My VBAC Birth Experience - sort of an analysis

I wanted to end with the pictures, but since I'm having trouble moving things around, we'll just start with them.


Here I am on the continual monitors - hospital policy as we know it.


Laboring with the ball:

DH helping me:

Meeting our baby!

Happy just to be with Alex:

How to even start this post. . . . . . .I've wanted to do this for a long time - to further elaborate on not just the positive things about my VBAC, but about the not so positive things as well. You can read Alex's birth story in full on the ICAN website. Again, there are many positive things that occurred with her birth, but there are things that I wish could have been different. I almost feel like - geesh - just get over it - I got my VBAC, so what am I complaining about. Don't get me wrong - the goal was to have this baby vaginally and for that I am ever grateful, but I think my story can show how different fears, policies, etc can play into birth.

Let me start back at my 34 week appointment. That appointment was when I went over my birth plan with one of my favorite midwives in the practice. In my plan I wrote something like "I understand the need for continuous monitoring, and am fine with that if the telemetry monitors are available. If they are not, then I will consent to intermittent monitoring." The midwife commented that I really needed to be continuously monitored and I explained that if for some reason the tele monitors were unavailable, I didn't want to be stuck on a 7 foot cord or unable to labor in the tub. She assured me that those monitors are there and that I'd be able to use one. I again emphasized that if they weren't available I really didn't want to be stuck on a short cord. I tried to bring up some of the things that could be issues when it came to the birth so I wouldn't have to be uncomfortable fighting any battles when I was in labor and delivery. One thing I did appreciate at this appointment was that the midwife looked at my file and was like "Oh, you had your VBAC consult with the OB." (Yes, the lovely "consult" where they emphasize all of the horrible things that could happen in a VBAC and then you sign a form.) My midwife goes, "She said that she emphasized the importance of internal monitoring." And I was like "Yeah, she said if I came in labor, they would automatically break my water and place an internal monitor. I'm not letting anyone break my water for the sake of placing that and I will only allow internal monitoring if it really looks like my baby is having problems." And my midwife agreed and said "We don't place internal monitors unless there is a real reason." So, overall I felt good.

I think from here I'm just going to make a list of the good and bad of my VBAC experience:

Starting with the bad or not so good:

• My labor started with my water breaking. . . . while I was in the middle of a night shift as a nurse. I was already sleep deprived from nights.


• I seemed to have a lot of fears that I didn't realize. I did drive home after my water broke and I had contractions that were every 3-5 minutes lasting 45 seconds to 1 minute long. They were very tolerable. But, I kept worrying about the baby - and what if I spent a lot of time at home, only to learn it was struggling. I kept having this fear of what if the cord had rushed down when my water broke and the baby's head was on it (my mom had put that fear into me.)


• My plan had been to have labor start with contractions and I would contact the midwives when I was ready to come in. But when it started wtih my water breaking, I knew I had to tell them the truth. I just wasn't comfortable fudging around with times. I would have felt like I was "lying." And of course when I called and told the midwife my water broke, she advised me to come in.


• The hospital environment totally shut down my labor. As soon as I entered the hospital my contractions went to 10 minutes apart, when they had been 3-5 minutes apart for 4 hours.
  
  
• The waterproof tele monitors weren't working, and I wasn't strong enough to refuse the external monitors. Had they been working I feel like I could have gotten farther into my labor without the epidural, but 5 hours with intense pitocin contractions and being at 4cm, and not able to get into the tub was hard.


• With all of the cords attached to me it was hard to walk to the bathroom. I was drinking a lot of water, but when the pain got really bad I didn't want to walk. I think emptying my bladder might have helped me relax and dilate a little more on my own before accepting the epidural (and I instantly went from 4cm to 6cm right after the epidural and catheter in my bladder were placed - but that could have been a combo of things).
• I knew that I was on somewhat of a timeline in the hospital. They weren't a strict 1cm an hour or anything. But once I had been at 2cm for 15 hours, I knew I had to accept pitocin, because I wasn't getting anywhere, and I don't think contractions would have increased in intensity - my body was not excited about birthing in a hospital.


• I got an epidural. I had a lot of interventions.

Good:

• Despite some of the undesireable things. I had a great midwife throughout my labor whose whole goal was to make sure my baby came out vaginally. She let me sit at 2cm for 15 hours from my water breaking without suggesting any interventions. I'm sure many OBs would have sectioned me by then.
  
  
• She didn't freak out when I was having some high blood pressures on admission and labor (which were due partly from the nurses being around, because when they left, I'd take it again and they'd be better).


• My doula explained that my midwife and the nurses were very reasonable in my scenario.



• When I felt I needed the epidural, I really felt like it was an informed decision. I hadn't progressed past 4 cm in 3 hours (and prior to that I had been at 2cm for a total of 18 hours) and contractions were very tough (again - pitocin augmented) and I really felt I needed the epidural to relax. My midwife made sure they did everything possible to prevent a fast blood pressure drop, because it was the epidural that made my first baby go into distress. And you know - I really feel like the epidural did what it was actually supposed to do - allow me to relax so my cervix could open. My midwife checked me very shortly after it was placed and I was found to be 6 cm! I got a 2.5 hour nap after that. And after my nap all I had left was a rim of cervix.


• No one was anxious about checking dilation. I was only checked when I asked.


• When it came to pushing, no one checked me for 2 hours after I was found with only a rim of cervix because I had no urge to push. I finally asked to be checked around 7:30am, and the nurse got maybe two knuckles in, but was still like "Oh, you have time." I finally called the midwife in around 8am and she was like "The head is right there!" And got maybe 1 knuckle in. The epidural allowed me to labor the baby all the way down and I pushed for maybe two contractions.
• I was given my baby immediately after birth and she stayed on my chest for almost an hour. No one weighed her, poked her, touched her, etc. It was so important that I get breastfeeding off to a good start as it went so horribly with Matthew.
• I was awake for this baby's birth!
  

One thing that bothers me also is at my 6 week post-partum appointment, I was talking to the midwife who was at the delivery (she had just come on). And I told her how I was disappointed about not being able to try the tub and what would have happened if I would have refused the external monitors - as I was really worried about compromising the relationship between myself and the care providers. And she said "That would have been ok, we wouldn't have thought of you any different. We would have just had to hold a doppler to your stomach." I was kind of like - man, I should have refused.

You can look at this from so many different angles. There were many positives - and I did get a VBAC and I sincerely believe that my whole team was trying to help me in the best ways they knew possible. There are pros and cons about giving birth in the hospital. I've seen my VBAC from so many different perspectives and learn/think something new about it all the time

If my husband ever decides we can have one more, I want to seriously consider homebirth. I feel like if I would have had a homebirth this last time, I could have had my midwife come over, check fetal heart tones, assure me that all was ok, and I could have continued to labor in the peace of my own home.

I hope you all learned something from this or enjoyed it.