At about 6 months gestation, I went to the E.R. for what I thought was premature labor. My previous pregnancy had resulted in a miscarriage so I had some cause for concern. After plenty of testing, the results were inconclusive. I was having some fierce abdominal pain that we could not identify. I went home that night and started looking online. It turns out that quite a few women with a history of c-sections have pain from their scar tissue being twisted and tugged with successive pregnancies. Yup, that was my problem. That damned scar tissue.
So what was supposed to be a “routine and scheduled c-section” turned out to be the worst possible thing in the world for me long term. I knew how to undergo one, how to recover from one, how to attempt to bond with my new baby despite being ridiculously out of it but this issue with the scar tissue and with possibly forming more of it once my peritoneal cavity was opened up again scared the living crap out of me.
I work in the medical field as a social worker and when I told my peers about my concerns they laughed them off, reporting that they (as nurses and physicians) had had “multiple c-sections” and that it “wasn’t a big deal because it wasn’t child birth.” Their point of view, as medical insiders was that babies were something that you scheduled when it was appropriate for your work schedule.
So now the “routine and scheduled c-section” looked a little more against the grain for me.
I began looking back on my original birth plan for my first baby, the emergency c-section baby, the one who started all this fervor over my birth choices… I had wanted a natural birth, had pursued Lamaze and some other techniques, but when push came to shove (literally) his position was off, he started registering as distressed, and after 8 hours of labor they cut him out of me.
I began looking online again, this time at VBAC alternatives (vaginal birth after caesarean). The first thing when you start examining VBAC options that pops out at you is the warning of uterine rupture – something that many practitioners warned women about and started the convention of repeat caesareans so as to avoid. In other words, there have been instances where the caesarean incision line has given way and the mother and baby’s health has been jeopardized.
But I knew my scar tissue… It was ridiculously strong. That was the mantra that I kept repeating throughout the process that I was about to undergo.
That my past experiences would give me the strength to get through whatever was barreling down the pike at me in 3 months time.
I enlisted the help of a monatrice, or doula that specializes in VBACs, who also had her midwifery training. She advised me to consult with a physician with a better VBAC record than my current practitioner. So at 7 months gestation I switched OB-GYN practices to be followed by a physician with one of the best VBAC positive outcomes in town. I was given a wealth of information by his practice, was made to feel very confident about my decision.
I met with my monatrice throughout the last few months of my pregnancy to address my birth plan and the process of applying my plan for a natural, drug-free birth. I was instructed by my practitioners that one of the best ways to assure a laboring mother with a history of c-sections that everything is “okay” is to go without an epidural so as to remain aware of where the labor is emanating from. A major alert that something is “not right” would be if the laboring mother were to feel an intense amount of pain from her incision site. If that were the case, then a VBAC were unlikely and a repeat caesarean would be undergone to prevent the mother and baby from harm.
My monitrice played a huge part in the success of my birth, I have no doubt.
My first time with the emergency c-section was a 3-ring circus in so many respects, most notably being my lack of labor support, through my own lack of planning. I now recognize that every laboring mother needs a support person who knows the process of birth and is unafraid of it, someone who is a professional in the sense where the mother is not concerned about their well-being or “protecting them.” Amy, my monatrice was just such a person. She was and is well-seasoned, gutsy, worldly, and pretty effing fearless.
At 37 weeks, we had a bit of a surprise. Our great VBAC outcome OB was leaving the practice. The physician who would take over the birth was extremely experienced but not a “VBAC guy.” There were nurse-midwives affiliated with the practice but they did not have their VBAC accreditation, as of yet.
“Great…” I thought. “Awesome. I’m full term and I don’t have a doctor to deliver this baby if something goes wrong.”
I had planned for a hospital birth after laboring as long as possible at home. We had rented an Aqua Doula heated tub and had set it up in the dining room for when the time was right. I wanted to get to 7 cm and then head to the hospital because despite working in a hospital, my perspective as a patient remains freakish when attended by multiple folks in scrubs.
So now my birth plan was coming into question again. However, there was a chance that the nurse-midwives would get their certification approved in time to deliver my baby in the manner that I wanted. It was just a question of paperwork.
“Hold on, little guy, just hold on!” I tried to convince the kid to stay as long as possible despite my ever-growing lack of sensation below the pelvis, increasing heart burn, and evil attitude toward everything that was more mobile than I.
For some fantastic reason the nurse-midwives got their paperwork approved and the attending physician who had taken over my care consented to the nurse-midwives delivering my baby when the time was right. Amy and I were thrilled. I would say that my spouse was thrilled as well but he had no idea what any of this stuff meant other than his “hippie wife” was doing “crazy hippie shit” with regards to the birth of our second son.
I didn’t care what my husband thought as long as he didn’t get in the way and I told him as much. I suppose that is the difference between this birth and my first. My first had gone so horribly awry despite my best intentions that this time I was not going to focus on anything other than getting this kid out in a way that was appropriate and healthy for him. Everyone else in the 3-ring circus could pop in and put in their 2 cents when the show was over. For the labor and birth, this show belonged to me, my monatrice and my new nurse-midwife, Emily.
And it was an awesome show, at least for me.
We were a day over due and I was getting increasingly evil and uncomfortable so I consulted a chiropractor who specialized in pregnant mothers, at Amy’s suggestion. She must’ve done something magical because 30 minutes after my appointment finished, I was having productive contractions in the middle of a café with my mother. I sat down for a couple of hours in the café and worked through most of the contractions. I drank a ton of orange juice and water knowing that I was “in it to win it” and that these contractions were going somewhere (increasing intensity, increasingly regular). My mom drove me to pick up my 3 year old who we then dropped off at my sister’s for the evening. We then went home where I labored until I got to 3 cm while cleaning my bathroom and finding obsessive compulsive tasks to do. Amy got to my house at about the same time my husband did and relieved my mother. We set up the tub and I got in, working to 7 cm with the help of the warm water and changing my position quite a bit. This little baby was a lot like his brother- not quite anterior enough – and I was having a good deal of back labor. Reflecting back, I spent most of my labor on all fours or hunched over some pillows in an attempt to get him to move into position.
We arrived at the hospital at 7 cm where I crumbled into a little heap in the waiting room. There was someone else’s large family waiting for a baby to make her arrival who saw me and I suspect I caused them a little concern, but I didn’t care. I was hurting, I was doing this “au naturel” and they could mind their own beeswax.
We got back to our room at 11 pm and Emily, my nurse-midwife, was waiting for us. She was there, with us, for the entire labor along with Amy. My mother and spouse sat in chairs on the sidelines, amusing and distracting each other. It was Amy and Emily who were in the trenches with me, that was what I wanted, how I felt most comfortable. My mom and husband would pop over to me to offer a word of encouragement every half hour or so but they understood that they were not responsible for the birth of the baby and I think it was a welcome relief to them.
I soon got into the birthing tub in the hospital room and was hooked up to the telemetry monitors to make sure that the little guy was okay. He was still out of position and I was starting to panic with the increasing contractions. I began questioning whether I “needed an epidural” but the warm water helped once more, Amy and Emily reassured me once more, and my water finally broke. Things started rolling a little faster now. Thank God.
I got into the bed and hunched over it, grunting my way through each contraction. I began feeling the urge to push as this incredible pressure began moving its way down (the baby’s head). I felt this weird ferocity in the center of my being as the pressure increased. The ferocity was coming face to face with my fear of the birth spinning out of control and helped to quell it. The ferocity devoured the fear, for the most part. There were a few times where I said crazy things, especially when monitors began malfunctioning and the hospital staff started invading the space increasingly questioning whether everything was “okay.” At several points during the birth, Emily had her methods questioned, but, held her ground and kept her “game face” on. I felt no indication that she was anything less than perfectly competent.
The baby began going into distress and Emily placed a monitor on him internally. I saw the monitor dangling out of me, just like my first baby had and began to panic. Amy and Emily pulled me back down to earth and had me touch my baby’s head. He was right there. We were almost there.
The supervising OB was paged, there were some concerns that the baby would not get out without a vacuum. Emily took one last look and said, “Alright, we’re going to do this, we’re going to give this one last shot.” She directed me to lie on my side and pull my leg into me while pushing. She would force the last centimeter of my cervix open and pull the little guy out if we could time the push correctly. That was the plan. And that’s what we did. She plopped him on my chest and I was in complete shock.
By 1 am, after 10 hours of labor, I had gained a baby, a placenta, a 2nd degree episiotomy, and a sense of satisfaction I’ve never known.
My husband looked at me like I was from another planet. “You did it,” he said. “I can’t believe you did it.”
My mom was taking a million pictures. I felt very little pain. My body had done what it was designed to do. My uterus was a miraculous thing. It had been cut in half in another lifetime but lived to push a baby out. It was the muscle that wouldn’t die. Amazing.
My hospital stay was brief. I stayed for one day and went home, quite happily. There was no reason for me to stay, in my mind, I had a three year old excitedly awaiting the arrival of his baby brother, and no need to be administered pain meds so what was the point?
I did enjoy the brief respite for that day at the hospital. When my husband went home to take care of our 3 year old, I wept with relief and gratitude for how dignified and loving my experience had been.
I watched my baby look around with alert eyes, watched him feed more than adequately, held him constantly. I felt the ability to attach to him increasingly as I wasn’t battling an exorbitant amount of pain and the meds that came with it.
I do not have plans to have any more children but if I do, I now trust my ability to do so. I trust my body, I trust my mind. I trust my Higher Power who was resolutely available to me the entire time.
We’ve gotten many positive reactions, most notably my 84 year old grandmother who enjoys showing the now 10 day old baby off to the other folks at my grandfather’s nursing home. She likes to announce that the baby is a product of “a natural birth” to anyone who will listen – aides, techs, physical therapists. Everyone knows.
My sister-in-law, who was present for my first birth had an equally great reaction when we told her our story. “You had a VBAC with no drugs and no epidural? Women don’t do that!!”
Yes they do. I did and I’m not a superhero. I am one of many. But a woman needs support to do it.
Thank you Amy.
Thank you Emily.
We couldn’t have done it without you.