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Thursday, 06 March 2014 15:04

My VBAC: A Time of Learning and Healing

A little under four years ago we became pregnant with our first child. January 26, 2011 was one of the most amazing but traumatic days of my life.  My doctor has been my doctor since I was young and I went into this pregnancy trusting the medical system.  I guess you could say this is a tale of complacency. I never had a reason not to trust doctors and I didn't really know I could question their opinions. I respected their authority I guess you could say. I had a healthy pregnancy and had a birth plan that I discussed with my doctor over and over again. I had attended prenatal classes, had my bag packed, a nursery ready and was so looking forward to having this little bundle in my arms. 

I went into labor in the early hours of the 26th. I had steady contractions and we headed up to the hospital around 5 am. I was a couple of centimeters dilated so we were sent home and I was told to hop in the bath to help things along. So we did what we were told and as contractions remained steady we headed back up to the hospital. I was now around four centimeters dilated and was told “I was progressing slowly”. Hearing that worried me but I had no reference point. We were admitted and there we were, in a labor and delivery room by ourselves, dealing with my strong contractions and hoping I would “progress quicker”. The doctor came in to check me and this is when I found out that the doctor to deliver your baby is whoever is on-call when you go into labor. What? OK another thing to make me anxious. It just so happened to be the husband of my doctor.

I was dealing with strong, consistent contractions and my husband was pretty much my leaning post. Although the nurses and doctors came in and out of our room we felt really alone. I had horrible back labor but baby was not stressing so I set my mind to it and went through the motions. Did we try a variety of positions? Nope. Why?  We just really didn't know what would be best for our situation with the back labor. We did some of the techniques they showed us in prenatal class and did some of the things we read in books. The next time the doctor came in to check me I had only progressed another centimeter or so. He decided it would be a good time to break my waters. I didn't know that I had a choice. I was complacent. Thinking “ah OK, you’re the doctor and you must know best because you've seen this and done this before”.  Within a short time after breaking my waters the doctor told me he would check on me in an hour. So there we wait, consistent, strong contractions and hoping for the best. Baby was not stressing so we kept on keeping on. When he checked me again I had not progressed much and I was told they would administer Pitocin (I did not know this could cause fetal distress and increase my chances of c-section nor did I ask the “right” questions I guess. When we asked what it did he just told us it would cause my uterus to contract and speed up the process).  So again we were complacent and did what we were told would be best not knowing the possible effects. The contractions became extremely intense and the doctor suggested I get an epidural. So I did. They continued to administer the pitocin and he literally told me he was giving me half an hour and if I had not dilated more any more we would have to do a c-section because my water had been broken for some time now. Half an hour later he told me that baby was starting to stress so it was c-section time. The obstetrician had good bedside manner and told me what would happen next. I remember laying there crying that 1) My baby was now in distress and 2) That I wouldn't get to do skin to skin contact and 3) Why had I let the doctor do any augmentation?  Especially since I had decided I was not interested in getting anything. If baby was fine and I was slowly progressing why was that not okay? 

It was now about 12 hours after coming to the hospital the first time and I just wanted my baby to be safe. The team that did my c-section were very warm and supportive and Marley was born at 6:26 pm on January 26th.  After a quick snuggle (my arms weren't frozen) and a kiss, off she went with nurses and my husband. My body went into shock almost the moment they left the room and I had a seizure and was throwing up. After getting that under control they put me back together and whisked me off to the recovery room. I asked constantly to see my daughter but they said it was “against policy” and I had to be “unfrozen” before I could go up.  I laid there and talked to an older lady nurse about how excited I was to see her and how I was so happy she was healthy and safe. About two hours later I got to finally hold my beautiful girl. My husband was doing skin to skin with her when I was wheeled in and I was so happy that at least he was with her. Almost five hours after delivering Marley we tried to breastfeed. Breastfeeding hurt but I didn't care. We were in the hospital for four days and I must say the staff took amazing care of us and I barely let Marley leave my arms. I just wanted to hold her and have her on me. 

I will share more detail in the future but to summarize, the first seven weeks of breastfeeding hurt like death but I stuck it out. I had some postpartum depression to deal with as well. My scar healed and six weeks after the c-section I was somewhat back to normal physically in terms of walking, carrying, driving, etc. This little girl was a firecracker and so sweet. Smiling, eating, pooping, discovering.

Fast forward to November - nine months after Marley was born - we got pregnant a second time! We were so happy. I told my doctor during my daughter’s checkup and the first thing she said to me was “Would you like to go ahead and book a c-section?” We had discussed my situation from our first baby appointments with Marley and she knew how much I felt uncomfortable and unhappy with what had happened. She blew it off. And now she was asking me to go through it again. I said no and reiterated that I felt that the c-section with my daughter was due to impatience and interference as no one could ever give me an answer to why I had a c-section. Any fetal distress was due to augmentations as far as I could tell. My family doctor became a bit defensive. Remember that her husband was the doctor on call with me.  When I left I said I would be looking into getting a midwife and I would let her know. When I got home I immediately called a midwife in town (1 of 2) and told her my story. It was one of the luckiest days of my life because she had a cancellation and had a spot available the week of my due date. I was about 2-3 months along and heaven knows where I live you book the midwife at the first plus sign on the pregnancy test! Either way I counted my lucky stars and went to my first appointment with Sylvia.

It was purely night and day compared to my doctor’s appointments with my first pregnancy. Appointments lasted close to an hour, whereas my appointments with my doctor were 15 minutes! There were a lot of questions asked, points discussed, pros and cons, plans, etc.  She recommended books and gave me homework in a sense and told me to come with questions for our next appointment. I was a "high risk" VBAC because my babies were only 18 months apart so there was a lot of extra information she gave me. 

A huge moment of truth was when she sent me to a women's doctor in town whom she trusted. He needed to review my file and give her and I the go ahead before she was going to go any further. He is a leading doctor in my area. He had looked at my file and he actually looked me in the eyes and apologized for the experience I had with the other doctor. It simply came down to impatience - not letting things naturally progress at the pace my body had set. My daughter was not stuck, had no coning.  He looked for details about fetal distress and couldn't find them. There was some heart rate ups and downs but nothing out of the ordinary in a labor situation. By the sounds of it this doctor is known for his impatience. He told me too there was no reason I could not have this baby naturally based on my first birth and I should “go for it”.

I left there with feelings of utter happiness mainly because I was going to try for a vaginal birth but also that my intuition was right all along. It was a moment where I knew I had to trust myself more, do what was best for my baby and me and I should always ask questions and get all of the options straight. 

My midwife was down to business and kept me on my toes. This lady was phenomenal and our philosophies about childbirth were the same. Plus she would be the one to help me through labor and honor my birth plan whenever possible. Yes I knew there was a possibility of having a repeat c-section but having my baby naturally was something that was so important to me since there was no medical reason not to. I went into labor at 3 am on August 21st, 2012.  Contractions picked up as time went on and we called my midwife at 8 am. She came and checked me out. Things were looking good, I was in labor but not dilated much. She told me to eat a big plate of pasta, drink lots of fluids and keep moving. My mom, my husband and my daughter helped me through this part and my midwife came back every few hours to check on me. At 3 pm we checked into the hospital and it was game on. Contractions started getting very intense at around 4 pm and we utilized the shower and a variety of positions. Everything progressed as planned - I am a slow laborer. It was intense for most of the time and I had some contractions that were 10 minutes long. I decided to use the gas, which didn't do much but took some of the edge off. It was just so nice having my midwife there with us, walking us through, checking on baby, giving us pointers, giving us confidence. At nine centimeters I was going through extremely intense contractions and my cervix was not yet lined up - it was more pointed to my rear so I had tons of pressure on my rear making it hard to focus and get everything into position. I ended up getting a special hybrid of a spinal and epidural at that point. It was perfect because I wasn't frozen but it just took the pressure off my rear (like feeling like you have to go bathroom and holding it in) and let me focus on opening up and letting baby come. I really think birth has a huge mental component. So the pressure eased on my rear and within hour Sylvia sat down beside me and checked me.  She said the words I was dying to hear “OK it’s time to push!”  I was over the moon and knew the next part was a different kind of work. 

Close to thirty minutes of pushing and Jonah arrived at 1:47 am on August 22, 2012. So 20+ hours of labor and finally I had my little man in my arms. He came immediately on my bare chest and stayed there for the next three hours! He was crying when he first came out, and then stopped when he was on me for a minute. He looked at me and he laid calmly on me, moving his limbs around, curious about his new world. Within minutes of being born he was rooting and he had a little to eat.  Soon after he fell asleep on me and then we worked on delivering the placenta and stitching me up. After three hours of holding him my midwife asked if it would be okay if she just took him over to the table to weigh and measure him. After a couple of minutes, daddy holding him, and a bathroom break, he was back on me. I ate a little and re-swaddled him up. He had his first rest on his little bed beside me and I had a rest too. This was the most amazing experience of my life. The bond was immediate and breastfeeding was a breeze compared to my experience with my daughter. We went home the next morning and went to the fair four days later!  Recovery was so different. I didn't experience depression like I did after my daughter. I had a little 18-month-old girl and a new little guy to look after and I felt blessed.  The birth of my son was truly a healing birth. I wish every woman could go through a natural childbirth and do the immediate skin to skin contact. I am also thankful we have the resources to do c-sections if medically necessary. 

So what can you take away from my story? If you can work with a midwife and she/he will be delivering the baby then great! If you have a doctor or you do not know who will be delivering your baby be cautious.  I just want to reiterate that in the emergency case where a c-section in medically necessary you need to do what is safe for you and baby.   

  1. Ask questions no matter how intimidated you might feel.
  2. Ask about all options and the possible effects each outcome may have. During labor you might not be in a position to ask so make sure you have someone on your team that knows exactly what you want and what is important to you. They need to be your advocate. A midwife is perfect for this if you have the same philosophy. A doula would be my second recommendation.
  3. Stand your ground and don’t feel obligated to do something that you don’t feel comfortable doing (just because the doctor wants to do it or that is how they do it).
  4. Do your research beforehand and come up with a plan that covers all the bases.  Also reading Ina May’s Guide to Natural Childbirth would be on my to do list.  
  5. Talk to other moms who have delivered recently in the hospital (or birthing center) and find out about their experiences, which doctors or midwives they worked with and what they wish they knew beforehand. Moms can be one of your best resources. 
  6. This is a tip my midwife told me to do: Go on all fours daily throughout your pregnancy to help baby get into a good position.
  7. Find out about procedures immediately following birth and the “why’s”.  For example, weighing right away isn't necessary and that is why my midwife left my baby to do skin to skin. What’s more important? Skin to skin or a weight? Also bathing the baby. My midwife told me not to bath the baby until I got home, whereas with my first baby I thought that is just what the hospital does. The shots they give baby right after and the serums etc. What is necessary and why? 
  8. No regrets: do what you need to do to stand up for your rights for a natural birth. If the doctor is impatient or if they need the bed? Too bad. Do your thing, your body has it’s own mind.
  9. If you knowingly decide to use augmentation, know you facts. Next time I would do it the same as my son - give it time and use as little augmentation as possible.  

You are strong and your body is amazing.  It is absolutely fascinating to me how many things need to line up to take place for healthy birth to occur. Your body is absolutely phenomenal. Have faith in yourself and your choices. People that KNOW better DO better.

Published in Birthing Stories

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