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Mari’s VBAC Birth Story

The story of my VBAC would not be complete without first understanding the story of my first birth, which was vastly different than this one. So here it is:

The Birth of Olivia Susan:

I’ve been putting off writing this in it’s entirety for 31 months now for several reasons: one is that it is really emotional for me and the other is that I have started to forget the details. In preparation for my second birth I feel as though I need to just stick it out and write it down.

I was due to have my first baby on October 7th, 2009. It had taken my husband, Scott, and I the better part of three years to conceive and carry a baby to term. The time in my life was tumultuous even before the pregnancy: Scott had recently lost his job and I was dealing with a large amount of mental health and physical problems when I found out I was pregnant. It had taken us years to get here, however, and so we were clearly having the baby regardless of our situation at that time.

The pregnancy was long and hard for me. I felt guilty almost every day because I didn’t enjoy being pregnant more. I was diagnosed with gestational diabetes and branded “high risk” around week 28 or so, and was followed very closely from that point on to watch my diet and the baby’s growth. We were in very tight financial straights at that time, so I made a few decisions that definitely impacted my birth experience. I elected not to take any sort of childbirth education class: it was super costly and we simply didn’t have the funds for it. I also decided very early into my pregnancy that I would have an epidural because “childbirth hurts”. I relied a bit too heavily on my medical training (I am an ICU registered nurse at heart) and knew that childbirth was painful, often long, and always unpredictable. I just wanted an epidural and I wanted a vaginal birth: other than that I was thinking I’d just go with the flow.

Fast forward to 41 week: I was over a week overdue and I was miserable. I went to the Perinatal specialist for my weekly sonogram (which really becomes a lot less exciting after months of weekly appointments, believe it or not). I had no idea that the beginning of two of the hardest days of my life were starting that morning.

Dr B (who I had come to like very much over the course of my pregnancy) became concerned very quickly about the lack of fluid they found during my ultrasound. I was told that my placenta was old and wasn’t functioning any longer. They were also concerned that my baby wasn’t moving. I immediately started crying, fearing the worst that my baby wasn’t going to survive. (I had previously suffered four miscarriages prior to this pregnancy). They sent me immediately to Frederick Memorial Hospital.

I was admitted to FMH at 9:30 in the morning. Scott was there with me. We called a bunch of people, Nora, my parents, Scott’s parents. We tried to warn them that it would likely be awhile. The original plan was that they were going to just section me on the spot, but I really didn’t want to have major surgery without even trying for a vaginal birth. I begged them to test the baby and see if the little one could handle an induction. I was on the monitors for two hours and the baby’s activity looked fine so they opted to induced. I should mention at this point that I was 0cm dilated, and only 20% effaced even though I was ten days past my EDD. At 11:30 in the morning they gave me my first dose of cervadil. I laid on my back for an hour, and was then told to walk. So I walked. And walked. And Walked. Then they checked me after several hours. No progress. 0cm, 20% effaced, -1 station. Repeat above. I was given another dose of cervadil, made to wait an hour, then walked for what seemed like an endless amount of time. Again, I had made no progress. This took a full 18 hours before something changed. They did, before the end of the night, switch me over to another drug to supposedly dilate my cervix, I can’t remember what that one was called, but I was supposed to keep it in over night. Finally, at a random check in the middle of the night by Dr A I had finally dilated to 1 whole centimeter! I was 30% effaced at this point.

Enter pitocin. This was the beginning of the horror for me. Up until this point, while it had been a long process it was relatively manageable. The pitocin was administered via an IV line and within two hours I was in so much pain that I cold not even see straight. I was having trouble breathing, urinating, walking, sitting, laying, taking, everything. And the even better part was that I wasn’t dilating any further, I was still at 1cm. I remember very clearly having a moment where I was standing in the entryway to the bathroom holding myself up on the door jam and feeling utterly alone, unable to even scream the pain was so bad. I caved: I asked for my epidural at 1cm at sometime in the middle of the night (it’s been so long that time has lost all sense of meaning to me at this point…)

They gave me my epidural. It was wonderful at the time, but I was already disheartened because I’d wanted to make it to 5cm and I was worried I’d just cut my nose off to spite my face. It’d already been a horrible 20ish hours and I had made almost no progress. I cried. A lot. But the pain was gone, so at this point they continued to increase my pitocin to a ridiculous amount unbeknownist to me–I wasn’t feeling any pain. It took a long, long time but after another 8 hours I had finally dilated to 5 cm. My doctor decided to break my water. Then things got real scary. I entered the transition from hell and went from 5 cm to 9.5 cm in about 20 minutes. I was shaking, sweating, scared, and the nurse I had at this point was completely terrible. In hindsight, I should have asked for someone else. I will if ever put in that situation again. I kept feeling like I had to push and was told by the nurse that I still had a lip of a cervix. It was a very strong urge and it didn’t go away. I kept asking her to check me. The nurse (Suzanne, I’ll never forget her name) finally huffed at me and said “If you feel like  you have to push then just push.” And rolled her eyes. I was crying, scared didn’t know what was going on and tried to explain that I didn’t want to push if it wasn’t time because I knew enough to know that that would drastically decrease the chance that I would be able to deliver this baby vaginally.

I finally started pushing. My epidural wore off 4 times. I couldn’t catch my breath, I couldn’t get on top of my contractions. The nurse was terrible. She kept coming into the room and doing things to me (hanging medications into my IV, squirting stuff on my vagina, taking my temperature and rolling her eyes) without explaining at all what she was doing to me. It made me panic more. I kept getting yelled at for not holding my breath while I pushed, but that made me feel like my eyes were going to explode out of my head. After about an hour of this the nurse callously announced that “first time mothers can push for 2-4 hours” and I burst into tears–I had thought I was almost done! She also discouragingly shook her head at the doctor when she came in to check on my progress. It was horrible. I spiked a fever and then proceeded to have all these additional interventions done. My epidural wore off again, and I was having horrible searing, burning pains in my clitoris. Not my vagina, the baby never crowned, but in my actual clitoris. It was awful. I was stuck on my back for an endless amount of time–pushing, crying, screaming, with no support from the staff. I felt isolated from my daughter, my husband and my best friend who were all there at the time. I felt alone and scared and I was trying so hard to do what I was supposed to and nothing seemed to be working. I was exhausted. At one point I explained to Dr A when she came in that I just couldn’t get on top of my contractions. She looked at the IV pump and commented that the pitocin drip was up way higher than it should have been and abruptly turned it off.

Finally, a technician came in with a grab bar for me and allowed me to push standing up. This was SO much more productive. I wish that I had been allowed to push like this from the beginning, it made such a difference. At that point they checked me again to see if the baby had made any progress: and discovered meconium. So, after hours of pushing and pain, the doctor felt the baby was stressed and that they needed to get the baby out as quickly as possible. I was rushed into the surgical suite for a Cesarean section. I felt like such a failure at this point. It’d been 36 hours, I’d tried so hard and I was just so exhausted. So I agreed.

This next part, I thought I would be relieved, but I was even more terrified. I felt as though something was being done to my body and I had absolutely no control over. I couldn’t see what was going on, and the medication they gave me in my epidural wasn’t working: I could feel them cutting me so they had to numb me to the point that I was numb up to my neck. I felt so claustrophobic – the sheet was pulled up so close to my face, I couldn’t see anything. Luckily the anesthesiologist was being very patient with me and explaining step by step what was going on. I was terrified. I was crying, shaking and so scared.

I felt like a drawer that someone was rummaging through. Finally they pulled the baby out (there was a lot of pressure) and announced that it was a girl! (We had not found out the sex of the baby previously). This is one of the few tender moments I remember from the whole experience. The doctor asked me what her name was: we told her “Olivia Susan”. I didn’t get to see her. She left me and Scott went with her to take pictures of the baby and watch over her: it was just me and the anesthesiologist. They did at one point bring the baby to me and showed her to me. She was gorgeous: big eyes and looked just like Scott and my father. She was born at 6:33pm on October 15th, 2009. They took her away from me and Scott went with her. I didn’t see her again until almost 11pm that night. They did call back from the nursery and tell me the weight of the baby: she was 6 pounds and 3 ounces and 19 3/4″ long. It took them another hour to sew me up and I was then finally transferred to the PACU.

They had given me some medication in my epidural that was supposed to keep me pain free for 24 hours. Of course, nothing had worked as far as pain management up until this point, so this didn’t either. I was all alone in this tiny recovery room all by myself in excruciating pain. They wouldn’t let me go to the postpartum room or to see my baby until my pain was under control. They were having to give me IV pain medication every 15 minutes and I was still in pain. At one point my husband did come back to see me: this is when I found out that most of my family had left to go home. They’d all seen the baby and were ‘tired’. I cried. I was so dejected, lonely, and sad.

When they finally got me back to a room with some sort of pain control I had to argue with the nursery nurses for over an hour: they wanted to wash the baby, check the baby’s blood sugar, and do nine million other treatments. They had cooled her down too much (I’d had a fever during delivery and the baby was born with one). Finally I demanded that they just bring me my baby (it was 10:45pm at this point: she hadn’t nursed, I hadn’t held her, and it’d been two days I’d been trying to have this baby). I was so tired when I finally got to see my baby that I almost dropped her (they kept putting benadryl in my IV because I was itching from all the pain medication without my consent–and I’d been up for the better part of two days).

They finally brought her to me, and I got to look at her. She was gorgeous.

Luckily, I still loved her. So very, very much. She was the cutest thing I’d ever seen. Welcome, baby Olivia. You are perfect.

The Birth of Alice Kathryn:

After what I can only describe as a traumatic event, it goes without saying that we wanted a very different birth when I got pregnant with our second, and last, child. I immediately dove into crazy amounts of research the instant I saw two lines on the little stick (at exactly 4 weeks to the day!). I read easily two dozen books starting before I’d even been to my 7 week checkup. A few of my favorites were Pushed, Natural Hospital Childbirth, Ina May’s Guide to Childbirth, and The VBAC Experience. I also immediately started searching for a VBAC friendly provider. While I did not have any major problems with my OBs the first go round, I did feel as though I’d fallen prey to a lot of unnecessary interventions that had contributed on many levels to my first birth resulting in a cesarean. Unfortunately, due to insurance limitations, I quickly discovered that I was unable to deliver at home it with a midwife, which is what I truly wanted. I decided to go to my first prenatal appointment with my current physicians and see what they had to say, armed with a million questions.

My worries turned out to be unnecessary, however. The very first thing they did at the office was present me with the VBAC consent form which included unbiased information about the benefits and risks of a VBAC vs a repeat cesarean. The pregnancy was relatively routine: about three weeks before my due date I started having acupuncture, chiropractic treatment, using evening primrose oil daily, walking every day trying to get things as relaxed and in line as I could. Scott and I had taken a Bradley class with a local instructor who was amazing and we learned so much. There was a brief scuffle where my OB tried to schedule me for a section at 39 weeks and after much discussion and information I convinced them to give me until 41 1/2 weeks until they’d take the baby. I had a section scheduled for June 7th (two days after my oldest’s 21st birthday. Even with a supportive OB you still have to be willing to advocate for themselves because they do get caught up in the doctrine of being surgeons, in my opinion.

So I hit 39 weeks – only 1cm and 10% effaced at this point. I’m getting worried: I really want to have this baby naturally. I start having frequent contractions that seem like active labor and then go away when I go to bed. Very frustrating. The week comes and goes: every day I have contractions, every night they go away. At this point I. Am. Done. Luckily my doula is amazing and keeps me going.

I had been having pretty intense contractions all week at this point, but they would go away when I would lay down to go to sleep. I was beyond frustrated by the time Saturday came around when, once again, I had contractions all throughout the day. Since nothing had come of them all week long, I elected to go to a good friend’s housewarming party that night rather than sit home and be frustrated. The contractions continued throughout the party, and I kept asking my husband how long it’d been since the last one. Each time he replied “Ten minutes.” They hurt, but I could talk through them and continued to enjoy the party until my two year old needed to be taken home and put to bed. This was about 9:30 at night. My contractions had become irregular by then: I figured I’d just get ready for bed and they’d peter out by morning just as they had all week.

As I got into bed they almost immediately intensified: laying down was really uncomfortable. I tried to sleep anyway, and my husband came to bed shortly after, some time around 10:30. At 11:45 they had become so uncomfortable I woke him up saying I just couldn’t handle them by myself any longer. This is when the night truly began. I sent my doula a message letting her know that I was in labor, but should be okay on my own for awhile longer.

The contractions were consistently erratic, sometimes as close as three minutes apart, sometimes varying as long as seven minutes. After I woke Scott up he suggested I get in the shower, which I did. And I stayed there for a good two hours. I was able to allow myself to relax much better with the hot water directly on my back. I was trying to think positive, dilating thoughts. I probably would have stayed in the shower the entire time, but unfortunately the hot water ran out! :(

I was still contracting, but very, very tired. The contractions were centered in my back and would work their way around front with each one. Back labor is painful! I decided to try and sleep. Scott and I both laid down at about 1:30 in the morning for an hour, and I slept–but was rudely awakened with every contraction that came. After an hour I woke Scott up, I couldn’t sit still, couldn’t sleep, couldn’t have anyone touch me, couldn’t sit on the birthing ball, I had to be standing . We woke our oldest, Nora, and told her we were walking around the neighborhood and to listen out for our (then) youngest, Olivia. So we walked. And stopped every 4-7 minutes so I could sway with the contractions and try to relax through them. If I focused on anything else except breathing slowly the pain became unbearable. We walked for awhile, desperately trying to decide on a boy’s name between contractions as we had not picked one yet and it seemed that this baby would be arriving the next day and we did not know if we were having a boy or a girl. I remember being embarrassed at having to stop in front of someone’s house for a contraction and the front door opened: a guy was walking his (obviously drunk) girlfriend to the car and we were in the way! I had to make them walk around me–I was so intently focused I couldn’t even explain what was going on! I have a vague memory of my husband greeting them and then focusing back on me, which in hindsight is pretty funny, I suppose.

I had been texting people to see who could take Olivia for me while we were at the hospital and hadn’t gotten a response back yet. It was about 3am at this point so I’m not sure who I expected to wake up but not having anyone to for sure take her was making me anxious. We got back home and I was making myself eat and drink between contractions, even though I wasn’t really hungry. I drank a lot of raspberry leaf tea and ate a lot of applesauce. I had to sit on the birthing ball between contractions and stand up to either lean on the desk or sit on all fours to focus on the contractions. At 4am I sent my doula another message: it was go time.

I think I anticipated that we’d be rushing to the hospital as soon as Aurora (my doula) arrived. I felt like I’d been working for a long, long time and was silently hoping I was almost done. She got there about 5am and was very calm and wonderful. This is also the time that Nora woke up for the day as well. Aurora gently guided us and reminded us that you dilate approximately 1cm per hour during active labor, and I decided there was no need to rush to the hospital. At her suggestion I headed back up to take another hot shower. I remember feeling like I was being a rude host leaving her downstairs! I spent another hour or so in the shower and the contractions were so intense. I developed a silent mantra “Breathe in, breathe out. Open wide. Dilate. Breathe in, breathe out.” I was totally silent and in my head throughout most of this process.

After the shower I ended up essentially completing the rest of the process in my bathroom downstairs, on the toilet with the light off. I could sit through the contractions, stand if I need to, and pee freely. I finally got a response from the girl who normally watches Olivia that she could take her for the day. After cooking me an egg for breakfast that I couldn’t eat much of, Scott went to take her there so she would be situated when we needed to leave for the hospital and I remember having a pang of concern for my firstborn as she kissed me goodbye and walked out the door. I felt immensely better about the situation once Scott returned having safely delivered Liv. This was around 8:00 in the morning. I was feeling uncertain at this point. I knew things were picking up–I was becoming unable to tolerate having clothing touch my abdomen and the contractions were so very intense. I was also worried about going to the hospital and having things stop or slow down or end up with a section again–I knew this was possible. I was worried. I reached out to Aurora because I just didn’t know what to do. I could no longer sit at this point. My contractions were not as close and as regular as “typical” active labor is. I was starting to get frightened – it had been a long time and I was starting to get scared.

At about 9am after a conversation I don’t really remember with Aurora I decided it was time to go. It was abrupt but when I had felt it was time, I was ready. I was wearing nothing by my husband’s robe at this point: not even any underwear! All of us piled into three cars and then everyone had to wait for me to finish a contraction because I couldn’t get in the car while having one.

The ride to the hospital was awful. Every bump made the pain worse, it was really hard to continue being focused and calm and relaxed. I called my OB and let them know what was going on, and we called my mothers in law and left a message letting them know we were going to the hospital. It took me probably a good 20 minutes to walk the ten feet to the door of the FMH emergency room. I had three contractions on the way and had to stop and breathe with each one. Nora, Scott, Aurora and I all stood there with each one–with a ton of crap! We had my wedge pillow, my birthing ball, a cooler for my placenta, the bag, one of the nurses joked that it looked like we were going for a Memorial Day cookout! (this was the Sunday before Memorial Day). Once we entered the hospital I refused to sit down in a wheelchair–I simply couldn’t sit at all, even between contractions at this point.

We finally made it to the labor and delivery unit and they weighed me (in kg, yay!) and then sent me to the triage area–I think I was so calm and quiet that they didn’t think I was very far along. Based on their reactions I was worried about getting sent home because I wasn’t as far along as I thought I should be. I was very scared that my contractions weren’t productive like my first labor and I wasn’t going to be able to make it through this process. They had me pee and then it was time for my first vaginal check in almost eleven hours of labor. I held my breath due to nerves and the nurse (Kari) asked me “How far along do you think you are?” I almost burst into tears and was afraid to even guess -”I don’t know!” to which she replied “How does 7-8cm sound? And you’re fully effaced and this won’t be long!” My entire entourage, myself included, literally cheered and I did start crying – this time from relief. They asked me about what I wanted to use for pain management and my husband dutifully answered all the questions and explained that I was doing this naturally. He handled all the questions for the most part, which was wonderful. Especially when we realized I had forgotten my purse and had no ID and did not have my insurance card!

They immediately got me into a birthing room and checked the baby–baby was looking awesome on the monitor so they let me go back to my favorite place – the shower. This was the point where they realized I was a VBAC and I got worried – they started calling the charge nurse and telling her that I was a VBAC and reminding my OB that I was a VBAC, I thought ‘oh god please don’t let this be the end!” Luckily not much changed in their demeanor at this point. I got back into the shower for another hour. A new nurse, Shayna, came in at one point and checked the baby’s heartbeat with a doppler and baby still sounded great. Scott made sure everyone had my birth plan, and wasn’t gone away from me for more than a few minutes to pee the entire time we were at the hospital.

Once I got out of the shower I didn’t get dressed again until after the baby was born. In hindsight I realized that I must have entered transition in the shower–my contractions started double peaking, I couldn’t rest even between contractions, and they checked me again – I was at 9cm. It had been about an hour and a half since my last check and I verbalized – “I can’t do this for another hour and a half!” Aurora and Scott and Nora said all the right things, I remember none of them, however, and very shortly after felt the urge to push. Dr Chen came in and checked me – said I was at 9.5cm. Then I got scared again. This was what happened with my oldest – I had a lip of a cervix and I started pushing too soon and ended up with a section. Dr Chen also told me that it was going to take along time to push out the baby because I didn’t have my oldest vaginally so it was going to be like a first delivery. This is one reason that I will remind people that words are powerful: I started to unravel at this point. Also, At some point during this interaction he broke my water. I really didn’t want to have my water broken–I had really bad associations with it during my first labor. They told me it was medically necessary for reasons that made perfect sense at the time that I can’t recall right now. I was in bed when Dr Chen broke my water and it was so gross–fluid went everywhere. I didn’t want anyone to touch me to clean it up and the nurse was laughing at herself for wanting to clean me! There was meconium all over the place and Dr Chen said that we could keep going at this point but they’d have a neonatologist for immediately after the delivery and that family couldn’t cut the cord and I couldn’t have the baby on my stomach. I remember the pang of sadness I felt at that.

Luckily I had an amazing nursing team. I must give credit where credit is due: Traci the technician had been there when Olivia was born–and she was the only saving grace. When she walked into my room I burst out with “You are my FAVORITE! You were there when I delivered my daughter!” She laughed and replied “I like you, already!”

I kept saying “I feel like I have to push!” and they kept telling me not to. Secretly, at this point, I was bearing down between contractions – sort of mini pushing. They were so intense, they hurt so much at this point, I looked at Aurora and said “I really don’t think I can do this any longer.” She told me “You are doing this.” Nora told me “Just keep swimming.” Scott told me “I love you.”

Shayna, my phenomenal nurse, had me get on the bed and pushed the remainder of my cervix out of the way while I bore down. It was uncomfortable, but it was better than trying to continue doing nothing. Dr Chen came back into the room, checked the baby and started taking the bed apart and pulling out instruments: I got panicky. “They aren’t going to cut me, are they?” Dr Chen replied: “No, I’m getting ready to deliver this baby.”

Then the pushing started. I thought it would be easier this time around: it was not. I was still unprepared for the pain, the intensity, the exhaustion. I pushed and wasn’t pushing right, I just knew it. Directed pushing is not for me. If I ever have another baby I’m doing it at home, alone. I couldn’t find a good position in the bed: I tried the bar, on my side, on my back, nothing felt like it was working right. The counting and the yelling didn’t help much, either. Dr Chen came in and checked me again: told me nothing had changed. I got more panicky, yelled at him to please not touch me, tried breathing through a few contractions, nothing worked. Dr Chen started to get concerned about the baby’s heart rate: the nurses went to bat for me and told him that the baby had a low baseline heart rate and things were fine. When he left the room Shayna reminded me that this was what I wanted, and it was time to push this baby out. She didn’t want to give Dr Chen any reason to take me to the OR. I gathered up my willpower and decided to refocus and try again. It hurt so badly, in my head I was convinced I was going to fail at this again. All my preparation, my study, my practice, my 15 hours of drug free labor and I was going to fail again. I looked at my husband and begged him, “Just let them take the baby.” He told me no, he couldn’t do that. Aurora and Nora told me no, too. Traci then made me mad on purpose, told me she was getting me the mirror and I was going to watch me push this baby out all by myself weather I liked it or not. And something switched in me. I can’t describe it, I can barely remember it. I remember pushing and seeing my baby’s head and thinking “well, that looks much less swollen than last time. If I can see it–I bet I can push this baby out in no time.” Once I got the mirror, I saw that baby’s head and I was like a madwoman. I knew it was so close–if I could just push harder. So I did. And after three big pushes and a ton of burning all of a sudden the baby’s head was out! It was purple and scrunched and I was worried something was wrong. They told me to slow down while Dr Chen rotated the baby–I could feel the shoulders behind my pubic bone. Then they told me to push again, so I did and the baby literally fell out of me.

It seemed to sudden, I could barley believe it–everyone was laughing and cheering and I saw Scott crying. Aurora and Nora were crying. I was stunned. They showed the baby to me as they clipped and clamped the cord, I couldn’t believe I had done it and it was over! Then I remembered I didn’t know if it was a boy or a girl, I had to ask. They were so not used to people not knowing they had forgotten to tell me! Scott said “It’s a girl!!” That was when it hit me: I had a daughter. I had brought her Earthside under my own power, with minimal “modern advancements” and a phenomenal birthing team. I started crying and saying “I have a daughter, is she okay? I have a daughter!” over and over again. They took her over to the table and Dr Chen started sewing me up. In my urgency to get the baby out once I saw her head crowning I had torn in two places, a second degree tear. That was unpleasant. I also suddenly became aware that I was naked and asked for a robe–I was cold, too. Nora was on the phone calling Jake, I was texting the nanny a picture of the new baby to show Olivia, and this whole time my baby girl was maybe three feet away from me. I got to see her messy, watch her take her first breath. Scott went over and asked the doctors when they could bring the baby over to Mom. It was like he’d woken them from a daze: they were so intent on the “routine” of the hospital that they hadn’t even realized I hadn’t held her yet. So they brought her to me.

So in awe, so in love, so perfectly. I love you, Alice Kathryn. Welcome.

Follow up notes: Alice was born on her due date, May 27th, 2012. Alice’s APGAR scores were 8 and 9. She weighed 7 pounds and 1 ounce, 18 3/4 inches long, born at 2:33pm after 15.5 hours of active labor. Alice nursed within ten minutes of being born and we were discharged as soon as she was 24 hours old on a holiday. I was up to pee 30 minutes after they finally finished sewing me up, and my nurse told me I was the first patient in her 10 years as an L&D nurse who requested to walk from the delivery room to her PP room, which I did, without incident. My recovery was almost immediate. I went home on nothing more than ibuprofen. I did fracture my spine in delivering her (in my opinion this was directly related to pushing in those unnatural positions) and I *still* recommend this VBAC experience over my first section. However, I needed the confidence, the education, and the amazing birthing team that I had to be able to accomplish the feat of giving birth.