what sense does it make to rip a baby out of the womb before he's really ready? And why wouldn't you know, again, I can't go back. I don't know. Maybe he really did have a growth issue. And maybe he really did have to come out. I'll never know the truth. I just wish I saw another provider which I got a second opinion. Wish I knew that I had options. I didn't know that I had choices. You know, they never really asked me do you want to do this or this? They just said we're sending you here we're doing this we're doing this.

Babies very rarely, are better off out of the womb than in the womb. Very rarely, even when a woman goes past her due date. Well, even when she goes well past her due date. But you know, when you're talking about a woman whose baby is clearly growth restricted, clearly growth is not happening. And she smokes or she's doing drugs, you can start to put it together and create a story and a rationale. When you have a healthy woman who is like oh, you touch that 10% And we have to remind ourselves that in this nation with the highest maternal mortality in the industrialized world, there's a reason that, for example, the hospital you gave birth in has a 50% Zerrin rate. Why? Because they're creating reasons versus areas that aren't legitimate. That's the only way 50% as possible. How do they do that? by convincing women, there's a need for that intervention or that C section. So not to mention you didn't receive an ounce of informed consent, you were not told anything about the risks of what you were about to enter into. You were only told that this is what you should do.

And you weren't given a choice, which is also what meta analysis has shown that women are not given choices, and you always have a choice, they can never say, Well, you're not going home today better. Call yours, call your husband, and they can't do that. They have to explain to you what their recommendation is, and then give you space and privacy to make a decision. But it we believe it because it's too painful to think that this is happening for no reason we believe it well, what if, what if he really will do better out? And then it will, of course, the next thought as well, I don't want to take any chances. But that therein lies our society taking chances. And that's what points to our higher mortality rates for babies and moms. And women blame themselves? Yes, I did for a long time. And you know, and everyone said, Well, the doctor saved your baby's life and all of that the doctor risks your baby's life and all that. Exactly. That's how it sounds.

Again, I blamed myself for so long. And then I started reading more and more, you know, the only thing I remember them asking me asking for my consent, because I had a sign a paper was if I wanted to give him the hep a vaccine. And again, I didn't even think about it. I knew nothing about it. I didn't do enough research I did a little bit, but not enough to know what decision I wanted to make at that time. So I remember saying, I don't know, what does everyone else do?

That's exactly what women say. That's what I said.

And I kicked myself now because I know apparently, there's no different dose for little babies. So you know, they administered that. And looking back, my baby didn't need that. You know, vaccines are the only medicine that they don't weigh, they don't take dosage into consideration.

My teeny tiny four and a half pound baby like I did it who didn't even need that.

No, my one of my best friends had twins at two and three pounds each and the same thing. They were just like offering her the lineup of vaccines. And that's when she learned the dose wasn't smaller, my dry children weighed four times what her children weighed, and they would have applied the same dosage.

So that's the only only thing I remember asking, didn't again, I still at this point, didn't know what planet I was on or what was going on. So how could I give informed consent at that point, but there's that so you know, now my son is four and a half almost. And he's great. But every day everything that goes wrong, I always think back. What if he had a vaginal birth? What if he didn't have that injection? What if what if, you know, what if I could have just found a better doctor and he was allowed to go to full term? Right? And then I think about my husband, who was a five pound baby and myself who was a six pound baby. So obviously, I don't think I would have made a huge baby. Exactly. So that's another thing. I don't know how relevant that is. But to me, it would have made sense.

It is relevant genetics, and it has nothing to do with our adult size. But the genetic component is what do we in our family weigh at birth. And if it was coming from both sides, maternal and paternal, of course, you're extremely likely to have a small baby at birth.

Yeah, yeah. So you know, my son had various issues. You know, I don't want to go into detail but things that I just always trace back to the traumatic birth to certain things and interventions that happened. I remember my teeny tiny preemie I had at least five doctors and nurses come into my room asking me if I wanted to circumcise him. Shouldn't one time of me telling you know, don't touch my baby be enough? Why did they have multiple people coming in? bothering my poor teeny tiny baby? You know, and then I remember one doctor asked me Oh, why not? And I said, Well, we don't do that.

Yeah. Why? Because my child deserves the right to his full body.

Let's let's be honest, we never talked about this but the doctor has a conflict of interest. Of course, it's another surgery. Right? Shame on them for another unnecessary harmful surgery. And that so that's, you know, and I think God that was one thing I was well informed on. That is huge. Congrats. I'm so happy that I knew better for that but everything else I always think back and I'm always, my husband just says, you know, you can change it, you could just move forward. And, you know, after that for about a year, I said, That's it, I will never get pregnant again. I will never give birth again. I will never go in the hospital again. I was one and done. I said to my husband, I will never do that again. Even though I wanted a big family. I said never again. So after just over a year, I said to my husband, well, if we want to grow the family, you know, we just try see what happens, you know, he can't really plan perfectly. So B got pregnant in 2020. But this time, I wasn't working, I was home, I had less stress. I was more informed. I read so many wonderful books, by Dr. Jack Newman, and Dr. James McKenna, and, you know, your baby's microbiome, and I read all these wonderful books, and I took my lactation education training courses, and I learned so much. I took a childbirth certification course so I could be a childbirth educator. I did it more for me to help me learn. And I gained all this knowledge and I felt so different. I felt like a new person. And I said to my husband, you know, I'm gonna meet with a few midwives. This time around change my providers. I started with a group of hospital midwives at a local university hospital and they were fine. Until I did my little interview for my VBAC wishes. And they said, Well, you know, we have to monitor you and give you the epidural, just in case you need another C section. So I was like, Okay, this is not in line with what I want. I met with the home birth midwife, and I fell in love. She was everything I ever dreamed up for a care provider. And I told my husband we're having a home birth. He said, What? Okay, I made up your mind. It was yeah.

Yeah. I said, this is my midwife for having a home birth. I don't want my midwife. Yeah. I said, I'm not you didn't. You didn't introduce your husband to her. You introduced her to your husband.

I said, I am not ever giving birth in a hospital. A hospital is not a place for birth, especially not where I went. So I said, I'm having my baby at home. So I brought him to meet the midwife. She answered all his questions, to help him feel confident that anything that happened during my first pregnancy had nothing to do with this one. I was healthy. My baby was healthy. I had no issues. And fast forward to today. I had my home birth with my husband, your home birth after cesarean? Yes, my H back my home birth after cesarean. And it was the best surprise ever. Another boy and after that experience, you know, I felt like Superwoman, I felt like I could literally do anything. My baby latched right away. I was floating like on a cloud for I don't even know how long it was so empowering. I felt literally like I was flying. And I told my husband, I could do this, like 10 more times. And the midwife arrived 10 minutes before the birth, you know, my husband was like, Yeah, you were crowning. I didn't even want to tell you. But I remember, you know, just I was roaring like an animal like a wild lioness or something. I just totally surrendered my body. It just happened. It was so amazing. And I remember thinking at one point, this is so intense, like, I don't know what if since I'm a first time laborer, this is like a 24 hour thing, because I heard stories like that. You know, first time labor is long. Once the midwife was on the phone, and she heard me, she told my husband, all right, well, the baby's probably going to arrive before me. And when I heard that, I was so happy, because I was like, okay, the baby's coming soon. But she made it 10 minutes before the birth, and it was just lovely in every aspect. And I just wish that every woman could have the gift of a beautiful, peaceful birth.

After your second birth, how did you then receive your first birth? You had years to think about your first birth, you had come to certain conclusions, then you had this incredible experience that exceeded your expectations? How did that change how you then proceed your first birth, what new emotions came up for you?

You know, definitely regret that my, my firstborn child couldn't have all of these things, you know. But also glad that I learned that it wasn't me. It wasn't my fault. I didn't harm my baby, that my body wasn't broken that I wasn't broken, you know that I was capable. And with a little bit of education and the right support, I could make the positive changes that I needed to for myself and for my family.

Many women go into their first birth, thinking that they'll just see how things go or just take it as a co or they just sort of trust the doctor implicitly to guide them along the way. After this experience, how would you advise women? What would you say to them about preparing for their first birth?

There are many factors and ways to prepare, I think it's mostly a mental exercise. Just knowing that your body knows what to do, and your baby knows what to do. But really, number one, I, you know, in my personal experience, I believe my birth trauma would have been avoided if I would have paid attention to all the red flags with my ex OBGYN. And if I would have fired him before my birth, you know, I didn't realize that I could switch providers. And, you know, the red flags him telling me there was no gentle Syrians, him telling me that I couldn't breastfeed after 20 weeks of pregnancy with my second child, because I would go into preterm labor, and I knew that was false after him. You know, there were just many red flags. I didn't know I genuinely didn't know that there were homebirth midwives let alone midwives on Long Island. And then, you know, with my first pregnancy, every birth story I heard was horrific. And, you know, there was nothing good said by my friends and relatives about the birth stories. My second pregnancy, I joined all these home birth support groups. I spoke with women who had home births, or, you know, births with midwives and hospitals. And just by hearing the stories of my friends and relatives who had an OBGYN hospital births, compared to the homebred stories, it was a no brainer. I just want women to know that we don't have to continue these cycles of birth trauma, it can end and it will end if we keep speaking, keep sharing stories, keep informing one another and keep supporting each other.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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