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CAM Birth Story #36: Lexi’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)!

Lexi’s first VBAC…

Towards the end of my pregnancy, I started having odd dreams. I remember two in particular.

The first:
I’m in the hospital and I just gave birth vaginally to a preemie. They whisked her away right away and I didn’t even get to see her. This is all dream knowledge, because the dream opened with me in the hall. They want to take me to a recovery room and I’m refusing to get in the wheelchair. I’m going to walk, thank you very much. So they give me a room number and tell me to find it myself. I have to go down a flight of stairs only to find that I’m not on the maternity floor, but stuck in a room on the first floor that they reserve for people whose babies have died. I get really mad and I call the nurse on a telephone on a desk in the middle of the hall. I tell her we are going home right now. I send DH up to get the baby while I’m arguing with the nurse. She keeps telling me the baby won’t eat and can’t go home. I then “know” in that dream way that they tried to give her a bottle and she wouldn’t take it and right now are trying to put a feeding tube down her nose. Suddenly Chris comes down the stairs with the baby and hands her to me where she latches on instantly. I think, “Yep, she’s just a booby baby.” And we go into the delivery room to gather our things so we can go. The room is PACKED with our things from home. Pillows and blankets, but mostly Maddie’s toys. Even her tricycle. I woke up while we were packing things into the stroller.

The second:
I’m walking into the hospital crying because I’m going to a scheduled c/s and I don’t know why it needed to be scheduled. In the hall Chris and I run into Tonya, who is working on a computer. I’m wondering what the heck she is doing there, but I’m so glad to have someone from ICAN to talk to that I don’t really care. I sit down to wait for her to finish on the computer. A doctor walks up, a tall blonde woman, and introduces herself as Michelle Tiffany (The one OB visit I went to with this pg was with a man named Micheal Tiffany.) and says she’s going to be my surgeon. I say something under my breath along the lines of “Who gives a s***?” Then tell her “nope, not doing this. I’m going home.” She looks at me and says “I don’t blame you. After all the nursery is closed.” I have no idea what she means, but anything that gets me out of there without a fight. So we go walking down the hall to the door and pass the nursery that has a sign hanging in it that reads “Closed due to feng shui problems.” (did I mention I have strange dreams?) On the way out, I start having lots of contractions, so we hurry home. I woke up having to use the bathroom really bad, so I was probably really having those contractions.

These dreams really illustrated to me the fears I was having under the surface. I was afraid of a long labor, afraid I’d get tired and give up. I was very afraid of having another cesarean. I didn’t think I could ever recover from that. I did the best I could by planning for a long labor. We had a birth tub, a birth ball, a bag full of snacks and Gatorade and Emergen-c. We had a whole little nest set up in the basement. One of the TVs was down there, and a blow-up mattress, and the rocking chair. Other than these things, I didn’t know what else I could do to tip the scales in my favor. I really couldn’t know anything else until I was in labor. This left me feeling like an over-wound spring for the last several weeks of my pregnancy. This feeling, combined with the fact that I could barely move my huge belly around and some minor prodromal labor left me very anxious to get this labor underway.

I tried to keep my mind on other things. I sewed the last of the diapers, and hung up all our baby clothes. Even the dresses, despite the fact that I didn’t know if the baby was a boy or a girl. I worked on two different baby blankets. Chris took my pregnancy pictures. I also spent as much one-on-one time as I could with Maddie, knowing I wouldn’t have as much time soon.

As soon as I hit 38 weeks I just couldn’t take it anymore. I wanted to be done with being pregnant so badly. Very early Wednesday morning I woke up to a pop. I managed to get to the bathroom before I released a good bit of amniotic fluid. Then I hobbled up the stairs, with fluid running down my leg, to the birth bag to grab one of the adult diapers we had bought for just such an occasion. I debated telling Chris what had happened. I was afraid he would get excited and not be able to sleep. I knew I needed to sleep as much as possible. He woke up when I laid down though, so I told him. He didn’t seem to have any trouble going back to sleep.

I was really surprised when I woke up that morning. I had slept almost all night. I was having some contractions, but nothing serious. I was in very early labor. Chris called in to work and started his paternity leave. He had two weeks.

Nothing really happened on Wednesday. I saw the chiropractor in hopes it would get things moving. But nothing. I went to bed that night, expecting to be up in the middle of the night sometime, but woke up Thursday morning to the same few contractions I had gone to bed with. Maddie had a gymnastics class Thursday night, and we took her to that. Other than my waters continuing to leak, not much was going on with labor. Sometimes I would have several hard contractions back to back, but most of the time they were very light and irregular. I was really working with my optimal fetal positioning (OFP) postures, but the baby seemed perfectly positioned. Perhaps she was asynclitic and I couldn’t tell, I don’t know.

Thursday night (and each night after) I woke up and was awake with contractions for several hours. They weren’t bad, I didn’t need to breathe through them, but I couldn’t sleep. So I sat in my chair, leaning forward for OFP, and watched TV, surfed the internet, or just sat in the dark, talking to my baby. Eventually they would slow down, and I could go to sleep.

By Friday, I was getting pretty worried that we would use up all of Chris’s paternity leave before the baby came! I was getting very anxious and feeling the stress. I wasn’t worried about us physically, I was monitoring my temperature for signs of infection, staying hydrated, and baby was moving frequently. On Saturday, we went and walked the mall for several hours. I had quite a few contractions that I had to stop and breathe through. I could also feel the baby finally move into my pelvis. When we went home, I was tired from so much walking, but it was a good tired.

I woke up at about 4:00 in the morning with contractions that were regular and required my attention. I sat by myself for a few hours waiting to see if they would go away. I wasn’t timing them, but I would guess they were about seven minutes apart. When Chris and Maddie got up, I did regular morning things in between contractions.

By early afternoon, the contractions were about five minutes apart and I wanted to go down to my “nest” in the basement. I took a few of my favorite movies with me, the ones I know by heart and don’t mind missing chunks of, because I couldn’t concentrate on anything during the contractions, but I was fine between them. I spent all afternoon and evening watching movies and rocking in my rocking chair. I would get up and stand, leaning slightly forward (OFP!) and sway my hips during the contractions. Chris brought me dinner. I wasn’t hungry, but I made myself eat because I knew I still had a long way to go. I was making myself drink water, too, because I wasn’t thirsty.

Once Chris had Maddie in bed, he came downstairs with me. I kind of expected things to pick up right away, but they seemed to stay exactly the same. About five minutes apart (we never did time them, but it seemed about five minutes.) and I had to work through them, but they weren’t awful. I decided to get in my birth tub, mainly because I thought things might slow down and I could get some rest. As soon as I got in the tub though, things really got into gear. The contractions started coming every two or so minutes and the were really hard to get through. It took everything I had to concentrate on relaxing and moving so I didn’t feel like I was going to rip apart. They weren’t painful, but I felt like they were washing over my head and trying to drown me. I had to spend all the time in between contractions preparing myself for the next one. I made Chris turn off the TV because it was irritating me, distracting my focus. Poor Chris was rushing back and forth making me drinks and snacks in between contractions and holding me and talking to me during them. We did this for hours.

It was getting on towards Monday morning when I had a slight urge to push. It was very small, not at all overwhelming like I expected, but I was so anxious I pushed anyway. I pushed for maybe three contractions when everything stopped. My contractions went down to about every twenty minutes. And they started to really hurt. I had been in labor for over 24 hours now and everything was just stopping? I was so frustrated I couldn’t stand it. I got out of the tub and walked around, just paced the basement, trying to get something, anything, started again. The few contractions I was having hurt so badly. I had promised myself that I wouldn’t let a fear of taking pain medications at home cause me to transfer to the hospital. I had Chris go get me the Percocet I had left over from my cesarean. I took one and tried to sleep. I would just get to dozing when a contraction would hit, and I would be totally unprepared for it. This made it so much worse, and the medication didn’t seem to be helping the pain at all.

As soon as it was 6:00 am, I called my friend Shannon. Somehow we got disconnected, and I waited for awhile for her to call me back before I realised we hadn’t turned the phone ringer back on. I called her again. I don’t remember a single word of what she said to me, but I will never forget the sound of her voice. By the time the phone call ended, I was contracting regularly again. They still hurt, and I was dealing with them on my own now because Maddie was awake. Chris was doing his absolute best to be there for both of us, but he couldn’t be everywhere. Without him reminding me to eat and drink, I stopped doing it.

By noon, I was still contracting about every five minutes, but I wasn’t making any progress, or I felt like I wasn’t. I decided it was time to go to the hospital. I knew I as going for a repeat cesarean, but at the time, I was very at peace with that. Something was obviously going on that was preventing this baby from being born. I was ready to go. Chris tried and tried to talk me out of it. Reluctantly, he started getting Maddie ready to go.

She threw the biggest fit I have ever seen a child throw. Every time he would get her shirt over her head, she would rip it off. She was kicking and screaming and hollering. Meanwhile, I was pitifully attempting to get myself into some sweatpants, but I couldn’t manage to get my feet into the legholes with my big old belly. It was funny then, but it is hilarious to me now.

It took until 3:00 to get everyone ready to go. Three hours! I realised at the last second that I needed to call my friend Meredith to pick up Maddie. I called her at work, feeling so guilty, and asked her to meet us at the hospital. Then we headed out. The hospital was maybe 10 or so minutes away, but we hit every single red light. Chris was talking about how he was never doing this again, he was getting a vasectomy. All I could think about was if it was too late to get into the CBAC session at the upcoming ICAN conference.

We finally got to the hospital, but we didn’t know where to go. We stood and waited, me contracting all the while, in a long line at the information desk. Finally we got pointed in the right direction. I was warned that it was a pretty long walk and was offered a wheelchair. I wanted to get into that wheelchair so badly. But I couldn’t. I don’t know if it was my ICAN “brainwashing,” sheer stubbornness, or divine intervention, but I could not accept that wheelchair.

I started the long walk down the hall. And it was a long walk, even when I walked it again a few days later, not in labor. I had to stop what felt like every three feet and tense my whole body into the contraction. It was the only way I could get through it without screaming, and I couldn’t scare Maddie like that. Eventually we got to the elevator that took us to the “birthing center.” It was really only a labor and delivery floor in a hospital, but I guessed it just sounded better. I walked up to the nurses’s station and waited for someone to notice me. There was another woman, who appeared in early labor, walking the hall. She looked frightened when she saw me.

It took me three contractions to even tell the woman at the desk my name. She asked if my water had broken and when. When I said, “Wednesday morning,” I thought she would have a heart attack. She told another nurse to just show me to a room. They didn’t need to bother with triage as it was obvious I was in advanced labor. I was actually in or nearing transition, but I didn’t know that then.

We were shown to my room and left alone for a few minute while the nurses got together whatever they needed to get. My friend Meredith showed up for Maddie. I could see in her eyes that I looked like hell. I thanked her for picking up Maddie and getting there so quickly. She knew that things must be bad for me to be at the hospital, so she leaned over and said, “Remember, all that matters is a healthy baby.” I hate that phrase, but I knew she meant it in all love and kindness. She left then, with my little girl.

The nurse came in and asked me to give a urine sample, which I couldn’t do and gave me a gown to get into. I was actually grateful for this because my pants were getting very wet. I hadn’t been able to get anything on underneath them. She said something about needing to do a speculum exam because my waters were broken. I was to far gone to even care, though normally I wouldn’t allow something like that. Once I got into the bed, though, it was obvious I didn’t need it because all she had needed was to make sure it was amniotic fluid with one of those little tester papers, and I was leaving convenient little puddles everywhere. All she had to do was touch me with the paper and it turned color.

The nurse taking my history asked about my previous birth. I mentioned that it was a cesarean and she looked at me and said, “Oooohh… uhh… we don’t do VBACs here.” I think I snapped at her something along the lines of, “I’m a home birth transport. I wouldn’t be here if I didn’t need another cesarean!”

Once I was in bed and the monitors on, I was informed that the doctor on call, the one doctor I had seen prenatally, was going off call and was not going to help me. The doctor coming on call was in Racine, 10 miles away, seeing patients. I didn’t care.

I was checked, and found to be at 7 cm. Not that it mattered to me, I was having a cesarean now, and that was that. A nurse came in to put in the catheter. I asked if it couldn’t be done after I was given the anesthesia, and she said it was going to be a rush to get the surgery done before the baby came out on its own as it was, so she had to place it now. The statement struck me as odd at the time, but I was so convinced that my baby was simply not going to come out without surgery that I thought she was simply very mistaken. Now, looking back, I cannot believe the absurdity of that statement. We have to rush to do surgery, otherwise the baby might just come out!! It says a great deal about our medical system.

Having that catheter placed without the anesthesia was awful! Beyond the pain of getting it in, which was excruciating, I could feel it all the time, and it made me feel like I had to pee. It was awful.

I also got an IV of fluids, which I desperately needed, and antibiotics, which I probably didn’t, but which seemed prudent to do before surgery. I was tied to machines just about everywhere I could be.

Suddenly, the door opened and the anesthesiologist came in. He informed me that they were planning to do a spinal for the surgery, but the doctor was delayed and it was clear I was in pain, so they were going to give me an epidural now. I have never been so happy to see a man with a surgical mask! He ran down with me the risks of the anesthesia real quick, and then started to tell me why a repeat cesarean was more risky than a VBAC. My brain was so conditioned to expect the opposite that I just said, “Yeah, yeah, I know you think I was dumb…”

He got a little firmer with me then, to get my attention. “No. You aren’t listening to me. We are going to get this baby out before the doctor can get here. You do not want to deal with all the risks of surgery. You do not want to deal with recovering from that with a new baby. I’m going to give you just enough medicine to take the edge off, okay?”

I could not believe it. This man, this doctor, had just reminded me of who I was and what I wanted. I got the epidural, and sure enough, the next contraction had no pain. But I could still move, and feel (especially that damned catheter), and I had to breathe and work through the contractions. They were still really difficult and took a lot of effort, but the pain that made me want to scream was gone. I was so grateful to his man. And I don’t even remember his name.

He left and the nurse checked me again. I was at 9 cm! I couldn’t believe it! She told me to let her know when I felt pushy. I didn’t yet. There were two nurses in with me and one of them was talking about how she had used to work at a hospital that had VBACs all the time. The other said something about how she wished she saw more of them. I couldn’t believe my luck, being surrounded by supportive people. They also placed an internal monitor on the baby. I only agreed because it seemed like the only way I would have the vaginal birth I desperately wanted now. Even then I could see the irony of that monitor. The one piece of equipment I had had my cesarean to prevent my first baby from having, I was now willingly using on my second. I felt like I was allowing her to be hurt to save myself. But at the same time, I knew a cesarean would be worse on her than the monitor, or that’s how I justified it.

The doctor on call walked in about twenty minutes later. I had the courage and the strength I needed back now and I told her I would not be having surgery anymore. She tried her best to talk me out of it, talking about how there was a serious risk and how I may have read studies, but didn’t know everything. I was telling her numbers, like a 0.5% chance of rupture, and all she kept saying back to me was that I couldn’t know everything. I was actually enjoying sparring with her between contractions. Chris said he thought she was being very obnoxious and coming on very strong, but I thought she was doing a very poor job of “convincing” me. I was actually a little disappointed when she finally said, “Well, you are the boss, and I have to do what you say, so if you sign these forms (the Against Medical Advice, AMA, papers) I can’t say anything about it.” because it ended my fun. I signed the papers at 5:03 pm.

I asked the nurse about delayed cord cutting. She looked at me in horror. “The baby could bleed to death if you don’t cut the cord right away!” I wanted to push the issue, but how do you undo that much misinformation so quickly?

I started to feel a little pushy soon after she left and I called the nurse. She said I was 9 and a half. Really, I just had a small lip. It probably would have gone away if I had gotten on my knees, but I was so tired and didn’t even think of it. I was able to not push with the contractions and so it wasn’t a problem. I wasn’t really keen on the idea of pushing on an incomplete cervix, even if it was almost there. The urge to push got steadily more intense and I called her back again and again. Eventually I had no control over the pushing my body was doing. The nurse rushed in and told me the monitors showed I was pushing. Duh. She checked again and it felt like she wiggled that last little bit of cervix around the head. She pronounced me complete and started setting up the stirrups. I asked if I had to push like that, and she (genuinely, not rude or facetiously) asked how I would prefer to push. Ten seconds earlier I had wanted to be up on my knees, but at that moment, my brain failed me. I said I didn’t know.

I got all set up and pushed with the next contraction. Immediately, the baby’s heartrate did all kinds of crazy things. I was taken out of the stirrups and laid on my right side. Her heart rate immediately improved. I was warned not to push, but I couldn’t help it. I really did try, and it seemed her heart was fine with what my body was doing when I couldn’t fight the urge hard enough. I couldn’t feel it, but she was moving lower and lower. I didn’t need to be checked to tell. It was obvious when it was finally time for me to really push.

Chris says that from this point on, her heart was always fine, but that was not my truth at the time. I will tell the story as I lived it. My contractions were one on top of the other. I wasn’t getting any break between them. The doctor came in and told me that if this continued, and her heartrate didn’t improve, they were going to need to “take me back,” which I understood to mean “to surgery.” There was talk of giving me Trebutaline, to slow the contractions, but slowly, I was getting just enough space between them for the baby’s heartrate to recover. Eventually, though, it became time to just get her out. The stirrups came out again, but my legs were held so far back that I didn’t even touch them. They were really nice to have to rest in for the few seconds between contractions though. Chris was standing on one side holding one leg, and my nurse on the other. I pushed like my life depended on it, because I felt like the baby’s might. The dotor was trying to direct my pushing, but I couldn’t make sense of it. Push one I directed towards my vagina, and it was like pushing on a wall. Push two was directed towards my rectum, same thing. Push three, I tried pushing towards my sacrum. I could feel it working now! Suddenly I could feel the ring of fire starting to burn. I still had the presence of mind to think, “Wow! That hurts! But I am so glad I can feel it. I am so glad the epidural didn’t numb it away.”

During the moments between pushes, I would look up at Chris’s face. He was watching our baby be born, and I was seeing the birth on his face. After each push, the look of awe grew. I’m so glad I didn’t have a mirror, or I might have been looking at that and missed those looks.

At some point I yelled out between pushes, “Nobody announce the sex of the baby! I want to see for myself.” The doctor repeated my request to the other people in the room. I was aware of Chris and the nurse, and only vaguely aware of the doctor and a pediatrician and his nurse. I got back to pushing.

I pushed right into that ring of fire. It hurt, but I found it oddly pleasurable to push to the limits of that pain, to feel myself stretch that far. I felt like I was going to rip in every direction. Suddenly, I pushed past my limits. There was a blinding pain and I let out a horrible, loud whimper. The sound of it still echoes in my ears. All of my pushing power deflated.

I gathered my breath to push again when I heard the nurse holding my leg say, “Stop pushing, we have to suction.” I was confused for a moment, and then it slowly dawned on me. “The head is out?” I asked quietly, then louder, “The head is out?” The nurse assured me that yes, the head was out. It was in that moment I realised that I was still waiting for the general anesthesia mask to come into view. I had still been sure that I would be rushed off to surgery. It was also the moment I realised that was actually going to do this. I was going to birth my baby!

I didn’t have time to dwell on it, though, because I had to push, NOW! I felt her shoulder slide under my pubic bone, and then blinding pain as hands pushed it back. It felt like there were five hands inside me (it was actually three), yanking on that shoulder. It would have come fine on its own, but now it was a bit sticky. I tore badly. I felt the baby kick me as the body and legs slid out.

I opened my eyes just in time to see the doctor hand the baby to the pediatrician. “We have a girl! Chris, we have another little girl!” I was thrilled. A HUGE roar of cheers went up. I was unaware of it, but Chris said there were at least thirty people in the room. It took me by surprise and I jumped. But I had other things on my mind. They had taken the baby (she still didn’t have a name) to the warmer. She didn’t breathe right away. I wasn’t really worried, I knew she’d be fine. She was. Someone called out the time. My little girl was born at 8:55pm on Monday, February 26, 2007.

Suddenly I couldn’t stop laughing. I wanted to cry in happiness, but I just laughed and laughed. i kept saying, “I did it! I did it!” over and over.

The doctor asked me to push one more time and the placenta plopped out. Then my baby was being placed in my arms. Typing it, it seems like it took a long time, but really, it was maybe three minutes. Everything was happening so fast. I hollered at Chris to grab the camera.

He took several pictures, and I got a nurse to take a picture of him holding the baby. The doctor started stitching and I felt every stitch. Chris left to go get Maddie. I felt odd that he was leaving so quickly, and he felt like I was pushing him to go get her. So, a bit of a miscommunication there.

Emily weighed 8 pounds, three ounces. Madelynn had weighed six pounds, fourteen ounces. So much for my small, deformed pelvis!

Slowly the ruckus quieted. The doctor finished stitching and left. I noticed the placenta in a bucket and asked the two nurses left in the room to show it to me. They not only showed me, they took a couple pictures for me. I didn’t touch it, and I wish now I had, but I didn’t think of it at the time. I realised I was ravenous. I asked one of the nurses if I could get something to eat.

I also had to pee very badly. I wasn’t supposed to be able to get up so quickly, but the nurses helped me. They also disconnected me from everything except the IV. I was getting some pitocin to help my uterus clamp down as I was still bleeding a good bit. Not horrible, but enough that I felt the pitocin was prudent.

Chris came back with Maddie, who was very tired. We called all of the relatives to announce her arrival! We visited for awhile and then we decided it would be good for Maddie to sleep in her own bed that night, even though everyone was welcome to stay. The hospital’s policy on other children is “Whatever you want.” Maddie stayed the second night with us.

I was alone with the baby. That was probably a very bad idea. I was so tired. All I wanted was to sleep. She nursed for forty-five minutes the first time. After that, any time I moved, she would cry. She did not like having her center of gravity disturbed. It was so bad that if she fell asleep when I was mid-step, if I put the other foot down, she would wake up and cry. I walked her as much as I could, but I had to try to rest. I sat down on the bed and was bouncing her in my arms. I fell into a microsleep and woke up just in time to see her roll down my body and towards the edge of the bed. She stopped millimeters from the edge. I was terrified and I wanted to send her to the nursery, but I couldn’t bring myself to do that. I put the bed in a recline and put up all the rails. Finally I was able to get a bit of sleep. It was only an hour that night, but it was something.

The next morning I was able to really appreciate where I was. My room was huge, and private. The nurses left us almost completely alone. In the bathroom there was a huge, jetted tub for water labors (I don’t know if they actually have people birth in them, but for sure they labor there). It had room for three grown people in it! The shower was big enough for at least two. It was so nice to have a shower that morning once Chris brought me some clothes and shampoo. Really, the rest of our stay was like being in a fancy hotel. Even the food was good. I could order anything I wanted off of the “room service” menu. Even the fresh green beans really were fresh!

We named the baby that afternoon. We had been considering Chloe, Ainsley, and Emily. She just looked like an Emily. We chose her middle name, Michelle, because it is Chris’s sister’s middle name.

Every time I looked at Emily’s head though, I felt sad. I would see that scab and cry. I felt like I had betrayed her for allowing that monitor. It is one thing I would love to be able to change. She will probably carry that scar forever. Was it fair for me to avoid my scar by inflicting one on her?

We went home after 36 hours in the hospital. As nice as it was, I couldn’t wait to be home.

Originally posted on Birth is Life