Saturday, April 25, 2015

Dear Consologic

(In 2011, my husband and I started a business from the ground up. Today, four years later, we close the doors. It was an incredible experience and I wanted to remember my thoughts from today. Today marks the end of a chapter and the anticipation of a new one.)

Dear Consologic,

You were the place. 

You were the place that started as a "what-if". You were a dream, then a spark. You stood for independence. You were risk and hard work. You were ours. 

You were the place we tore apart, ripped out, spackled, painted, furnished; made new. You were a mess when we found you. You were given a new identity and purpose. 

You were the place my marriage was tried, tested, and refined. You were the place I read about pregnancy and labor and sleep training, back when you acted as our only baby and we were expecting. 

You were the place that allowed our daughter to spend so much time with her father. You allowed her to watch him succeed. You taught her the basics of commerce before she could even speak. You were the place she took her first steps. 

You were the place that gave me a large dose of reality and struggle. You made me critical, cynical, grateful, and humble  You taught me about blind faith and divine providence.

Today I say goodbye to you. I say thank you, too, for what you were and what you provided. 

Kristin Suzanne Ball

Saturday, January 10, 2015

Charlise Suzanne - A VBAC Birth Story

Charlise Suzanne at two weeks old

I feel beyond grateful that I am able to add a VBAC success story to the internet, even if it's just on this little blog of mine. I obsessed over other people's birth stories throughout my pregnancy. I dreamed of having a birth story that would be a joy to reflect on and transcribe.

And here I am, eight weeks postpardum, the birth endorphins have long wore off and yet I still feel overwhelming joy and pride when I think about Charlise's birth. It's not just hormones, it's true empowerment and healing from a c-section that haunted me.

But before I delve into her birth story, I need to take you back - back over two years ago to Vivian's birth.

Let me set the scene -

It's Sunday. Five pm. I lie in a hospital bed under fluorescent bulbs, with external monitors over my swollen belly, an IV pumping fluid and Pitocin into my arm, an epidural plugged into my back, a catheter taped to my leg, and an internal monitor screwed into my unborn baby's head. I was delirious from not eating the past 48 hours. Through my bloodshot, nearly-swollen shut eyes I can see my husband, my sister, and my mother staring at me with their own tired eyes, wanting all of this to be over just as much as I do.

I had been pushing the past three hours. At least, that's what they told me. I couldn't actually tell that I was doing anything with all of the pain medication. But I can confirm that I had been lying on my back, waiting for them to tell me when I was having a contraction so that I could make some feeble effort to move my baby through the birth canal. It wasn't working.

This had all started with a hopeful induction. I had practically skipped into the hospital with my birthing ball on my hip and my husband at my side on Friday evening. At a week "overdue", we were eager to meet our little girl. I didn't want an induction, but it was the final option given to me before a scheduled c-section. My doctor was convinced my baby was just too big for me to deliver, as an ultrasound had estimated her weight to be nearly ten pounds. She wanted me to schedule a c-section but I protested and she reluctantly agreed to induce me. I was ready to give it my best shot and receive as few interventions as possible.

My naivety is almost comical to me now. I'd had a textbook pregnancy and done a bunch of research about birth. I hadn't, however, done any research about the hospital itself. I didn't know they had the highest c-section rates in the entire area. I didn't know about the Bishop's score and that I would have scored a zero. I imagined a quick trip to the hospital for the delivery, clean and neat.

But there I was, completely immobile, feeling more like a science fair project than a woman in labor.

"Well," began my OBGYN, "I can cut an episiotomy and use vacuum extraction. Buuut, you will probably tear severely and potentially have permanent hip damage... Her collarbone may break... Or I can just do a c-section."


I can't tell you how tired I was of that word. All weekend, my doctor had been airing that word into the delivery room with raised eyebrows over her round condescending eyes. She would come into the room every two hours or so and utter some variation of "If you don't progress to X over Y amount of time, we will want to perform a c-section."

A landslide of interventions had led me to this moment - the final ultimatum. I caved. I agreed to a c-section. A decision that in turn was admitting that my body was broken, that it couldn't deliver a baby. My doctor had told me so. She had been right all along. I was defeated.


I was in the recovery room when I first got to touch my baby. They wheeled her in inside a plastic bassinet, all washed and swaddled, so detached from me. Was she mine? I couldn't be sure. I was so groggy from the medication. They placed her on me and I made some feeble attempt to breastfeed for the first time, remembering that Golden Hour I had read about and missed. She screamed as I tried to hold her up in my weakness and attempted to position her above my bandaged incision site. My doctor came into the room and started giving me details about the surgery. Over my infants cries, she told me it had been "dicey" in there and everything was "so swollen" and that next time I "just need to schedule a c-section".

Now, I have to pause to acknowledge that things could have gone much worse. My daughter was, after all, born as healthy as could be - 9lb, 2oz, 23 inches long. The surgery itself wasn't particularly traumatic. I was stitched up cleanly and my vagina was in one piece. We eventually got the hang of breastfeeding and developed a strong bond, despite missing the Golden Hour. I felt relief that labor was over at last. My postpartum room was a spacious private suite with attentive nurses and a steady stream of visitors. My home recovery was made easy by my visiting sister, Sheridan, an RN with an excellent ability to perceive discomfort and make it go away. She stayed with us for eleven days after the birth and I can emphatically say I couldn't have done it without her.

But there was still that feeling of failure that I couldn't shake. When I found out I was pregnant 18 months later, I doubted that my body would be able to go into labor on it's own. I just couldn't take another grueling induction. Scheduling a c-section would be less of a fuss and I toyed with the idea.

Early in my pregnancy, Sheridan was once again visiting from Southern California. She had just delivered a beautiful baby girl after a long, difficult labor. We were up late talking on the couch, as we often are, and I was telling her about my concerns. What if this baby is as big as Vivian had been? What if my body just doesn't know how to go into labor? What if my pelvis is too narrow? What if...

"What if you could?" Sheridan retaliated. "If you can't have a vaginal birth and end up with a c-section, that's okay. If you aren't able to VBAC, that's fine. But what if you could?"

What if i could?

I started doing research. If I was going to do this thing, I needed a supportive birth team. As amazing and supportive as Corey (my husband) is, he isn't a birth coach. We knew Husband-Coached Childbirth would not be a good fit for us. I needed a care provider and a coach that had more faith in birth than I currently had. I switched health care providers to Kaiser with their team of Nurse Midwives. They were excited about my decision to VBAC and provided a ton of encouragement and recommendations to maximize my chances.

I emailed Capital City Doulas, Sacramento's collective of birth coaches, and told my story and my hopes for a VBAC. About eight doulas responded, interested in working with me. I set up interviews with the four that seemed like a good fit. Nanci was the last doula I interviewed. I knew within ten minutes of sitting with her that she was the one. She felt like an old friend. She had worked with many VBACing mothers in the past and was extremely knowledgeable and personable. I had my coach.

What if I could?

I poured over Ina May's Guide to Childbirth and the Hypnobirthing book. Both boosted my confidence tremendously. Achieving a VBAC grew into an obsession. I did everything I could to increase my chances. I maintained a low-glycemic diet by avoiding white carbs and sugary sweets throughout my pregnancy. I did yoga three times a week throughout my third trimester.

I wrote out 8 to 10 Birth Affirmations on 5x7 index cards. "I trust in my ability to birth my baby." ... "The power and intensity of your contractions cannot be stronger than you... because they are you." Just writing them out was therapeutic for me.

Nanci introduced me to the Sacramento Chapter of the International Cesarean Awareness Network. I got involved with their Facebook page, asking questions and gaining advice. I attended a meeting and met a whole group of women that believed in birth and my ability to VBAC. "It's only a VBAC to the hospital - to you, it's just a birth," I remember someone saying at the meeting. They made me a bracelet out of individually selected beads to remind me of their support.

What if I could?

I was sure I could. I felt confident and excited for labor, even when November 6, my due date, came and passed.

At 2:07 am on November 9, I woke up to my first uncomfortable contraction. I had had sporadic Braxton Hicks contractions for the past week or so and this was definitely different. I got up and went to the bathroom. Sure enough, I had lost some mucus plug. Something was happening!
I laid back down with my phone open to a contraction timing app. Mild cramp-like contractions came every three minutes or so. I texted Nanci with an update. She suggested I try and get some sleep because I would need it if this was true labor. I was so giddy to be in any stage of labor that it was difficult to settle down. Eventually, the contractions fizzled out around 4am and I was able to sleep soundly until 7am or so.

In the morning, I made breakfast for Corey, Vivian, and myself. I proceeded to do the dishes and start some laundry. I had been nesting for days so the house was near spotless (a real feat with a live-in tornado of a two year old). I started working on a craft project for the nursery. As I painted a little fox on a wooden storage box around 8am, the contractions eased back in. They were again averaging three minutes apart and felt like mild period cramps. I finished my craft project and began another. 

Meanwhile, my in-laws were over, fixing a leak in the front yard sprinkler pipe. Corey and Vivian were running in and out of the house, fetching tools and toys. At first, they were a welcome distraction, then they became an annoyance. That's when I knew I was in active labor.

I packed an overnight bag for Vivian between contractions (still 3 minutes apart). My in-laws took her home with them after the sprinkler pipe was fixed around 2pm. Before she left, she hugged and kissed me goodbye.

Nanci suggested that I take a bath to help me relax. I'm not really a bath person but I gave it a shot. It really did help ease the moderate pain I was feeling. After 30 minutes or so, I moved to the bedroom and laid down. It was difficult to remain in one position. I tried taking a shower but it didn't provide much relief. I ended up back in the bathtub where I set up Corey's tablet and watched back to back episodes of Gilmore Girls. (Thank you Netflix) Corey periodically checked on me but I preferred to labor alone at this point.

Nanci had been actively texting me all day. I was sending her reports from the contraction timing app straight to her email so she had an accurate picture of my progress. Because my contractions were so frequent and not yet intolerable, she had a hunch I was in prodromal labor and that I could be in labor for days. She asked a series of questions to help me work through anything that was mentally holding me back from true labor. Was I anxious? Was there tension in any of my relationships? Were there fears from my past labor that were surfacing? No. No. No. I felt calm and happy.

Around 5 pm, I sent Corey to the store to get some labor friendly snacks, namely the coconut water popsicles that I was craving. He returned with said popsicles, a bag of mixed nuts, a granola bar, and applesauce squeeze packets. Bless him.

I ate one of my popcicles in the tub before getting out and getting back into bed to continue watching Gilmore Girls. The intensity of the contractions was gradually increasing but I could still follow the show's storyline and I able to breath through them. Corey joined me in bed and I suggested that we watch something funny as a distraction. He put on Anger Management (Netflix, again). The contractions came every 2-3 minutes. I would breath through them and attempt to distract myself with the movie. It was supposed to be funny but I found it difficult to laugh. A few times, Corey would pause it when I was having a contraction. I would yell at him to turn it back on because it was helping distract me! Thirty minutes into the movie, I was no longer able to follow the storyline. I turned my back to the screen and concentrated on my breathing. Corey turned the movie off at some point and I labored in silence, breathing carefully for another 40 minutes or so.

The contractions started to last really long, about two minutes each with only a minute in between them. I thought it might be time to go to the hospital. I talked to my doula on the phone. I could still walk (on my tip toes) and talk (slowly) through the contractions. She encouraged me to stay home but recommended I call the hospital and get their opinion. She told me to ask for Gabi, a Kaiser nurse who is a part of the local VBAC support community.

I called Labor and Delivery at 6:45 pm. Gabi happened to answer the phone. She had been expecting my call because Nanci had already contracted her. She listened to me talk through a few contractions and also encouraged me to stay home.

"You only come to the hospital for one of two reasons," Gabi said. "If you want something here that you can't get at home (pain relief) or if you're ready to have the baby". She said I didn't sound like I wanted to kill anyone yet, so I wasn't ready.

We decided to wait it out a bit longer. Corey made me a cup of tea. He was so calm. I had anticipated him anxious to get to the hospital but he said I didn't seem like I was in enough pain to need to go in. He reminded me that the hospital would be less comfortable, that machines would be beeping, and people would be interrupting. Corey used light touch massage through some contractions and that helped a lot. I laid on my side in some sort of trance for a good ten contractions, breathing them out and moaning.

Suddenly, I thought I was going to puke and attempted to hurry to the toilet. Corey came behind me and rubbed my shoulders and held me up. I didn't puke and stood up to walk back to the bed. I had another contraction that was so intense it sent me back to the floor. I couldn't get back up because they kept coming. I remember moaning loudly and repeating "No!" over and over. They were coming on top of each other and I felt a ton of pressure down there. It felt like one long contraction without relief with peaks.

I told Corey it was time to go in. He was skeptical and so was I. As uncomfortable as I felt, I didn't know how much worse it could get. I had never been in labor without Pitocin. I worried that I would only be 3 or 4 cm dilated and would be at the hospital for a long time and risk unnecessary interventions. Corey suggested that I drink the tea he had made but I couldn't. He loaded the car with the hospital bags as I shuffled through the house towards the garage as best I could. I had another contraction that brought me to my knees, literally, in the garage. I managed to get into the car. Corey called Nanci and told her that we were on our way. I called Labor and Delivery and told Gabi the same.

The car ride was intense. I had my eyes pressed shut just about the entire ride. I couldn't fully sit down because of the pressure. My pelvis was lifted from the seat and my neck stretched back. I remember opening my eyes just once on the freeway. I saw a dizzying blur of streetlights and headlights and glowing green freeway signs. I closed my eyes again and breathed.

We got to Kaiser. I managed to get out of the car and shuffle towards the door. Corey helped me into the World's Most Uncomfortable Wheelchair and wheeled me back into Triage. A nurse asked me to sign some papers. I scribbled over them as best I could. Corey left to go park the car and the Triage nurse asked me to undress and lie on the bed so she could check my progress. I couldn't undress without her help. When she finally was able to check my progress, she said I was complete!

I was shocked and so relieved. They were having trouble getting an IV set up. Apparently I was dehydrated - whoops. They wheeled me into the delivery room without an IV. The doctor on duty insisted I needed one because I was attempting a VBAC. Nanci arrived as they were finalizing the IV. Finally, they got it situated and I was allowed to push. I didn't feel any strong urge in any direction. Gabi and Nanci coached me, giving me pointers and encouragement. After a few unproductive attempts, the doctor broke my bag of water just by touching it. There was so much fluid! I started to feel like I needed to push with the contractions.
I tried a few positions and everything felt so awkward. Memories of pushing unproductively two years ago flooded back. I was losing confidence. Finally, they brought out the squat bar. Nanci wrapped a rebozo around it for me to pull on. I positioned my feet on the sides of the squat bar and pushed.

Pushing was definitely the hardest part of labor for me. I didn't feel possible to push out this baby. I started to get really scared.
Gabi's voice grew with urgency as she watched the baby's heart rate monitor. "She needs to come out now," she said.
I knew that. I was working on it.

"I don't like what I'm seeing," Gabi was wide-eyed. "You need to get this baby out or you're headed to the ER. Give it all you've got or this is going to be an emergency c-section."

I was terrified. I knew this was it, my last chance. I threw my fear aside, concentrated on moving my baby through the birth canal, and pushed. Nanci told me to tuck my chin and hold in any sound I felt like making and focus all energy on pushing. Nanci and Gabi got excited. "That's it! Do it like that again!" I pushed again and again. I could feel her moving through the birth canal. How exhilarating!

"Her head is out!" They said. How surreal!

A few minutes later, she was born. What relief!
They cut the cord immediately and carried her over to a table. The cord had been wrapped around her neck. They jostled her around and she started to cry. Another relief!
Charlise Suzanne was 7 lb, 11oz and 20.5 inches long! One pound and a half smaller than her sister had been.

I was able to breastfeed almost immediately after they handed her to me. She was wide-eyed but so calm. I felt amazing. I felt absolutely no pain, even when I felt the needle thread in and out as the doctor stitched up a small tear. I felt joy and disbelieve that she was here and that I had got my VBAC!
The doctor delivered my placenta quickly. He estimated I had lost about 500 cc of blood. It was everywhere.

I rested for an hour or so as Gabi recorded things in the computer and chatted with me like an old friend. She asked me all of the questions we didn't have time to answer during our frantic arrival to the hospital. I was on top of the world. They wanted me to get up and use the restroom. When I stood, I lost a large amount of blood. On the way back from a failed attempt to pee, my vision started to fade and I groped for the bed. My head was spinning.

They called the doctor back in and he confirmed that I was hemorrhaging. What happened next was the most painful thing I have ever experienced. He had to aggressively massage my abdomen while using some sort of hook to scrape inside my uterus. It was excruciating. All of labor was nothing compared to this pain. Nanci rubbed my head and helped me breathe. Finally, he pulled out a small piece of placenta that had been left behind.

I had lost upwards of 1000 cc of blood at this point. I was so pale and so, so thirsty. Nanci brought a straw to my lips and helped me drink. My hands and feet tingled. The doctor warned me of a possible blood transfusion or a DNC. That scared me. They kept me in the deliver room for a few more hours to monitor the bleeding.

Corey went out to get himself food at 2am. He hadn't eaten anything since lunch! Thank God for Nanci. She talked with me and helped me rehydrate.

While Corey was out, they cleared me for transfer to my postpartum room. They wheeled me through the halls as I cradled little Charlise. A lullaby rang out from the speakers - an announcement of my daughter's birth, an anthem to my VBAC.

After we got situated in our room, I called my sister to gush over the details. Nanci said her goodbyes and Corey attempted to get comfortable on a tiny, lumpy couch. I was on such a high that I slept less than 30 minutes the whole night. I kept replaying the day in my head and gazing over at my tiny, beautiful daughter.
Recovery was tremendously easier than it was with my C-Section. We were able to go home just 24 hours after the birth! My breastmilk came in almost immediately (versus the five days I took after my C-Section) and breastfeeding was a cinch. Corey pointed out how much calmer the whole experience was, especially for our baby. She had a confidence of her own that I believe came directly from my own confidence. In hindsight, the stress and fear that surrounded my first labor experience was probably a huge contributor to my inability to progress.


If you yearning for a VBAC of your own, build a support structure of people that believe in you. It was my sister who posed the challenge, my midwives who kept me on track with nutrition and exercise, and my husband and doula who held me up emotionally. The people rooting for me, praying for me, uplifting me, encouraging me made all the difference in the world.