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Elizabeth’s VBAC

My story begins in March of 2008 with a positive pregnancy test for my first baby, which readers of the ICAN blog should know by now ended in a c-section. To cut to the chase, this c-section  in December of 2008 was horrific. I had labored for 40 hours, something like 30 of those narturally. The anesthesia failed. I felt nearly everything. I begged and pleaded for the surgery to stop. No one showed my son to me until my doula shouted across the OR, “SOMEONE BRING HIM OVER RIGHT NOW!” And the first time I saw him, he was swaddled in a blanket with a hat on his head. I have no idea what he looked like naked and gleaming in vernix.

Then there was the aftermath in the hospital. I was admitted on a Saturday evening. I didn’t get to shower until Wednesday. A nurse asked me questions pertaining to a vaginal birth because she mixed my chart with that of someone across the hall, and she asked how my son was recovering from his procedure — my son didn’t have any procedures. It took a few minutes for us to realize she meant a circumcision, which we did not elect to do for our son. I had people in and out of my room constantly, taking my temperature, giving me pain medications, asking me how I was feeling. I wanted to be left alone.

What followed leaving the hospital is a story in of itself, suffice to say for this story’s purpose that I was later diagnosed with Post-Partum Depression and Post Traumatic Stress Disorder. I wasn’t able to nurse my son, which I worked incredibly hard to do and failed to do at every turn. I had pain for close to a year that my OB refused to listen to, and each time I tried to talk to my OB about what had happened to me, she made the conversation about her.  She gave me a 50% chance of ever having a VBAC, and I gave myself a 0% chance. Because I decided not to have any more children.

The c-section I underwent didn’t affect only me, but it affected my family. It affected my husband. It affected my relationship with my son.  I was afraid of sex because I was afraid of getting pregnant.  I had therapy.  It didn’t help much. Time passed. It didn’t help much.  I eventually came to a position of resignation. I resigned myself to having only one child. I resigned myself to having fell on the wrong side of all the statistics. And I convinced myself I could move through my experience, not past and not beyond. That was supposed to have been that.

We spent the Christmas of 2010 with my in-laws. We had driven the eight hours down and spent an entire week with them. Halfway through that week I found myself incredibly tired even though I was sleeping well and my son was sleeping well. He had only become a good sleeper a few months before his second birthday. On New Years Eve, we made the drive to a friend’s within two hours of our home in order to spend New Years with him. I spent a portion of the car ride telling my husband I was so tired, I couldn’t even keep my eyes open. “I don’t understand why I’m so tired! I’ve slept plenty!”

When we arrived home on New Years Day, I felt I had been struck by a lightning bolt. I hadn’t had a period in December!  Soon as we got home, I fished out a pregnancy test from when we had my son — apparently some brands don’t expire for three years! It was positive. So at about two on New Years Day 2011, I learned I was pregnant again. Something I didn’t think I could face. I came out of the bathroom, holding up the positive pregnancy test, and said to my husband, “This is why I’ve been so tired.” He looked at me with that confused look only a husband can give, “Really?”

I was not prepared for this.  I didn’t really know what to do, and I think an instinctual drive to just do something kicked in because I found myself saying we should pick up some more pregnancy tests just to make sure and we should probably get some prenatal vitamins. I spent the next three weeks saying things that necessitated telling my two year old that, “Mommy didn’t say that!” I told my husband if, IF we had this baby, it wasn’t going to be in a hospital. He said okay. I told my husband I didn’t even know if I could have this baby. He said okay. I told my husband I didn’t want our son to be an only child. He said okay. I told him I didn’t think I could do this again. He said okay. While I was going crazy with fear and doubt and weighing what my family, not just me but my family, had gone through after my c-section, my husband was trying to contain his overwhelming joy at having another child. But he knew I had to come around in my own time. He never put any direct questions to me about my intentions with this pregnancy, and he supported whatever decisions I made.

About two weeks after receiving the positive pregnancy test, and while still saying things that should not be said in front of a two year old, I began looking for homebirth midwives. And I knew I had found mine the minute I landed on her web page. She had a particular passion for VBACs. She had studied at Maternidad La Luz. She viewed her role in midwifery as practical. Her webpage contained very little about trusting birth, trusting one’s body, and a lot about how having a homebirth is just, well, giving birth. It was the most practically minded approach to birth I had seen, and when I interviewed her in late January, it reaffirmed that she was midwife. She informed she had an excellent student midwife in mind, and would I mind if she too followed my pregnancy? I did not mind one bit.

I will skip over a good portion of my pregnancy and come to 36 weeks. We had learned at the 20 week ultrasound that my placenta was anterior, which just killed me. If the placenta adhered to the scar, a condition called placenta accreta, I’d have to have another c-section. At 36 weeks, we learned the placenta had not adhered to my scar. Phew! Then I had the GBS test, which came back positive. My midwife went over all the risks and the various options. I could still birth at home and follow a hibiclens protocol that she used, or I could transfer to the hospital. I was dismayed by this because with my son I had been GBS negative. I weighed the risks of the hospital for me against the birthing at home GBS+. Other mothers would have made a different decision, but the thought of the hospital upset me so much that I would shake. I just couldn’t do the hospital again. My husband, who is a chemist by training, is very scientific minded when it comes to calculating risks, and he was fine with continuing on with our homebirth plans. That put me at some ease.

I had been having strong Braxton-hicks contractions for close to a month by then, but then they stopped completely. A few times I thought my water had broken. I had a sense that this entire pregnancy this baby would come before 40 weeks. My son came right on the nose on his due date. My due date this time came and went. Then I was 41 weeks. My midwives did a non-stress test. Then I was 41.5 weeks. On Saturday September 17th, I had my last prenatal. My midwives had reached out to a homebirth friendly nurse-midwife at our back-up hospital.  If I didn’t go into labor by Friday, we needed to have a back up plan in place. I couldn’t believe we had to have this conversation! Why wasn’t my baby here yet? What was going on that I hadn’t gone into labor by now? My midwives did a vaginal check and swept my membranes. I wasn’t even one centimeter.  I was devastated.                  I was not going to be having this baby at home.

The following day, my husband and I were on our way to the grocery store before my son returned from his visit with my grandparents. The Nat King Cole song “Smile” came on the radio — “Smile, even though you heart is aching. Smile, even though it’s breaking” — and I began to ball my eyes out. My husband took one look at me and rather uncharitably said, “Pull yourself together! Nothing bad has happened yet. You still have time.” I asked him what if something bad did happen. He said, “First, you don’t know that it will. Second it, until it does, there’s nothing to worry about.” There’s that scientific brain at work! It certainly didn’t help me feel any better.

My parents dropped my son off around 2 or 3 in that afternoon. We took him to the playground, and almost instantly the contractions were back after weeks of silence! I called my midwife to let her know. But I hadn’t had any hope that they meant much of anything. They were just piddly little things, like the ones from before. Then at home, my husband made dinner. The contractions kept up. But still weren’t anything to write home about. After my husband put my son to sleep, I told him I was going to go for a walk. I didn’t want the contractions to fade, even though I doubted they were much of anything. During my walk, I stopped at every bench and did lunges. I walked fast. I walked slow. I texted a friend who had been labor stalking me who repeatedly wrote me encouraging things. Then I went home. My husband went to bed around 10 that night. I couldn’t sleep. Stupid contractions that weren’t doing anything.  Around 12:30, I told my friend, with whom I had been conversing via gmail chat, that I should probably get to bed but I just didn’t feel tired. I ended up staying up. Twenty minutes later, I peed myself. I ran to the bathroom and could not understand why I couldn’t stop peeing! Then it dawned on me. I asked my friend, “Does your water breaking feel like you can’t stop peeing?” With my son, my water had broken in trickles, so this was an entirely new experience for me. Her response? “YES! CALL YOUR MIDWIFE!!!!”

So called her I did. My midwife told me to try to get some sleep, but if I couldn’t sleep in half an hour to call her back. I then woke up my husband, told him my water broke, that I called the midwife, and that he should sleep while he could but I wanted to let him know what was going on. Half an hour later, I called my midwife back. She said they would be on their way — she wanted to shower first. Understandable. Nothing was going to happen for awhile, anyway.

My husband got up to get the pool ready — it was just this oversized kiddie pool, nothing fancy. But it didn’t come with an air pump, so he had to blow it up by mouth! At one point, I told him I didn’t care about the damn pool, I wanted him with me! He said, “If I don’t do this now, there won’t be a pool at all.” Damn scientific mind! But he was right. I ate a red popsicle and promptly threw it up. Then I got in the shower and began singing Gershwin songs. Seriously.  I was belting out “Embraceable You” for as long as I could. I was on my hands and knees when the door opened and the midwifery student was there, “Liz, how’re you doing?” I don’t think I had ever been so thankful to see anyone in my life. She asked me where it hurt. “My back!” She put her hand on my lower spine in the coccyx area, and I felt so much relief. Glorious relief!

Then I got out of the shower and put my bathrobe on. I stood against a wall and shouted, “WHY ISN’T ANYONE HELPING ME?!” By this time, my primary midwife had arrived and even in my labor haze, I could tell she had to try very hard not to laugh at me. She went about her business of sterilizing her tools while the midwife student took care of me. At some point, my back up midwife arrived, too, and the pool was ready to go. My husband stated later on that every time he went into the cellar — he had cleaned up a bunch of dirty clothes from the floor — another one arrived. “They just kept coming!”

I know that some number of women have this fear before going into labor, and I’m here to tell them not to fear it. What I wanted to do more than anything was poop! This meant the baby had descended and would be here soon. I kept begging to poop! I’d fall asleep between contractions and dream of poop! I wish I were kidding. But there it is. I had nothing but pooping on my mind. I felt this primal urge to get this thing out of my body now, and I began to push.  About this time, my son woke up at his usual time. My husband had called our kid-wrangler, but as we learned later, she took the day off from work and forgot to tell us so while he was calling her about the time she would be up for a work day, she was sleeping in. So when it became clear that my son was upset and that was upsetting me, my husband took him out to breakfast.

And I proceeded to push.

And push.

And push.

To no avail.

The baby didn’t come out.

So I pushed again.

And again.

And again.

I pushed in the tub screaming. I pushed in the tub holding my breath. I pushed. I told my midwife I wanted go to the hospital. She said, “We can talk about that after I check you after this contraction.”

“Liz, you have an inch and a half to go. You’re doing this!”

That was all the resolve I needed. An inch and a half! An inch and a half and my baby would be here!

So I pushed.

And pushed

And pushed.

And again.

And again.

And there was no baby. I pushed in all sorts of positions. Still no baby. With every contraction I began asking where she was. With every contraction I was told she was coming. I was told she was so close. Sometime my husband and my son came back, and my midwife said, “This is not a good time. Tell them to leave.” I learned later this had upset my husband some, even though he understood. He felt my son needed to see me and didn’t appreciate being ushered out of his own home. At the same time, my midwives knew how upset my son being upset had made me and that that would be one of the worst things that could happen to me now. So my husband and son left for the playground as I continued to push.

Shortly after this I heard my midwife speculate that maybe she had turned posterior and my heart dropped. My son had been posterior. Finally my midwives led me to the sofa bed in our living room, which was set up with clean sheets and a lot of pillows. My midwife said, “Okay. We’re going to push like we’re in the hospital. I want you to sit up and bring your knees in.” And I pushed this way. Continually. I kept pushing and I felt myself fall back against the pillows and all of a sudden I heard someone say, “The cord,” and suddenly a squirmy, purple thing was in the air above me and then on my chest. Before I could process what happened, a sheet was pulled over us and hat placed on my darling girl’s little head. We all admired her, and I can’t even remember what I said except that I was overcome with a joy I had never known, a joy I should have known with my son.

I asked what day it was because in my hazed mind I had no idea! It was Monday morning still! It was only a little bit past nine! It had only been 8 hours since my water breaking to when she made her appearance! I felt as if an entire lifetime had passed! I began asking where my husband was! The poor man had missed the grand event. My midwives and I called him repeatedly. I texted him to come home. Half an hour after our baby was born, he came back with my son. His phone had shut down on its own, and he only realized it when he pulled it out of his pocket to see if there were any updates! When he saw the, “Come home,” text, he immediately scooped up our son and did just that.

It took awhile before the placenta came out. My midwife had to do some traction on it, and finally what got it going was standing over the toilet. My back up midwife called the toilet magic. When nothing else works, the toilet does! I had an insanely long umbilical cord that had apparently been wrapped loosely around my daughter’s body and then halfway around her neck. Plus! Her right arm was across her chest and against her left shoulder, which is why it took 4 hours to get her out. Had she not been in that position, my midwife is convinced she would have flown out in no time at all. It turned out I didn’t even need stitches, but since I already had a toddler and would be up more, my midwives recommended I get the four tiny ones it would take. So I agreed to that.

After starting a load of laundry, seeing my daughter nurse twice, and making sure my husband knew what to look for in both of us, the three midwives left, leaving us a new family of four until our friend arrived a few hours later. I didn’t have hoards of people coming in to disrupt me. I didn’t have the beeping of machines to contend with. I didn’t even take any pain medication aside from cramp bark, which works pretty much like aspirin. In the afternoon light, I just got to look at my girl, nuzzle my girl, and keep her close to me.  I had my daughter. I had my VBAC. I had my homebirth.  I truly had nothing more to ask of life that day.