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CAM Birth Story #15: Terra’s VBAC

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)!

My first son, Keaton was born via c-section in April 2007 after 36 hours of labor, to sum it up, he was posterior, acynclitic (not coming out “straight”) and had a very short cord causing major drops in his heart rate while pushing. After two hours of pushing and his heart rate remaining around 40 bpm, my OB called for a c-section. I, of course, was concerned for my son, above all other things. As I healed I became devastated and heart broken over the birth I wasn’t able to have. When we got pregnant 6.5 short months later, we were bound and determined to do what it took to have a healthy, natural delivery. Prior to Benjamin’s birth we did two things – we switched to seeing midwives (as my OB, who said, of course, you can have a VBAC, switched his tone and told me there was no way in the world I could ever push out a baby over 6lbs. -Keaton was 8lbs.9oz.) and we sought the assistance of a doula (we ended up with two doulas, as a friend from church was needing certification hours). A couple weeks before my due date, we talked with our doula to go over a birth plan. She encouraged us to name two “must haves” (as opposed to the 3 pages of “I want’s & I don’t want’s” that people typically bring to the hospital. We did have our list of our want’s & don’t wants, but just informed the staff of these two upon arrival. Once Benjamin was born, I simply told them what I wanted and didn’t want, and they obliged without question). My two were:

1. Avoid a c-section at all costs, barring any emergency, and, if there is time, seek a 2nd opinion before agreeing to the c-section

2. Have a completely natural, drug-free birth (as an epidural increases your chances for a c-section, and I already had that in my favor)

My estimated due date was August 16th, 2008. I’d been having sporadic contractions off and on for about a week before the “big day” (as with Keaton, I’d been having Braxton Hicks contractions for months on end – pretty much starting around 5 months). Thursday (8-14) I woke up to Keaton crying out around 3:45am. I went to the bathroom and came back to bed. After laying there for about 20 minutes or so, I realized that I had had three really intense contractions. I looked at the clock and saw that it was only 4:05am. I waited until 4:20 (two more contractions later) before telling Zach. The contractions were very short (15-20 seconds) but coming every 6 minutes. I called my mom to see if she could come down and help with Keaton (knowing if it wasn’t that day it would be the next). She agreed and got to work getting ready & heading down. I called my midwife to ask how long they needed to be (I knew they needed to last longer than 15 seconds). She asked me to wait until they were 60-90 seconds long.

Throughout the morning, the contractions stayed fairly regular, but after lunch, they “fizzled” out and became very sporadic. I talked with our doula, Faye, and she suggested I call my chiropractor and see if she could get things going again. I made an appointment for 4:30pm and Zach went with me. A good thing, too. As soon as she was done adjusting me, my contractions picked back up to 5 minutes apart and started to get a little longer (30-45 seconds) and even more intense.

We headed home with dinner and my contractions continued throughout dinner. I got a shower and they still continued. I called Faye, and she encouraged me to rest, rest, rest. After a couple more hours, they were lasting between 45-60 seconds with a couple lasting closer to 90. I called the midwife she asked me to wait just a bit longer. I was getting antsy – I really didn’t want to be laboring at the hospital, but I wanted to be there SHOULD something go wrong. I wanted to be in the comfort of my own home, but, I knew we had a 45-60 minute drive. Faye came over, showed me a couple of things to get things going even more. So I’d do these things for a few minutes and rest (mainly between contractions).

At 9:30pm, I decided that it was time. My goal was to be 7cm when we got to the hospital. My contractions were starting to feel like they did when I got the epidural with Keaton (at 6cm) – which is what lead me to believe I was at 6cm or getting close! We called our second doula, Shanna, and she headed on over and our entourage headed to UNC hospital. On the ride to the hospital, my contractions went from roughly 5 minutes apart to 2-5 minutes apart (I won’t lie – at a few points, I thought we may not make it to UNC) as I was already having the urge to push with every contraction. I really did not feel that I was that far along and to suppress the urge to push, I would push my feet on the floorboard of Zach’s truck and lift myself up. I never told Zach I had to push until after we got to the hospital, I knew he’d freak!

We got to UNC and checked into triage and they started to monitor Benjamin and myself. I got checked and the nurse informed me I was at “a good 6cm” – I was bummed, but also glad I was that far along. They got me a room with a tub – something I waited ALL day to get into! – and started to get me hooked up to the mobile telemetry units (continuous monitoring was required as a VBAC patient). After some time, I finally was able to get in the tub. As SOON as I sat down, the midwife came in and informed me that they weren’t getting a good read on Benjamin’s heart rate and were picking up some “decels” (decelerations in his heart rate). She informed me that they were going to break my water (NOT what I wanted) and do internal monitoring on Benjamin (also, NOT what I wanted!) I was very irritated, but knew the monitoring was for the best. I got out of the tub (not after demanding 5 more minutes and not getting that!) and headed back into my room. The nurse tried to find my veins to start a hep lock for an IV, if one was needed – it took her two VERY painful tries and then she went to get another nurse to help her out, she eventually got it.

My midwife went to break my water and then inserted/started the internal monitoring. I was still allowed to get up and move around, but at this point, I was getting frustrated and didn’t feel up to it. Faye came over and reminded me that this was for mine AND Benjamin’s good, that labors don’t always go the exact way we plan, but that his birth is more likely to go as planned with the internal monitoring. I labored a bit longer, alternating between standing, squatting and sitting. The contractions were getting more intense. I remember looking at Faye and apparently, I had “that look” (the look of I’m not really sure I can do this!)

*Backing up, when we met to talk about what I did and not want during my labor, she asked if I’d like to be reminded to “vocalize” the contractions. I told her probably not as I just did not picture myself “being loud” during labor….

Faye came over and quietly suggested I moan deeply through the contractions. I kind of laughed and told her I didn’t want to. She informed me that keeping the noises long and low throughout the contractions would help immensely with the discomfort (not PAIN!) I was feeling. So two more intense contractions later, I finally gave in. I closed my eyes (I didn’t want to see the nurses staring at me like I had 18 heads while I was moaning!) and just moaned through the contraction….HOW much better that felt!!! It was amazing!

I continued to labor and around 2:15am I was checked again (only my 2nd time my whole pregnancy, woohoo!) and was told that I was “9 and a lip” (basically just about a 10) and if I felt the urge to push, I could GENTLY do so to get around the lip. I’d been having that urge for a VERY long time so it was nice to be “allowed” to!

The urge to push was much more extreme by this point and this is when I really began to doubt myself. Faye was very encouraging in “teaching” me how to get through these rough contractions. She continued to remind me of my goal and how close I was to holding our sweet boy! It felt so good to push! I can vividly remember the relief with each contraction. I clearly remember thinking between two contractions that I couldn’t wait for the next one just so I could push again (not because it was all fun and games, but it was just a relief).

But, that’s when things started to get scary. Benjamin’s heart rate began to drop during the contractions when I was pushing (this is normal, but his was dropping lower than normal) – the same point Keaton’s did. I started to really get discouraged by this. It didn’t help that the Attending OB was standing right there witnessing this (I could see dollar signs in her eyes as she was picturing my c-section! The attending was there because the midwife had another patient who was pushing before me. She left to be with her and said she would return as soon as that baby was born – turns out, both our babies were born at the exact same time!)

I got on my side to push, then to my other side. After about 30 minutes of this and his heart rate continuing to drop, they told me my last resort was on hands and knees and oxygen between contractions (they gave me the option of squatting, but I didn’t have the energy to stand anymore). As soon as this position/method started, I was wishing for more rest. If I didn’t need the oxygen, I could have relaxed a bit between contractions, but unfortunately, I had to continue to hold myself up with one hand and the mask with the other (I did have help from Zach, Faye & Shanna in holding myself, but things would have gotten worse if someone was forcing that mask against my face! My doula told me that I was ‘very relaxed’ and it had been a long time since seeing a laboring mama that relaxed. She informed me that nurses would ask me a question and I wouldn’t answer…I don’t remember any questions ever being asked of me. She said I entered ‘Labor Land’ perfectly….Zach said I set up a tent and camped out, lol) Shortly after being on my hands and knees, Benjamin started crowning and everyone cheering that they could see him encouraged me to press through!

However, at 3am, after about 40 minutes of pushing, I was really starting to get tired. Also, hearing his heart rate drop in between contractions and take some time to rise again was not encouraging – I felt like I was doing something wrong to him by pushing. Shortly after 3, the attending said that I needed to get serious and get him out soon. I thought that I had been trying with all that was in me before, but when she said that, all I heard in my mind was, “Get him out NOW or it’s another c-section…” All I could think was how much I wanted to avoid that surgery, that recovery, those feelings/thoughts that still plague my mind…. I was screaming “GET OUT” in my head through the next contraction. For most of the contractions, I could get out 3-3.5 pushes (if there is such a thing as half!) For the last contraction, I got serious…5 pushes and then, before I could realize it, he was out & I heard his sweet screams!

I didn’t know what to do with myself once he was out! I just collapsed against the head of the bed (and chucked the oxygen mask, lol) and tried to catch my breath and wrap my mind around what just happened (and what I just did!) I remember looking at Zach seconds after I pushed him out and asking, “That’s it??” (WHY in the world I asked this, I’m not sure! I think it was because after his fat head (see below, lol), the rest of him just plopped out and I was not expecting that at all!)

I heard one of the nurses comment about his cord being wrapped around his neck twice (causing the “decels”). Zach said it had to have been loosely wrapped because when he came out, by the time he could realize he was here and look, there wasn’t anything around his neck.

I got some help turning over and finally got to see my sweet, sweet boy. It was so amazing to be able to see, touch and HOLD him immediately after birth. Being able to nurse him and bond with him immediately was incredible (as opposed to stare at him from across the room for a couple hours, like I had to do with Keaton). I did have 2nd degree tear and I nursed him while they repaired my tear.

Benjamin Cai was born on August 15th, 2008 at 3:25am. He weighed in at 8lbs. 5oz. and was 21 1/4 inches long.