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CAM Birth Story #6: Lily’s HBAC

In honor of Cesarean Awareness Month 2010, we will be filling the blogosphere with stories from real women (and their families) who know first-hand the consequences of a 32% cesarean rate. Each day we will post at least one birth story submitted by these women. Prepare to be moved (hint: grab a box of Kleenex)!

As I begin to write the story of Sofie’s birth, I feel my heart overflowing with joy and love. Love not only for my baby, but also for the wonderful women who surrounded me throughout.

This birth went beyond affirming my ability to birth. There I was – fat, naked, in pain, and afraid… facing every insecurity I had ever faced as a child and as a grown woman… and it was all okay. The support was unlike anything I had ever experienced before. The people who were with me at this birth gave me one of the greatest gifts a human being can give another: acceptance.

* * *

My son Lucas was born by cesarean in March of 2005. I had labored for 20 hours when I gave up during transition and agreed to the cesarean for what they call “failure to progress.” The doctor said my baby was “just too big” to get through, and I felt like a failure for my body’s inability to give birth. In the months after my cesarean, I tried to convince myself that there HAD to have been something wrong when the pain got so unbearable, but I often wondered, “Maybe I just wasn’t strong enough…”

My daughter Elisa was born via unmedicated VBAC in January of 2007 after planning a home birth with a doctor but transferring to the hospital during transition. I got to the hospital begging for an epidural, but that epidural never came because my body ended up pushing my baby out all on its own, within two hours of arriving. It was a triumphant birth, yet traumatic because of the despair that I felt when I saw myself losing control of my body.

Again, I struggled to figure out whether I was too weak for the intensity of birth. I was starting to see pattern—I would “fail to progress” at some point, I would lose faith in my ability to get through the pain, despairing at the loss of control and meeting little resistance when I decided to give up. I had labored for 32 hours the second time, much longer than I had the first time, and the difference in outcomes seemed to be only due to the fact that I had done most of my laboring at home.

In the days and weeks after Elisa’s birth, however, the women of ICAN helped me consider the idea that it wasn’t that I was too weak, but that it was all about support.  Almost every woman experiences those “I can’t do it” moments, and how it is handled depends on what kind of support she has during what is the most vulnerable event of her life.

In time, I came to revel in the power of my body and my ability to give birth.

The night I found out I was pregnant with Sofie, I had a dream that I pushed her out easily, quickly, and squatting… into my own hands. This dream would repeat itself at least 4 times throughout my pregnancy, and it reflected my  newfound trust in my body and its ability to give birth.

The same night I found out I was pregnant with Sofie, March 30, I heard back from Bonnie, a doula and a friend of mine from ICAN. She was the same person I had called on for support an hour or so before transferring to the hospital during my VBAC with Elisa. Her email said “SURE”—she would agree to fly in to be my doula for this birth—this time, in person.

And so it began.

In putting together my dream birth team, I knew I had to find people who I trusted, and who trusted in me. That’s why I ventured to ask Bonnie if she would fly in for the birth. It is why I chose a midwife whose skill I could sense from miles away, and who still possessed that special *something* that told me she was someone I could safely entrust myself to. It is also why I asked my mom to come all the way from Japan to care for Lucas and Elisa during the birth, and why I asked a special doctor friend of mine to be there for me in case we needed the hospital.

* * *

Bonnie and my mom arrived on a Thursday, the day before my due date. The kids and I had spent the day running errands before heading to the airport and I noticed I was starting to have contractions that got more intense as the day progressed. By the time we left the airport, I was sure we were going to meet the baby that night, seeing as the rest of my birth team was finally here. After dinner, though, I figured out I was probably just dehydrated because the contractions soon dissipated.

Having prided myself on patience as my guess date neared, I was surprised to see my impatience grow. Since I had gone into labor the day before my guess date with Elisa, I was, for some reason, holding on to the idea that it would happen the same way with this baby (never mind that Lucas had been 11 days late!) Each of the 5 mornings after Bonnie and my mom arrived, I met with disappointment. I was still pregnant, and it felt like I was going to be pregnant forever.

The days came and went without much going on other than getting things ready for the birth. The Sunday prior we had met up with Barb to get from her the dyed sheets we had used for the BOLD Red Tent on Labor Day. While we waited for labor, Bonnie and I hung the sheets to cover the ugly walls and ceiling of the unfinished basement of our new house. We set up the birth pool, brought a futon down, and laid out remnants of the carpet we had installed before closing on this (our very first!) house. The basement transformed into a very cozy space. I called it my “nook;” Bonnie called it “The Spa.” Eventually, it became “The Red Tent.”

And so it was that we made it to Tuesday. Bonnie writes:

So I went with Lily to meet her back-up physician today. Nice guy, I extend my hand to meet him. Lily introduces me as her doula. He does some obligatory greeting with Lily, and then starts to chat.

Him: So are you from Illinois?

Me: No Maryland. But I’m originally from St. Louis.

Him: So you’re gonna catch the baby.

Me: Umm. I don’t know. I don’t think so. If I do, it will be the first one I ever caught.

Lily: Well if I need to, I’ll just reach down and catch the baby myself.

Him (stuttering as his eyes open wide—the look of disbelief in his eyes—and his jaw hits the floor, buying some more time): “Oh, you really ARE a doula!”

Lily and I held it together until we left his office… but the expression on his face when he thought I was a midwife who had never caught a baby was PRICELESS!!!

Funny as it was, the humor had to be put aside for a while. My blood pressure was up at that visit. This concerned me at first, because it was significantly higher than my typical readings.  Dr. F asked me to lie down and rest before taking another reading.  After 10 minutes, there was no change and we sat down to talk.

To my surprise, Dr. F said he wasn’t concerned.  After all, I had no swelling and no protein in my urine so pre-eclampsia was unlikely.  We decided to run some labs just in case, but he said it was probably just some chronic hypertension manifesting itself.

In talking to Bonnie, I realized it was in line with my history.  With both Lucas and Elisa, I had gotten high blood pressure readings upon checking in to the hospital.  I left the office thinking higher blood pressure that day might mean labor was near…

That afternoon, I decided to visit Cary, my chiropractor, in the hopes that an adjustment would re-align things and allow an imminent labor to start.

That night, we came home, ate dinner, and sat at the table chatting. After dinner, I couldn’t hold it in any longer, so I announced, “Well… I’ve been contracting all through dinner and it’s still going!”

I was excited, but I had decided to ignore contractions until I couldn’t any longer. After dinner, I got on the computer and worked for a while. When it was time for bed, I took the calcium/magnesium supplement I had been taking for leg cramps (and to sleep better at night!), said goodnight to everyone, told them I’d see them in the morning if it wasn’t labor, and fell asleep.

The contractions continued to come regularly and their intensity managed to wake me up every hour that night. By 4 am, I was hungry so I got up to eat and never went back to sleep. Around 6 am, Trey woke up and asked me if everything was okay and I told him it was, but that I was in early labor. He asked me if I still wanted him to go to work that day and I said, “Oh, definitely,” sensing it was going to be a while. He kept me company through a few contractions and then got ready for work.

When everyone else was up, I gave an update of what was going on and Bonnie suggested I call my midwife to update her as well. The plan was to get up, head to the mall and walk around, get a few last-minute things from Walgreens, and have my mom check into the Holiday Inn with the kids in the afternoon. (Speaking of the Holiday Inn, one of the things I had loved about having a baby in the hospital was that I got to spend time with the new baby on my own, so this time we arranged to have my mom spend a couple of nights at a hotel with the kids. They loved it!)

As everyone got up and the day began, my contractions began to space out quite a bit. I noticed I didn’t feel any contractions at all while I was in the shower, so I figured the busyness of the morning must have halted my labor briefly.

It took forever for us to get ready to go, and even then we never did make it out the door. We ended up eating lunch at home while I finished a few loads of diapers between contractions.

When I went down to the basement to check on the laundry, I found, in horror, that we had a repeat of the sewage backup of a few weeks before… and this time half of the carpet and several of the red sheets were wet!

As soon as I realized what was happening, I yelled, “Oh no, oh no! Oh nooo!” several times, thinking my cozy little nook was ruined. Bonnie and my mom came running, thinking something catastrophic had happened to me, and were relieved to see it was nothing serious. I, however, had lost it and was sobbing inconsolably (hormones, anyone?). As I cried, I felt a very powerful contraction come on, which made me feel even more vulnerable.

The kids started to lose it, too, when they saw me crying. Seeing them lose it made me even more upset, so I told my mom to just take them and check in at the hotel. Thankfully, we all managed to calm down before they left.

In between all this chaos, Bonnie had called Trey to tell him about the sewer problem and he had made it home in under 10 minutes. After he had taken care of things (which ended up being… nothing, actually, because I had decided I wanted to clean things up myself!) he went back to work with a promise to stop by Walgreens on his way home. The number one thing on my list was a bottle of Hibiclens, which I wanted to have handy in case my water broke early since I had tested positive for group B strep. My plan was to do a Hibiclens wash every so often after my water broke, which we ended up not doing because my water didn’t break until—

Wait a minute, I have no idea when my water broke. It had to have been some time between 8 cm and birth because my midwife could still feel it when she checked me for the second and last time during my entire labor, at 8 cm. All I know is that I never felt a pop!

Back to the story…

At some point during all this, we also called my midwife to give her an update. I was embarrassed to admit that we had forgotten to time contractions yet again. I apologized as I told her we didn’t know much other than that things were still happening. We were left with instructions to finally start timing contractions to see where we stood at that point.

Bonnie and I decided to watch Orgasmic Birth while she timed my contractions.  I can’t remember in what sort of pattern my contractions were coming other than that they were somewhat irregular.  My midwife called back a little while later and she decided to head over to our house.

When she arrived, we were still sitting in the living room (with Orgasmic Birth paused at the point where they talk about cesareans… yuck!).  She asked me if I wanted to be checked. I thought about it for a moment and finally decided that yes, I wanted to see what sort of progress my contractions had made since the previous evening. I felt like some information was warranted in order to make decisions about what to do next.

After we found some olive oil, we headed to the “red tent.”  I was amazed at how respectfully my midwife went about performing a vaginal exam. “She really gets how vulnerable it feels to be in this position,” I thought.  Indeed, it was very comforting to sense from her that my body was worthy of such respect. You may think, “Of course it is!” But that had never been my experience until now, especially not in the hospital with people I had never met—people who tended to think of it as “just another procedure.”

As it turns out, I was 3 cm dilated.  However, my cervix was not centered at all.  In fact, it was all the way to my left, pointing toward my leg.

My midwife mentioned that she often she sees this in moms with asynclitic babies (meaning the baby’s head is slightly tilted)… and I wondered how it was that I had never heard of the cervix “behaving” this way.

For a moment, I was afraid. I was afraid that my baby being asynclitic might mean a CBAC, as I had seen several moms come back to ICAN telling the story of a long, drawn-out labor ending in CBAC due to what in retrospect was probably an asynclitic baby. One of my biggest fears was ending up with another cesarean, even if it was a medically necessary.

To my surprise, my ever-so-knowledgeable midwife said there was something I could do: get on all fours and move my hips from side to side to line up the baby’s head. She said it usually works to correct the problem, allowing a start-stop labor to pick back up. Soon, I was no longer afraid—I was grateful that my midwife was able to identify the malposition in time to correct it.

Knowing what the next step would be, I made the decision to eat and sleep for an hour before starting on those exercises.  I wanted to be nourished and rested before labor picked back up. My midwife and her assistant left and said they would be back later.

Around eight o’clock that night, we got started. I got on the couch on all fours and laid my head on a pillow. As soon as we started, I felt the baby’s head move. Sure enough, my contractions got closer together and more intense as I moved my pelvis from side to side. Not only that, but after feeling many of the contractions mostly on my left, I could tell they were getting centered again.

The contractions intensified and I started moaning as I tried to cope with the pain. It was satisfying to be able to keep a positive outlook in the face of the pain, especially since I hadn’t been too good that that in my previous labors. Finally accepting the pain as normal (for more on this, read my friend Krista’s story) and having support people who believed in my ability to cope was crucial.

To keep the contractions going, I would get up, walk around, get back on the couch, get back up, go to the bathroom, etc. Soon enough, I started to get tired… not so much physically, but mentally tired. Labor was hard work.  This is a picture of me, with tears in my eyes from being emotionally exhausted, forcing a smile to document my only bare belly picture of this pregnancy.

After a while, Trey finally made it home after running errands for me and dropping off a few things for the kids at the hotel. I was happy to see him. Things were getting tough – I was feeling especially vulnerable and being with him was very comforting. I’m glad he was there as I labored on the ball in the living room.

Also happy to see Trey was Pokey, who spent most of my late labor pacing back and forth like a nervous watchdog!

My midwife returned soon after that—I don’t know what time it was but I do remember very clearly the moment she said this would be a good time to try the birth pool. I was in the bathroom at that moment and REALLY wanting a change of some sort.

I headed down to the basement and tested the water, which was too cold for my taste. We had depleted our hot water heater, so Trey set some pots of water to boil and took turns with Bonnie going up and down the stairs to pour boiling water into the lukewarm pool.

When it felt warm enough for me, I got in. I struggled to find a suitable position to labor in for the first few contractions, but eventually got the hang of floating in the pool with my neck on the rim of the pool.

At that point, I remember feeling very relaxed, but starting to feel a bit frustrated and impatient at the fact that my contractions were strong and painful but didn’t seem to get closer together. At least, not enough to let me know that the end was near. Trying to cope with the pain while thinking that I still had while to go was… overwhelming.

All of a sudden, I started to shake. I had no idea what was up with that…maybe anxiety? Maybe transition? Couldn’t be—my contractions were still too far apart!

My midwife gave me a few drops of something and had her assistant help her press on certain spots on my legs to get rid of the shakes.

Internally, I was struggling. My contractions were freakishly strong, but they were so far apart there was no way we could be close to the end.  Little did I know…

My midwife suggested getting out of the pool to get my contractions to pick back up again. I asked for the pail I’d been using as a toilet, and then I asked my midwife to check me again.

I was 8 cm with now a mostly centered cervix that was slightly thicker on one side. My midwife was amazed at the change with such few contractions! She suggested laying on my right side to help even out pressure on the cervix. I did that for about 10 minutes—two contractions… until I couldn’t take it anymore. At that point, I got up, turned around, and instinctively got on all fours.

The pain intensified with each contraction. How far apart they were exactly, I don’t know, but it seemed like an eternity between each one, giving me enough time to anticipate the next bout of pain with fear.

“I’m scared”

“What are you scared of, Lily?” My midwife whispered in my ear.

“I’m scared of something going wrong… I’m scared of more pain.”

“You’re doing fine, and baby is doing fine… more pain means your baby will be here soon.”

“I’m scared that my contractions aren’t close enough together… I’m scared that this is going to take forever!”

“Lily, you’re almost there… you’re almost done.”

I glanced at the newborn hat and oxygen tank a few feet away from me. Unbelievably, it seemed like they all thought I was about to push the baby out!

I noticed myself starting to grunt at the end of each contraction, but I kept thinking it was probably me wanting to be there so much that I was somehow doing it on purpose.

“What was I thinking wanting to do this stupid natural birth thing again?!? I wish I were in the hospital with an epidural right now! No, no I don’t, not really but ooohh this hurts!!!”

Another contraction came and I really did not want to do it… “I don’t want to, I don’t want to, I don’t want tooooooo!!!”

Trey had been holding my hand for the last few contractions when all of a sudden he got up to go get something. It became clear to me just how much I needed the comfort of his hands at that moment… and I just love that I did.

After a few more contractions, my body started to push involuntarily.

I finally realized I really was almost there. But like in my previous VBAC, I didn’t like pushing at all.

“Ohhhh… pushing hurts!!!”

My midwife asked me to breathe it out but I said I couldn’t… I didn’t want to push but didn’t know how not to.

“Lily, don’t close your lips – go like this (quickly): puh-puh-puh-puh-puh…”

“Puh-puh-puh-puh-puh-puh-puh-….UUNGH!…puh-puh-puh-puh-pnnnnnggh”

I loved it! All I had to do was “puh-puh-puh” each pushing contraction and it wouldn’t hurt too much. Baby was moving down beautifully… even though it still seemed like forever between each contraction.

All of a sudden, I felt her hit my pelvic floor…”UUUUNGH!!”

“Lily, ‘puh-puh-puh-puh’—you want to ease your baby out, you don’t want to tear.”

“”Puh-puh-puh-puh-puh-puh….”

As I breathed her down, I could feel a lot of pain around the area of my urethra—same intense pain as with Elisa. The good thing was that it was only pain – everything else felt fine. I did not feel like I was about to break in half as I had with Elisa. Still, that one pain was very intense.

I breathed her down a few more times when all of a sudden I felt the ring of fire, which actually wasn’t that bad. I knew I could push her head out with the next contraction, so I did. I pushed, pushed, pushed and just like that, her head was out. Then, I waited for the next urge to push her shoulders out—push, push, push and…woooosh! She flew out!

I don’t think there is a better feeling in the world than that of a baby wooshing out! It happened very quickly and, amazingly, Bonnie was able to take a photo of both Sofie’s head out and then the rest of her body flying out. It was 1:51 am on Thursday, December 11, 2008.

The first thing I said the second she was out was, “I’m done! I can’t believe I’m done! I am so glad that is over!”

Then my midwife passed Sofie under me through my legs so I could hold her.

“Oh, my baby! Hi Sofie! Hi! Oh, you look just like your big brother Lucas did when he was born! Oh baby, shhh, don’t cry, mama’s here, I’m here… I love you! (I am so glad that’s over!)”

I wanted to check to make sure she really was Sofie and not a surprise boy. Sure enough, it was Sofie.

“Look, Daddy, Sofie is here! Isn’t she beautiful?”

I was so happy.

After a few moments, we moved over to the futon to lie down and get some skin-to-skin time with Sofie. As soon as I remembered, I asked for the cell phone to call my mom at the hotel.

“Mom, I did it!”

“What?”

“I did it, Sofie is here!”

“Oh, I’m so glad! I was so worried!” Grin. She knew she had to wait to tell me that until after the birth. I love my mom.

Trey put Sofie’s hat on. The placenta came out in 18 minutes. I kept asking my midwife if my bleeding was okay, and she said it was. No concerns there. She also checked me out for tearing and said I had no tears except for a tiny nick on my perineum that wouldn’t require stitches.

Once the placenta had been out for a while, Trey cut the cord. It was the first time he had ever cut the cord. I’m so glad he did.

After a while, my midwife weighed Sofie: 9 lbs 8 oz. Almost as big as Lucas, my cesarean baby for “CPD.” Just 4 ounces shy, actually.

After about an hour or maybe two, we decided to head back upstairs. That in itself was a challenge, but we finally made it—slowly but surely.

After making sure we were all doing well, my midwife prepared to leave and Bonnie got ready for bed. Trey also went to bed, as I know he was exhausted.

Me? I couldn’t sleep. I was still high from the birth. I replayed it in my head and realized it ended up being a very undisturbed birth, even with other people present. The basement had been dark, everyone quiet… I never even heard the sound of my midwife’s doppler every time she checked heart tones. I did what felt right, and appreciated my midwife’s suggestion to “puh-puh-puh” during pushing. I literally breathed Sofie out… it was as gentle as birth can be—for her, too.

In the morning, my mom took Lucas to preschool and came home with Elisa, who then met Sofie for the first time. All she wanted to do was kiss her baby sister (and cuddle with mama). After preschool was over, Lucas came home and met Sofie, too. The moment he saw her, I could tell he fell in love with her. He had the biggest smile I had ever seen on his face.

My recovery was as good as the birth. Unlike after Elisa’s birth, I had no stitches and just a couple of hours after the birth, I wasn’t even sore. My bottom felt 100% normal and I didn’t burn to pee! Wonderful.

When I finally lay down to sleep that morning with Sofie snuggled at my breast, I closed my eyes and prayed, “Thank you, Lord, for the gift of this baby. Thank you, Lord, for the gift of this birth.”

Sofie Anne

Born at 1:51 am on Thursday, December 11, 2008

9 lbs 8 oz

22 inches

13 3/4 inch head

One Comment

  1. [...] This post was mentioned on Twitter by Brandi Hefner Doucet and ICAN Main Online, Desirre Andrews. Desirre Andrews said: Birth story #6 CAM – http://bit.ly/aZaLTG #csaware [...]