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Isha’s Birth: From ERCS to unmedicated VBAC

From the time my husband and I learned I was pregnant with our second child, we began discussing whether I would opt for the repeat c-section or go for the VBAC. My daughter was breech during my first pregnancy, which led to the c-section.   I had been planning throughout my first pregnancy that I would have a natural, unmedicated child birth, and had done all I could to prepare for it. As my due date was approaching, and she was still breech, I was doing everything I learned about to get her to turn – chiropractic work, acupuncture, hanging upside down, and an external version – but she never budged. I was incredibly disappointed once I realized the c-section was inevitable. In the end, however, it really wasn’t all that bad. That is what made it difficult when it came to deciding what I would do for my second pregnancy.

About half way through my second pregnancy my husband and I decided I would have the c-section. It just seemed easier. We live about an hour away from the hospital, in a rural setting. My daughter is not a good sleeper, and still was sleeping with me. The idea of possibly getting her up in the middle of the night and bringing her to a friend’s house kept me up at night with worry. With the scheduled c-section, she could go to daycare, and my husband could be back in the evening to pick her up. I’m a planner, and knowing exactly when everything would happen was reassuring. The surgery was scheduled for June 8, 2012. However, in the few weeks before the surgery, I found myself hoping I would go into labor before the 8th, and decided that I would try and have a VBAC if that happened. Then a week before the c-section, someone asked me my reasons for deciding on the surgery. I explained my reasoning as I had with several others who had questioned why. This time, however, I felt different afterwards. My reasons no longer seemed justifiable to me. I started to realize that the potential benefits of a successful VBAC far outweighed the risk of my daughter having a difficult night, and the person watching her having an even more difficult night. The idea of not being able to pick up my daughter for awhile, and likely having to keep her away from me some of the time due to her always climbing all over me, was so sad and brought me to tears.

A few days later, I let my midwife know that I had begun considering a VBAC. The surgery was scheduled for three days later, but I let her know I still needed to think about it. She and the other three midwives at this practice (who I saw on a rotating basis) were all very supportive of this. From the beginning they let me know the risks of both options, but never seemed to persuade me in either direction. It seemed, however, that they were happy with the idea of the VBAC. The midwife I was seeing this day did an examination, and said the baby’s head was as low as he could go, which was a very good sign. That night I talked with my husband, and we decided that I would cancel the surgery.

A whole new set of worries began to emerge. I had done absolutely nothing to prepare for childbirth. I had done a lot of reading two years ago during my first pregnancy, learning about the Bradley method and techniques described in Ina May Gaskin’s book. I had no idea where these books were though, and didn’t remember many of the specifics. What I did recall from my reading, and conversations I had had with friends, was that relaxation was key. A friend talked about focusing on loosening any tension, and keeping her jaw and toes relaxed. I began to feel pretty confident that if I could simply focus on relaxing, it would be enough.

Fast forward a week and a half later to June 15.  I began having contractions in the early morning, which then eased throughout the day. They kicked back in that evening, and I was surprised at how much they hurt. I had thought that contractions typically began with slight discomfort, but not necessarily intense pain. Not the case for me. They hurt right from the beginning. They were coming every ten minutes or so and a few hours later my husband became concerned and wanted to go to the hospital. I told him it was way too early, but he insisted. He is after all a registered nurse, and he worried about the potential complications. So we left the house at about 1:00 in the morning. My mom was actually visiting at this point. She had bought her plane ticket a few months before, planning to be there shortly after the c-section. This worked out wonderfully, and we were able to leave without waking up my daughter. As we were driving, the contractions slowed way down, and we decided to get a hotel room near the hospital. I spent the night having horribly painful contractions every ten to twenty minutes. I was having the feeling of intense pressure with every contraction, which I attributed to him being so low. I of course got no sleep, but my husband did, which was a good thing. I needed him rested.

The next morning we decided to go walk around and see how things progressed. We spent the next few hours walking, going to a café, and visiting with friends we ran into. It was awkward having contractions while doing all these things, but I think I managed to hide it. Each time one happened, I would put my head down and focus on relaxing. My friend told me I could go to her house to hang out, because it seemed I likely had a long way to go. I declined, saying I wanted to keep walking. The contractions were coming every five minutes or so. At 11:30 I got a text from my sister, saying she had arrived at the airport. My mom was running late to pick her up, so we decided to go get her since the airport was a few minutes away. Sitting in the car was excruciating   garage for my mother to arrive. She picked up my sister, and my husband and I checked into the hospital. At that point my contractions were coming every three to four minutes.

When I got to my room, I was hooked up to a monitor and had to recline on the bed. My contractions slowed to every ten minutes. I looked at my husband, and had a feeling of defeat. I had heard stories of women showing up at the hospital and contractions stopping. I was worried of “failure to progress,” which would inevitably be followed by a c-section. I asked the nurse if I could stand up for a bit. Once I did this, the contractions picked right back up. She wanted to check how much I was dilated. After feeling she said she thought I was about 5 cm, but wanted to bring in another nurse to double check, because she could not be sure. The other nurse came in, checked me out, and said she thought I was about 8cm! They said I was completely effaced, and the head and amniotic sac were right there, making it somewhat difficult to measure me. They brought a telemetry monitor, which allowed me to be wire-free, and move around. I had asked for this when we first checked in, which was recommended by the midwife. They only had one, and I wanted to be sure to get it. After I was set up with the monitor, the nurse told me that things would likely happen soon, and the midwife was on her way. If I felt the need to push, I needed to let them know. I soon had an intense feeling of having to go to the bathroom. As soon as I sat down on the toilet, the feeling of needing to push overwhelmed me. I shouted to my husband that I had to push, and he went to get the nurse. About a minute later, as I came back into the room, I again had to push. At this point, the midwife arrived. She told me to go ahead and push if I wanted to when I had the next contraction. Over the next thirty minutes or so I pushed with each contraction. I was having a very difficult time finding a position I liked. I couldn’t squat down at all because the pressure was way too intense and painful. Bending over and holding onto the bar on the bed wasn’t working. Panic was beginning to set in a bit. I began to think to myself, and I think I said it aloud, that I could not do this. What was I thinking?! I should have prepared for this. I should have gotten an epidural! This is too much pain, and I still have to push him out! I am usually a pretty quiet person, but that was not happening here. Yelling and groaning was the only way I could find any sort of relief from the pain. Finally someone suggested I get on the bed on my side.  This position was much more manageable. My husband held one leg back for me, and a nurse held the other. The midwife broke my water at this point, and I heard her quietly say “meconium.” One of the nurses got on the phone for the NICU nurses and a physician to come to the room. The midwife told me I was crowning and I needed to push harder. She or one of the nurses told me that there had been meconium in the fluid, and depending on how he was and whether he cried when he came out, he may need to be taken the NICU. Concerned, yet needing to focus on getting him out, I gave a big and oh-so-incredibly-painful push and the head was out, another push for the shoulders, and then an amazing feeling of release as the rest of him came out. The midwife put him on my chest where he rested for a few moments. The nurse apologized as she took him from me, saying they needed to evaluate him. He let out a sweet adorable cry. They expressed minor concerns about his rapid breathing, but all was good. My baby boy was born at 3:28 pm on June 16, 2012 (two and a half hours after we checked in.) He weighed nine pounds, three ounces, and was twenty-one and a half inches long!

The difference in recovery, as compared to my c-section, was night and day. I was able to get up and walk around soon after birth. There was, and still is, definitely pain going on, but it has been manageable with just ibuprofen. I didn’t have nurses coming into the room every couple hours throughout the night to check on me and give me medication. And I was able to leave after 24 hours as opposed to three days. Best part though was being able to pick up my daughter the next day. That was what had inspired the change of plans, and one of the best decisions I have ever made.

Looking back on the experience, there are a few things that I feel made the VBAC successful. The first was walking. I noticed that when I lied down and sat down the contractions slowed. If I had gotten an epidural, I would of course had to be lying down, and I believe things would have gone very differently. Having the telemetry monitor, which allowed me to walk around was also key. I again feel that things would have been different had I been confined to the bed to be monitored. Waiting as long as possible to check in at the hospital was also crucial. Again, I was only there for two and a half hours before my son was born. Finally, having the support of my husband made it all possible. Without him, I don’t think I could have done it.