I am a bit late to this discussion, but I did have
something to add.
 I am a natural-vaginal-non-intervention birth believer and
supporter…..if that is what is safest for the mother and baby.
  When I became pregnant with my first baby 18 years ago, I
thought I would have nothing but a natural, vaginal non-intervention laden
birth with my baby at my breast a few short minutes afterward. I saw no
reason that anything else would occur.

  I then experienced a 56 hour labor, a strange presentation,
(I don’t know the term, but Sarah’s neck was at an angle and the side of
her head was presenting, attempts to move the head were not successful) I
pushed for more than 3 hours, in every position know to woman, and the baby
never descending past -1 station. I passed out, hallucinated, cried,
screamed, prayed, and begged NOT to have a section, only to consent when my
strength gave out completely. It appears that I have an android pelvis, and
with the long labor and less than perfect cephalic presentation, it appears
a vaginal birth was not safely possible. (My OB did tell me later that 15
or even 10 years earlier I would have been subject to a “High Forceps”
delivery. Those of you in OB nursing know what that could have done to my
vaginal tissue, as well as cervix.) I did have a short, low dose epi. I was
well past my 45th hour of hard labor, and the epi was not allowed until
after 5 cm, I was dilating, before the epi at about one cm per 5 hours, my
dilation actually picked up after the epi. I was not granted an other after
7 cm, as my OB said it would inhibit my ability to push. It was completely
worn off by the time I hit 10cm and started the more than three hour
pushing ordeal.
 After my sweet baby girl was born via C-section, I was so sick and
shaking so hard and nearly incoherent from exhaustion and pain that holding
her, much less nursing her was impossible. My dh held her and put her
against my face for about an hour or so after she was born. She was taken
to the nursery, (after an hour or so in special care) and, without my
knowledge, given several bottles of Similac. I was allowed to hold her
about 4 hours after her birth, but was not “allowed” to nurse her for about
8 hours after the birth. I could hear her crying in the nursery down and
hall, and I was crying, too. She subsequently suffered from nipple
confusion, although we overcame it, with a lot of work. She developed a
cow's milk allergy, also. (Similac in first hours after birth?)
 For close to 2 years a wondered if the section was necessary.
 Two years later I had my dd Rebecca. The labor was eerily similar.
But my OB was also working with a midwife. This labor was more than 26
hours in length, (Becca was a posterior brow presentation, and like in my
labor with Sarah, neither attempts to move the baby into a better position,
and my getting into a dozen different pushing positions resulted in much
progression down the canal.) I pushed for over 1 and a half hours. I felt
Becca move down the canal for the first half hour, then the feeling of
descent stopped, despite more than an other hour of pushing. An other
section then performed. Becca had not progressed past the -1 or zero
station. Again, I was so sick from the long labor that I was unable to hold
or nurse her. She stayed in Recovery with my dh and me for about an hour. I
demanded she be given no supplements,( in those days they insisted on a
sugar water feed to test for “fistula.”) I requested they bring me all the
nipples they had in the nursery, and I had my dh hold them to my mouth as I
sucked on each one until I found one with a small hole and a wide base. The
nurse later told me Becca took about a “half a sip” of the water.(She
didn't have a fistula either!) After returning to my room, I asked for the
baby, and she nursed well, but it was several hours after her birth.  She
had no subsequent feeding problems, but was mildly jaundiced and a bit
sleepy.  There was no attempt to “treat” the jaundice, and no reason to. I
no longer had ANY doubts about the necessity of my c sections.

Eleven years later I became pregnant with my dd Hannah. My OB said “Do you
want to try an other VBAC? We’ll try it, if you want, it has been eleven
years and that pelvis hasn’t changed. Do you want to?” I said “Nope.”

Hannah was born via planned c section at about 37 weeks gestation at 5 lbs
12 oz, 17 inches long.  I had been in preterm labor at 27 weeks and had
been experiening almost constant contractions and was in early labor (again)
(not "active" labor) when we did the section. Hannah was born within
minutes of the spinal taking effect. She was healthy, vigorous, pink and
had optimal APGARS. (She was really cute, too!)

After the section, with Hannah with us in Recovery, the anesthesiologist
gave me some Zofran for the dry heaves, I could then hold her, and then
Hannah nursed expertly, with swallowing, at aprox. 20 minutes after her
birth. She was not overly sleepy or at all jaundiced at any time.

My recovery, even with a three time incision, was fantastic, compared to
the sections, which were preceded by incredibly long labors. Most
importantly, I was able to nurse the baby within minutes, not hours after
the birth. This meant the world to me. It also meant the world to Hannah.
She had no exposure to ABM, artificial nipples or need to be out of my
sight or my arms. (We rejected placing her under warming lights and
kangarooed instead.) Her exposure to anesthesia was shorter than with
either of my labors which raged on for days. *I* was ABLE to care for my
infant within minutes after the birth, something that just was not possible
after the long grueling labors I experienced. With Sarah and Becca I needed
help changing my own sanitary napkins for several days, with Hannah, I was
out of bed and caring for her, and myself, within hours. It was a totally
different post birth experience. Much better for my baby and for myself.

In most cases vaginal birth is possible and the best choice. In a few
cases, the exhaustion, longer exposure to anesthesia, the eventuality of a
surgical birth and stress on the baby can have adverse effects on mother
baby bonding and breastfeeding. I know my case is an exception, but it is
not a one of a kind.

I just felt I needed to express this side of the coin.

Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice

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