Ava Maggie

well Aimee this friend of mine from high school has created a blog for her child. I feel bad I didnt do this for Michael but the thought never occurred to me. I was more thinking along the lines of scrapbooking so never considered this.
I actually was reading her birth story and thought it was interesting to document my birth story. I'm pretty neurotic as I am an internist- I guess it goes with the territory. I was trying with my second baby to have a VBAC- vaginal birth after C-Section. I had some misgivings about this birth- due to my age (37 i.e. old!) and my ability to have a VBAC. After all 1 in 400 women rupture their uterus which is a less than desirable outcome.


First child Michael's story

But after having my first child Michael, I felt I needed to try for a VBAC. The painful recovery process the first time made things very hard. I was sweating on a Saturday and went to sleep because I had severe back pain but didnt think it was labor yet. When I woke up on a Sunday I realized I had passed out all night and felt my breath coming faster and faster.
I went to Mount Sinai Hospital and they told me I was 8 cm dilated. After three tries by the anesthesia resident the anesthesia attending placed an epidural on me. My friend later on told me, "Two type of people never get the right care. Lawyers and doctors."
I think I intimidated the doctors because I knew what they were doing. But this could not be helped.
After the epidural they placed an IV and I was stuck in bed in this awful position. I didn't know I could have disconnected the IV and walked around and bend into all these positions. I didn't know all this. It's weird but I hadn't really researched it. I had no idea. I guess I was afraid and in denial a bit.
So after about 1 hour of pushing they tried to place a probe- I think a ph scalp one maybe. The doctor was a OB/GYN resident of mine when I was a med student at Elmhurst. Big mistake. She was thin tanned and even more neurotic than I was.
She couldn't get a scalp pH and told me there was meconium which meant the baby was in distress. She freaked out. I don't remember the result of the stress test- anyways it doesn't matter. She recommended a C/Section and by this time I had been without water and without food for while. I was too tired and feeble to put up a protest. I didn't know they wouldn't let me eat before giving birth once I was admitted- so I didn't eat before going into the hospital. Big mistake.
I was dehydrated and told them if I got some IV fluid the baby would turn and come out. But they didn't listen and my husband got afraid and I got scared- so I had the C/section. In hindsight I should have stuck to my guns and not had it. But I was young scared and inexperienced.
After the C/Section I had severe pain for 2months and my wound got infected. I stayed in the hospital for 2 weeks on triple antibiotics and was really unable to sleep or breastfeed properly. I got stressed out. I was on leave from residency and had some time off before I started my fellowship but I was still really stressed.


Conceiving and Chinese Medicine

So this second baby I was determined to have my VBAC. I prayed about it. I didn't know how I was able to do it. My first baby I conceived the first time we tried and didn't use a condom. The second baby I was worried about fertility due to age but needn't have worried. I went to see a Chinese medicine doctor who told me to take some herbs and my mother told me to eat a whole bag of dried longan- a Chinese herb which she said would make the womb hot.
I ate it and I did feel more heat in this area.
People may think its funny that I believe in Chinese medicine since I practice Western medicine but the fact is my mother used to give me Chinese herbs all the time as a child growing up. My grandmother practiced acupressure for years in China and Taiwan. That was how she earned her living. But that is a story for another time. Suffice it to say I never differentiated between Eastern and Western medicine. I thought they were the same- something I drank that tasted horrible to make me feel better somehow. I just thought they acted in different ways. I've had moxibustion as a child, cupping as a child, acupuncture about 10 times, acupressure as a child when I was febrile performed on me by my grandmother- I believed in Chinese medicine wholeheartedly.

We tried about 11 times and I got pregnant. But I was very nervous still about risk of Downs Syndrome and autism. But my baby is fine and has no problems. I needn't have worried. But again my neuroticism.


Finding a VBAC friendly doctor

In the beginning I asked my neighbor for her advice and she told me to see another North Shore OB. But this OB told me to have a C-Section when I told her my story. I knew then I was going to have to change doctors. It was a painful process. I felt scared. A lot of physicians are afraid of lawsuits when a VBAC goes bad- ie uterine rupture or something else occurs like fetal distress and death. She said, "I love surgery! You'll just have a C-section now and if you want another child, have another C-section. " I didn't want to have another two C-sections- I didn't want even the one I had had! I was appalled that she wanted to operate so easily on me. I felt that if I was a layperson, I would have felt compelled to have the section.
Luckily I was medically trained and knew the risk and was more defiant.
I started my prenatal care at St Lukes Roosevelt. I didn't really have any OB friends to ask who to go to- so I found this website which recommended Dr.Renuka Paka as VBAC friendly. They were very nice- the nurses. I gave one midwife a hard time when I felt I needed to investigate proteinuria but they reassured me there was no preeclampsia present and proteinuria and edema was not a criteria anymore for preeclampsia but more other clinical symptoms like hypertension. I didn't know this. The nurses always called me back in a timely fashion and I didn't have to wait long in the waiting room. Transferring my records wasn't a problem. They did all my tests and got results. I did my amnio and fetal anatomy scan at LIJ since there wasnt any appt available at St Lukes or anywhere in Manhattan when I needed to do it. They were able to get the results easily at St Lukes. Front desk efficiency was excellent.

One problem was I was going to have to move to Manhattan for the birth. I was told to do this around 38 weeks. I lived in Queens at the time and this was hard. There wasn't a lot of space at my parents house and it made everything difficult.
But the problem of knowledge- I made sure I knew everything. I signed up for realbirth's VBAC refresher course when I was 2 months and ran into two high school friends there. It was so funny to see them at that time. I didn't know you had to bring your husband I didn't bring anyone. I took it again when I was 8 months and reviewed everything. This time I brought my sister since it was on a Sunday and my husband works on Sundays. She took notes and I tried to remember everything. It was only us and the instructor the second time so it was a nice small class just around me. I felt comfortable and knowledgeable. It was very reassuring. Looking back it was the best $200 I ever spent. It was also great to see old friends. Sometimes old friends even with their gap silence conversations are the best. They understand without too many words.

I also at this time lost my babysittter. We felt we had to fire her because she locked my 7 year old out of the house. He came home one day and not only did she not pick him up but she wasn't home when he knocked on the door. This was child abandonment and we felt scared Mike would be kidnapped by someone and we might never see him again or we might lose him to ACS.
I was training a second babysitter out in Queens when the contractions started. I was due on Friday and they started on a Wednesday.

I also tried to pamper myself a little this time while pregnant. After the VBAC refresher I went with my sister to eat at Kyotofu which had great tofu desserts and vegan curry. The atmosphere was light bright and happy. I also went to Candle Cafe and had tempeh sandwiches along with peanut butter jelly shakes. It was delicious vegetarian filling and tasted great. I really need to restart the vegetarianism again.


Giving birth two days early NOT in Manhattan

It was Thanksgiving week and I had to train the babysitter. Noone else wanted to do this job.
It was 4 in the morning when I felt pain. I sat down, stood up and walked around. I ate and drank. I felt fine. I did some deep breathing. I wrote down on my palm treo all the times the contractions came. I passed some blood and mucus and thought- oh that was the mucus plug.
At 6:25 am I felt I couldn't breathe easily and woke my husband up. The contractions were coming faster and I wasn't able to write on my treo anymore. I kept hoping I was not giving birth but it was coming. My husband used some sterile gloves and felt me. I was not going to the hospital until I was ready to push because I didnt want another C-Section if I was too early.
I said, "How many cm am I dilated?" My husband David said, " I'm not sure how many cm but I feel a head thats hair I feel!" I said " Oh!" That meant that I was fully dilated and ready to push (either 12 cm or something like that)
I didn't know where to go but my husband brought me to LIJ since they have SChneiders Childrens Hospital there.
I remember the guard helping me into a wheelchair and some of the nurses being mean. Yelling at me that I should know better when I am an internist to not go to a hospital where I didn't do prenatal care. I felt bad and hurt but I really had no choice in this process. Eventually I ignored them. The pain was coming and they talked about giving an epidural but my contractions were too strong and too close and they were afraid of hurting me.
I was screaming in pain and I remember the OB attending on call Dr.Jonathan Herman telling me he would try to do VBAC.
He was trying to get me to push. I remember pushing incorrectly and the nurses would try to get me to correct my pushing to be in my pelvis and not my legs. I pushed for three hours and my baby came at 9:23am. I didn't think she would come. The three hours were so long and painful. Its the worst pain of my life. I had some rectal pain while her head was crowning and then she came. She was so small and beautiful and perfect. Well I suppose all mothers say these things.
It was afterwards that I found out this doctor liked VBACS infact he told me his sister-in-law had had seven VBACS which were all successful. He did have to cut an episiotomy but I was stitched up nicely.


Postpartum Care
I left the hospital after two days. I still felt weak but not painful. This time I had burning pain from my tailbone which I think I had broken. I had an Xray which was inconclusive. My breast feeding went fine although my baby was a little hungry so I made a mistake of giving her formula. She found it hard to latch on in the future.

Strange! His office was around the corner from my previous OB who refused to do a VBAC on me. I had to meet him in the hospital though. It was predestined for us to meet. I don't think he understood what a favor he did for me. For this Dr Herman I thank you.


There is more to write but its got to wait for another day. Today we lose one hour of sleep and the baby is screaming. We're trying to sleep train her but its not working.
I need to pump my boobs - which I give alongside formula.
My husband is trying to sleep on our new couch we got from Macys-
I guess I should stop typing for another day.