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Jeanette’s (nearly) 12 pound VBAC of Quinn!

Quinn Keith Albright

Born September 28, 2012 at 4:25pm

11 pounds 15 ounces

22” long

15.25” head circumference, 15.75” chest

 

Preface:
This birth was by me, for me.

 

This birth story is about me.  The mother of 4.  The wife of Aaron.  The woman of strength and self doubt.  Of determination and defeat.  Of love and broken heartedness.  My choices are my own based on knowledge and experience and instinct.
This birth story is NOT about me the birth worker, although I do know and understand the value that my births can offer others if needed.  I am an advocate for mothers and babies and the birth of their desire and my birthing experiences are beneficial in my teaching and educating however, I am not comfortable with words like Birth Warrior, Birth Goddess, Hero or Superwoman nor definitions like successful VBAC.  I am not a martyr.  I did not set out to try and impact the “system” or show the doctors I know best – I was just seeking the birth me and my baby wanted and needed.

 

More importantly, this birth story is about God.  And a journey.  And faith.  And the power of prayer.  And patience.  And humility.

 

My pregnancy:
 

Aaron and I always talked about wanting four children.  We gave it more of an adjustment period between baby #3 and this one but when we were ready the Lord blessed us with another healthy pregnancy after one month of trying.  We announced it to our family and friends through a Valentine advertisement in our local newspaper.  When we told the kids, Ethan wasn’t too thrilled at first about another sibling but Grace was wide eyed excited for a “Grace baby” (she wanted a girl and to name it Grace – when she understood we couldn’t give it her name, she started a campaign of princess names).  Weston finally understood there was a baby in my belly when my lap started to disappear.  For all of our babies, we’ve never found out the gender.

 

Without a doubt, I knew my goal for this labor and delivery was to have a VBAC (vaginal birth after cesarean).  My first 2 births were natural vaginal births and my third was an emergency cesarean due to a placental abruption.   I chose to stay with a hospital birth (my husband was a little leery of other options) and with the same care provider I’ve had with the other 3.  Even though I knew I could be facing some opposition to my VBAC goal and a more managed pregnancy and labor, my doctor had always honored my birthing desires and I was confident that we would be able to maintain a good relationship that would aid in me getting the birth I wanted.  Throughout the pregnancy, I continued to research and process the benefits versus risks of different scenarios for my situation and we were prepared with facts and documents that supported our decisions and we were confident in our choice.  To my surprise, I had to face some opposition from even family and friends to this path but I chose to make it an opportunity to educate and ask for support regardless and then I had to leave that aside so I could focus on a positive mental and emotional state to progress me towards my desires.

 

Using my last menstrual period, we had an estimated due date of September 11th.  My doc had me do an early ultrasound as I was measuring weeks ahead of that projection but when the ultrasound indicated a date within 2 weeks of my date, she left it as is.  Throughout the pregnancy, I had a feeling this baby would come sooner rather than later since it was my 4th and I was hopeful we wouldn’t be facing over due dates with the VBAC goal.  Of course, since all my other pregnancies carried up to 2 weeks over my estimated due date, I should’ve known better.

My pregnancy was challenged this time around by sciatica issues that affected my left leg and back.  I started under Webster chiropractic care at about 8 weeks and even though it was a long journey, I found relief from that pain at about week 30 of the pregnancy.  This was the first pregnancy where I got chiropractic care during pregnancy and I now am testimony of the wondrous things it does for good pelvic alignment and comfort that aid in your delivery.

 

Other than that, I was blessed to not be plagued with morning sickness (4 for 4) or heartburn.  I also only gained about 30 pounds this pregnancy (about 20 pounds less than all my others) and I carried this one so tight and up high which was different than any of the others.  I also experienced Braxton-Hicks regularly from about 23 weeks where I never had them with the other 3.

 

September 14th:

After my 40w due date came and went, I had some small bouts of prodromal labor which I welcomed since I knew they could be helping to bring my baby but it was frustrating that they would just fade away.  My check up that week was positive and my doc said we’d avoid talking about other options until my next appointment.

September 21st:

41 weeks came and went.  My doc called a day before my appointment, worried and nervous for me and wanted me to come in a day early to get checked over.  This was the only time I felt sort of betrayed by her lack of support.  There were some scare tactic statements that were unnecessary and could have been detrimental to my positive attitude of having a healthy VBAC.  I held firm to our originally scheduled appointment which yielded a good check up and the biophysical showed all was well with me and baby so my doc had no choice but to support us in not intervening with the natural course.  I did consent to a vaginal exam at this point and we learned I was 1cm, 50% effaced and baby was really high up at -2 station.  It is typical that a multipara does not drop until labor begins but my doc mentioned the big baby issue again and hinted again that she felt fit might be why baby is so high but then added in that she knows I’ve birthed a 10+ pound baby previously.  We did talk about some options in induction given my current cervical state.  My doc does not support the use of chemicals to augment a VBAC birth even though ACOG does not rule it out so her choices were mechanical methods (Foley catheter and/or AROM – artificial rupture of membranes).  I was okay with a Foley bulb but my 2nd option would have been low dose Pitocin over AROM.  Again, since me and the baby were okay, we walked out of there and I raised my arms high over my head and said “FREEDOM” to my husband.  I thanked the Lord again for a good report too as if there was anything amiss; it would’ve just opened the door for my doctor to want to do an intervention.

 

This is the week I really struggled with self doubt.  I really had thought the baby wasn’t going to go past dates and I was going to get my desired VBAC on its own accord so there was some self wallowing as well.  Even though I was concerned with some of the risks of going over as a VBAC, I was an emotional wreck about facing an induction the following week and told my husband the day before that I might still want to walk out of that next appointment.  I had mixed feelings of knowing that an induction meant my baby would likely arrive soon but also that I was giving into those naysayers as well as that I was abandoning the natural process.  I prayed continuously for God to give me guidance and direction and a labor, of course.  I knew though that I had to find peace with all of this and just let go and trust God so I changed my prayer to asking God to give us clear indications as to the choices we needed to make.  What a blessing that he did show us quite plainly soon enough!

 

September 27th:

At 42 weeks we went in prepared (well almost so) to go over to the hospital side to do the induction.  We had another good biophysical report and my vaginal exam showed almost a 2cm dilation, still 50% effaced and still -2 station for baby.  Doc said she could start the Foley that night or the following morning.  Not knowing whether the Foley might take a few hours or even longer, I didn’t want to chance laboring through the night on little or no sleep so we opted for Friday morning for the induction.   I felt immediate relief and it was amazing to walk out of that office again.  I had the doc do a membrane sweep and this way I had one more day of walking and trying to get labor to start on its own.

 

After the appointment, I was feeling mildly crampy so I went on a walk while Aaron fed the kids and put them down for naps.  The walk down our road was pretty slow going as I was feeling very loose in my pelvis and hips.  After 20+ minutes, I had had 5 contractions and felt very tired so I returned home to lay down for awhile and of course, the contractions stopped.  Since our induction was early that next morning, my mother in law was coming over that night to stay the night to be there for the kids.  It seemed within minutes of her arrival, I got some good strong contractions about 10 minutes apart.  It was late so I went to bed and called for Aaron about 30 minutes later to join me as the contractions were pretty intense and I wanted his help.  Praise the Lord, those 10 minute apart contractions continued all night long!

 

My labor (First Stage):

 

The contractions continued to be very strong and intense and I had a lot of loose bowels and some bloody show.  In my mind, I thought “yeah, early labor signs” but I was also nervous that the contractions would just fall away again and being that they were 10 minutes apart, technically I wasn’t “in labor”.  I prayed to God and thanked him for the contractions (probably the only woman praying that that night) and asked Him to keep them going.  I was able to sleep a few minutes after each contraction but I would wake with every one of them.  I did a lot of groaning and had my husband rub my low back during them.  I drank lots of water and ate a pear.  Some contractions did get near 8 minutes but mostly they stayed around 10 minutes.  I remember telling Aaron that bloody show during labor occurs around 4cm (which is the number the Foley usually dilates you to) so when we were getting close to the time to go in for the induction we were debating if we should stay at home and continue to labor until the contractions got closer or if we should still show up to the induction.  Since we also noticed that the kids seem to be a distraction for me, we opted to go to the hospital and see if we progressed any and perhaps labor there.

 

We were put into a triage room on the OB floor and our nurse Natalie (super great support) came in and right away said she had already read my birth plan and asked us some questions about it.  She told us to let her know if we want to be left alone or want support from her – she was really laid back and we felt she was a great fit with our birthing goals.  I asked if my doctor was there yet and told Natalie to tell her that I had had contractions all night long so she said she would check me before she got anything out and prepped.  During the vaginal exam, she said “Jeanette, we aren’t going to need the Foley bulb – you are a 5.”  I cried tears of joy.  I couldn’t believe it.  Finally!  17 days overdue from my LMP and I was in labor, my body was doing what it needed to do and I did not have to have that intervention.  The baby’s head was at -2 station.  This was around 7am on Friday, September 28th.

 

I prayed and thanked God again for the progress and we were moved to a labor, delivery and recovery suite.  Our nurse Natalie asked if we minded that a shadow nurse, Sarah would be following her all day.  She said she had an interest in natural birth so I was totally fine with her being present.  I sat on the birth ball and moved and bounced in between contractions.  I ordered a light breakfast and continued to drink lots of water and have more loose bowels and bloody show.  My contractions would be 8 minutes apart for an hour and then 3 minutes apart for an hour.  It was definitely not text book.  With the baby’s head still being up so high earlier we wanted to see if labor and gravity had helped to get the baby engaged so I had another vaginal exam around 10am.  We were closer to a 6 at that time, more effaced but baby was still at -2 station.

I then got up and walked the halls for awhile and we saw the husband of one my natural childbirth class couples who had had their baby the day before.  It was during the walking that the contractions picked up even more intensity and stayed closer together so it wasn’t long before I wanted to lay down and labor.  Around noon, I consented again to be checked (who would’ve thought I would’ve wanted so many exams) again and now I was 8cm, 100% effaced but the baby was STILL -2 station.  I was told there was a bulging bag of waters that was down in front of the head so we were hopeful that it would soon break and that would drop the head into the pelvis more.

 

Just a half an hour later, I felt some rectal pressure but I thought maybe it was just a wishful urge to be complete as it was likely the bag of waters being intact still causing that.  Thankfully, around 1:30pm the waters finally broke to such a relief from me.  Of course that made for some more intense contractions and I could not get relaxed or comfortable.  We later discovered too that the waters breaking was only my forewaters and there was still a bag in front of the baby’s head!

 

At 2:15pm, I was 9cm dilated and feeling more urges to push and there was a bit of movement down with the baby to -1 station.  At this time though, there were some decels with the baby so we consented to a bolus of fluids being hung and that made the baby’s heart rate stabilize again.  Of course though, this prompted the fit issue discussion again from my doctor and her suggesting strongly that we opt for a cesarean before there is an emergency situation.  Aaron and I exchanged looks.   Both the nurse and doc said things like “we know this is not what you want” and then the dreaded “healthy mom and healthy baby” card came out.  I snapped and said something to the effect that it is so much more than they could understand.  My doc and the nurse left the room and Aaron and I talked a bit.  I didn’t feel comfortable going straight to cesarean and I reminded Aaron that fit issues cannot be “diagnosed” until sufficient pushing time in second stage.  Since we weren’t there yet, I wasn’t comfortable going that route since there was no medical indication to do so.  I asked our nurse off the record, knowing that my doc trends toward being conservative, what was her take on the situation and I recall it being something positive about keeping on track with what I was doing.  Upon coming back in, my doc is the one who actually gave me the energy to fight and keep going when she said that with the fluids in, the baby looked good.  I am so grateful for that because we may have made a different choice otherwise.

 

Unbelievably though, an anesthesiologist and nurse came in to meet with us, “just in case”.  They said there was an emergency earlier (I had heard alarms) and if they come see me now and get prepared, then they wouldn’t be needed.  *Eyeroll* from me but I answered their questions and then got back to getting my baby out without them.  When they left, Aaron said there was a team outside the door just waiting to start the cesarean and our doctor shooed them away. 

 

So onward laboring we go.  Again, there were more prayers to God to give us a clear sign if we needed to make a different decision. 

 

“I Won’t Give Up” by Jason Mraz

When I look into your eyes
It’s like watching the night sky
Or a beautiful sunrise
There’s so much they hold
And just like them old stars
I see that you’ve come so far
To be right where you are
How old is your soul?

I won’t give up on us
Even if the skies get rough
I’m giving you all my love
I’m still looking up

And when you’re needing your space
To do some navigating
I’ll be here patiently waiting
To see what you find

‘Cause even the stars they burn
Some even fall to the earth
We’ve got a lot to learn
God knows we’re worth it
No: I won’t give up

I don’t wanna be someone who walks away so easily
I’m here to stay and make the difference that I can make
Our differences they do a lot to teach us how to use
The tools and gifts we got, yeah, we got a lot at stake
And in the end, you’re still my friend at least we did intend
For us to work we didn’t break, we didn’t burn
We had to learn how to bend without the world caving in
I had to learn what I’ve got, and what I’m not, and who I am

I won’t give up on us
Even if the skies get rough
I’m giving you all my love
I’m still looking up, still looking up.

I won’t give up on us (no I’m not giving up)
God knows I’m tough enough (I am tough, I am loved)
We’ve got a lot to learn (we’re alive, we are loved)
God knows we’re worth it (and we’re worth it)

I won’t give up on us
Even if the skies get rough
I’m giving you all my love
I’m still looking up

 

 

The next hour was the hardest yet with contraction intensity and it’s a blur of what happened when so forgive the confusion.  I wanted to push at times yet wasn’t quite complete.  One time I was over the toilet and my body just pushed.  I grunted, “I’m pushing” as I stood up and Natalie ran in and said “Oh no you’re not – you will not be having a toilet baby.”  I said, “it’s not like it’s going to come out in one push” and her reply was that I’m a 4th time mom and anything can happen so we went back to the bed.  I was in such misery that I consented to my doc breaking my bag of waters hoping that would bring the head down.  This was around 3:30pm.  Again, it was still up so high.  It was so defeating but I wasn’t giving up.  We did a modified Walcher’s position or as the nurse called it – I was sitting on my throne.  I was at the end of the bed, the bottom was dropped, my knees were up and there was a towel behind my back to bring my pelvis forward.  Wow, was that painful but again, I was game for anything to get baby engaged.  After about an hour of this, my legs were shaky and I needed a rest.  The nurse talked me into 15 more minutes and then she told me to roll to a side if I wanted a break.
Immediately upon going to my left, I felt this HUGE movement, I yelled “I have to push” and Natalie said, “go ahead”, so I did.  AND THE BABY CROWNED!  Wahoo.  From -1 station to crowning.  Finally!  I was in second stage – it was so incredible.  And then it got real chaotic.

 

My labor, continued (Second Stage):

 

With just Natalie and her shadow, Sarah in the room, Natalie placed a hand on the baby’s head and told Sarah to get some people in the room.  My doc enters and said, “yep, that is a head” and asked why I was on my side.  Tee hee.  Nice Natalie gave me a break from my throne position and that very thing is what helped the baby to come down!  What followed was a lot of calm directions to get things set up from the doctor (no one could figure out the new beds).  My urge to push was so strong, I was screaming during the pushes.  I had forgone all my training and went full force into getting that baby out – there was no control.  They were trying to move me to the end of the bed so the doc could get at the baby but I didn’t want to move.  Everyone had to help pick me up and scoot me down.  When I did have a break in a contraction, they tried to line a mirror up for me to see as I had stated in my birth plan but it was so small and the nurse couldn’t take direction well that I only got one quick glimpse of some dark hair.  Another push or two and the head was out.  Then the doc had the confirmation that it indeed was a large baby and she immediately directed everyone into pulling my legs back and trying to avoid a dystocia issue while getting the shoulders and chest out.  Scissors were handed to Aaron and I reminded everyone we wanted to wait out the cord pulsing before cutting.  Doc said she didn’t like the dip in the heart tones and told me I had to get the baby out (Aaron told me later he saw the rate dip into the 80s a few times and as low as 60 but it would go back up over 100 as well).  I was pushing without contractions, screaming as I did.  I heard a popping noise and I thought I broke my tailbone or dislocated a hip bone (we learned later it was the baby) and I heard her say the chest was out and he could get a breath now.  I still had to give another push though (for the butt?) and then I felt the warmth of him being put on my belly and everyone was rubbing him and I announced he was a boy.  He was quickly whisked away though so they could work on him.

 

“Be Still”by The Fray

Be still and know that I’m with you
Be still and know that I am here
Be still and know that I’m with you
Be still, be still, and know

When darkness comes upon you
And covers you with fear and shame
Be still and know that I’m with you
And I will say your name

 

If terror falls upon your bed
And sleep no longer comes
Remember all the words I said
Be still, be still, and know

And when you go through the valley
And the shadow comes down from the hill
If morning never comes to be
Be still, be still, be still

If you forget the way to go
And lose where you came from
If no one is standing beside you
Be still and know I am

Be still and know that I’m with you
Be still and know I am

 

We heard a nurse say, “good heart tones, good heart tones” and another one say “breathe baby, breathe”.  It was excruciating to watch.  We were saying “c’mon baby, c’mon” and then we heard some muffled cries.  Doc asked for a baby update and we were told he scored a 2 on his APGAR at the one minute mark and then a 9 at the 5 minute.  I leaned back and just kept repeating through my tears “he’s here, he’s here, he’s here.”  Aaron had to lean in to hear what I was saying probably because my voice was so hoarse from screaming.  They then put him on the scale and everyone exclaimed and gasped when a nurse said 5400-something grams.  I said “what is that?” and finally they announced his weight at 11 pounds 15 ounces.  I was amazed.  I knew it was likely a big baby but who knew it’d be that big!

 

He was then placed on me and we did skin to skin and tried to get him to breastfeed.  It took a few tries and some time before he was ready for that but it was so incredible to finally just hold him and kiss him!  He was safe and sound in my arms.

 

I have no recollection of my participation in third stage (I suspect doc used cord traction as my placenta encapsulist indicated it looked like the cord may have broke and there was a tear at the base? – can’t remember her technical terms for it) but Aaron was on top of retrieving our placenta immediately upon doc giving it a once over.  He said he couldn’t believe how pink and good it looked.  I didn’t need pitocin for bleeding and I only had a small tear into my previous tear and I opted for no stitches.

 

Recovery:

 

When the baby was placed on my belly, we noticed right away that he had a cleft lip.  After consulting with our pediatrician and a lactation consultant, we had positive feedback that it was very minor, wouldn’t effect breastfeeding and would hardly even be noticed after correction.  What a relief.  We also had confirmation that the popping noise I felt and heard was Quinn’s left clavicle breaking which is a common side effect of shoulder dystocia.  It will heal on its own and quickly.  We had to have a few other tests done due to his size and some results found in his biophysical exams in utero but all those turned out fine.  The day we were leaving, Quinn did have some yellowing of jaundice but it was low enough that some sun and breastfeeding was all that was required.  Quinn’s discharge weight was 11 pounds 3 ounces and 5 days later at his pediatrician appointment, he was back to his birth weight.

“Home” by Phillip Phillips

Hold on, to me as we go
As we roll down this unfamiliar road
And although this wave is stringing us along
Just know you’re not alone
Cause I’m going to make this place your home

Settle down, it’ll all be clear
Don’t pay no mind to the demons
They fill you with fear
The trouble it might drag you down
If you get lost, you can always be found

Just know you’re not alone
Cause I’m going to make this place your home

Settle down, it’ll all be clear
Don’t pay no mind to the demons
They fill you with fear
The trouble it might drag you down
If you get lost, you can always be found

Just know you’re not alone
Cause I’m going to make this place your home

 

Conclusion:

 

I must say I was pleasantly surprised at the wonderful support I received while at our county’s community hospital.  They followed my birth plan with no opposition (including refusal of their typical procedures) and there were some very nice improvements (such as lactation cookies on the menu and a birth day cake for the family) since the last time we had used the facilities.  The shadow nurse, Sarah’s shift ended at 3pm and she stayed with us until the end of our birth because she was so vested in it and she thanked us for letting her witness it and be a part of it (turns out she ended up helping with a leg even since Aaron told her to but she was supposed to be hands off).  Our nurse Natalie returned after her shift in her plainclothes just to say good bye and congratulations.  Also, the head OB nurse (who is a lactation specialist) came in on her day off just for us and our cleft lip concerns.  We do feel such compassion towards our doctor as well as we know for certain, had it been any other within this medical community, our birth would not have progressed in this manner.  She really had to carry a burden of concern for me and the baby and we feel for her and respect her for still doing her best to support me how I needed.

Even though we pushed the boundaries of our doctor’s comfort level with this birth, I stand behind every decision we made.  Without clear medical indications, we made our choices based on the intent of allowing God to take control and that He was in charge and He would watch over us.

 

I feel so blessed to have had this birthing experience.  The Lord answered our prayers while still teaching me a thing or two.  We got the birth He decided we needed, all we had to do was be faithful.  Quinn has completed our family and his birth completed me.  Thank you to all who encouraged me and supported me on this journey with love and compassion.  God is so good!