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Monday, November 10, 2014

A Healing VBAC Birth

My first birth experience was pretty traumatic. I had gone into the experience with some knowledge and a lot of trust in my doctor. I ended up with a failed induction, an epidural, a c-section in which my uterine artery was severed, a life-threatening blood loss, the loss of an ovary, and a long, rough recovery full of pain and breastfeeding trouble.
My sadness, guilt, anger, and sheer, bone-deep disappointment about my first birth proved to be something positive for me. I realized that any woman who is not trained in natural birth could wind up having the experience that I had. It angered and motivated me. I became a doula. I was determined to help other families avoid the same feelings about their birth.
So, when I was fortunate enough to become pregnant again, I was a little defensive about how I was going to birth. I was going to go into labor on my own. I was going to avoid pain medication. I was going to push this baby out, dammit.
I switched providers, going from OB to midwife care. I hired a fantastic doula. I read everything about VBACs. I wanted that VBAC more than I think I've ever wanted anything, other than a healthy baby.
During a consult with an OB at 36 weeks, he informed me that I needed to have a c-section on the books, and he wouldn't want me to wait longer than 41 weeks. My heart hurt. But I squared my shoulders and said that I wasn't comfortable with that, and that it would be discouraging to have something on the books. He said that it was likely that I'd go into labor on my own, and that I didn't have to do anything.
I didn't go into labor by 41 weeks. I tried everything. EVERYTHING. Nothing worked. I got more pressure to schedule my c-section. My midwives hugged me, checked me, reassured me. But they didn't feel like waiting past 42 weeks was in my baby's best interest. Finally, 9 days past my due date, exhausted, anxious, and feeling discouraged I sat down and told my baby, "No one is going to decide when your birthday will be except you. I'm your mom and it's my job to let you do this."
On my tenth day past my due date, I woke up at 3 AM with different contractions. I had regular, strong contractions every 10 minutes all that day, then went to bed at 10PM. I woke up at 1 AM with very strong contractions. I labored in bed without waking my husband until 4:30AM, then called my parents, who were coming to watch my toddler, and my midwife to tell her I would be coming in that morning.
We arrived at the hospital at 7:30AM at 4 cm. The nurse and midwife were both a little skittish around me and informed me that they had seen some problems with VBACs lately, and that they'd probably be "a little jumpy." Neither of them were warm or supportive.
When they left the room, I began to cry and told my husband, "I'm having another c-section. I can just feel it." But then, minutes later, my amazing doula arrived. She was like a breath of fresh air. When the nurse began to tether me to the monitor and the IV, Emily spoke up with me to say we needed to get me walking. Her cool hands and cool head helped me through the contractions in the beginning, and her support never let up, even when I labored intensely for 14 hours and got stuck at 8 cm. The pain was bearable, but I had the overwhelming urge to push and couldn't stop bearing down. I was having contractions that lasted well over 2 minutes and were less than a minute apart. The midwife suggested I have an epidural to help me relax. I did, but the level was left low so I could still feel a lot of pressure.
Eventually, I learned my baby was OP, and that his heart rate wasn't picking up as well as they'd like after contractions. The doctors and midwife were concerned that I wouldn't be able to push him out quickly enough. A very gentle doctor discussed using a vacuum or foreceps because he was worried about my baby's heart rate. He said that he was concerned enough about the baby to suggest another c-section but thought we could try to avoid it.
In the end, it was determined that my pushing was strong enough to try the vacuum. He said I might still push for up to 20 minutes, but I only needed one contraction and one push. He was born, safe and healthy, all 9 lbs 4 oz, and put right on my chest. He nursed immediately and has pretty much never stopped!
I was so glad that I was assertive about my birth, and so fortunate to have a lot of support during my birth. I hope to be that for many women in the future!

Monday, November 3, 2014

A VBAC Birth

The day I was 39 weeks pregnant, I was home with our 2 year old son Cameron and around 11am I lost my mucus plug. I called my husband at work and let him know, but figured it could still be a few more days or so (although with our son I went into labor hours after losing my plug). After I put Cam down for nap I tried to nap myself but was having “cramps.” They definitely didn’t feel like contractions, just crampy. This went on for 2 or 3 hours and then I called and told Dan he better bring his work stuff home for the weekend just in case this was real labor. We went out dinner around 5pm and by then I was tensing up with these “cramps” and we were starting to think they were contractions, but they were very irregular and not getting stronger. We went home and put Cam to bed and then I proceeded to go on my nightly hour long walk with my neighbor. During the walk the “cramps” completely stopped, so I figured it must have been just false labor. When I got home around 8pm they picked up again and I started timing them. They were all over the board, 5 minutes apart, 13 minutes apart, and then 3 minutes apart. Finally they spaced out to over 10 minutes apart and I decided to try to go to sleep around10:30pm. I was feeling a bit discouraged that it was just false labor. I no sooner got in bed and pulled the covers up, and they started coming fast and hard. I started timing them again and they were 2 minutes apart, lasting 45 seconds. I timed them for 10 minutes and then went downstairs and told Dan they were fast and furious now. He was in the middle of a fantasy football draft at the time and I think wasn’t really convinced this was happening. I called the hospital and the maternity nurse said I should get to the hospital within an hour since I was a VBAC patient and they were so close together. I called my parents and they got out of bed and began the 40 minute drive down. During this time, I was lying over an exercise ball and had to breathe through every contraction. I was starting to panic a little because my OB told me that since I was a VBAC patient I needed to be properly monitored during labor for signs of uterine rupture. We also weren’t fully packed, so Dan was running around throwing stuff into bags and drafting fantasy players in between (who says men can’t multitask?J)!  About 30 minutes went by and we both started to feel like things were progressing too quickly and we could not wait for my parents to arrive. We called my neighbor to come over and we hit the road.

We got to the hospital shortly after midnight and were admitted right away. I figured I would be dilated to 7-8 cm with my contractions as close together as they were, but unfortunately, I got checked and I was only 3-4cm! I was so disappointed! However, I was in so much pain and knew it could be a long haul (27 hours with our son), I called for the epidural right away. Which, I am very glad I did, because 2 hours later I was still waiting for it. I stood at the side of my bed and breathed through every contraction, while getting more and more upset that anesthesia was still not there to give me some relief. Our amazing doula Alison arrived during this time and was such a welcome sight! She proceeded to apply counter pressure on my back and talk me through the contractions.  I also threw up three times, during the wait, which only added to the fun. Finally around2am, I got my epidural. Sweet relief! The unfortunate part was that it only lasted a couple hours. During those hours, Dan was able to catch a short cat nap and I was supposed to nap, but my blood pressure cuff was going off every 5 minutes, so that wasn’t happening. Around 3am, I was checked and was 6cm dilated and the baby’s head was ENGAGED! I was elated! This never happened with our son, who was a CS due to “failure to descend.” I was finally starting to feel like, maybe, just maybe, this would actually happen for me!

 During this time, the nurses thought that putting one of my legs up on a peanut ball (a huge peanut-shaped exercise ball) might help baby to descend further. So I laid like that for several hours. A couple hours later, I started feeling the contractions again, not just pressure, but actual pain. I had to breathe through them again. Anesthesia was called and gave me a bolus in my epidural line, but it just numbed it for a bit longer, didn’t ever take the pain away again. At that point, my only choice was to remove the epidural and put in a new one, which has the possibility of nerve damage. I opted out of that and was on my own to get through the pain. It was now about 5:30am and I was 8cm dilated. The decision was made to break my water the next time I was checked in order to get things moving.  I hung out until 6:30am and they broke my water. Shortly after that I started feeling like I had to have a bowel movement and they said that was good news. I was checked around 7am and they said I was “almost” a 10 and that I could push if I wanted. I decided to wait until I was a complete 10 and that lip of cervix was gone. At 7:45am I started pushing. After 10 minutes or so, I started feeling very discouraged. I felt like nothing was happening and kept asking the nurses “where is the doctor?” They said they wouldn’t call the doctor until I was only a few pushes away, so then I began to obsess over that. After every contraction I would say (or yellJ) “The doctor isn’t here, I am not even close!!!!” Thank goodness for our doula, she kept telling me “one contraction at a time, stop worrying about the doctor.” My husband, bless his heart, just stood next to me, and held my sweaty hand. As it got on after 8am, I started to freak out a bit that I was going to have to push for 3 hours like I did with my son and started to really have a panic attack of sorts. I was so exhausted, hungry and dehydrated after not having any water or even ice chips.  My blood pressure went up and the nurses and my doula had to really talk me through each contraction. They were coming so close together and I was doing 4 pushes each, so I was exhausted.  Finally, the sweetest thing happened, the DOCTOR WALKED IN! I could have kissed him! I was close! I was going to actually push this baby out! He watched me push through a few contractions and I said “put your hands up there and GET IT OUT!” He calmly asked the nurse to set up the vacuum. Thank GOODNESS, I couldn’t have been happier, even though I know there are risks with the vacuum, I needed that baby out in a bad way.

After several contractions with the vacuum, at 8:21am on August 30th, 2014, our sweet baby was born. The doctor told Dan to “call the gender” and he was crying and there was so much blood/fluid he exclaimed “IT’S A BOY!” and the nurses quickly said “no no, look again” and he said “Oh, it’s a GIRL!”  He said all he say was two of something and though it must have been testicles! We laugh about it still! We were very surprised, as we had a “feeling” it was another boy, but chose not to have the gender revealed during the pregnancy. Dan got to cut the cord and they put Lauren Rae up on my chest and she immediately fell asleep! She laid content and sleeping on my chest for 25 minutes before I reluctantly gave her up so my husband could hold her. Even though my doctor did a slight episiotomy, I still tore from front to back and was in stirrups for 45 minutes getting stitched up. A very unpleasant experience if I do say so myself. However, I got to hold my sweet baby girl for most of it, which was like nothing I could have ever imagined. After not getting to see our son until hours after the delivery, this was such an amazing blessing.  We delayed weighing and bathing, but later on found out she was 7lbs 15oz and 20 inches long. Ten fingers, ten toes, a complete miracle. Our doula, Alison, stayed and helped me get breastfeeding going and took lots and lots of pictures for us. I truly do not think I could have done it with her. She was a constant encouragement to me and to my husband. She never let us think about a C-section and she was able to help me contain me fear when it was creeping in. When Lauren was born, we were all crying, even Alison. She was so invested in the birth of our child, even after only knowing us for 8 hours. I still have to pinch myself when I think how I worked so long and hard toward a VBAC and it actually happened! I was able to do it! I think I always thought I would try, but would probably have another C-section.  I never thought it could go as quickly as smoothly as it did. We are truly blessed.