I know this is a departure from my usual blog content, but I spent a lot of time while I was pregnant reading about other successful VBAC (vaginal birth after cesarean) stories and they really helped me prep for E's birth, so maybe this will help someone else trying for a VBAC too.
First up: the back story. With S, I went into labor on my own a week before my due date - my water broke in a bookstore and I had to trundle all the way back through the mall looking like I'd wet myself! I was progressing fast until I got an epidural at about eight centimeters. I then spent a long time lying on my back, because I didn't know any better. I had a hard time when I started pushing, because I couldn't feel anything, so they turned off the epidural. It was beyond excruciating; apparently, having the epidural and then turning it off makes the pain that much worse than not having an epidural at all. I pushed for three hours, but S was facing the wrong direction - towards my front rather than my back - and he kept getting stuck at my pelvis, so I had a c-section. The poor guy was bruised all over his head.
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| {Me with S shortly after his cesarean delivery} |
I had a rough time with recovery, and felt very emotional about how it had all panned out, to the point that I couldn't easily talk about it for a good few months afterward. I also really regretted being so out of it when he was born and missing at least the first hour of his life.
This time around, I was determined to avoid surgery. The Mister and I hired a doula and did a lot of prep practicing exercises that would help the baby move into a good position for a natural birth. I wanted to avoid another epidural because I wanted to be able to move around during labor.
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| {24 weeks pregnant - the last almost-flattering photo of me pregnant!} |
I had been having mild contractions for two weeks and two days before I went into the hospital. As frustrating as that was, it got me to five centimeters dilated - half way there - before I even went into proper labor! Because of that, my midwives agreed to cancel the repeat c-section we had scheduled for ten days after my due date in favor of an induction, which was awesome. (Often, doctors won't allow inductions for VBACs.)
On Saturday, February 18th, at 40 weeks and six days pregnant, I got an inkling that I might be leaking fluid. The Mr thought I was being silly but I gave the midwife a call anyway. She thought much the same, but said I could come in and get checked if I really wanted to. I did a Target run, popped home to unload the shopping and then headed to the hospital.
We arrived in Triage about 5:30pm and I was hooked up to monitors to confirm that E was still doing okay (she was). The nurse checked me, told me it probably wasn't amniotic fluid, and left us to go test it just in case. Turns out, it was - apparently I had a small tear in my water bag which had probably sealed itself again - I had no idea that could even happen! Since there was a risk of infection (my waters had been ruptured at least 36 hours at this point), they decided to induce that evening. We called our doula, Holly, to let her know what was up and she said she'd head over as soon as she could. I had a quick ultrasound to confirm E was head down, during which they estimated her size to be about eight and a half pounds, then we made our way to L&D.
We were "greeted" - and I use that term very loosely - by a horrible nurse. She put an IV in my hand in a very awkward position and may or may not have missed the vein more than once. She hooked me up to a bag of fluids, and I asked what they were for. She seemed offended by the question, and refused to give me a straight answer. Thankfully, her shift ended about 20 minutes later, and she was replaced by Sam, who was possibly the best nurse ever. She was so much nicer, right from the get-go, and more than happy to fill us in on everything that was going on.
My midwife, Julie, arrived once we were a bit more settled and started me on pitocin at 8:30pm. We had a visit from an anesthesiologist to talk about getting an epidural. He explained that there were "absolutely no risks" (to which the Mister and I both rolled our eyes) and also explained that if I
did have to have an emergency c-section and I
didn't get an epidural, they would have to completely knock me out because they wouldn't have time to place the catheter in my back. We declined, because I really didn't want to be confined to bed. The anesthesiologist got a bit stroppy and left.
I was hooked up to a monitor and a drip that I could move around, so the Mister and I went for a stroll. We had only walked to the other end of the hallway when the midwife, Julie, came and found us. She explained that E's heart rate was elevated at 180 to 190 bpm; normally, it stayed consistently in the 140s . She suggested I go back to the room and try resting to see if it would come down.
I was nervous about lying down, because of what had happened with S. In an effort to avoid a similar situation this time around, we had spent the past few weeks practicing positions (with our doula's help) that would get this baby the right way round so I wouldn't have to have a c-section again. None of them involved lying down. Still, I gave it a go for the baby's sake, and her heart rate did come down a little.
Another anesthesiologist came to visit, and again tried to push the epidural, explaining a second time that they would have to knock me out if I needed an emergency c-section. This time, though, I was given the option to have the catheter placed in my spine without administering the drugs, so I agreed.
I still wasn't feeling contractions any stronger than I had been for the past two weeks at this point. Julie suggested breaking my water bag to move things along. Our doula, Holly, had arrived around 8pm, and my waters were broken at 8:30, which was uncomfortable but not horrendous.
Shortly after that, the anesthesiologist arrived to place the catheter. Everyone had to leave the room except for the nurse. When he put the needle in, I got a strong pain in my right thigh, which radiated down my whole leg. It was a bit unnerving (what if he was causing permanent damage to my spine?), but the anesthesiologist was adamant that he was doing it right. Still, at my insistence, he adjusted it so eventually the pain in my leg wasn't so bad. During this time, my contractions
really got going. By the time he was done, I was unable to talk through them, and they were getting very close together. As long as I was sitting up though, I felt able to stay in control by focusing on my breathing.
My midwife was very keen for me to lie down again because E's heart rate had gone back up and she was obviously stressed. It was excruciating, and I started to feel like I wasn't able to cope with the pain anymore. I also really needed the loo, so I got back up and headed for the toilet with the Mister and our doula supporting me. Being upright again, I was able to breath through the contractions and stay in control of the pain again.
Julie came in while I was on the toilet, having been but still needing to go - I'm guessing because the baby was very low. She said they really weren't comfortable with me being in the bathroom and I
needed to lie down again. She suggested that maybe I should consider the epidural, on the off chance that it might have a beneficial effect on E's stress levels and probably my own. She was very apologetic, and made a point of telling me that although she knew how much I wanted to avoid drugs, it might be the best way forward given the circumstances. She left to give me and the Mister a chance to chat, and I decided that if I was going to be confined to bed anyway, I might as well take the drugs.
Soon, I was back in bed and contracting almost constantly. They turned the pitocin off, and the contractions spaced out a tiny bit, so I got a few seconds of sanity in between, but they were still as strong as ever. It took a while to call the anesthesiologist back in to administer the drugs, and when he came back he was beaming in an "I told you so" sort of way. (He may have actually said something along those lines too.)
It took a while for the epi to kick in, and when it did, it was only on my right side, which happened to be the side I was lying on and the only position in which E's heart rate had stabilized. I started feeling the urge to push every now and then, and when Julie checked me I was fully dilated.
I asked to switch to the other side, hoping that would avoid E getting stuck in a bad position and distribute the epidural a bit more effectively. Very shortly after I moved, E's heart rate went
way up. Suddenly the room filled with people and it got a bit scary for a while. They had me trying to push on all fours for a bit, but it didn't help. I got back onto my left side, which wasn't easy, and eventually the baby calmed down enough that they felt okay to let me keep laboring. We were *this* close to an emergency c-section again.
The epidural finally kicked in right as I started pushing, and even though it was late, I was
very thankful for it. I could still feel contractions and move around a bit, but it gave me the chance to relax in between contractions and focus on what I had to do.
The Mr gave me a lot of encouragement, but it took me a while to get the technique down. Sam, the nurse, gave me some advice that was incredibly helpful - where I had been taking two or three breaths in between bearing down, she told me to just take one so the baby wouldn't get as much chance to return to a higher position. I started pushing much more effectively after that. The one other thing that
really helped me was the mirror I asked them to bring in - as horrifying as it was seeing what was going on down there, seeing more and more of E's head descending was enormously motivating.
Julie, the midwife, explained that because E had obviously been in distress, a lot of people would come in to check her out once she was born, and I wouldn't be able to hold her immediately. Soon enough, the room started filling with people, and not long after that - only five hours after they'd started the pitocin - E was born. I had pushed for an hour and a half.
She lay on the bed for a couple of seconds, and I tried to reach for her. Then they took her to check her out. It didn't take long to determine that she was healthy, so they handed her back to me. My "little" lady was 10 lbs 1 oz and 22.75 inches long!
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| {Me and E a few hours after her birth - we were both in much better shape than S & I were after his birth} |
We nursed while I got stitched up. I had a fourth degree tear - about as bad as it gets - but recovery has been much easier than after my c-section. I was able to walk to the bathroom once we got to our postpartum room, although I blacked out when I stood up for too long. I was up and about that evening, albeit very gingerly.
I feel so thankful that I was able to have a "normal" birth experience - it was very healing for me emotionally. Now, almost four months later, baby E and I are both still doing well, and I think I can happily say that we have adjusted nicely to being a family of four.
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| {Baby E at 3 weeks old} |
