Reality Bites

Everyday I go for a walk. I breathe in the fresh air and remind myself that the world is still turning. The sun rises and the sun sets. I cry a little less each day. I have started brushing my hair again. Flossing my teeth. All the things I stopped doing as they seemed so insignificant, so pointless in the presence of so much pain.

The toughest time is first thing in the morning. I still dream that I am pregnant. I dream of the baby that was supposed to be here in October. And when I wake up in the morning I still think that I am pregnant for a second or two. As my eyes flutter open and I see that morning light has filled the bedroom, the dream-world fades and being pregnant becomes just a memory. Just a wonderful, beautiful memory.

It hurts when I realize that becoming a mum in 2010 is impossible now. There will be no 2010 baby. I was so happy to think that I would have a baby this year. I would have been a mum in my 30th year. I would have been 6 months pregnant on my 30th birthday. All this hurts so much. It scares me to think I have to suffer through these landmarks, always knowing what should have been in the back of my mind.

Right now it feels like I was never really pregnant. That it was all really just a dream. It was simply a glimpse at another life. A glorious joy filled life. And I feel like I have just dropped 1000 feet. Slammed back down to reality. So this is what forgetting to pack a parachute feels like. Ouch.

A breech vaginal HypnoBirth in Canada

This is a news article about a recent vaginal breech birth in Canada, where vaginal breech deliveries are becoming more common. The doula that attended this birth shared that the couple also took HypnoBirthing classes from her. After reading the article, you can listen to Dr. Posner's experience of being the OB that helped to receive this breech baby.

Vaginal Breech in Ottawa

Every birth is a miracle, of course. But the arrival of Lily
Luck-Henderson, just after midnight last Tuesday morning at the General campus of the Ottawa Hospital, was something else as well.

Lily was breech, as are about four per cent of babies, meaning she
emerged from her mother's womb bottom first, rather than head first.
But, unlike most breech babies born in Canada in recent years, Lily was delivered vaginally, rather than by caesarean section.

Her successful delivery is seen as a harbinger of coming change in the
way babies are delivered in Canada -- or at least a step along the way.

At five days old, she has already played a starring role in something
significant, according to Ottawa midwife and researcher Betty-Anne
Daviss, a leading advocate for the return of breech birth deliveries in Canada, who, along with two obstetricians and a doula attended the
birth. It "was a pretty momentous occasion in Ottawa," she said, and an important step toward normalizing childbirth in Canada, something the organization representing Canadian obstetricians stands behind.

"The safest way to deliver a baby has always been the natural way,"
Andre Lalonde, head of the Society of Obstetricians and Gynecologists of Canada, said last year when it began an effort to bring back breech
birth. "Vaginal births are the preferred method of having a baby because a C-section in itself has complications. "

Not so long ago, evidence said something different.

The practice of delivering breech babies by C-sections was already
becoming the norm when a Canadian-based study published in The Lancet
concluded in 2000 that vaginal deliveries put breech babies at risk. The study cited 16 cases of fetal death, 13 of those involving women who delivered vaginally. The risk was considered so significant that the study was shut down early.

It had an immediate and far-reaching impact in Canada and around the
world. As a result, having a breech baby, in most cases, automatically
meant surgery.

Since then, a reassessment of the earlier trials has come to a different conclusion -- that vaginal deliveries in breech births do not increase complications. As a result, the Society of Obstetricians and Gynecologists of Canada has revised its position, saying physicians should not automatically perform C-sections for breech births, but, under the right circumstances, should allow women choice.

The new guidelines were announced last June, but change has been slow.

The problem is that many doctors have never delivered a breech baby and others have limited experience. It had become a lost art.

Ottawa obstetrician Glenn Posner began practising after the
controversial breech birth study and, as a result, had no practical
experience delivering breech babies. He is anxious to change that. On
Monday night he helped deliver Lily Luck-Henderson. He says watching a
video about how it is done in Germany, with women in an upright position or on their hands and knees rather than lying down, helped.

It is time women were given the choice about attempting to deliver
breech babies without surgery, he added. "Aren't we supposed to let
people make their own choices? It's not the 1950s when you tell people
what to do and they say, 'OK, doctor.' "

Daviss, a midwife and researcher has traveled around the world
collecting and dispersing knowledge about breech birth deliveries. She
was recently in Israel where she taught techniques to help mothers
deliver breech babies without surgery. She conducts weekly sessions for mothers and care providers in Ottawa. And she is instrumental in the formation of a "breech birth squad" in Ottawa of physicians comfortable with and experienced in vaginal breech deliveries.

Last year, Daviss was involved in a conference sponsored by the
Ottawa-based Coalition for Breech Birth, aimed at bringing breech birth delivery back to Canada. The coalition was started by an Ottawa mother, Robin Guy, who had a breech baby by C-section.

The issue can be emotional for some. Guy has said her surgery was
unnecessary, except for the lack of skilled care providers to help her. She has lobbied to improve breech skills in Canada.

Daviss calls the return of vaginal breech birth "only a microcosm of
what else might change in obstetrics."

Since the 1960s, probably before, women have talked about taking back
control of birth. Still, with each decade, it has become more a medical procedure and less a natural event.

In the 1960s, about five per cent of Canadian women delivered by
C-section. Today, more than 27 per cent of babies are delivered
surgically and there is a national debate about whether women should
have the option of C-sections on demand.

Some will argue that if women want them and if they reduce risk, then
they should have them. But Daviss and others counter that C-sections are far from risk-free, something women are often not aware of.
Complications, even death, can result. What is more, reliance on
C-sections results in a loss of medical expertise, as has happened with breech deliveries. And "you never know when you are going to be in a place where you don't have a C-section available," Daviss says.

Lily's birth turned out to be problem free. "It went very easily," said Lily's mother Jennifer Luck. "If this helps make things easier for women along the way, I think that's fantastic."

Elizabeth Payne is a member of the Citizen's editorial board.
E-mail: epayne@thecitizen. canwest.com
C Copyright (c) The Ottawa Citizen

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The Best of All in a Day April 13, 2010 "Breech Births"

The Society of Obstetricians and Gynecologists reversed its position on breech deliveries last year. They now say that it's safe to deliver breech births naturally in most cases. But a lot of obstetricians aren't trained in delivering breeches, because for years doctors have been directed to do C-sections instead. Well, this is all slowly changing at Ottawa Hospitals. Dr. Glenn Posner is an ob-gyn who's been trying out natural breech delivery. Robin Guy is from the Coalition for Breech Birth.

Listen to Dr. Posner talk about receiving a breech


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Way to go Dr. Posner & Canada! Now we just have to get the U.S. OBs on board!

www.AWellLivedLife.Net
www.AWellLivedLife.blogspot.com

Recovering

I don't really know what to say. This has been the toughest week of my life. I have been so moved by all the comments left on my blog. The empathy and the kind words from everyone has been a great support. Thank you.

I never even realized how much I already loved this baby until I was told 'something's wrong'. Something's wrong. I will never forget that for the rest of my life. I felt like my heart had been ripped out my chest. Where's the heart beat? I asked Dr. B. He shook his head and turned off the machine. I'm sorry, he said. I screamed for my mum who was sitting beside me. I began shouting, screaming as the dreadful reality became clear. My baby. My baby. The shock was all consuming. No sound came out when I cried anymore. It was though everything was happening in slow motion. I will never forget that day. The smell of the room. The clothes I wore. My telephone call to Mr. T. The tears, the pain, the helplessness.

I don't know how I managed to get home. I don't know how I put one foot in front of the other to walk out the clinic. I don't know how I kept breathing at all. If it wasn't for my mum holding me, crying with me and soothing me I wouldn't have managed to have coped at all. I will never forget that awful day. Mr. T was incredible. He booked a flight home for that evening and jumped in a cab that cost him 600 Euros to get to the airport. The whole time he was on the phone to me, consoling me, telling me he loved me and that he was going to be home soon. God knows what our phone bill will be this month. That night I cried myself to sleep, still wearing my clothes, surrounded by tissues and clutching my mum. When Mr. T arrived I felt a strange mixture of relief but also a surge of bitter sorrow and despair - I was so sorry to have to bring him bad news. So sorry that it was this bad news that had brought him back to me.

A silent miscarriage. How cruel. My body believed I was pregnant as I was still carrying the baby. So all the morning sickness, the sore boobs, all the pregnancy signs were still there. They made me believe everything was okay. But all this time. For nearly a month, my baby's heart has stopped beating and he or she had stopped growing. I had continued to feel nauseous, to vomit and felt so secure that my pregnancy was progressing well. How was I supposed to know? That hurts and scares me the most. That I had no idea something was wrong - what had I done? What had I been exposed to? Why had my body not recognized something was wrong? Why was there no bleeding, no cramping? I ached so much knowing that my baby was still there. Floating inside of me. But dead. It was agonizing. When would my body eventually recognize that something had gone wrong and start the process of bleeding out? Could I cope with the wait until then, not to mention the physical and emotional pain of bleeding out? What

if an infection was developing, what if I needed to have a d & c right away? I decided that whatever was needed I had to go back to the UK. I wanted to be seen by a specialist and if a d & c was what I needed then I wanted it done in the UK.

Getting the flight home was so hard. My mum and Mr. T surrounded and protected me as much as possible. A hat saved me from brushing my hair and large dark glasses allowed me to cry freely and hide my swollen eyes. Airports during the Easter holidays are full of happy families. It was like baby central, everywhere I looked, it was so damn hard. The Moroccan airport officials were so kind. As we stood in the immigration line, I was surrounded by babies and infants. The lines were long and moving slow. Mr. T saw I was losing it. He found an immigration official and had a gentle word with him in Arabic. Before I knew it we were called into a small room, where they stamped our passports and then led us into the departure area, away from the long queues. As we walked out, the immigration guy said to Mr. T in Arabic, 'tell your wife to be brave. To be patient.' It still moves me that in the midst of all that bureaucracy, that sterile official environment, behind someone's uniform and glasses, their compassion and humanity shone out.

My amazing dad had been on the phone all day with OBGYNs in the vicinity of the airport and had got an emergency appointment for me. I went straight from the airport in London to the hospital and the consultant confirmed everything Dr. B had said. She suspected that I might have a fibroid. But the uterus changes during pregnancy and so it was hard to tell - we will have to wait until my uterus is back to normal before we can know anything. We discussed my options and she booked me in for a d & c after the weekend.

Over the weekend I tried to bring on the bleed naturally. I was scared of the d & c and thought that it might be better if my body did it naturally. I went running, did power yoga, lifted weights and drank cupfuls of raspberry leaf tea. My mum stimulated the reflexology points of my uterus on my feet. It was the most difficult thing emotionally. Everything I was doing felt so wrong. After trying so hard to keep the baby safe, to do the right thing during my first trimester, I was now doing the opposite. I decided to switch off and not think anymore, just do. By the time the d & c appointment came around I had started to have a slight bleed but nothing much and no cramping.

So I had the d & c yesterday. Or what they call the Evacuation of the Products of Conception. Ugh. Awful name. I have to admit I was so scared. Scared of the pain. Scared that something would go wrong. That I might be scarred, that my womb would be damaged and then there would no chance of ever having children (we had a big discussion with the OBGYN and made her sign a paper that stated this would be a guided d & c and not done blindly. I think I will post more on this later.) The tears ran down my cheeks as I lay there in preparation room. The general anesthesia was a welcome relief. When I awoke, I remembered where I was and why I was there, I felt the soreness in my womb, and I cried unconsolably. It's over. My baby is really gone now.

I still feel the ache in my womb. The emptiness and sense of loss is palpable. It makes my whole body ache. I wish I could have known whether my baby was a boy or a girl. I wish I could have given him or her a name. I wish we could have known each other. Mr. T tells me the baby is in a better place now. That one day we will be reunited. He tells me that God tests those he loves the most. And that special blessings will come to mothers who have lost children. He tells me that the baby always belonged to God. And there is a comfort in his words. A kind of solace. It makes it easier to say goodbye. To let go.

As I lie in bed recovering from the procedure, I try to understand. But there is no comprehending, just hurt and pain. But there is also love. Lots of love. Love from my family, my friends, even the strangers who have reached out to me in this difficult time. And most of all love from my husband. My dear husband. Who is suffering the pain and sadness too but who has been so strong for me. He holds me up when I feel like I am falling. He comforts me in the middle of the night, when I wake up crying. He has done so much for me these last few days when I have been completely lost. Just when I think I can't love him anymore than I do, I find a whole new deeper level of love and admiration. He truly is my everything. To my husband - thank you. I love you. You are right. Together we can get through anything.

I have lit candles before for others' losses. Today this candle is for my angel. You will be in my heart forever. I love you.