I have a Choice

HOW I LEARNED I DO HAVE A CHOICE
By Brandy Behrisch

previously published in Birth Issues Fall 2011

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I am the mother of five children. Each of them is very special in their own way, much like their birth stories are special. I have learned so much as a woman and a mother from them. I live in Fort McMurray, Alberta. A bustling city in the north-eastern part of Alberta that has grown at a phenomenal rate. There are many young families here and many have more than two children like you often see in Canada. Sadly, most of the women birthing here will have highly medicalized births, unless they choose to not go to the hospital or have a strong voice and fight for what they want.

My first child was born in 1999, I was a newlywed and didn’t know a lot about childbirth. While I was expecting I found a group that has since folded, it was called The Association for Safe Choices in Childbirth1. This group showed films on natural childbirth and talked about midwives. I learned a lot during this time and I thought, “I can do that, I can give birth naturally.” I didn’t see a need for a midwife, I thought homebirth was ‘weird’.

My daughter was born on November 30, 1999. I had a very medically managed hospital birth with a surgeon (we had two obstetricians at the time, those were the only options). Nobody listened to me asking for help. Instead, help was given in the form of pain medications. I was given pitocin and laughing gas. I was also given cytotec, it was a white pill that I swallowed to, “help your labour pick up”. This pill causes tetanic contractions, which can lead to fetal distress and uterine rupture!2

I didn’t know the words to use. I didn’t know how to advocate for myself. Toward the end of my labour, my daughter’s heart rate plummeted all the way down in the 60s (normal is in between 110-140 beats/min) so I had an emergency episiotomy and vacuum extraction—although nobody asked me if I wanted these or even told me I was going to have them, they were just done.

I truly believed at that time, and for the longest time, that if it wasn’t for the skill of my surgeon I surely would have lost my daughter. He had saved us. I was very grateful. In a way he did, but wasn’t the saving due to an intervention?

After this difficult birth my daughter was with the nurses for the first six hours of her life, she was ‘snuffly` and needed observation. I finally asked over the intercom, “Did my baby die?” and she was finally brought to me. I met my Sydney Charlotte who was 7lbs. 8oz, 22.5 inches tall. She had a broken collarbone. I thought it was because I wasn’t big enough to have her. After all, my mother had two scheduled caesareans because x-rays revealed that her pelvis was not big enough to deliver a child. I was amazed I didn’t need surgery too. Nobody thought of explaining to me what the broken collarbone was due to!

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In 2000 I was pregnant with my second child, a son. As soon as I found out I was expecting him, I called a doula. I was 5 weeks along and I knew I needed someone on my side. I learned so much from my doula. It is thanks to her that I joined the above-mentioned group. I found a new family physician (who has since moved south of Fort McMurray) that would attend hospital births and I felt so much more confident in my ability to birth a baby.

When labour began this time I was calm. I called my doula, laboured at home and was admitted to the hospital at seven centimeters. I was so proud. I birthed my baby on July 3, our 2nd wedding anniversary, and was proud to say I had no pain medications, no augmentation and this baby was even bigger than my first! Addison Caelan was 9 lb, 4.5 oz and 22.25 inches—but he also had a broken collarbone. Maybe something was wrong with my body, maybe I wasn’t really big enough, maybe I was like my mom?

In 2002 I was expecting baby number three. This time I called and met a number of midwives. I settled on one from the Edmonton area. I was elated! Then my husband got cold feet. He wasn’t sure if he was comfortable with her and it was “a lot of money” so I let her know I didn’t need her3. I looked some more and found another midwife (from Fort Fitzgerald, Alberta) and I thought he would be comfortable with her. I made arrangements but at 31 weeks she called to say she was unable to be my midwife because she had to travel out of her town to attend more births in order to renew her registration. But not to worry, she had spoken to yet another midwife on my behalf and I could still have my homebirth.

I met my midwife four weeks before my daughter was born. We traveled to Edmonton (5 hour drive) to meet her and felt very comfortable with her. When labour began I called her and she made the drive all the way here to witness her birth.

It was so different (and so much better) than my hospital experiences. I also had a friend present who was a registered nurse (and is now a registered midwife in Edmonton), a 2nd attendant (who was a registered nurse) and a student nurse. During this birth I was the one in control. I didn’t have to ask for permission to do anything, I did what I wanted when I wanted. Kiera Capri was born in water (the fishy pool) on December 10, and was 8 lb 13 oz, 20 inches and—didn’t have a broken collarbone.

In 2005 I was expecting baby number four. I called my midwife but she was unable to be with me. She was now working for the Shared Care Maternity program at the Westview Health Center in Stony Plain and couldn’t travel to births out of the city anymore. I was crushed. I wanted to have the same birth as with my last baby. I wanted a midwife. I had to find a way to have the same birth experience.

I decided that I would have my baby at home anyway. Why did I need a hospital? I had three healthy babies, I didn’t tear, I didn’t need medical management and I definitely didn’t need to fight to birth my baby the way my body was meant to. I learned a lot that year. I learned to trust in myself, my body and in birth.

My husband was initially anxious, but he became more comfortable as we progressed through the pregnancy. We prepared by reading many books on trusting birth, homebirth and some on emergency birth. I also prepared by eating healthy and keeping active. And finally, I reached out to others that had unassisted births and benefited from their mentorship.

I woke at 2am on the day my second son was born. At 3:30am my husband came to the bathroom to check up on me and quickly fell back asleep. I laboured comfortably in the bathtub. “We would inflate the fishy pool soon”, I thought, “after all, my shortest labour was 12 hours.”

At 6am my water broke and at 6:15am I was holding my 10 lb 3 oz, 21 inch son, Julius Crispin. I caught him, my husband watched, he was born in the bathtub. He had the cord around his neck, but he was fine. We unwrapped it and he pinked up quickly—

and he too didn’t have a broken collarbone. I know that if I had been in the hospital it would have been handled very differently.

I did it on my own. I had a baby without an attendant. Would I have liked one, definitely, but without a midwife available, what could I do?

In 2008 I was expecting my fifth child. I called the midwives again, but no midwives would come. I was comfortable with having another unassisted birth, although I would have rather had a midwife present. Approximately 8 weeks before my son was born we realized he was breech. We did not panic. We knew he could turn on his own. But he didn’t.

My family doctor knew my history and knew my plan to birth unassisted at home. She advised me that an external cephalic version (ECV) was a good idea4. I called the obstetricians in Fort McMurray: One was on vacation, one was unable to do an ECV without ultrasound in the office and the other would see me. The day before my appointment the clinic called, “the Doctor reviewed your history, because of your bleeding disorder (Von Willebrands’ Disease, a clotting issue) she is advising that ECV is too dangerous and you should schedule a caesarean”. What?

My family doctor let me know that the hospital knew my baby was breech and that if I showed up I would have no other option than to have a caesarean section. I was told that I would have no option to say no and that a doctor would sign forms to consent to the surgery. Whether it was true or not, I was very frightened and felt cornered.

What was I to do? I wanted a healthy baby too. Should I have a breech baby unassisted or have surgery I didn’t consent to? I called everyone: the International Cesarean Awareness network group (ICAN) in Edmonton, my previous midwife, I called all over. I needed help. I tried everything: Webster’s’ Technique, moxibustion, pulsatilla, visualization, massage, relaxation, upside down on the ironing board, etc. It didn’t work. I even went to Edmonton, and had an ECV. But it was unsuccessful.

I went home again. I called more people and I made arrangements to birth in Yellowknife, if need be, with an awesome obstetrician I have never met who agreed to support my choice to give birth naturally. He agreed that he would attend my birth and wouldn’t force a caesarean upon me. I also found two obstetricians in Edmonton that would attend a breech vaginal delivery. But I really wanted another homebirth. I tried another ECV in Edmonton and this one worked! What relief … eight days later labour started.

This time labour began after my husband went to work. I called him at 11:15am to tell him it was baby day. He walked in the door at 11:55am and our son was born at 12:12pm, in the bathtub. Labour was 3 hours long. I was alone, with 4 children, for most of it. I would have very much loved to have a midwife present, but even if I had hired an Edmonton area midwife, she wouldn’t have made it in time. Sebastien Carmon was born July 27th, he was 8 lb 13oz and 20 inches tall with an intact collarbone. He is my last baby.

I am happy to have learned all I have, but I wish it wasn’t all such a fight to have what I wanted in childbirth. I wish there was more available options to women. My journey as a mother has been interesting, I have learned how to advocate for myself and make choices that suit me and my family. I have made choices that appear extreme, but not without research and careful planning. My husband has always been fully supportive and we feel empowered by the choices me made. They were our choices. We wouldn’t have done anything differently. I only regret one thing: not having midwives in Fort McMurray!

Brandy Behrisch resides in Fort McMurray, is a married mother of five, a birth and postpartum doula, as well as a childbirth educator and a breastfeeding counselor.  Brandy enjoys attending homebirths and runs a breastfeeding support group.  In her spare time, Brandy enjoys walking with her dogs, reading and learning to garden.  Brandy is currently a student in Justice Studies in Lethbridge College. 

Editorial notes:

1. In 2001, I became a member of ‘The Association for Safe Choices in Childbirth’, later on it was re-named ‘Birth Choices’. I became president of this group from 2005-2009 and then it folded.

2. Cytotec, also called Misoprostol, is a synthetic prostaglandin used to stimulate uterine contractions and prevent postpartum hemorrhage. It is a very strong drug in a small pill that can be taken orally or broken in pieces and inserted vaginally. Side effects include diarrhea, abdominal pain, uterine rupture and vaginal bleeding. It should never be used during pregnancy or to stimulate labour since it can cause abortion, premature birth, tetanic contractions, fetal distress, and fetal death!

3. Midwifery services used to cost between $2000-3500. Since 2009, Alberta Health covers midwifery services.

4. An external cephalic version (ECV) is a process by which a breech baby can sometimes be turned from buttocks or foot first to head first. It is usually performed late in the pregnancy. In this procedure hands are placed on the mother’s abdomen around the baby. The baby is moved up and away from the pelvis and gently turned in several steps from breech, to a sideways position, and finally to a head first presentation. An epidural is often placed, continuous fetal monitoring, and an operating room is made available just in case baby goes into distress. An ultrasound is used to estimate if there is sufficient amount of amniotic fluid to move baby.

 

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