Monday, August 6, 2012

Vaginal Birth After TWO Cesareans- A VBAC Interview

I am so excited to present another installment in our VBAC interview series.  It is awesome and incredible that so many women are able to have successful VBACs in the hospital.  This sadly is not always the case.  This mom had to choose a home birth in order to get the birth she wanted.  OPTIONS for every women are simply still needed in the American birthing climate.  
Enjoy!  
-So, I would love for you to first give a brief rundown of your first birth/s and what you feel like happened and why you had a c-section.

My first cesarean was a result of lack of education completely. I put my full trust in my OB and never questioned a thing. It was an elective cesarean at the OB's prompting as a result of the baby's size. I remember her discussing concerns with me about the baby being too big, getting stuck, shoulder dystocia, 4th degree tears, and such. That was enough to scare this uneducated, first time mom. The cesarean was an awful experience. I don't remember meeting my baby or breastfeeding, did not bond for quite some time, and I had hives for two weeks from some medicine I was given for the surgery. My baby was 10lbs 4oz and 21.5 inches long.

My second cesarean was not supposed to be. I was planning a VBAC at a local hospital with a midwife who worked in a group practice. At 41w4d I was still pregnant and had gone in for another BPP and NST, baby looked good. The OB stripped my membranes to try to get things going and suggested that if things didn't get going that night then I should come in the next afternoon to see if I would be favorable to have my water broken. I was up half the night with contractions but then went to sleep so I would be rested. Things slowed. The next day I was packing my bag to go into the hospital when I got a phone call from my midwife. By this point my contractions were regular again but not intense. The midwife talked to me for a minute then says that one of the OBs wanted to talk with me. (The OB in the practice who has a known reputation of not supporting VBAC's and being c-section happy. I was actually told by the midwife to avoid her, so I did. This was our first interaction.) She proceeds to tell me that she is the OB on call for the weekend, to her my pregnancy ended at 39 weeks, and I no longer had options at their hospital. If I showed up, they would just perform the cesarean. Of coarse, I knew I could not be forced to a cesarean against my will but I was irate over the phone call. I honestly did not know what to do. I was not prepared to fight every second for my VBAC - everyone had been supportive until then. I ended up driving to another city in search of someone to support my VBAC, literally last minute. It didn't happen. I had my second cesarean that day with an OB I did not know, at a hospital that I had never been to. He was 9lbs 15oz and 21.5inches long. The cesarean itself was better than my first, physical recovery was easy but my emotional recovery was extremely difficult.

-What made you desire a VBA2C when they seem so hard to come by in the current obstetric climate?
I wanted a VBAC because my 1st c/s was so hard. Even with the pain medicine, I needed help with everything. The the hives I got had me in and out of the ER the first week home. I was extremely upset that I don't remember my first moments with my child and while I was getting sewn up and recovering we had family show up(who were told not to) who go to see my baby and take pictures before I even got to hold him. Other things that helped in the decision were that we want a big family. Also, when my 2nd baby would be born, my 1st would be 18 months old. I wanted to be able to hold him and care for him after the baby came. Then, of coarse the research I did made me feel more confident in my decision to VBAC. And all these reasons were why I went for my HBA2C with our 3rd baby, too.

-How did you find a care provider who would support you?


I knew after my VBAC hospital attempt with my 2nd baby that if we had another baby, we would do it at home. I actually met my home birth midwife at an ICAN meeting.

-What was labor like for you?


Different than what I expected. It was hard and it was long but the worst part for me was I had never labored before and I assumed that in labor I would know where I was. I thought I would be able to tell if I was at 7cm or if I was at 10cm - but it all felt the same at the time so I never felt like things were going anywhere. Also, I stalled twice so as a VBAC mom that felt very discouraging.

-What helped you VBAC?


My supportive midwife. She was so encouraging and never second guessed my desire to VBAC. My doula was awesome, too. She would tell me over and over, "You are going to do awesome!" I NEEDED support to make my VBAC happen...and I got it!

-How did you prepare for your VBAC (was there anything you did differently)?


I took a natural birth class, did prenatal yoga videos, and watched probably every VBAC and home birth video on YouTube. I also read "Ina May's Guide to Childbirth!" I found reading birth stories really helped me prepare.

-Describe your VBAC birth story.  We would LOVE to hear about it!


I woke up around 2am Saturday(May 12th), with contractions coming approximately every 3 minutes. I timed them for a while and then decided to contact my doula. Unsure of what was going on, she decided to come over and I continued laboring. I laid back down to try to rest more before the sun came up. I was able to sleep some in between contractions. When morning came we called our babysitter. Our boys left and I ate some breakfast. I labored during the morning and about 10am my midwife showed up and my contractions started slowing. She suggested Billy & I go for a walk so we started walking up and down our road. Things were not picking up and we came back inside. I went to lay down in bed to keep from exhausting myself since things seemed to be stalling. I felt disappointed. As a VBAC mom I just felt like my body was failing or something. I laid in bed listening to music and a praise song came on and it said, “my whole word is caving in but I feel you now more than I did then. How can I come to the end of me and somehow still have all I need? God I want to know you more, this is how it starts…I find you when I fall apart.” It hit me hard because I felt like everything was falling apart. I had wanted this VBAC for over 2 years and I knew at that moment that it was out of my control but in God’s control. 



Around 1pm, my midwife and I decided to do a cervical check just to see what was going on. She checked me and at first I was 3cm. However, that was only because I tensed up – when I relaxed I was actually 7-8cm. (Note: I only learned this after labor! For the longest time I thought I was only at 3 at that point! Funny now, not funny then!) We decided to strip my membranes to see if everything would start moving along more consistently. Also, my cervix was still a bit posterior. After an hour or 2 my labor picked up again. Then next 8 hours are a complete blur. I was in the birth pool, out of the pool, leaning on a bench, hanging off DH, to the bathroom, back in the pool. One vivid moment I remember was laboring in the pool and listening to music. I was in between contractions and singing along to the Matthew West song “Strong Enough.” I staring at my doula and singing, “I can do all things, through Christ who gives me strength.” Those lyrics gave me strength for quite some time. At some point my contractions began getting very strong on my back. Billy, my doula, and friend took turns and had to constantly be at my side for rubbing my back and applying counter pressure. It seemed that I was in transition for hours upon hours. I felt something was stalling me again and I was dealing with exhaustion. At times my legs lacked the energy to stand. I remember telling my doula that I didn’t feel like things were progressing.

About 11:00pm we decided to do another cervical check to figure out what was happening. Turns out my doula and midwife both were suspecting a cervical lip. I went to lay in bed for the check.  I felt I could not cope with contractions laying in bed. I was 9-9.5cm, bag of water still intact, with a cervical lip, and the baby moved at some point during labor and was now asynclitic. We decided to move the lip, then break my water, and possibly try to realign the baby correctly. This was the hardest part of my labor and it felt like it lasted forever. I endured at least 15+ contractions during that cervical check, laying on my side/back in my bed. (Being confined to the bed at that point made me realize later on why an epidural would be appealing for someone confined to a bed laboring in the hospital.) After my midwife was done she had went back upstairs and I laid in bed for a few more contractions. I was waiting for a break before I got up to get back in the pool. Billy & my friend stayed with me. My doula left the room to go pump.  As I experienced those last contractions on the bed I felt like I needed to push. I was laying on my side…felt like the baby was going to shoot out but I was so tired I couldn’t even lift my leg to ease that feeling. As soon as I got up I had a hard contraction and by body threw itself into a squatting position beside the bed. My doula came back and I made it a few feet and another hard one hit me and I squatted next to the couch. My midwife heard that one, hung up from her phone call, and came down the stairs. I finally made it to the tub and my midwife was asking if those pushes were involuntary – my doula said yes and I gave a quick head nod.

I was in the tub and I was on my knees, sort of squatting, and my body was completely in control pushing him out. Wildest feeling ever. It finally hit me at that point. I realized my VBAC was happening. It was reality. I also quickly realized that this was the part everyone says is painful but I didn’t care. My body was working hard. And soon I was able to feel him coming. Billy was feeling him come out which was amazing. He was giving everyone the play by play…he would tell us that he could feel his ears, nose, and even his tongue sticking out. Those were amazing moments – I could see and hear the excitement from Billy and I felt so focused and in control. I actually enjoyed pushing! I breathed through the pushes to keep things going slowly. Finally at 1:14am, May 13th, he appeared in the water and Billy caught him with tears in his eyes and he and placed him in my arms. 


I began nursing and shortly after I delivered the placenta in the tub without much effort. (It was huge!) Also, the cord was 3 feet long with a true knot.  I got out of the tub, got cleaned, and into bed. I relaxed in bed while the newborn check was being done. Billy made me a smoothie and fed me a bowl of cereal. About 2 hours after he was born Billy cut his cord and I fell asleep in the middle of it all. I delivered a 9lb 8oz and 22inch long baby with an intact perineum. I got a small cut on my labia but nothing that needed any care. Best of all, my sweet boy Eli came to me early morning of Mother’s Day. I am so blessed.

- Has the postpartum experience been different than your other birth/s?  What about it surprised you?

Yes, like night and day. Our baby never left us postpartum. It felt so weird to give birth and then walk myself to the bathroom and to bed. To wake up the next morning and take a shower. (With no help!) Have my older kids sit on my lap. My milk came in within 24 hours. (Took 4 days with my previous babies!) I did feel VERY sore which surprised me but I was able to go to the chiropractor and an adjustment helped me feel much better.

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