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Pam’s VBAC of Mateo

This week on the Blog, I thought it would be good to feature several birth stories from a mom who has had multiple VBACs.  I know when I was preparing for my VBA2C, I spent a lot of time thinking about my HBAC to CBAC birth and expecting my VBA2C to be just like that labor, and I was surprised to find that they were worlds apart!!  Pam had 3 VBACs and 3 different labors, and I think it’s important for mamas who may have labored before to really understand that, even in a woman who has had a VBAC, her labors and deliveries may be different each time. Today we have her first VBAC story, Wednesday I will post her second VBAC and Friday her third.  Pam is an at home mom living in Colorado with her husband and four kids. Her birth experiences helped her become passionate about the rights of birthing women everywhere, and she has moderated BabyCenter’s VBAC Support Board for over five years. She strongly believes that birth is beautiful and empowering no matter where it happens!

Mateo’s VBAC Birth Story

Brief background: My cesarean was for failure to dilate at 9 cm following 27 hours of induced labor at 41 weeks 1 day.  It wasn’t a terrible experience but it wasn’t one I cared to repeat, and VBAC was very important to me. I was fortunate to have supportive providers, but I did have some hurdles to overcome. I had 2 miscarriages between my first and second sons, and then when I conceived my second child I had a lot of early bleeding that culminated in a diagnosis of complete placenta previa after I passed a huge gush of blood, fluid, and clots at 14 weeks. Fortunately the rest of my pregnancy was uneventful! This is the story of my first VBAC:

At 40 weeks I was 1 cm dilated, 25% effaced, and the baby was still floating above my pelvis.  I had scheduled an NST and AFI for 41 weeks and my OB agreed we could continue monitoring the baby and go to 42 weeks if we needed to. My OB told me not to get discouraged about having no progress because it could happen in a matter of hours.

My due date came and went, as I suspected it would. The following Monday I was 3 days late, and right before bed I lost my mucous plug. I was really excited because that hadn’t happened with my first son- and it was my first sign of something related to labor. All day Tuesday I had painless, wimpy braxton hicks contractions, but that was even more exciting because they had all but stopped after 36 weeks. Tuesday evening at dinner I told my husband, Tomas, that I’d lost my plug and was having contractions, and his face just lit up. I tried to temper the excitement by telling him it could still be days, but I think both of us had a sense that it would be much sooner.

At 1:30 Wednesday morning I woke up with contractions that felt like bad menstrual cramps. I knew if labor was starting I’d need the energy to get through it, so I took a couple Tylenol and went back to bed.

By 2:30 a.m. I gave up the pretense of being able to sleep or doze between contractions. They were coming every 3-5 minutes and increasing in intensity, and I was much more comfortable on my birth ball or pacing my kitchen. I still thought it could be false labor, and every half hour or so I’d time 3-4 contractions to make sure they were still coming regularly.

By 4:30 a.m. I knew “today’s the day.” Although the contractions weren’t nearly as painful as my induced labor with Vince, I was having to breathe through the peaks and my most comfortable spot was my rocking chair. When my husband’s alarm went off at 6, I went in and told him he’d need to call in to work.

We called my mother-in-law around 8:30 to have her watch our son while we went to the hospital. I did my best to give Vince a little extra attention and love but it was hard. He knew something was up, and he wasn’t too happy about it. Tomas took him to Grandma’s house a little after 9, and we left for the hospital around 9:45. I asked Tomas to not make fun of me if I wasn’t really in labor and we weren’t admitted. He said it was okay, because we’d be having the baby by tonight for sure. I laughed and said noon sounded better to me- but what were the chances of that?

On the way to the hospital I joked that we should flag down a police officer for an escort, and we chatted between contractions. Contractions were getting much more intense, and hitting a pothole during one was brutal. The drive wasn’t as bad as I thought it’d be, but it wasn’t exactly fun.

As we checked in to the hospital, a strong contraction came and I put my arms around Tomas and stood there rocking, tears streaming down my face, and said, “I feel like such a wuss.”  In the background I heard the check-in receptionist calling a nurse to take me triage right away. “She’s really uncomfortable.”  The doors opened, and we went through.

If you’ve given birth in a hospital, you know the routine: gown, monitors, pee in a cup, lie here in bed, OB will be in to check you. I told the nurse I was VBAC and GBS positive, that at 40 weeks I was 1 cm, 25%, and that I hoped when I was checked that I wasn’t still at 2 cm. I was checked at roughly 10:30 and was 4 cm, 100%. This was it!!

The rest of Mateo’s birth went so fast that it seems almost dreamlike to me. I stayed on the external monitors in triage while my nurse went to find a nurse anesthetist to do my IV (I’m tough to get an IV into, but needed it for the penicillin), and before they came back my water broke. It was a pretty weird sensation- a strong contraction followed by a POP and a gush. Very different from amniotomy. I had Tomas go find the nurse so I could get a towel under myself, and we discovered very heavy meconium in the fluid. Contractions immediately intensified to a level where I decided (in my exact words), “I wanted natural childbirth but I was an idiot.” I was checked again and had dilated from 4 to 6 in 40 minutes. The anesthetist got my IV in on the first try, and the nurse had called in the OB to 1) evaluate baby’s heart tracings and 2) discuss pain relief with me. Because of the heavy meconium and some apparent late decels we decided to place internal monitors- something I’d initially been against. Because I was progressing so quickly I wouldn’t be allowed to have narcotics, and I still didn’t really want an epidural (Tomas was in the background saying “we’ll see how it goes babe, you’re doing great). An LDR room was being prepared for me, and after I was transferred I’d have all the monitors placed and discuss an epidural again.

In the hall between the triage room and the LDR room, I went through transition. The sheer physical intensity of it was more than I was prepared for, and I honestly don’t really remember much more than little snatches of conversation- Tomas telling me I was doing great, me quite literally begging for an epidural and asking someone to make it stop, the nurse telling the OB that I was dilating like crazy, me having to pee but not able to, nurse saying if I felt like I had to have a BM it was probably the baby, contractions one on top of the other, the resident OB telling my delivering OB that she couldn’t place an IUPC because there was such a small lip of cervix left, me thinking “WHAT??? I was only at 6 a minute ago!”, the resident placing an internal monitor on the baby and announcing that I was complete, and then it was time to push.

I did not like pushing. I felt very exposed, totally overwhelmed, and it HURT. After the first couple contractions the OB told me that I’d dilated really fast because my cervix had done that before, but that since I hadn’t delivered vaginally I might be pushing for a while. He said I’d probably have the baby within the hour- and I thought there was no way I could push for an hour. A couple contractions later and everyone realized the baby was coming fast. It was a mad rush to get the special care nursery folks in the room (they would pay extra attention to baby because of all the meconium) and get everything set up for delivery. The OB, my L&D nurse, and my husband stood at the foot of my bed holding my legs, cheering me on as I pushed.

Once the baby started crowning I was overwhelmed by the bestiality of it all. I felt wild, feral- almost like some part of me had sprouted fangs and claws and sprung free from an inner corner of my spirit. I roared with each push, panted between contractions, my mind and body seemed to be in two completely different places, and still I can’t quite fathom that it was ME harboring that raw animal instinct. At one point the OB told me to reach down and feel the baby’s head- it was so soft, and so foreign, and so strange, and just what I needed to find the strength to push the baby OUT. Feeling his body slide out after delivering his shoulders was amazing. It was one final push and a swift flow of baby and fluid, and there was our perfect son! He weighed 8 pounds 5.6 ounces, and was 19.5 inches long. Later I asked the nurse how long I had pushed and she laughed and said, “You could count it in contractions instead of minutes- let’s see, you pushed for 9 contractions.”  Roughly 15 minutes. Amazing.

Because of all the meconium (and I’m telling you, it was a LOT), Tomas didn’t cut the cord and Mateo was immediately handed off to the nursery team. They suctioned him and cleaned him up there in my room, and then gave him to Tomas. His apgars were 9,9,9 which they said is “perfect” for a high-altitude baby, so the meconium was a bit of a mystery. After a little while he started having trouble breathing and was taken down to the nursery for oxygen. Meanwhile I had delivered the placenta (the OB later showed it and all its parts to me, which was pretty cool) and was being stitched for a 2nd degree perineal tear and 2 anterior/urethral tears. It seemed like it took forever, and I lost track of how many times the OB and the resident turned around for more sutures. I got the post-delivery shakes while they were stitching, and it seemed like every time I saw their hands the blood was further up their arms. But, finally, they were done and I was able to lie in bed and be amazed at what I had just done.

Overall this was as close to my ideal birth as I could have experienced. I have absolutely no regrets about any of it, and I would take 100 deliveries like this over another cesarean. I feel amazingly blessed to have had such an easy and fast labor. Given all the hurdles I had during the pregnancy and the “anti-VBAC” indicators I had in my history, experiencing this birth has been amazingly empowering. I am strong, I am capable, and I was not ever wrong to believe in the creative feminine power of my body.

Pam

Vincente 8/17/02

Mateo 9/8/04

Andrea’s CBAC of Johnathan

This is Andrea’s story of her CBAC birth of baby Johnathan.  Andrea exerienced a complete uterine rupture, which both she and Johnathan survived.  When commenting, please keep in mind the incredible strength and courage it took for her to share her story so publicly.

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When we found out that we were expecting another baby, our emotions were all over the place. Of course, we were happy.. but at the same time, we were very scared. Scared that we might not be able to care for two children. Scared that Alex might not respond well to a new baby. Scared that we wouldn’t be able to love them equally since Alex was our whole world. It was really hard trying to wrap our heads around it all. Alex was only 9 months old, still a baby himself. But as time went on, we saw this new baby as a gift, especially to Alex, that was coming our way. The idea of having two small kids was growing on us, but we were still scared. I guess that’s normal though. We had no idea how the transition from one kid to two kids would go. All we knew was that they were going to be close. Really close. And we really liked that idea.
                           I was a lot sicker with this pregnancy than with my first. I was always so tired and I  never wanted to do anything. Everyone told me that I was going to have a girl because my pregnancies were so different. But I think everyone just thought that because I already had a boy, I had to be having a girl now. From the very start, I knew that I wanted a VBAC. I knew that I did not want to go through what I went through with Alex again. There was no way I was going to get cut open again. Thankfully, my midwives supported me 100%. There were no questions asked, and there was nothing in their eyes that would prevent me from birthing this baby naturally, which was awesome. I didn’t know at that point that some women had to fight for a VBAC–I thought all providers we this great. I know the truth now, and I see how lucky I really was.

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Time kept going by, and I kept getting bigger. The fatigue started to hit hard and I started to realize that it was not easy to chase after a toddler while being pregnant. Alex’s crazy amount of energy never failed to wear me out. Still, I had to keep it together for him and be the best mommy I could be…because he needed me.

     We went for our 20 week anatomy scan and found out that we were having another BOY! Exciting but very unexpected. I had a feeling that I was going to have a girl this time. I guess not! Also, the perinatologist explained to us that during the ultrasound, they found a bright spot on his heart and a cyst on his brain. Those signs together could indicate Down’s Syndrome. My odds almost doubled after that scan and we were offered an amniocentesis to see if he had it for sure. We declined and chose to wait to find out. They wanted to see me again in about a month to see if the markers went away and I was told not to worry. Not to worry? Seriously? I worried for a long time. I tried to mentally prepare myself for taking care of a special needs child. I knew I was capable, it was just all so new to me. I just wanted my baby to be healthy, just like every parent out there. I will admit that deep down, I knew everything was going to be fine. I would try to prepare myself, but it was like my mind was telling me that there was no need to. M was a lot more worried than I was though. I had to constantly remind him that everything was going to be okay. As life got busier, we let those worries slip from our minds. Until the next ultrasound, of course. And that scan showed us that our boy was perfectly healthy. Both markers disappeared. We were overjoyed!

     Throughout my pregnancy, Johnathan was going back and forth between being head down and being oblique (head at my hip) and I was always so good at telling where he was. After many attempts at trying to get a midwife to feel him oblique, we finally caught him. I was told to get a belly band and wear it tightly all day to try to get him to stay head down and engage. I also spent a lot of time on the yoga ball, trying to get him in a better position. I do wish I would have done more about it though. I know now how important positioning is, and I didn’t know that before. The midwives told me that I could still try for my VBAC, but since he was malpositioned, they were not going to push my body too hard. And they wanted me in ASAP if my water was to break, since the chance of cord prolapse was greater.

     So fast forward to the day I went into labor. It was March 3rd, 2012. A Saturday. M had just gotten off of work and we were having dinner–it was around 6:30 PM. I can’t quite remember what we were having though. I remember a gross feeling “down there.” I went to the restroom and peed, and as I got up, I discovered bloody show!! I literally screamed “OMG!” and went to go tell M what had happened. I was shocked, but since I was just a bit over 37 weeks when I had Alex, I knew I was going to go early again. And I did! I was told that they found I had a bicornuate uterus during my c-section, so the babies literally run out of room to grow anymore in there, making me go into labor a bit early. Contractions started at around 10:00 PM, pretty mild at first. M offered to put Alex to sleep that night since I was “in labor.” I was still in denial, as always. M started playing StarCraft since things were still pretty easy for me. I sat at the kitchen table, feeling my contractions get stronger and stronger. I started feeling this intense scar painp–I’ve never felt pain at my scar so it was pretty alarming. It was very strong while I was standing up, and never really went away, even between contractions. It was a sharp pain that went through my entire incision site. It burned.. a lot. But when I sat down, I didn’t feel anything. I guess that was the weird part for me. I was really having a hard time straightening my midsection out. Something was not right, and I was starting to get nervous. I actually tried to avoid sitting down because I didn’t want my contractions to slow down or stop. At this point I told M that I needed to go in and get checked. He then told his game buddies that we were off to have a baby. I filled him in on the pain I was having and how I felt about it. I decided to go ahead and call the midwives. It took me so long to get in touch with someone, which was really odd because I’ve never had to call them more than once. M had fallen asleep on the couch and I was pacing back in forth in the living room trying to get a hold of someone. After a few pages, I got a call back. She said for some reason her pager was not working properly. My contractions were not consistent, but I still felt like I needed to go in. I explained everything to her and she said that I was probably in early labor and that the scar pain sounded normal. I sure didn’t feel normal. She heard me breathe through a contraction and gave me the option to either come in or wait it out. But she was sure that I was fine. I opted to go in and get checked anyway. I woke M up and told him we had to go. His mom was “on call” for us since they live down the street. It was around 3 AM. He tried to call his parents multiple times, and no answer! He ended up having to go to their house and jump the fence to get her to wake up. While he was gone, I got all of my toiletries and bags ready. Finally, M’s mom was here, I kissed Alex and we were on our way.

     On the car ride there, my contractions were starting to fizzle out. I had maybe a couple the entire drive there. I kept making sure M knew that I just needed to be checked, and that we are better safe than sorry. I didn’t want him to be disappointed if we got sent home, since I was sure we wouldn’t be admitted. We got to the parking structure and started walking towards the hospital. I didn’t have ANY contractions on the way up. I was still very sore though, so we had to take it easy. We got to L&D and it was pretty empty, so we got into our room right away. The nurse gave me my robe and said she was going to set everything up while I was changing. As soon as I walked in to the restroom and started changing.. bam!!  Contractions hit again. And they hit hard. I walked out of there in a lot of pain and for once I thought that this could actually be it. I got all set up on the monitors and his heart rate looked perfect….what a relief. They confirmed that I was having contractions every minute and a half, and they were lasting long. Really right on top of each other. The nurse said that we had to get a few minutes of the contractions on paper and that she was going to call the midwife down. It was hell laying on that bed, I was not getting any breaks from the pain. Finally the midwife came down. She said she was going to check me so I took my underwear off. I had a pad on and I felt embarrassed so I explained that things felt very “weird” down there and it felt like my water was going to break any second. She waited untilI was not having a contraction and then proceeded to check me. She said “oh yeah, you are preeeetty dilated”. I was so expecting her to say I was 2 cm, maybe 3 cm dilated. But no, I was a whole 8 cm dilated!!! I was thin and soft with a really big bulging bag of water. I guess that’s when it really hit me, I was going to give birth in just a couple short hours. I couldn’t believe it, M and I were in shock. It had taken me SO long to dilate last time that I just couldn’t believe it. It was literally a dream come true because I always said that I wanted to show up super progressed to the hospital this time. And it happened! All without me even knowing I was in labor to begin with. I guess I probably hit transition as I arrived to the hospital.

     So this part still kills me. The midwife was starting to walk away and she said she was going to make some phone calls and get all of my paperwork set up. I asked her if she thought it was a good idea for me to get the epidural. She said “Yes! that is a good idea” and walked out of the room to call anesthesia. I have no idea what brought me to ask her that. I was set on a natural birth and everything was going so perfectly. I blame it on fear. But on fear of what? I have no idea.. and I still regret it to this day. I guess I needed someone to tell me that I didn’t need it and that I was fine without it. I can’t even begin to explain what was going though my mind at that point. I think that has to be the moment I most regret. But I do know I needed relief form those piggyback contractions. They seriously never stopped. At this point, two nurses come in to place my IV. I was so not in the mood for these idiots. I could tell from the momentthey walked in that something weird was going to happen. They start talking about I don’t even know what.. maybe how their weekend went? Something like that. One starts my IV, oh so slowly. And I’m over here in transition, in bed, and just not comfortable. As she goes to put the tube in, she does it too slowly and blood gushes ALL over. Mostly all over her though. Her clothes, her hair, her arm. And they start cracking up. Still, I was not in the mood and really wanted them out of my face. The other one tells me that I have to forgive them, it was 4 am and they were just exhausted. I sat there as she finished up with tears rolling down my cheeks because I was just that annoyed and in pain.

     So the anesthesiologist gets in, and he’s basically god to me at that point because the pain was excruciating and just was not going away, even in between contractions. I have two new (awesome) nurses at this point and one was holding me as I leaned over the side of the bed to get my epidural placed. She helped me breathe through all of the pain and helped me stay still enough to get the needle in. Everything wasplaced and I was a happy camper. My new nurses went ahead and put my catheter in and M went to go get the bags out of the car.. because we were staying!!

     One of my nurses wasnamed Gloria and she was just the best. The epidural was nice for awhile but eventually started fading. They had to call the anesthesiologist back in over and over again to keep uping my dose. It just kept wearing off. Even the little button they gave me to push (for more medication) was not working. The anesthesiologist’s name was Johnathan, pretty cool since that was the name we had picked out for our baby. He didn’t have a problem with coming in so much to help me. We were all pretty confused as to what was going on, since he was confident that it was placed right. After awhile, it felt like I didn’t have any pain relief at all. And of course, the contractions never let up. I was checked again and I was at a 9. One more cm to go, I was so excited. So I continued to labor and I continued to get medicine placed in my IV for the pain. During the check, I was also told that baby’s head was still very high, and kind of off to the side. People were starting to get concerned about my contractions. I guess it was weird to see NO breaks at all in between them. My uterus was working extra hard to try to get that baby in the right position. Everything went by so quickly to me, so I don’t remember exactly when I got checked.. but I know that I was stuck at a 9 for awhile. The new midwife whose shift had just begun was scared to break my water because she didn’t want the cord to come out. She called in an OB to do it for her. They were hoping that would help me dilate that last cm. I was told that was supposed to be the easiest dilation, and that I was not supposed to get stuck at that point. The OB checked me before she was going to break my water, and during the check, my water broke on its own. She kept her hand in there for awhile just to make sure none of the cord came out. Of course I was still at a 9 and he wasn’t engaged. I was told that there was A LOT of fluid. M said he saw, and it was basically a waterfall!! The fluid was nice and clear.

     So I was still in a lot of pain and the anesthesiologist kept giving me more pain relief. It was just an ongoing cycle. The closeness of my contractions was starting to get everyone concerned. I remember a test being done, I’m just not sure what it was called or what was done. My mind is not remembering it for some reason, but I think it had to do with checking to see if there was a mixture between maternal and fetal blood. I’m not sure if that was it exactly, or why they did it, but it came back normal. The midwife said that she wanted to put internal monitors in me and check to see if the problems were because my contractions were not strong enough. I didn’t feel so good about that, so I declined. I changed my position as much as I could being somewhat numb in the legs. Then the midwife offered pitocin. Really? Was this lady really trying to give me pitocin, when my contractions were already coming at a dangerous rate?? Of course I said no thanks. Even Gloria thought she was crazy, she told me that she was NOT going to let her give me any of that. I have no idea why that was even suggested. I think it was around this time that I had a break down. I cried about the fact that I couldn’t progress, I cried because I was in so much pain. I was ready to give up. I did not want this to end up like Alexander’s birth, my main goal was a healthy baby. I didn’t care at this point how he got here, I just didn’t want to go through that trauma again. Everyone in the room tried to convince me that everything was okay. Gloria said that we were going to have a VBAC in that room,  and soon.

     At around 11:40 AM, on Sunday March 4th, I made the decision to go in for a repeat c-section. I was just not comfortable laboring anymore. I was a mess, I just wanted my baby out and in my arms. It was a hard pill to swallow. I talked it over with M, who really wanted me to have my VBAC, and we agreed that it was time. Neither of us were happy about it though. I told the midwife and she said she would have me into surgery soon and the anesthesiologist gave me another dose of medicine. Before the midwife walked out of the room, she had my lay in a position on my side, with one leg up, in a last effort attempt to get me dilated.

     Almost as soon as she left the room, Gloria and a few others rushed in. They seemed so calm, I didn’t think anything of it. They told me that they needed to adjust the monitors. I turned all of the way on my side, and then to my back, as they searched. I started to feel a bit scared. More people came in and someone threw an oxygen mask on me. They told me that I needed to breath deeply. I was checked one more time (I was called COMPLETE and +2!!!) and an internal monitor was placed on baby’s head. The midwife yelled “Well baby just made up his mind for you!”, which was not true because I had asked for the c-section right before that. Anyway, they started getting my bed ready to go and I was freaking out. I thought I had lost my baby. I thought he was dead. No one was telling me anything, and chaos was happening all around me. Right before they wheeled me out, I grabbed M’s hand. He told me everything was going to be okay. As they are rushing me down the hallway, I’m bawling. I felt so sick to my stomach and scared. I was hoping that it was all a dream, it felt like a dream. The doctor was going over the risks with me, as her and a handful of other people flew me to the OR. When we got there, they stopped my bed right next to the operating table. They told me that I really needed to get on it. So without even knowing how I did it, I jumped with numb legs onto the table. I just knew that I needed to be fast and there was no time to waste. They did a quick ultrasound and said his heart rate was in the 30’s. That was the first thing I heard the whole time about the situation. I knew he was still alive, but for how long? I was checked to make sure I was numb enough, and I was. So the surgery started. It was literally a few seconds till I heard “baby is out” and I heard the sweetest little whimper. He was okay. I breathed a sigh of relief but was quickly brought back to fear as I hear “complete uterine rupture!” Really? You have to be kidding me. The only thing that I was told over and over was so rare actually happened to me? The doctor was yelling as she was operating “what is this?!,” “is this cervix?” and even “where does this go?” Everyone was just in awe. I begged them to save me. I had two little boys who needed their mom. I had to live for them. I continued to beg, and to cry. I started to pray. I needed strength, I needed to live. I was getting IVs put in both wrists, on the bottom sides of them. It was extremely painful, but my arms were being held down by other people so all I was able to do was cry some more. It was then that the anesthesiologist took off my oxygen mask and put another one on. I asked him if that one was oxygen as well, he said yes. I was then put to sleep.

     I woke up at around 3 pm to people all around me. I was confused, but soon remembered what happened. Before I even said anything, they reassured me that my baby was okay. That he was fine, but he was in the NICU. I can’t even begin to explain how much joy and relief I felt at that moment. I was freezing and as soon as I was able to talk again, I asked for a whole bunch of blankets. My throat was so sore from the breathing tube they put in, and my voice was so raspy. I wasn’t in the regular recovery room, I was in a big empty room with empty beds along the walls. One of the nurses went to get Michael. He told me about our baby. He showed me pictures, and I cried some more. They had him in the NICU for monitoring, because he was shocked at birth and wasn’t breathing. Johnathan Samuel was born at 11:52 am, weighing 7lbs 7oz and 20.5 inches long. I found out that his heart rate dropped to the 40s out of nowhere. The heart monitors saved his life. And when the doctors cut me open, they didn’t have to cut my uterus to deliver him. There was a huge hole in my uterus. His arm, cord and body were hanging outside of my uterus in my abdominal cavity. My entire previous c-section scar had opened and the rupture extended down all of the way through my cervix and into my vagina. The surgery took almost 3 hours, but they were able to save my uterus. I had an in-surgery consult with urology, because there was suspected injury to my bladder. Everything turned out fine with that though. I experienced uterine atony on the table and lost a lot of blood. I was injected with a shot of pitocin directly into my uterus, which caused my uterus to contract and stop bleeding. I received two blood transfusions and one bag of plasma while asleep.

     After I spent awhile in recovery, I was taken back to my L&D room for about an hour. My dad was in there waiting for us. M had called him while I was in surgery. He stayed for a bit, but didn’t go see Johnathan because he was getting over a cold. At around 6:30, I was finally wheeled down to the NICU. A place that I never thought I’d see again. I had promised myself that I’d do everything possible to prevent another birth like Alex’s, but it happened anyway. I saw my sweet little baby asleep in his bassinet. He needed help breathing for a few hours, but  by the time I got to see him, he was fine. He did have an IV in because I was running a teeny tiny fever during my labor, and they wanted to treat him just in case. His cultures all came back negative though. The nurse handed him to me and I started crying. I couldn’t  believe he had pulled through. My true miracle baby. Everyone was looking at me with a sad look in their eyes. I’m assuming everyone had heard that I had a UR, because all the nurses in the NICU took time out to tell me congrats. I was so in love with him. He looked a lot like his big brother, just perfect.

johnathanandrea

     I tried to start skin to skin contact as soon as I could, even though he was already almost 7 hours old. I offered him my breast and he actually latched on. I cried again as he nursed like he was starving, like he was so happy to have me holding him. After having breastfeeding fail with Alex, I really wanted to make it work this time. Even after all we had just gone through, it was a very magical moment.

     We are so beyond thankful to have our little blessing with us today, because I know he was so close to death, and a lot of other moms didn’t have the outcome I did with such a large rupture. I just can’t wrap my head around how lucky we were. There was a lot of survivors guilt there in the beginning, when I was in contact with other UR moms whose babies passed away. Why did Johnathan survive? I’m 100% sure he had an angel watching over him that day. The whole thing brought a lot of emotional pain, trauma and questions. Why did this all happen to us? What did we do to deserve that? I grieved over the fact that I was told not to have anymore children. That was very hard to hear. Not only did my VBAC fail, but I was never allowed to try again, when all I ever wanted was a positive birth experience. It was a ton to process at one time. That one thing that is so rare happened to us. It was unbelievable. I’m very very very thankful for the staff who were on-call that day. He was born 12 minutes after the first sign of rupture, and that was almost not even fast enough. The longest 12 minutes of my life.They all worked so fast, with minimal “decision to incision” time. I couldn’t have asked for better doctors or nurses. I have realized that even though my baby survived, UR is not something you can just get over. The scars are not only physical, but emotional as well.. if not more emotional than physical.

     Now Johnathan is a happy and healthy 10 month old baby. He is such a joy to be around and a complete mama’s boy. We have a wonderful breastfeeding relationship still and I am so thankful for that. I can’t imagine life without him. His big brother Alex just adores him. I have had the best time watching them grow in to being best friends and I’m excited for our future together as a family. I thank God everyday that he’s here with us. As for me, I’m still working through the pain. I still think about it all every day and often replay my story in my head, trying to figure out where I went wrong. I wasn’t as prepared as I should have been. There are so many things I would have gone back and changed. BUT, there is no use thinking about all of that now–I’m still in the process of learning how to make all of that stop.

johnathan

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Dr. Joseph Tate wins inaugural REAL Award

Dr. Joseph Tate of Atlanta, Georgia, a professional subscriber to ICAN, has been awarded the inaugural REAL Award in the field of Newborn and Mother Care.  Dr. Tate is a wonderful supporter and advocate for women, and has attended VbAmC, vaginal breech birth and even a VBA2C of triplets!  He is active in the Atlanta chapter of ICAN, and we are so glad he received this award! To read more, check out this article, authored by ICAN of Atlanta co-leader Christine Strain.

Marci’s New Year’s Day Blessing: The HBAC of Cayla Ariel

 

Marci’s New Year’s Day Blessing: The HBAC of Cayla Ariel

 

This is the story of the HBAC of Cayla.  In many ways, it begins with the birth of her older sister, Annalise, so I’ll start there. Forty-nine hours into labor, I was transferred to the hospital, and after fifty-six hours of pain-med free labor, Annalise was surgically delivered via caesarean section. I had the classic occiput posterior labor with Annalise: back labor, painful contractions that inhibited rest, very little dilation for all the laboring done. I was fortunate that labor started soon after PROM with a gentle nudge from homeopathy and acupuncture, but since her amniotic sac was gone, once she turned from ROT to OP position she had a really difficult time turning into either the OA or LOA positions that are ideal for vaginal birth. Although I only had maybe three vaginal exams during my labor with her, my temperature started to creep up at home, at which point we abandoned our plans for a homebirth and heeded our midwives’ advice to transfer to the hospital. By the time I got to the hospital, I had a full-blown fever, and both my heartrate and Annalise’s were tachychardic. They managed to get my heartrate down after administering antibiotics and fluids, but her heartrate remained high.  The OB on call recommended pitocin to expedite delivery, because there was only so long I could go on laboring now that Annalise’s heartrate was tachycardic. She also wondered if the tachycardia might be due to Annalise being in a sleep cycle, but as labor progressed, it became clear that this wasn’t the case.

I did all the things that generally increase the chances of successful, non-traumatic vaginal birth: I remained pain med free until they wheeled me into the OR and gave me a spinal for the c-section; I was active during my whole labor, trying to use various positions to help Annalise move out of her malposition into optimal birthing position, and I only accepted interventions as they became truly medically indicated. Despite this, Annalise was born with an APGAR of 2, was a “Code pink” baby and had to be resuscitated for a long time after birth. I’ll never forget what it was like to hear the terror in the pediatrician’s voice.  He hadn’t intubated Annalise, thinking she’d be okay.  (The OB was going to go ahead to surgery without the pediatrician present; my midwife intervened and insisted that the pediatrician be there specifically because Annalise’s heartrate was so high and she thought he might well need to intubate her at birth. [sigh])  Turned out she had thick meconium and mucous blocking her airways and the suction device got clogged and stopped working. A back up suction device wasn’t handy, and he started to shout to the staff “I need suction! I need stimulation! Code Pink! Within seconds, people were pouring into the room from all doors, and working on Annalise.  After all that, her breathing still wasn’t okay, and she was in the NICU for 48 hours.

I figure I did my best, and in life, there really are no guarantees. Most times, what you accomplish will reflect your efforts. But sometimes, what you accomplish won’t be what you envisioned.  I tried to give Annalise a good birth and that didn’t really happen, but I really did try my best….so I leave it at that.  Despite the fact that the birth didn’t go as planned, I am so thankful for those in my immediate and church family who prayed for me during the birth. I truly do still feel that God protected Annalise and helped her to be born just in time.

When I returned home five days after my c-section, the waterbirth tub we’d rented was still full of toasty warm water….and I’d never gotten in because of the hospital transfer. Ouch.

When I got pregnant with Cayla, I knew I was going to try for a VBAC. I had done research into the risks and benefits of VBAC versus RCS, and knew I wanted to at least try. 

What I didn’t know was whether or not I was going to attempt VBAC at home or in the hospital.

[Well, I knew what I wanted....]

I live in Ontario, Canada, and here, we have one of the best midwifery systems in the world. So I could choose to have my birth at home or in hospital, and because midwives here must attend both hospital and homebirths, I knew that if there were signs I needed to be transferred, the midwives would recommend transfer because – unlike some other places in the world – transferring to the hospital setting would not prevent them from continuing all my care and would allow them access to any necessary interventions. Still, the question of birth location is one I discussed at length with my husband Orett, my doula Jo-Ann, and my midwives, Kara and Edie.

There isn’t a lot of research on HBAC, but my main question was whether or not, in event of emergency such as uterine rupture, I would actually get access to lifesaving surgery any faster by being in a hospital. Because of how close I lived to the hospital, and the hospital’s “decision to incision” time of 20 minutes according to my midwives (the OB I consulted with at the local hospital was reluctant to guarantee a “decision to incision” time of sooner than 30 minutes, but the midwives use 20 minutes to err on the side of caution when advising a client about whether or not HBAC is generally a safe option in her specific case), I actually wouldn’t receive lifesaving surgery any faster by being in hospital. Of course, people have become accustomed to believing in the inherent safety of all things hospital and most folks actually think that, should there be an emergency, lifesaving surgery is performed immediately. Even when the call for surgery is made and given priority status, real life just isn’t like it is on many medical TV shows: rescue efforts still take time. My distance from the hospital meant that should my uterus rupture, the midwives would make the call in immediately so the hospital could get everything ready for surgery and they would run all my IV lines and prep me for surgery in the ambulance: I would arrive at the hospital BEFORE the hospital was even ready to make an incision. Once the hospital was ready, they’d give me general anesthesia and surgery would commence. If I lived further away, or lived close to one of those rare but awesome hospitals that had a “decision to incision” time of five or ten minutes, the hospital would’ve been a safer place for my birth; however, my proximity to the hospital and its “decision to incision” time opened up HBAC as a safe option for me.

I hoped, though, to avoid needing surgery and interventions in general. So from July 2011 till I gave birth, I faithfully went to chiropractic care to get my spine and pelvis in optimal condition for birthing (I was in a car accident just before I got pregnant with Annalise, and – despite four months of physiotherapy – still had problems with my pelvis and spine).  I ate healthy, tried to remain active, took lots of vitamin D (to lower chances of c-section birth), and vitamin C (to prevent repeat PROM scenario and increase my body’s natural oxytocin levels). I took Gentle Birth Formula, a tincture to promote uterine tone and prepare the body for labor. I prayed and asked others to pray for me when I felt overwhelmed by the idea that achieving a vaginal birth after caesarean is often harder than getting a vaginal birth as a first-time mom. (My immediate family and church family were AWESOME about praying whenever I asked!).  I connected with VBAC support boards that could help me navigate the emotional and physical politics of achieving VBAC. I hired a doula who specialized in birth trauma and had worked with VBAC moms before to help me do the necessary emotional work before and during labor to have a successful outcome. And I had three sessions of craniosacral therapy, since spinningbabies.com suggested that body work like this could increase the chances of malpositioned babies turning to optimal positions either prior to or before labor. In my case, every time the craniosacral therapist did a session, my baby would shift from ROT to LOT/LOA, which are better birthing positions. So even though Cayla did shift back to ROT at the beginning of labor, she did finally shift to LOA partway through labor, and I do credit this to all the extensive chiropractic care and craniosacral therapy I received helping to balance my body for birth.

I had hoped for a shorter birth.  It was shorter – 44 hours instead of 56 – but not as short as I’d hoped for. We don’t always get what we want, yet, as my story demonstrates, sometimes it’s still all for the best.

At my 37 week appointment, I asked my midwife for a vaginal exam, and I was not effaced or dilated at all. I wasn’t surprised, but because there are things in my medical history that make me more likely to need an induction, I did want my cervix to be at least ripe. Part way through the 37th week, I started using three capsules of Borage Oil and one capsule of zinc orally at night to ripen the cervix.

Around 5pm December 30th, 2012, I felt really nauseous. I didn’t throw up, but just wasn’t feeling very good. An hour later, I went to the toilet and had a serious bout of the runs. TMI, I know, but I was wondering at the time what on earth I’d eaten to have my system so upset: I was only 38 weeks pregnant, so I just didn’t quite connect it all to labor quite yet.  In any case, I felt pooped and decided I would go to bed really early. I woke up at 12:30 am on December 31st to use the bathroom and noticed bloody show.  Within 30 minutes, contractions 8-10 minutes apart commenced. They were long and strong right away, so that put an end to my attempts to fall asleep. Three hours later, the contractions were still strong, so I got out of bed and decided it was time to wash up the dishes I’d left in the sink the night before and do light cleaning. I made eggs and bacon, ate some, and then decided I would return to bed to try to sleep. After 20 minutes, my contractions finally stopped altogether, and I slept for about two hours, only to again wake to strong contractions, 8-10 minutes apart.

By this time, Annalise was stirring, so I got up and set about getting her fed and ready, etc. I sent my doula, Jo-Ann, an email letting her know that I had bloody show and had contractions 8-10 minutes apart. She wasn’t supposed to be “on call” for my birth for another 3 days, but she emailed me right back and said to consider her on call for my birth now. Contractions continued, and I closed my eyes and breathed through them. My husband Orett got home from working a night shift in the ER (he’s a Registered Nurse) and played with Annalise for awhile. I told him I was having strong contractions and that he needed to get the proper connector to attach the hose to the faucet, as I would never let him hear the end of it if I didn’t get a waterbirth this time round because he hadn’t got the connector in time!  Realizing I was serious, he hustled out to purchase the right connecting piece. Contractions continued 8-10 minutes apart. I was tired because I hadn’t had much sleep, and was a bit concerned that this labor pattern might just indicate that baby was again ROT or some other malposition. The contractions stopped at 12 noon and I immediately went to lay down and sleep, only to awake to more too-strong-to-sleep-through contractions at 1:30pm.

I got up and got more things ready for the baby’s arrival. Contractions were still 8-10 minutes apart and I continued most of the afternoon the same way. At around 6:30pm I spoke to my doula about the labor pattern and the fact that I was a bit concerned about how this was playing out. She suggested taking a warm bath and then taking homeopathic pullsatilla to see what effect this would have on my labor. I did this, and an hour after taking the bath and homeopathic, my contractions stopped. So at 8pm, I dashed into bed….only to – you guessed it! – awake at 10 pm to contractions 8-10 minutes apart.

I had told Orett it was okay to go to work before I went to sleep because, at this point, the homeopathic and bath had seemed to stop my labor, so I actually thought I was going to be the very lucky lady who got a whole night of sleep before labor resumed: I thought this would be just the ticket to waking up with contractions 5-1-1.  Orett promised to notify his work as soon as I was clear about the birth being imminent and return home. So I was really concerned when I awoke at 10pm with strong contractions 8-10 minutes apart. I was hoping for a whole night of sleep, not just a couple hours!

Finally, at midnight, I sent a text message to my doula and told her I was really concerned about the lack of sleep, yet I couldn’t sleep because the contractions were just too strong and I had to breath through them. She recommended Gravol, and then asked me if I’d contacted my midwives to let them know I was in labor. I said no – I’d kept waiting for labor to get to 5-1-1, and it hadn’t. She said that while she would recommend Gravol, I should really call the midwives and let them know what was happening and find out their recommendation. So I did, and my midwife, Edie, was concerned about the lack of sleep and how that might impede labor. She supported using Gravol…but we had none. Which isn’t surprising, because I rarely ever take so much as an Advil or Tylenol; I’m more of a ‘natural remedies’ type of gal.  So I dug around in our First Aid kit, found and took Tylenol (which did nothing to make me sleep) and then called Orett to come home at 3:31 am, asking him to bring Gravol. Orett got home and gave me Gravol. No change – contractions still 8-10 minutes apart and incredibly intense.

So despite taking the Tylenol and Gravol that were supposed to make me sleep, I actually didn’t get a wink more.

I called Edie around 8am in the morning explaining that I still couldn’t sleep – contractions were just too strong. She offered to come do a home visit and assess me, to which I agreed. She also mentioned that if this situation continued, she might have to take me to the hospital to get morphine, as that would knock me right out and then I could sleep. But she explained that that was sticky, because an OB would need to prescribe the morphine and depending on what happened with my cervix, this could create a “transfer of care” situation. Even though she’d be able to stay on in a supportive role during my birth if a transfer of care took place, we both agreed that this option should be a last resort.

By 9am, both Edie and Jo-Ann arrived to see what we could do about my labor. Edie watched me during a few contractions and confirmed that I was, indeed, having really strong contractions.  Edie did a vaginal exam, and confirmed that I was now 5 cms dilated and very soft, so there was no doubt I was laboring. She did a stretch and sweep to see if this would launch my contractions into 5-1-1 pattern sooner rather than later. She then checked the baby’s position, and baby was just as I’d suspected: ROT.  ROT fetal positioning tends to result in protracted labor, and until the baby’s head is more firmly applied to the cervix and the baby rotates to a position like LOA or OA, labor and progress are slow. But I took comfort in the fact that my cervix had dilated to 5cms, because with Annalise, after all that labor, I’d only dilated to 2cms: she just got wedged into a bad position early in labor and couldn’t get out.

Edie had me pee on a stick to check for keytones, which I had, so I then ate some more and she and Orett ran an IV line into my arm with fluids because the dehydration was so severe. She also gave me more Gravol, hoping it would knock me out and I’d sleep. No luck – the contractions were just too strong and I couldn’t even sleep between them.  She brought in some things for the homebirth and I stayed in bed laying on my left side for hours, trying to ride out the contractions and wishing I could sleep. Because we didn’t want baby to descend before rotating to an ideal birthing position, lying down was a good option at this point in my labor. Edie would come in at intervals to monitor the baby’s heartrate. I kept hoping and praying that things were going to progress.

Edie didn’t want me to feel like a watched pot, so she and the doula left for a bit.  Before Edie arrived in the morning I’d called Kitty, my naturopathic doctor who does acupuncture, to find out if she could use acupuncture to change the course of my labor. It was New Years Day and I KNEW she might not come, as it was a holiday. But she knew my story and that I really wanted a VBAC, and I called, hoping that she just might help me out. She called me back and said she would come to my home, but was concerned about using acupuncture for labor augmentation if I was already running on such little sleep. She suggested instead giving me herbs to reduce the contractions so I could sleep, and then – after a good sleep – seeing about bringing things on more strongly using acupuncture.

Now, by this point I was becoming skeptical of the notion that my labor could be quelled enough for me to sleep – after all, I had ardently been trying to sleep through contractions to no avail. But I recognized that if sleep could be had, it would be fantastic. So I agreed. While I waited for her to come, I got out of bed and labored on the toilet. It felt really good to do that and I started to feel rectal pressure. I labored there for an hour and then switched to the birth ball beside my bed to labor more. Kitty arrived after 2pm and did a full history on my current situation. She gave me a homeopathic remedy and then gave me some Crampbark tincture to help labor subside. She said that if the tincture were going to work, it would work within an hour, and said that I should take a ½ tsp dose every 10 minutes for an hour then wait a bit. She also mentioned that getting in the tub might also help to dissipate contractions. She asked my permission to speak to my midwife, and I granted it. She relayed her recommendations but asked what my midwife felt and left it up to her. My midwife agreed that if I could sleep, that would be best. But if I couldn’t, it was what it was. Kitty stayed with me for about half an hour, softly helping me breathe through contractions, then left.

I waited over an hour for the tincture to do its work.

And then I came to my senses.

Now faith is the substance of things hoped for, the evidence of things not seen

~ Hebrews 11:1 KJV~

 

Contractions were just getting stronger. I realized that our baby had decided to be born today, and it was time to get about the business of birthing my baby before severe maternal exhaustion set in and I would be unable to have a vaginal delivery without some variety of hospital drugs to assist me. I spoke to Orett about my feelings and he agreed 100%. I called my doula Jo-Ann around 4pm and told her that I felt sure that the baby wanted to come tonight, and that I was sure that if I could just birth my baby in the next four to eight hours, I would get my HBAC and all would be well. And I accepted the fact that if I couldn’t do it in that timeframe, I was probably looking at having to transfer to the hospital for drugs so I could sleep and then deliver vaginally. This was hard to say, as I really believe in not using drugs during childbirth unless truly medically indicated. But I know all interventions under the sun have their time and place, and if it was truly needed because I was exhausted, I would accept interventions.  I also acknowledged that there was the chance of a repeat c-section if some complication cropped up if I transferred, but for right now I just had to focus on birthing Cayla.  Jo-Ann mentioned that she loved the determination she heard in my voice and that I should continue to focus on welcoming labor now.

I called Edie and told her that the tincture didn’t work and I was still in labor. I asked if she would come to my house and check my cervix to see if I had progressed since the 5cms I was at 9am that morning.  I knew that she had recommended me calling her when contractions were five minutes apart, and even though they weren’t, I was completely going on my gut instinct now and asking her to trust my sense that this was going to happen. Most careproviders ask women to follow the 5-1-1 rule for their first planned vaginal delivery, as a woman is usually consider in “active labor” if her contractions are 5-1-1 and her dilation seems to confirm this diagnosis.   It was ultimately because I was not experiencing contractions five minutes apart when Edie checked me in the morning that we were all still waiting for this signal of “active labor.” But by this point in my labor, I knew that although my labor was not conforming to standard medical definitions of active labor, there was no doubt that I was laboring hard.

I also told Edie I wanted to know if the baby had shifted positions, because I’d been feeling a lot of flailing around in there. And I told her that after she checked, I intended to get into the birthing pool for at least an hour to see if the natural oxytocin increase that water labor creates would send us full steam ahead; or alternately, if this wasn’t “it”, stop labor. I was not going to transport to the hospital until I’d at least gotten into the water this time round!

[By this point, I really doubted that anything would stop labor....but I wanted to sound rational, because I knew my labor was not fitting textbook parameters and definitions]

I suggested that after doing all these things, we could all decide on the best course of action. Edie agreed.

I walked up and down our house, trying to focus as I listened to my birthing tracks, and feeling the labor intensity soar.

I had Orett call my parents and ask them to pick up Annalise, as I was in my birthing time and felt I needed less distractions now. They came, combed Annalise’s hair and got her ready, said a prayer for me that that Cayla would get into the right position for birthing, that my labor would progress, and that she would be born vaginally. They also prayed for wisdom in all our decision making as we went through labor. They asked us to keep them posted and then they left.

I continued to walk around our house, stopping for focused breathing when contractions would hit, and felt renewed faith that the Lord would hear the prayers of myself, Orett, our families, and the community of faith (huge shout out to The Campus Church – our home church in Aurora, Ontario!) we knew had been praying about this birth for so long.

At 6pm, Edie and Jo-Ann arrived. Contractions were still 8 minutes apart. Edie checked my cervix – I was 7cms dilated and Cayla had now shifted from ROT to LOA: the optimal position for vaginal birth. The energy in the room was just amazing and Orett still talks about how my countenance registered complete relief when I heard that Cayla was FINALLY in the optimal position for birthing. We all knew that her newly-altered position dramatically increased the odds that I was going to have a vaginal delivery, and I was so excited.

Jo-Ann gave me some homeopathic remedies to gently encourage labor on. I hopped into the birth pool. For an hour, my contractions didn’t get any closer together. Edie thought I should stay in the pool longer and felt things were going well. She even suggested she could break my waters. Since I had PROM with Annalise, I really didn’t want to get rid of my waters just yet, because AROM can cause a baby to get into a bad position and be unable to maneuver enough to get out….but decided I would do it before transport to the hospital if it came to that. For now, I would just labor with my amniotic sac intact.

Around 7pm, my contractions suddenly dropped to 2 minutes apart. I instinctively shifted to hands and knees during each contraction in the water. Jo-Ann and Orett talked me through visualizations with each contraction. Before I knew it, I was in transition, and contractions were double-peaking. I felt my body bear down and water from my amniotic sac shooting out of me like a rocket.  Finally, Edie said she wanted to check me. I asked her if she could just check me in the water. She chuckled and said she could, but it would be more accurate if I got out of the tub.

So feeling quite grumpy about having to leave the birth pool, I got out and lay on the couch. A contraction hit and I sat up to ride it. When it was done, I lay back down. She assessed me and said, “Well Marci, you are 9 ¾ dilated with an anterior lip.” I was so excited and asked if I could just get back in the pool. Everyone laughed and said that I could.

The urge to bear down just took over. When Edie realized that I wasn’t trying to push, my body was just ejecting the baby, she walked over to the phone. I heard her say “client has the uncontrollable urge to push, come right now.” With this, midwife #2, Amanda, was on her way.

(She didn’t make it before Cayla came out)

Once my body started pushing on its own, I remember trying to scheme in my head how I could get this baby out of me in no more than 10 minutes. A mom in one of my VBAC support groups had recently pushed for only eight minutes and that sounded like a pretty sweet deal to me…except I really had no control over the pushing; my body was just chugging her out and the pressure was incredible. Orett sat by the pool and held my hands and told me I was doing it, that our baby was coming to us just like we’d prayed for, that the pressure meant she was almost here, that my uterus was strong, that he knew I could do it. Almost thirty minutes after I started pushing, I felt the ring of fire. I gasped “I’m splitting!” as I felt her head crown. Edie asked me to flip from hands and knees to my bum after Cayla’d crowned and push through the burning.

And at 8:07 pm on New Year’s Day, Cayla Ariel Brown was born, a mere two hours and seven minutes after Edie had returned to check me at home and found me to be 7 cms dilated with contractions still eight minutes apart; an expeditious one hour and seven minutes after my contractions had finally dropped from every eight minutes to every two minutes.  Her APGAR’s were 8 and 9, and she was seven pounds, six ounces – six ounces heavier than Annalise had been at birth. It was so surreal when Edie lifted her out of the pool and placed Cayla on my chest, and Orett cut Cayla’s cord. I couldn’t believe I’d done it; I’d pushed a baby out the old fashioned way! I was so overwhelmed with emotion and felt so incredibly happy and lucky to have helped her have a gentle entry into this world through waterbirth, with the hormones of birth the Lord designed uninterrupted by labor drugs, and with lots of hugs and cuddles and skin-to-skin.  Birthing Cayla in a pool of warm water – in my living room, beside my fireplace and the twinkling lights from my Christmas tree – was such a blissful, peaceful experience, and I am truly thankful for this blessing.

Once Cayla was born, we figured out why – besides her pesky ROT positioning – it’d taken so long for her to come: she had a long cord, and somehow managed to get the cord not only around her neck, but knotted at the base. My midwives are sure that the cord was a significant part of why the labor took so long: with the cord knotted at her neck, she needed time to rotate and descend through my pelvis.  We’d planned for delayed cord clamping, but at this point, removing the knotted cord from around her neck was the priority. Her cord was clamped and then cut off her neck, and she took her first breath. In a lot of ways, I am fortunate that I had an amazing birth team at home. Were I admitted to the hospital at 7 cms dilation with contractions 8 minutes apart, it would’ve been typical for the on-call OB to recommend pitocin augmentation to “establish contractions and labor.”   But with the cord so tightly knotted at her neck, the oxygen deprivation that pitocin regularly causes could’ve easily produced another distressed baby, caesarean birth, and NICU stay. I am thankful for all the people who prayed for our VBAC birth, as I know the Lord protected us, guiding our decision making, so that we would chose the path most likely to result in the healthy birth of Cayla.

I hemorrhaged and was hypotensive after the birth, and my midwives were recommending that I be transported to the hospital. Despite the shot of pitocin and running pitocin through my IV line after birth, I was still bleeding. There are other PPH drugs they carry to births, but my uterus had already clamped down, so some of them were no longer medically indicated. But Orett asked if they could run one more bag of IV fluids, administer more meds, and monitor my bleeding and blood pressure for a further 30-60 minutes.  Once the bleeding stopped, they agreed to let me stay home because Orett had the nursing skills to continue to monitor me through the night.  (When Edie came for her home visit the day after Cayla’s birth, she told me that had Orett not been a Registered Nurse who worked in an ER, she would’ve insisted on transport. I’m such a lucky gal!!!).  Once it was under control, they applied some anesthesia and sewed up my second degree tear. (No, I wasn’t even TRYIN’ to get stitched up sans anesthesia lol!) It was so nice to have Cayla on my chest while they worked on me, as after my c-section with Annalise, they whisked her off to the NICU because of her breathing and I never got to see her till 6pm the next day.  It’s so wonderful to be able to bask in skin-to-skin bonding time after birth.

Even though my first day and a half were challenging because I was a bit lightheaded from blood loss, baby Cayla and I have both been doing well since delivery. Orett and I are so thrilled with Cayla’s HBAC birth and hope to do this again for any other children with which we are blessed.

MY BODY IS NOT BROKEN!!!!

I will praise thee; for I am fearfully and wonderfully made: marvellous are thy works; and that my soul knoweth right well

~Psalms 139:14 KJV~

 

Andrea’s HBAC of Josiah

Here is my birth story, about 99% complete.  Most of this story is from what I directly remember, but there are parts that I was told about afterwards, from my midwife and doula and a friend that was there, filling in the blanks when I was too out of it to fully realize what was going on.  I don’t yet have my midwife’s written notes, but it’ll be a little while before I get those, an Here is my birth story, about 99% complete.  Most of this story is from what I directly remember, but there are parts that I was told about afterwards, from my midwife and doula and a friend that was there, filling in the blanks when I was too out of it to fully realize what was going on.  I don’t yet have my midwife’s written notes, but it’ll be a little while before I get those, and she and I have talked about the birth, so I’ve included those bits in here and am going to call it good for now. 

 

I also mention my Christian faith a few times, so if that will offend you, just be aware that it is there and an important part of my life. 

 

And the final disclaimer, this is my narrative story and should in no way be taken as medical advice. 

 

The birth story of my fourth child starts with the birth of my third.  Jonathan, my third baby, was an emergency c-section at 25 weeks because of complete placental abruption (which followed my premature rupture of membranes at 23 weeks).  He was with us for 27 days before we lost him due to complications from an infection. 

 

Even if Jonathan had lived, Tim (hubby) and I would not have felt that our family was complete at only three children, but now I was a complicated case.  I was sneaking up on “advanced maternal age,” I was a hopeful VBAC, I had a history of a preterm birth (even though my first two births were nearly textbook).  Tim and I consulted with several people to see when we could try to get pregnant again and still have a reasonably good chance at a VBAC.  The delivering OB and another one both said we could try in three months (putting 12 months between the surgery and the next birth).  Other opinions wanted us to wait 6 or 9 months.  We decided to start trying at 4 months, never dreaming that we would get pregnant on the first try. 

 

I have to admit that I was more than a little nervous at first.  I’d read birth stories and talked to people who had a short time span between their c-section and their VBAC.  I’d also talked to people who had a full-term VBAC after having a premature c-section.  But all my searching came up mostly empty when I tried to find people who had both of these factors in the same pregnancy.  I didn’t know what would happen. 

 

I saw an OB for my whole pregnancy, taking P17 shots this time, and I saw an OB all the way up until the week before I delivered.  I also saw my midwife for prenatal visits that last month (but had kept in contact with her throughout the pregnancy as well), unsure until the very end whether I wanted to go to the hospital or try for another homebirth.  (My second child was a homebirth, and my third child was supposed to be a homebirth as well before my water broke so early and I had to transfer out of my midwife’s care.) 

 

I was officially due on 12/27, and in the couple of weeks leading up to that, I’d been having fairly decent Braxton Hicks off and on for several weeks, very similar to the way it happened with Benjamin (my second baby, 3 years old at the time of this birth).  My due date came and went.  I was a VBAC this time, so I didn’t want to be induced.  I just had to wait it out.  I had an appointment scheduled for 1/2 for a NST and ultrasound since I would be turning 41 weeks the next day.  Then if I made it to 42 weeks, the OB was recommending induction at that time (which I was agreeable to, but still praying that I wouldn’t make it nearly that far). 

 

With both of my other full-term labors, I had light bleeding throughout the whole active labor, so I kept waiting for that to show up to indicate that I was finally in real labor, but it never did.  I also was waiting for a loose stool, which could indicate my body cleaning itself out in preparation for labor, but that never happened either.  (I did, however, have two separate solid BMs during labor, once it finally started.) 

 

On 12/28 and 12/29, I was losing teeny tiny pieces of my mucous plug, but nothing to make me say, “This is it!”  I just kept monitoring it throughout the weekend, and it would come and go as the days passed.  I had an appointment with my midwife on 12/28 and my blood pressure had spiked a little bit, and she said that it might be an indicator of labor starting soon.  She estimated his size to be at about eight and a half pounds.  She also made the comment that she likes doing baby-size estimates on women with my body type because it’s easy for her to be fairly accurate.  The afternoon of that appointment, I made some eggplant Parmesan using a recipe that is “famous” for putting women into labor within 48 hours.  A friend of mine had made it with one of her babies and had gone into labor that same night.  I made the recipe, but it was deliciously ineffective for that first night and the second night. 

 

On 12/30, I woke up having lost a lot more of my plug the night before.  I was having contractions that could still be called BH, but they were coming close enough together for me to think that they could easily turn into something more later.  I texted our doula to see what time she was going to be in church, and to give her a heads up about the plug and that something might be happening later on.  Tim and the kids and I went to church as well, and were there from about 9:00 to 11:30, where I continued having contractions. 

 

After church was done, I got Tim’s attention and told him that he needed to get the kids in the car (i.e. don’t dawdle and visit with people) and that today was probably going to be the day.  He grinned at me.  :D   One of our friends who was going to come to the birth to help with chores or whatever else we needed came up to me before I could get outside and asked if I was in labor, and said that when she saw me when we first got there that morning, that it looked like I was.  I told her that I don’t know but that she should come over after lunch.  On the way home, I called our doula and our photographer and midwife and made plans to have them all come over at their various times that they could make it (from being out of town or whatever). 

 

My midwife got to the house first and we talked about what was possibly going on, and I went ahead and had her check me, and I was at a 3, 50% effaced, and very squishy.  My bag of waters was intact but she could feel the baby’s head through it.  He was floating, though.  Since I was still in very early labor, my midwife stepped out to grab lunch with her hubby and then run another errand. 

 

Throughout the afternoon, the rest of my “birth team” arrived, and we were lighthearted and chatty since my labor was also lighthearted.  :P   The birth supplies were assembled, but I couldn’t find the little hats that I had crocheted, so I spent a little time in early labor making one more hat, just to be sure we’d have one.  I also had some music on with a portable stereo, and Benjamin was laying down on the floor, directly facing the speakers, singing the familiar church songs on the CDs that I had picked out.  It was so heartwarming to watch him do that.  Lydia (my first baby, 6 years old at the time of this birth) played games on various electronic devices (like our photographer’s iPad and my Kindle).  We eventually let Benjamin take a long nap, but Lydia stayed up the whole day and all the way through to the birth. At some point, we blew up the birth pool (but didn’t put any water in it yet) and the kids were enthralled with their new “toy” and kept playing over the edges of it.  At one point, they managed to flip the pool on top of themselves, creating an air-filled cage.  :D

 

I got checked early in the afternoon when my midwife first got there, and I was at a 3, 50%, and very squishy.  Since labor was still so light, she went to eat lunch with her hubby and run another errand.  I gradually dilated to a 5, and at that check, my midwife was able to stretch me to a 6, but then I never dilated past that because my bag of waters was keeping the baby’s head from putting direct pressure onto my cervix.  (My midwives called it “bag of water dystocia.”)  I did a round of nipple stimulation, which helped the contractions get stronger and closer together, but it still wasn’t enough to move the baby onto my cervix and finish dilating.  She suggested maybe breaking my water in an hour or so if there’s been no progress (and if baby was not posterior). 

 

I wanted to go ahead and fill up the pool first, though, so we started to do that.  When Tim and I had made preparations for this birth, we got a hose and some fittings to fit it onto the shower head, because our washing machine spout wasn’t easily accessible.  We hadn’t run any water through the hose, though, and instead had just seen if it would screw onto the shower head prior to birth day.  Once it came time to actually fill the tub, Tim had a little trouble getting the fittings tightened properly, and it kept leaking, so we had a lot of stop-and-starts when trying to fill the pool.  He finally got the fittings finished and then turned on the water.  About a minute later, he called down the hallway, “Here comes some water!” to make sure that someone was holding the hose at the other end.  It was a humorously delayed warning, but someone had been holding the hose anyway, so everything was good. 

 

I was in the pool for an hour or so, but the contractions slowed down, so I continued the nipple stimulation.  They picked up, but again, not enough to do what they needed to do, so I got out and agreed to have my water broken.  It felt like a gallon came out of me (but was really only about two cups), and it kept coming out in several spurts as I continued laying there, but as soon as she broke it, I was at an 8.5.  She said that since I was so soft, it would probably be only an hour or so after she breaks my water and then the baby would be born.  My amniotic fluid was meconium-stained, so it was yet another thing to keep an eye on during this birth.  My doula had had a “streak” going where all of her clients had started labor with their water breaking, so I was glad to break her streak and have my water intact for so long.  It took her some effort to break my water since my sac was so strong this time, which was such a change from my third pregnancy. 

 

My contractions picked up in intensity, but not frequency, after my water was broken.  I was back in the pool but couldn’t get comfortable.  I started vocalizing and screaming through the contractions, and at one point, they suggested that I go to the bathroom to get my full bladder out of the way (everyone had been giving me sips of Recharge and water throughout the day).  I did that, and had a few contractions on the toilet and felt pushy.  I wanted to get to the bed so they could check me, but I had to time it just right because the contractions were finally coming pretty close together. 

 

I felt the contractions so low that it felt like they were running down the side of my thighs as well.  It was quite the odd sensation.  While still in the water, I started needing some counter pressure applied to my low back/hip area, which Tim did for me.  He was amazing through my whole labor, just doing what I said I needed instead of what he thought I needed.  :p  Overall, I’m glad that I gave water a try, but I don’t know if I’ll do it again.  It didn’t really feel like it was the “magical pain relief” that people have made it out to be.

 

I got to the bed and was checked, and I just had a lip that moved back and forth as the baby tried to find his way down.  I was complete, but my cervix kept slightly shrinking back with the contractions.  My midwife checked the position of his head, and he was asynclitic (with sort of a front “corner” of his head trying to come out first instead of the back of his head).  She spent a few contractions trying to push the lip over his head and at the same time get him to rotate.  Even with no water, there was room for him to do all that.  Both of those techniques were incredibly painful.  Throughout my contractions and especially during the pushing phase, my midwife never stopped praying for us, out loud.  I greatly appreciated this as it helped keep ME focused on who was in control of the situation as well.  Since I was GBS positive this time, they also gave me a chlorhexidine rinse every so often, which was cold!  Brrr!

 

During an incredibly painful contraction, I asked if I could push, and they told me I could.  Because of his presentation, I never did get the uncontrollable, “my body’s going to push whether I want it to or not” urge like I’d had with my other vaginal births.  My midwife was inside me trying to show me where to push (but I had thought she was holding my lip out of the way), which was also pretty painful.  She also was still trying to turn his head in between contractions to a better presentation, but then before the next contraction hit, he would turn right back.  I couldn’t feel it, but Tim kept seeing the baby flip back over as he watched my belly.  She told one of my friends later that I had a pelvis that could birth a 10-pound baby and that the baby just had too much room in there since he kept flipping back. 

 

I was getting tired and weak by this point and kept saying and thinking, “I can’t do it, I can’t do it,” over and over.  But I was also aware enough to realize that his heart rate had gone down into the 90s and stayed there, so they were getting nervous about a possible cord problem.  I gave it my all.  They didn’t know what was causing the drop in heart rate, but my midwife knew from my previous birth records that I could push a baby out fast, so she wasn’t as worried as she might have been if I were a first-time mom or having my first vaginal birth.  We didn’t have the luxury of taking an hour or more to push with that declining heart rate.  Tim was trying to help me push better/faster/harder by yelling, “PUSH!” several times at me, with increasing volume, but that wasn’t helping and before it started to bother me too much, the midwives told him to stop.

 

At some point, I was on my hands and knees trying to get the baby to a better position, but that wasn’t working, so I ended up on my back.  I have NEVER had a pushing phase hurt like this one did.  I had various people giving counter pressure on all four limbs to give me traction.  I wanted to scream from the pain, but I knew if I did, it would make my pushing less effective, so I tried to be quiet and just let all the energy go into my push.  From Tim’s point of view, there was one point where a big portion of the head was visible, but then when I stopped pushing, it slipped back.  At one point, they invited me to feel his head, and based on the pain I’d been feeling, I thought I was going to feel a huge portion of it, but it ended up feeling only like a half-dollar-sized amount of head.  The video is a little blurry because of the low lighting, but it ended up actually being a significant portion of head that I was feeling and not just a tiny little bit. 

 

When the head finally came out all the way, he was looking down towards my left leg.  Before the shoulders came out, he rotated clockwise, looking directly at my left leg, then up to the ceiling, then finally straight over at my right leg, and THEN the shoulders came out. 

 

He was neither breathing nor trying to (but did still have a pulse, which my midwife monitored with her fingers on his chest while they worked on him to get him breathing).  They kept him right at my feet where he had come out while they worked on him, leaving the cord intact.  They suctioned him (getting a lot of watery blood out when they did this) and gave him oxygen.  His one-minute APGAR score was only a 6 (but his five-minute one was 9).  My friend told me that my midwife was crying at one point.  After quite a bit of suctioning and some oxygen, he got a tiny spot of pink on his head which nearly immediately spread to his whole body, replacing the purple that he had been upon first arriving.  He started crying and they put him on my chest.  His cord (which was two feet long) ended up being wrapped around one of his feet, but that was the only place it was wrapped.  And remember that 8.5-pound estimate from a couple days prior?  The first thing I noticed when they laid him on me was how dense and heavy he felt.  This baby was not an 8.5-pound baby.  When we finally got around to weighing him, he was 9 pounds and 6 ounces, my heaviest baby so far. 

 

Another thing I noticed about him was that he had absolutely NO vernix on him, not even in his little neck folds or anything.  He was a very well-cooked baby.  :D   I cut the cord this time, and was surprised that I had the strength to do that since I didn’t even have the strength left to fully lift my head to see where to cut, and had to rely on others to move my hand into the proper position.  And 36 or so hours after the birth, I had a sudden realization, “Oh, yeah, I cut the cord this time,” like I’d forgotten that I did it.  The assistant midwife and my friend were looking at the placenta later, and that midwife pointed out the few calcification spots in there and said that it wasn’t a “bad” placenta, but it was definitely done and time for the baby to have been born.

 

One more thing I noticed was a “scratch” on his abdomen that looked like there had been a cat inside me with him that gave him a good clawing.  It ended up being just a weird arrangement of dried blood, though, and came off in the bath, revealing smooth and unblemished baby skin. 

 

Sometime earlier while I was still in the birth pool, I was nauseous, and threw up all the fluids I’d taken in in the previous hour or so.  They wanted me to keep taking more fluids, so I kept trying, but the nausea never went away, and I also threw up all those additional fluids along with the few bites of eggs that I’d tried to eat as my first postpartum meal.  This loss of fluids combined with the loss of blood made me incredibly weak and lightheaded, and I came very close to passing out many times, and actually did pass out once, later, after my herbal bath.  Baby was born at about 2:24 a.m. and it wasn’t until noon that I finally felt able to walk a few steps by myself and got my appetite back.  I didn’t even try to carry the baby before then, either, because I felt that bad, and instead just kept him near me in the bed and had Tim change all the diapers.  And even after feeling better, I still had another few sporadic incidents of lightheadedness where I had to stop and bend over, and these incidents reminded me even apart from bleeding intensity that I needed to get back into bed or into a semi-reclining position.   

 

It was a little while before I delivered the placenta.  They kept checking to see if it was ready to come out or where it was.  I had lost a lot of blood beforehand and they were wanting to make sure I didn’t have a bunch behind the placenta as well.  When it was finally ready to come out, I didn’t want to push it out since the baby had been such an effort.  But everyone reminded me that the placenta had no bones, lol, and I pushed it out and that was that.

 

He nursed very well, once we finally got around to it.  It ended up being about an hour and a half after the birth before we were able to successfully latch.  From the loss of blood and fluid, I was too weak to do it lying down (though I did try with what little strength I had) and too weak to sit up without help.  I was also too out of it mentally to ask for help sitting up and to realize how much time was actually passing. 

 

When we finally did sit up, my midwife asked us if we were going to circumcise him, and we said no.  She said “Yay,” but I didn’t quite understand what she said, and she had a weird look on her face and said it in a weird tone of voice.  I thought that she was upset at our decision until I asked her to repeat herself.  Tim and I had had that discussion while pregnant with Benjamin and had left him intact as well. 

 

I did not tear at all, but I had some bruising.  It felt like I had been trying to climb out of an above-ground pool but that I was repeatedly dropped on the edge of the pool, with one leg in and one leg out.  In addition, I was swollen so much that I couldn’t pee within the time that my midwives wanted me to (even with the assistance of some peppermint oil), so they did end up cath-ing me.  After that, the assistant went home but my primary stayed and dozed on the couch and wanted me to try to pee again after an hour and a half or so.  I was keeping fluids down again by then so I thought I might be able to go when it was time, and I did, and didn’t have any further issues in that regard.

 

They offered an herbal bath for me and the baby afterwards (and they also thought I might try to pee in the bath as well, but that didn’t work either), which I took, but I got increasingly lightheaded during that, and hindsight said that they probably should have skipped it.  I had to have a ton of assistance walking just to the door of the bathroom, then they had me sit in our wheeled office chair to wheel me to the bed, and I think I might have passed out for half a second.  I remember sitting down in the chair, then the next thing I know, they were calling my name and I realized I was leaning on the door jamb with my eyes closed.  I woke up from whatever state I was in, and then they wheeled me across the hallway and to the side of the bed. 

 

Baby is a champion nurser.  He latches beautifully and just knows exactly what to do, as if he’s been waiting his whole life for it.  :)   He had a bit of a “click” that first day or so, and after some investigating, I found out that he was turning in his bottom lip instead of turning it out, so I’m working to help him develop a better habit there.  Other than that, he is a great nurser, easily handling my gigantic letdown.  At three days postpartum, he was two ounces under his birth weight, but at five days old, he was two ounces over his birth weight. 

 

Tim changed all the diapers that first day, including the first meconium diaper, which had a HUGE pile in it for him.  Tim made the comment of “nothing wrong with that system,” lol. 

 

He smiled in his sleep within the first few hours, and then on Tuesday (I’m still wondering what happened to most of the rest of Monday), I saw him smile while he was awake and in a quiet alert phase.  :)  

 

One odd thing I noticed early postpartum with myself is that my uterus seemed almost cylindrical when it was freshly empty, instead of shrinking in a rounder fashion.  My midwife mentioned this to me at my postpartum visit and said that she and the assistant midwife had noticed the odd shape even from when they broke my water.  I don’t remember the shape of my postpartum uterus with my pre-c-section births being anything remarkable like that. 

 

The kids just love him to bits.  Benjamin was sleeping when Josiah was born, and when he woke up this morning, I was in the bed and I asked him where my baby is.  He indicated my now-shrunken tummy and said, “In your tummy.”  I told him that he came out, and Tim helped him climb onto the bed so he could see the baby.  Benjamin promptly squished him in a hug and said that “he’s sleeping” and gently touched his tiny hands.  :)   Lydia was still awake for the birth, and when he came out, she said that he was “so cute.”  :D   A good friend of ours took our kids for the first 36-ish hours after birth, so that was nice, since one of the things that first made me consider a hospital birth this time was the postpartum stay without having my big kids around.  :)  

 

We sort of have a “theme” going on with our names and our kids’ names – three-syllable names from the Bible.  (My name is Andrea, which is the feminine form of Andrew, so I’m counting my name as a Bible name as well.)  Then Tim is legally Timothy, and there’s Lydia, Benjamin and Jonathan.  What WERE we going to name this baby, to keep with our theme?  We chose the name Josiah Nathan, which means, “God has healed, God has given.”  We couldn’t think of a more appropriate name and are just so happy that he is finally here.  :)

Melek’s HBA2C of Evren Abel

This is the story of the home birth after two cesareans of our third son, Evren Abel, whose birth was the culmination of five years of hoping, planning, wishing for the peaceful, gentle birth I wanted so badly to give to all of my children.  I’m sitting beside him, having just nursed him to sleep in our bed, the bed he was born in, and all I can hear are the lyrics from that song “Breathe” by Anna Nalick.  “I feel like I’m naked in front of the crowd/Cause these words are my diary, screaming out loud/And I know that you’ll use them however you want to.”  I’ve already shared his birth pictures on Facebook and in a lot of ways, that is much easier than sharing this will be.  This feels a little bit like baring my entire soul in front of goodness knows who, because once I release this on to the Internet, I know anyone can read it.  There are people who just don’t “get it,” this longing some women have to deliver their children naturally and not surgically.  There are those out there who judge women who make choices like I did, and I know I am opening myself up to criticism for it.  And then there are women out there who desperately need to hear that what they feel is normal and natural, and that their bodies are strong and capable of giving birth to their babies without the assistance of a surgeon or a scalpel.  I know because I was that woman.  I am sharing this now for these women.

When we got home from the hospital after my HBAC turned CBAC in 2010, I sat down at the computer and I wrote and wrote and wrote and cried and cried and cried.  That is where the birth of Evren starts, with the processing of the birth of my second child, Emre, which by the way, I think I just finished two days ago when I gave birth to Evren.  I started a blog soon after, with the intention of blogging my way through the prep I would do before we conceived our third and during our pregnancy and birth.  It kind of quickly turned in to a huge part of my process, as I realize now that a big part of what I was doing was trying to understand what went wrong with that birth.  Don’t get me wrong, Emre’s birth was beautiful, but I wanted to understand why it hadn’t ended the way I planned and intended.  I had worked so hard for that birth and the vast majority of VBACs are successful, so why wasn’t mine?  I wrote a lot in the early months and then as time went on, and life got busy with the boys, I wrote less and less…such is life.  But the prep continued—Maya abdominal massages to break up adhesions and scar tissue from my cesareans, reading books about natural childbirth (more on this later), consultations with a local perinatologist about our options for a third delivery after my second son’s delivering OB said something to me about what he discovered internally that I wanted to get more information on.  I was going to fix whatever it was that went wrong and we were going to have a VBAC next time, dammit.

At some point during my reading, I stumbled upon a passage in an Ina May book about how she loves nothing more than to see a mama who is a lawyer shut her brain off, let her monkey do it and give birth to her baby.  Well, HELLO!  This really clicked with me, and I realized that my biggest challenge during our next pregnancy and birth would be to get out of my head, as I tend to live there and play the “well, what if this, then this and this and then this” game and on and on.  I could spit VBAC facts at you all day long, but obviously that hadn’t gotten me the birth I wanted, so I needed to do something to change that.  Don’t get me wrong, this wasn’t like a one day turn around—I struggled to stay out of my head, both before and during pregnancy, and in fact, had to enlist outside help on many occasions (thank you, Catherine!) to keep myself from going down never ending rabbit holes.

When we discovered we were pregnant with Evren, I was both happy and really nervous.  I had just decided that we would stop playing fast and loose with birth control since Emre had recently weaned and get serious about preventing another pregnancy for awhile.  Little did I know, I was already pregnant.  I only knew a few things: I wanted a VBAC, no matter how or where, I wanted him to come before or very soon after his due date so his head wouldn’t be a 15” unmoldable mass, I did not want the ambulance to come to my house again, and I wanted him to be smaller than my 10.8 pound CBAC babe.

We decided to keep this pregnancy a lot more private than we did with Emre’s, because I felt like I let a lot of outside pressure and influence come in to play in that birth, and I wanted to preserve my peace about this one by keeping it a little more personal.  To that end, there were no Facebook announcements, my twitter, Instagram and blog were made private, and we just went about life with as little fuss about it as we could manage, only telling a few people who we knew would be unconditionally supportive.  Something about the way I’m built or the way I carry my babies, I don’t necessarily look unmistakably pregnant until I’m fairly far along, so it wasn’t much of an issue.

The pregnancy itself was pretty blessedly uneventful.  An early dating ultrasound put his guess date around 12/2 or 12/3, which was close to my charting of when he was conceived, which gave a date of 11/30.  We found out we were expecting our third little boy at the anatomy scan, I confirmed my suspicions of an anterior placenta that was thankfully up and away from my scar, everything looked good for a VBAC.  Throughout my pregnancy, I was so blessed to be supported, encouraged, uplifted, and sustained by friends who had much more faith in me than I had in myself.  It’s a lot easier to believe other people are capable of something than you are, especially when you’ve tried before and not been successful.  I depended on these affirmations from them, they carried me through.  I hung out with my midwives and they’d talk about how big my pelvis was and how my body was built perfectly to birth my babies.

I had some grand plans for all the books I was going to read about coping techniques for natural labor and delivery, but I only ended up reading The Sears Birth Book (which was really good!!) before I felt myself slipping back in to that head space that I wanted to stay out of.  So I decided I was going to focus on reading women’s firsthand birth stories and watching their videos, which is a nice, no pressure, not at all like studying kind of activity that really worked for me.  I did have moments where I had to be talked off ledges, and at some points, I considered making a political statement by showing up to the hospital and declining a cesarean (that didn’t sound that fun), or renting a hotel room or birthing at my midwife’s house, which would be slightly closer to a hospital than I was, but at some point, I realized making all these contingency upon contingency plans was setting myself up to open the door to allow myself an out when things got intense.  Obviously I was not opposed to a hospital transport if it was necessary for my or baby’s safety (and I am thankful that I live close to one in which I would be treated kindly and with respect should we need to go in), but I wanted a home birth, and I wanted a home birth in MY home, so I kind of let those options quietly go.

I saw a chiropractor pretty regularly throughout pregnancy because I wanted to be on top of positioning.  Dr. Ron was great, and I didn’t deal with a lot of pain during the pregnancy, except towards the end when my pelvis started to spread.  I started taking Gentle Birth tincture around 35 weeks based on testimonials I heard about it.  It couldn’t hurt, I figured and hey, if it helped, all the better.  As soon as I started taking it, I started having frequent Braxton Hicks contractions.  I planned for acupuncture at the end of my pregnancy, just the last four weeks, though, because you know, I wasn’t going past my due date.  I also took 1000 mg of Vitamin C a day because I wanted my water bag to remain intact as long as possible.  Which it did.  I mean, that thing might still be intact somewhere.  What I’m saying here is, I had a really strong bag.

Around 36 weeks, I had a small Blessingway, which surprise!!! one of my internet best friends, who I had bonded with over our VBAC attempts with our second babes, flew in from Florida to surprise me for.  I may or may not have closed the door in her face when I opened it and saw her on my doorstep.  Sorry, Christine, I blame shock!! It was an intimate and really beautiful ceremony and Christine and I had a wonderful weekend of fun together.  I was so blessed during that time.

At some point, I realized I needed to take a social media break.  There was getting to be too much distraction and it was taking away from the peace I was working for, so I deactivated my Facebook account and told my twitter friends I’d see them in a few weeks.

Also during my third trimester, I started getting these flags with affirmations on them in the mail from the wonderful women I had met in my due date club on Mothering when pregnant with Emre.  I thought it was so incredibly sweet, and was only slightly embarrassed that it took me about 7 or 8 flags before I realized this was a beautifully orchestrated plan to show their support and belief in me and my body’s ability to birth my baby.  I can’t say enough about this group of women.  They lifted me up and believed for me when I had a hard time believing myself.  Another friend I met on twitter sent me a beautiful heart shaped rock that said “strength” on it, which I ended up holding on to the entire time I was in labor until the moment baby was on my chest.  I think every birthing mother should have one of those rocks.

I had halfway convinced myself that I would be going in to labor on 11/28, which was a full moon and I also was going to an acupuncturist that day known for getting babies out.  I mean, this wasn’t my first go round, I’d dilated before, I’m black, I mean come on!! This baby was totally coming before 40 weeks.  Obviously.  I waited patiently for the full moon to do its thing, and when it didn’t, I figured it had probably just started the ball rolling.  Surely I would be in labor by the weekend.  The acupuncturist, Alighta, who is basically one of the most awesome people I have ever met, suggested I come back in on Friday and we would try again.  I had used our entire acupuncture budget in the weeks leading up to the birth at another acupuncture clinic, but this wonderful woman offered to see me through this pregnancy for no charge.  I go in Friday and…..nothing.  Well, forget this!!! I had been careful with my diet, but I could feel babe packing on the pounds in there.  Could totally feel his little skull bones starting to become less and less moldable.  I wanted him O-U-T.  So, that Saturday, 12/1/12 (cover your eyes, hardcore natural childbirthers!!!!!!!!!!!), I tried to “naturally” (insert caveat about how there’s nothing natural about interfering with any part of birth) evict him.  Let’s not go in to specifics here, but let’s just say it didn’t work.  My midwives, who I feel I should say here are very non-interventionist and only supported me in decisions I made myself regarding this delivery, gave me the option to keep trying or just wait.  I felt like it was clear that he wasn’t ready and I decided not to push it.  All of a sudden, I had a zen attitude out of who knows where, and I just felt like he would be here by the next weekend.  I could make it one more week, right?  No big deal.

Then Wednesday came.  That freaking hump day will get you every time!!! All of a sudden, I’m in despair.  Baby is going to 42 weeks, he’ll be huge, I can’t birth a big baby, we had invested so much in this birth—emotionally, mentally and financially, and I was going to wind up on the operating table a third time.  Even though she had offered, I felt so guilty taking Alighta up on the gift of her services.  Brielle was like “shut your face and call her,” but in the nice way a midwife does (not really, she said it like that to me, but only because we are super close).  So, I call Alighta and she tells me we will do it once a day until baby comes.  I start back up seeing her Wednesday and I am also getting sweeps, which I had actually started before this 40th week, again, only at my request.  And by request, I mean desperate begging and pleading.  Seriously.

Wednesday.  No baby.  Thursday.  No baby.  Friday.  No baby.  Saturday.  WHERE IS MY BABY???

Saturday 12/8/12.

I had a second Facebook account which I kept active so that I could keep in touch with the ladies from Emre’s due date club.  One of them posted to check up on me.  I mention that as each day goes by, I feel my HBAC, or even a VBAC, slip away.  I just could.not.birth.a.big.baby.  The girls encourage me to do things to keep my mind off it before my scheduled midwife appointment that morning, so I go to the post office and then head to see the midwives.

11:30 See the midwives, beg for a sweep.  4-5 and 70%.  Started contracting.  Don’t get excited, I had been contracting nightly since I started seeing Alighta.  Never went anywhere.

1:00 See Alighta. More contractions.  Not getting excited.

3:00 Second strip.  More contractions.  Tons of bloody show.  Not getting excited.  Been losing plug for weeks.  Contractions not letting up, though.

5:00 Contractions getting painful.  Different than they’ve ever been.  Confused because I don’t feel them in my abdomen at all.  I only ever experience them as waves of rectal pressure.  This remained true for the duration of my labor.

5:30 Go to Sam’s and to get gas in the car just in case.  Start timing and they are about 4-5 minutes apart, lasting 30-45 seconds.  Thought about walking around neighborhood looking at lights as I labor.  Quickly dismissed.  Not leaving house.  Kids starting to annoy me with being loud.  My big kid asks me “Are you saying ‘oh God,’ because it’s <my uterus> hugging?”

7:10 Text Brielle.  This really hurts.  My bottom hurts.  She’s asking me questions about the contractions.  I don’t know.  They hurt.  She says take a bath and try to sleep.

8:00 Laboring away around the house.  Brielle wants to know if she should come.  Don’t want them to come too early and have labor stall or be really early on.

8:50 Out of the bath.  Only had a couple more mild contractions in there, but things pick right back up after I get out.

9:15 Brielle wants to know if she should come.  I’m still not convinced it’s time.  I’m texting to her and giving updates to my girlfriends.  I can’t be in that hard of labor.

10:30 I text Brielle that ok, I might finally believe it’s labor.  She suggests wine.  Choke wine down.  Nothing.  Still contracting.

10:50 I don’t want to do this anymore.  Crying through contractions.  I feel fine in between, but so much pressure during.   Tell Brielle I can’t do it anymore.  I want an epidural.  She says they are on their way.  They call me to listen through a couple contractions.  I’m crying and asking them to hurry.

11:00 Tons of bloody show.  My friend Emily says she guesses I am in transition.  No way.  With Emre, in transition, no way I could text or update anyone.

11:55 Last update for my girlfriends.  8 cm.  Midwives here.  Think they got here at 11:30.  Don’t know.

Time melts away now.  I have no idea what time anything happened from here on out except the time baby was born.  I’m probably going to get a lot of details or order of events wrong, but hey…that’s what happens when you’re trying to remember what happens in labor.  When they get here, I’m laboring in the bedroom and bathroom by myself.  I have a towel rod that I’m hanging on to.  It reminds me of my friend Jamie’s birth story and, since I now know how exactly it feels to want to rip a towel rod off a wall, I almost smile to myself.  Almost.  I tell Kari I want to punch someone in the face and then go ask her to get my “strength” rock.  They ask if I want to labor in the water in my tub or the giant, glorious birth tub.  Giant, glorious birth tub please.  Brielle started to fill it and I’m working through contractions with Kari as Brielle handles that.

Brielle’s daughter Kaya is coming to the birth with the other midwife who is coming just in case, Christy.  So glad Kaya is coming.  She is the best girl ever, and very calm around birth.  Also, she’s 10.  I can’t freak out and embarrass myself in front of a 10 year old.  Laura, my dear doula friend, comes to care for my older boys in case they wake during the labor, which they did.

I get in the tub and it’s ten times better than laboring in my little tub.  Don’t get me wrong, it still hurts, but like I’m prone to do, I find the easiest position to labor in and try to stay there.  By easiest, I mean, my contractions kind of start to space out and I can get a good break going.  Surprise, my midwives want me in positions that actually bring baby down and encourage my labor to keep progressing.  Darn it.  So, ever a lawyer, even if inactive, I bring my master negotiation skills to the table.  I will do some contractions in the tougher positions (on my knees, leaning over the edge of the tub), and then I get to get back in the easy position (sitting on my bottom in the pool with my back against the tub).  I sometimes negotiate for 30 seconds, sometimes for a number of contractions.  During contractions, I have Kari count—the contractions peak at 30 seconds, so I focus on her voice and getting to 30.  Wish she would count faster sometimes.  During one contraction, I feel myself start to lose control.  I remember my friend Jordan’s amazing birth with her second babe, when she talked about how important it was for her to stay present in her body and not allow herself to slip out of it.  I had started to say “I can’t, it hurts so bad,” thought of Jordan and started singing “Hurts So Good” by John Mellencamp.  We all laugh, and I remain present in my body and in the moment.  During a couple contractions, I chant “epidural, epidural, epidural,” which I remembered reading in a woman’s birth story.  She said she knew if she could say it, she didn’t need one.

Kari and Brielle encourage me to reach in and feel—I can feel the bulging water bag and baby’s head behind it.  I want the water bag to break because it’s holding me up, I think.  Started to bear down through some contractions.  They ask if I am pushing because I have the urge or if it just feels better.  It just feels better and I do little, tiny bear downs during contractions.  Makes it SO much better!  Decide to break the water—takes what feels like forever, but then I can reach in and really feel baby’s head.  I tell Kari and Brielle there’s a baby in my vagina, in case they didn’t know.  I tell them, “I’m going to have a VBAC!!!” Soon after, I have the urge to go to the bathroom.  You know, the URGE.  Kari and Brielle get me out of the tub—I thought I was going to have a water birth, but very thankful for midwives’ intuition.  This baby did not need to be born in water.  Go to the bathroom because I think I have to go.  Oops, no, time to push!!!

On to the bed.  Kari and Brielle are down below for the catch and Christy is by my head encouraging me.  Kaya is taking the pictures I’ve been wanting to have for so long and Jason is taking some that could be posted publicly.  I start to push because I want to be done.  Christy reminds me to wait for a contraction.  Oops, just wanted to be done.  Kari helps me get my pushing focused properly and she, Brielle and I all provide counter pressure while I push.  My friend Catherine had told me that during her birth, she pictured baby’s head as a boulder that she had to use her body to push out.  This visualization was so helpful, and at 3:31 AM, after less than a half hour of pushing, my first vaginally born baby flew out in to the world and was immediately placed on my chest.  Kari and Brielle later tell me that I yell out “I HAD A VBAC!!!!” before he was even all the way out.  When he was on my chest, I am crying and saying “I’m the only one touching my baby!!! Am I dreaming? Please don’t wake me up.”

Post birth rush, posting announcements to Facebook and my VBAC Support groups, etc.  My husband, Jason, got to cut his son’s cord for the first time and stay in the room with both of us after the birth, not decide which one of us to go with (the baby, of course).  My midwives gave us time to bond with baby alone and then we weighed and measured him.

I couldn’t birth a big baby, but then I pushed a 9.13 pound baby out.

I couldn’t birth my baby if his head was big and hard, but then I birthed a baby with a 14.75” head that did not mold.

I couldn’t go past my due date and Evren was born right about 41 weeks.

I am happy to report, though, that there were no ambulances called.

For reference, the CBAC birth of my second son, Emre: http://blog.ican-online.org/2011/03/02/emres-birth-a-powerful-cbac/

Advocacy Project–ICAN ladies, we need your help!

Are you pregnant or did you recently have an HBAC (or plan an HBAC
that ended in a CBAC) in an area that is not friendly to VBACs? We
need stories from HBAC moms, CBAC moms (who planned an HBAC) or moms planning HBACS in areas where;

1) hospital policy prohibits VBACs and
2) the state legislation either does not allow homebirths or
specifically prohibits HBACS.

Stories can involve VBA1C or VBA2C. We are looking for situations where moms really had no hospital or legal homebirth VBAC choices in their area due to both hospital policy and state legislation. If you know anyone please email Ruthie ASAP. Names are completely confidential.


 email: advocacy@ican-online.org

Kelly’s VBAC of Kathleen

Like most women who VBAC, my birth story begins with the birth of my son a little less than three and a half years prior to the birth of my daughter. While I wasn’t exactly ignorant of the birthing process with him, I trusted that I would be able to deliver him without a cesarean. I hired a doula and planned on an unmedicated birth in a hospital. I didn’t read a whole lot outside of a “typical” birth book for preparation and believed that I could do it, that I would rely on my doula for support and if I really needed an epidural, it wouldn’t be the end of the world. The day of I was unprepared, I went into labor relatively optimistically, but after arriving at the hospital with intense back to back contractions, being told that I wasn’t in labor because I was only 2 cm dilated and then never progressing past four, I needed an epidural. About 30 minutes later I had a high fever and I was assured there was nothing I could do besides have a c-section. I struggled with it after his birth. Cried a lot. Questioned my ability to really be a woman if I couldn’t give birth. I hated my scar. I hated that it was so traumatic. I hated that I had been cut open and that the only real sensation that I could remember from his delivery was tugging at my skin. I hated that I couldn’t walk to the NICU to nurse him, relying on less than helpful hospital staff, resulting in weeks of supply issues and stress on an already stressed first time mom. I had failed. Failed my son, failed my self. I vowed to never, ever do it again.

While I eventually came to terms with my son’s birth, I still knew that when I became pregnant again I would do everything I could to make sure that the outcome was different. Starting from the day I saw that extra line on the pregnancy test, it was. I kept up with my workout schedule and continued running several days per week, went to yoga and spin class, maintained a healthy diet and avoided the “I’m pregnant” excuse as much as possible. I still found my psyche scarred. When I watched births on TV, vaginal or cesarean, I would break down. I was scared. What if I couldn’t do it? My body wouldn’t dilate the first time, what if I was never able to dilate? What if I had to go through that again? Very early I vocalized to my husband how it was imperative that I have a VBAC. It was the most important thing about this pregnancy, outside of having a healthy baby. He understood and came on board right away.

I hired Cole Deelah as a doula, after several online conversations with her and just knowing she was the right temperament and personality to compliment mine. I created a birth team that included her, my cousin, Kristen (who is a PA and a close friend) and my husband. I was much more engaged and read everything I could about VBAC. I joined the ICAN listserve and frequented an online VBAC support group. I read Ina May Gaskin and Henci Goer. I read lots and lots of birth stories. I took medication off the table early on and told myself if I wanted a VBAC I had to do it without any interventions, and I’d have to stay at home as long as I possibly could. My goal was to wait until I was ready to push, which didn’t seem too unreasonable since my home is only about 5 miles from the hospital. We didn’t know the baby’s gender, but I would go on my early morning runs and talk to the baby and say “We’re in it together, we’re going to do this together. You are going to be my healing baby”. I felt like we had that understanding, as I toted along my bump on all the early runs in the dark and people thought I was totally crazy.

I had a lot of mom friends tell me it was okay to have a repeat c-section and not to think of myself as a failure if I didn’t get my VBAC. I would just smile and say “I’m having a VBAC” and continued to convince myself of it. My cousin never doubted it, my doula never doubted it and my husband never doubted it. I knew I’d be surrounded by positive energy and trusted that everyone had my interest first. Most importantly, they believed in me.

I woke up on Saturday, September 22, my due date, and went running with friends hoping it might get things going since I’d had a few contractions the day before. We went to breakfast as a family of three and did things around the house. I was ravenously hungry and felt cramps and pressure but wasn’t having contractions. My aunt and uncle and cousin came over and did a bunch of stuff around the house with us. Last minute nesting. During the course of the afternoon I was having some mild contractions but nothing consistent. I sent Kristen a text to rest this afternoon because we likely had a late night ahead of us. I was feeling a lot of pressure and kept thinking I needed to pee. Sitting on the toilet was more comfortable than walking around. On one of my trips to the bathroom I lost my mucous plug. After that I started to have slightly more consistent contractions, but they weren’t strong or regular. I sat down on the couch with my aunt as they were about to leave and said “I’m just kind of scared” not really knowing what was ahead. She said “Don’t be scared. You’ve run a marathon before. You can do this. Besides, nobody every died from pain”

“Yes, and it will end”

“Yes, and it will end.”

It was the pep talk I needed to get past that mental block out. Regular contractions started pretty soon after that. My aunt, uncle and cousin left at about 4 pm and I told them I would have a baby on their anniversary, which was Sunday the 23rd. I found out later that when they walked out the door my aunt told my uncle that the baby was coming today.

I downloaded a contractions timer app on my phone and started to time them. Every two minutes. But they were short and I could walk, talk, continue through them. I was a little frustrated because this is how labor had started with my son and I was sure these contractions weren’t doing anything except making me tired. I called Cole and she agreed and gave me some tips for slowing things down so I could relax a little and hopefully not feel worn out. Toward the end of our conversation she mentioned that if it really was labor my body would just keep going. I started chugging coconut water to make sure I was hydrated. My husband went out to run some last minute errands because I told him it was now or never. I was home alone with my 3 year old and letting him mostly play alone. Around 5 I called my husband to say I needed him home and ran some bath water to relax. I was cheerful, but the contractions were getting more intense. Still two minutes apart (that never changed) and still about 30 or 40 seconds long. My 3 year old came in the bathroom and knew what was happening and “helped” wash my hair and face like we do in his nightly baths and poured water on me and shared his bath toys with me. It was very sweet. I was started to feel like giving him attention was going to be too hard, and when I realized it was about 5:30 I called my mom to come get him so that we weren’t doing a late night drop off and he could have a normal evening. I got a call from a friend at about 6 and told her what was going on and to tell our friends. Still happy, but things were getting a little tougher. My mom showed up a little after 6 to pick up the kiddo and was giddy and excited and wanting to talk about how far apart my contractions were and what was happening. I said “I don’t know mom. I just want it to stop and want it to be over. And don’t call everyone and tell them what’s going on.” We have a very close family, and I didn’t want any unnecessary phone calls.

After my mom and son left I walked back to my bedroom and sent a text to my cousin to come any time, I was starting to have a hard time recovering between contractions. That was 6:30.

She got there right about 7 and took over. The rest is kind of a blur but I remember everything clearly at the same time. We were hanging out and talking. I was moving from the tub to the bed to the toilet to the tub, just trying to get comfortable. I was trying different positions to lessen the intensity and every move seemed to just make things hurt more. The only thing that helped was sitting on the toilet and getting in the bath. Contractions were still two minutes apart and 30-45 seconds long. I started to not really be able to talk about random things and joke anymore. I just kind of rested between contractions. I kept telling Kristen I wanted things to slow down, but they would not. She was on the phone off and on with Cole, telling Cole what was happening and getting tips. I was waiting for that magic one minute contraction to say yes, it’s time for Cole to come. My husband would pop in and out. He was doing things around the house and hanging out. He would come in and tell me I was doing a good job, then go off and do something. I didn’t really care what he did. Besides the magic one minute contraction, I was waiting for my water to break. I remember with my son after my water broke contractions went from heavy to incredibly intense. That never happened either. I completely lost track of time, but was managing. Things were uncomfortable, but I was recovering. I wanted to rest. I really wanted to rest. Only getting two minutes between contractions was making me tired and I thought this was going to go on all night. I had one contraction where I had 4 minutes between and I tried to will that to happen again. That was my one break in the evening and after that they kept getting stronger. I was trying to envision it as progress and I was opening my mouth and moaning and relaxing and it felt like things were moving. Joab brought me a glass of wine. It was gross but I chugged it hoping to relax a little. Nothing was slowing this baby down. I guess the labor was real, just like Cole had warned me.

Kristen would make gentle suggestions and encourage me and tell me I was doing great. Finally after trying what seemed like everything, I went back to the toilet and sat down. I had bloody show. I knew that was progress but it also made me a little nervous. Things must be getting close. I sat there a while then all of a sudden instead of breathing through a contraction I felt the urge to throw up and that my body was pushing. I remember saying “Kristen, I’m pushing”. She suggested we move back to the tub and we did. Things were getting more intense. I was becoming very vocal and moaning loud and hard. Contractions were lasting longer and she stopped telling me how long they were lasting or how much time in between. Didn’t really seem like any. I remember thinking there is no way in HELL I am leaving this house to go to the hospital. How am I going to get to the hospital? Kristen may have been wondering the same thing, but never showed it. Somewhere in that time we told Cole she should go ahead and come our way. I don’t think any of us realized just how close I was.

My husband had run to get Chipotle for me and him right before I got in the tub-this matters later. While in the tub Kristen called Cole and as they were on the phone I had a really strong contraction. Cole told her based on how I sounded I was at a 9 or a 10. I remember Kristen saying “10?” and I thought that was how long until Cole got there. Then Cole talked her through how to get me out of the tub and out the door and she would meet us at the hospital.

Kristen had to interrupt Joab eating his burrito to say she needed his help and we needed to go now. Like now. He grabbed clothes for me and then helped Kristen get me out of the tub then out the door. That’s when the moments of no way can I go on started. I remember telling them “I can’t do this. I can’t do this” and crying. They both reassured me I could. It was followed by moments of calm when I’d be telling myself you can do it, you can do it. *Get out of this tub and you can get an epidural. Out of the tub, you don’t need an epidural. Walk to the door and you can get an epidural. Made it to the door, you don’t need an epidural. Get in that car, you can get an epidural. You’re in the car. You don’t need an epidural.* And so on, all the way to the hospital. As I was climbing in the car and Kristen was helping me and Joab was grabbing last minute things I was saying “Boppy, boppy” Kristen had no clue what I was talking about (in fact was a little worried I was losing my mind and speaking in tongues) until I finally managed to muster up “Tell Joab to get the boppy” That was the last thing to load in the car (and Kristen realized it was, in fact a thing, not crazy talk) and we were off.

The car ride was the most comfortable I had been in a while as I sat in the back on my knees facing backward and grabbing on to the headrest. Kristen sat with me while I cursed Joab’s driving, though he did a really great job to be fair. Except making a few comments about how he just wanted to finish his burrito. I didn’t have to open my eyes at all because I knew the turns and lights so well since the drive to the hospital went right past my office. I had been dreading that drive almost my entire pregnancy because of the horrible, pot hole filled road leading right into the hospital. Anyone in Houston can attest to it. We bumped along those horrible bumps, I had some more contractions. Right when we pulled into the hospital Kristen and Joab jumped out. I was vocalizing. *There is no way I’m getting into that wheel chair. Get into that chair and you can get an epidural.* The most intense contraction yet came over me and there instead of breathing through it I was clinching and gritting. My body was starting to push the baby out. I screamed that I couldn’t breathe. Joab helped me out of the car and into the wheel chair being held by a security guard who was completely terrified. Some other talking and commotion happened. I was just happy to not have to walk and my eyes were opening and closing. I felt sorry for the person that got in the elevator with us. That person touched my shoulder and said “Kelly, it’s Cole” My doula had arrived! Perfect timing. I looked at her and said “Oh, HI!” I was so happy to have her there and instantly felt calmer. *You don’t need an epidural.*

We made it up to the delivery floor with a host of medical staff standing there with anxious faces, waiting to resuscitate me. “Ma’am are you ok? Can you hear me? Do you need help?” Something along those lines. “Um, yeah, I’m fine except I’m having a baby” Followed by some sighs of relief/disappointment on their faces. “She’s just in labor…blah blah blah” The doctor then told me the security guard called a code on me and they thought I was dying. Nope. Not dying. Can I get out of this damn hallway and into a delivery room? And people better stop asking me questions.

We got into the delivery room with what felt like a ton of people and an evil nurse yelling at me to get out of the chair and put on a hospital gown. I pushed the hospital gown out of my face and said “I’m not putting that thing on” and told them I couldn’t get out of the chair and I wasn’t getting on that bed. “You cannot have this baby in that chair” “I’m not going to!” Then a huge contraction, moaning and BOOM! All of a sudden I was on the bed and my shorts were off thanks to evil nurse picking me up and throwing me on the bed then making an exit.

More scrambling by everyone. The OB introduced herself. Not my regular OB but one from my practice who I knew. I remember saying “Oh, Dr. Vayas. I know you. Hi.” I kept asking for people to leave and the lights to be turned down. It was so chaotic in that delivery room. Very different from the calm of my home with dimmed lights and my calm husband and my calm cousin. Who don’t do this every day.  The OB tried, and actually told all nonessentials to leave, to which she got the response “We’re all essentials!” They were pushing down on my stomach and looking for a heartbeat. Found it, it sounded good. Cole was right by my side, holding my hand. All I had to do was look at her and she’d remind me I was doing great and I would feel calm. I was going to be checked. I had been dreading this moment. It was the part of my first child’s birth that brought me nothing but pain and disappointment. I was on my side and closed my eyes and tried not to clench. I just knew she was going to say 7.

I heard the nurse report it. 10 centimeters and +3 station.

They could see the head.

“All right Kelly, you’re ready to push”

What? I couldn’t believe it. I really couldn’t believe this was happening. I looked at Cole with disbelief and said “I am?” They wanted me to put my feet in stirrups, to scream and count while I pushed. I tried to fight them on all of it. Here I’d been laboring sitting, laboring standing and rocking. The last thing I wanted to do was get on my back and throw my legs in stirrups. The doctor asked how long I’d been laboring at home and I had no idea how to answer that question because I had lost all touch with time. I had a contraction and she told me to push. I was pushing wrong. Not surprising since I was on my back in stirrups, but I had given up that fight. I got some lessons. During this Joab said “Man, I wish I had my Chipotle right now” The OB, my cousin some other staff looked at him funny. I shouted some explicative about his burrito. In the next contraction I pushed like she told me to. I was doing it right, the baby was coming, but the baby’s heart rate was dropping. I needed to get her out now so I’d get an episiotomy. No! No! No! I don’t want that. The baby was showing meconium and was struggling so we needed to do it as quickly as possible. More looks to Cole. More reassurance that I was doing the right thing and that I would be okay and the doctor was not lying. Okay, we will do the episiotomy. Even in that moment, when they could see her head and I could feel her right there I was afraid that the doctor was going to tell me I had to have a csection to get her out.

Then a contraction came. I pushed as hard as I could, holding my breath like I was supposed to. I was exhausted and didn’t feel like I could do it but wanted to push her out. Baby was moving baby was coming and whoosh. The baby is out. The cord was wrapped around her neck and I was waiting to hear if it was a boy or a girl as the OB unwrapped it. It’s a girl! Cord was cut and she was whisked away. Also not what I wanted but they “had” to because the she was showing distress in delivery. I heard the OB call for APGARs 9 and 9. I felt relief and satisfaction, knowing that my body knew she would be ok. I never doubted she was ok. At that moment I looked at the clock. It was 10:28. It had only been about 4 hours since I knew it was the real thing. I really was one of those women who had a c-section after not dilating and then her next birth only took 4 hours.

I totally expected to cry and feel overwhelmed but I didn’t. I was so happy. I was so relieved. I was so shocked. The only thing going through my head was: I did it. I just did it. I can’t believe I did it. I just delivered a baby. By pushing. Without any meds. I really did it.

My birth team was proud of me. The medical staff was proud of me. I felt so supported and empowered. I told everyone I felt powerful. I did it! I thanked Ina May Gaskin and Cole and Kristen and Joab. I was so proud of myself. I still am. She is my healing baby, just like we agreed she would be on our morning runs.

Tonya’s HBAC of Kaia

For months and months I have dreamt of this moment. The moment when my daughter would be here and I would be able to say that I did it. I had my home birth after cesarean. I imagined what my birth story would contain and couldn’t wait to write it. And now that the time is finally here I find myself having a hard time putting into words everything that I am thinking and feeling. So, instead of a carefully planned story I’m just going to write and see what happens.

Most vbac stories start with the details of the prior C-section. But when I tried to write that out I realized that the details of my C-section aren’t important. The simple facts are… it happened. It gave me a beautiful, healthy son. I will probably never fully recover from the disappointment of having it. And, it changed the way I look at birth indefinitely. If it hadn’t been for that C-section I probably never would have realized that I could have a different experience. That I could actually have control over the choices made for me, my baby and my body.

From the moment I found out I was expecting I began to research vbacs and natural birthing options. I researched hospital vbacs, birthing centers and home births. The pros and cons of using a doctor or a midwife. Whether or not to have a doula. And every other decision I could possibly want to make. And I’m so thankful that I took the time to learn my options. I had the most empowering and healing birthing experience with a birth team that could not have supported me more.

My due date was November 14th which came and went. Day after day we waited as patiently as we could for our girl to decide she was ready to join us. Despite my best attempts at walking, squatting, bouncing on my birth ball and a handful of other natural induction techniques my girl was quite comfortable and showed no signs of budging. I started to get checked by my midwife fairly regularly at 40 weeks and although there was always progress it was very slow and steady. So it was no surprise that my labor began the same way. On November 25th at 41 weeks and 5 days pregnant I started to have regular contractions that were clearly different than the braxton hicks I had been having. I sent my husband and my son off to watch football and I started to time my contractions to see what they did. They were almost immediately 4 minutes apart and lasting 50-60 seconds. I timed them for a couple hours to see what they did and was pleasantly surprised when they stayed consistent. I called my husband and asked him to come home to help me get some things in order around the house in preparation for the birth “just in case.” By the time he got home my contractions were only about 3 minutes apart. They still weren’t super painful just annoying enough to slow me down. My husband decided he wanted my midwife to come check me and see what the status was. He also pulled out the birth pool so that he could set it up if I wanted him to. But wouldn’t you know… as soon as I saw the birth pool everything slowed way down. I told my husband it just felt like too much pressure and at this point I still wasn’t completely convinced that it was the real thing. My midwife came and checked me and there was some change but not much. I was still dilated to 3 cm as I had been for several days but I was more effaced than I had previously been. We all realized then that I needed to labor alone as much as I could. My midwife left and my husband and son spent the day upstairs playing and watching movies. I parked myself in the living room alternating between walking, squatting, bouncing and resting as much as I could. The contractions stayed consistent all day long. I tried to sleep that night but had a hard time getting much rest since my contractions actually became more painful when I was laying down. Around 2 a.m. I got up and started to rock and sway through them again. I realized that at this point they had spaced out quite a bit and were actually about 8 minutes apart. But they were lasting 1 1/2 minutes each. The day continued the same as before. I worked through each of my contractions on my own as much as I could. My midwife came again at about 12:00 p.m. at our request and much to my disappointment after 25 hours of consistent contractions I was still only dilated to 3 cm. Thankfully at this point I was fully effaced so I focused on the positive and went back to work getting through one contraction at a time. Around 1:00 p.m. I started having my husband apply heat packs to my back during every contraction since the back pain was getting more and more intense. We worked through contractions this way for about 2 1/2 hours. Around 3:30 I realized I was starting to need a lot more help to get through each contraction so I decided it was time to call in my team. By 4:30 p.m. my friend Jinna had arrived to keep my son occupied, my doula and midwife had both arrived and my sweet husband was setting up the birth pool. I decided to be checked one last time to make sure that getting in the pool wouldn’t slow down my labor. At 5:45 p.m. I was found to be only 4 cm. I was so disappointed. 31 hours of labor and I had only dilated to a 4. My midwife explained to me over and over that dilating to 4 was going to be one of the hardest things to do in my labor and that it was not uncommon for it to take the longest to go from 3 – 4 cm and that now I had reached 4 cm it was very likely that the rest of my labor would go at a much more typical pace. I remember saying, “How do I do this for at least another 6 hours?” And my midwifes response, “You don’t think about it in hours. You just do it one contraction at a time.” We went downstairs and at 6:00 p.m. I finally got into the birth pool. My contractions stayed consistent and with the help of my midwife, my doula and my husband I worked through one contraction at a time by reminding myself that I was doing exactly what my body had been designed to do and somehow I was able to completely relax and rest in between which is saying a lot since my contractions at that point were lasting 1 1/2 minutes a piece, double peaking at times and only giving me about 3 minutes of rest. I was even hand fed grapes and given sips of water between contractions (as all laboring women should be!) After about 3 hours in the pool my midwife said she wanted to check me after my next contraction. Little did I know my breathing had changed hinting to my doula and midwife that I may be getting close. During the next contraction I felt a gush, my hind waters had broken. I got out of the pool and before I knew what was happening I was in the middle of another contraction and literally hanging off of my husband to get through it. My midwife checked me at 9:00 p.m. and I was 7 cm. Then while being checked my water broke – what a relief! It was at this moment I professed my undying love for my midwife. She then uttered the only words I wanted to hear, “Oh wait you’re a 9. Wait, now you’re complete! Back in the pool, you can push whenever you feel the need.” I pushed for 40 minutes in the pool in several positions but because my girl was positioned just a little crooked it made pushing a challenge. So out I went to try another position. About 10 minutes later she was here!

After 35 hours of labor my girl was born at 10:01 p.m. She was immediately handed up to me. We had done it! All of the preparation, worry, pain and impatience were gone. All that mattered was that she was here. She stayed with me except for one short period in which she did some skin to skin with her Daddy. She latched 20 minutes after she arrived and nursed for almost 40 minutes. She was quiet, calm and very alert. Immediately recognizing her Daddy’s voice as he told her how beautiful she was. When we finally got around to weighing and measuring my girl weighed in at 8 lbs. 4 oz. and was 20 1/2 inches long with a giant 14 1/2 inch head! Sadly that large noggin caused a 2nd degree tear but what a small small price to pay for such a wonderful experience. I am so thankful that I was able to do this and so grateful for the support provided by my incredible birth team.