My VBAC Story

My adventure begins with my third pregnancy.  Having had two beautiful boys via c-section, I never felt like I was missing anything because I hadn't pushed a baby out of my vagina, however, when I became pregnant for a third time and started doing research, I was very frightened by the prospect of a 3rd c-section.  The more I read about repeat c-sections, the more frightened I became.

What is really scary about my journey, is how my then OB refused to consider a VBAC based on a relatively small increase in the chance of uterine rupture, but offered no comparative stats on the dangers of a repeat c-section.  When I asked if my OB knew of any practice in town that would considered a VBAC after 2 c-sections, I was given a very small, hypothetical list.  Unfortunately, since they wouldn't do a VBAC after 2 c-sections, they didn't educate themselves on who would. 

To put it mildly, I was very disappointed.

After doing more research, I found the midwives at VCU, and I was so grateful that I did.  While they could not guarantee a VBAC (no provider could), they were willing to give it a go, which is all I was asking for.

The midwives asked me to read several books about natural childbirth.  They are midwives, after all, and my favorite is Ina May's Guide to Childbirth.  It gave very practical reasons (in my opinion) for why women should give natural childbirth a chance, goopy baby on your belly, letting the cord stop pulsing and all.  I was also heavily influenced by The Business of Being Born films.  I found the women who chose natural childbirth incredibly beautiful when they gave birth, and I wanted that.  I am/was also convinced that my safest way to a VBAC was to avoid all drugs if possible.  If I wasn't doped up on pain meds, then I would immediately be aware of a rupture, at which point the OB's at the hospital where the midwives delivered could do a c-section within minutes.  In addition, based on my research on interventions, I was much more likely to achieve my VBAC if I avoided any interventions, which included pain meds.

Besides choosing midwifery care and natural childbirth, I employed a doula and attended Bradley natural childbirth classes.  My doula, Sara, was fantastic.  She provided additional information and affirmation of my choice of a VBAC and natural childbirth.  It was incredibly reassuring to know that she had attended many VBAC deliveries as a doula and had herself had 2 successful VBACs.

The Bradley natural childbirth classes were also helpful.  Our teacher, Lexy, was amazing and, again, supportive of our birth choices.  The classes themselves provided great information on childbirth, what to expect from natural childbirth (i.e. it doesn't follow a uniform line), birthing positions, comfort and coping strategies, and most importantly for me - practice.  My husband isn't one to practice at home, so the practice part was very important for me.  I must say that reading the Bradley method book was a disappointment since it was pretty outdated and focused solely on the husband as your only support during labor, which, unless your husband is an actual superhero, is a whole lot of pressure to put on one person for your success. 

To add to my team, I had invited my best friend, Katie, to come and support me.  I didn't expect great things from her, but her presence was what I wanted if she wanted to be there, which she did.  Since she was newly married and hoping to start her own family soon, I wanted to share my experience with her even more.

I have to say that despite my resolve to have a VBAC and the supportive team that I built around my delivery, I had days leading up to my delivery where I thought, why not just have a c-section?  It was an insidious thought, but my anxiety was so great at the end, that I was very tempted by the certainty of a c-section.   My biggest concern was going over my due date, which is what happened with my second son.  At a week over due, his heart rate dropped dramatically during a non-stress test, and I was whisked off to the hospital for a c-section.  Hope for that VBAC was over in a split second.

So, with my worries hanging heavy, I woke up on my due date to several good contractions, which naturally stopped, so I got ready for work like usual, prepared to hear the midwife tell me nothing was happening downstairs, which she did.  I was barely 1cm and my cervix was still long but softening.  The midwife recommended that I head on back to work, despite some constant contractions on the walk to her office and in the waiting room.  Naturally, they had stopped by the time I got to see her.  So, I went back to work and ate lunch.

At 1:30-ish my contractions started and didn't stop, but my last experience with labor (with my first) was super slow going, so I thought I could last until 5pm easy, right?  By 3:30pm I was sweating and feeling a bit sick to my stomach with every contraction and having tons of difficulty sitting in my chair.  I IM-ed my coworker and friend and asked him if he would help me to my car (a 3 block walk).  Being a great guy he naturally agreed.  He also offered to drive me home, which I was not apposed to, but when I got to my car, I thought I could make it home on my own.  After 3 or 4 good contractions during the car ride, I arrived home. 

Once home, I called my parents and my husband who was at the doctor's with our oldest for his regular checkup, letting them know that the show was on.  Then I laid down in bed and tried very hard to relax and rest.  My husband came home, and my mother came over to collect my oldest.  We called the doula and the midwife on call to let them know that I was in early labor.

5:30pm
My water broke while I was in bed.  Now that was a weird feeling.  About 20 or 30 minutes after we had called the doula, we called her back.  My water breaking helped kick up my contractions a bit and had us going to the hospital earlier than we expected, but I labored for a while with my doula at home before the midwife on call recommended that we just come in.  My husband also called my best friend to let her know she might want to get on the road, since she lived in North Carolina (a 4 hour drive from our home). 

8:00pm
We arrived at the hospital.

8:15pm
I was checked by the midwife on call, Amber.  I was (still) 1cm, 40% effaced and -4 station.  They inserted an IV since I was GBS positive and needed to receive antibiotics.  I really hated the hep-lock/saline lock.

I labored and labored all without any pain medication.  I was coping well until....

2:20am 
I was 2cm, 70% effaced, and still -4 station.

Talk about feeling like you are going nowhere fast.
 
At this time the midwife thought that we needed to get my contractions more regular.  She suggested adding a little pitocin to get them going, but it was totally my choice, and the midwife made that clear.  I accepted, but only because I was afraid that not accepting would get me closer to a c-section, since my water had broken a long time ago, and I was not making much progress.

This is when it really started to get hard. 

My contractions went from 5-7 minutes apart with a lovely, natural build up to hard and fast and 3 minutes apart.  I tried everything to make them easier to deal with, the shower, the ball, the toilet, hugging the back of the bed.  Nothing really helped or didn't for long, and I was getting more and more nauseous.  The nurses offered some medication for the nausea, which I was afraid to take, but finally did, because I just couldn't stand it anymore.

6:15am
I was 3cm, still 70% effaced, and -3 station.

This was very discouraging.  I was so tired that I actually passed out between some contractions.  I remember startling my doula and midwife, who were sitting at the end of the bed where I was laboring at the time, by shouting "Oh my God!" coming out of a dead sleep to the pain of a contraction.  It would have been funny if I weren't struggling so hard.

7:00am
The midwife on call changed to Leslie.  I will admit that at this time, I was questioning if I could do this.  I was very disheartened to have made so little progress.

Since squat was happening, Leslie suggested that I stand facing my husband with him supporting me.  She then took a rebozo baby carrier/sling and supporting my belly with it and did some 'chugging'.  Basically, she shook my belly between contractions.  The idea was that maybe the baby was not quite well positioned enough to move down, and this might just shake her into place.

When a contraction hit, she would stop and encouraged me to bend my knees and try to open my pelvis.  I started in earnest to make very loud moaning sounds.  It hurt so badly, but I had to move the baby down.  It was at this point that thoughts of an epidural and a c-section crossed my mind.  I kept thinking that they would be so much easier, but I kept those words to myself, afraid that if I voiced them, someone might agree with me.

My vocalizations at this point were very loud and full of the pain that I was experiencing.  I know this distressed both my husband and my best friend, but they never stopped supporting my efforts for a natural birth.

The positive energy in the room, however, kept me going.  Everyone believed that I could do this.  I remember hearing my husband's breath hitch because my pain distressed him so, but he kept telling me I could do it.  The midwife too kept telling me that I could do just one more contraction.  And I did.

8:20am

I had been begging the midwife for a while now to get into the tub, because I had heard/read how wonderful if would feel.  She said that she needed to check me to see if I had reached the desired 6-7cm.

I was 4-5cm, 90% effaced, and -2 station.

I must have looked bad or sounded really pathetic (which I think I did) because she gave me the go ahead to get into the tub.

The Tub
The tub felt like heaven for a few contractions, and then I started to change my position to see if that wouldn't help to ease the discomfort as the contractions again built in strength.

I didn't even notice the difference in the pushing contraction until I felt felt her head move down.  It was such a powerful feeling, and I don't mean that it made me feel powerful.  It was so strong, the urge to push, I mean, that I was powerless to stop what my body was trying to do.   At this point I was clutching the side of the tub and yelling something along the lines of "Oh my God!" over and over again.  A special thanks to the student midwife who was shadowing Leslie.  She noticed my own hand on my back and took over massaging it with the contractions.

I had 2 more contractions in the tub, feeling her head move down with each one.  At my second contraction the midwives seemed to notice that the baby was coming fairly quickly, and they wanted me on the bed to check me and make sure.  I told them there was not way I was getting out, and they assured me that I would be able to get out.  I didn't believe them, but after my next contraction (pushing contraction #3), I did manage to climb out with some helping hands to keep me steady.  I had another contraction at the side of the tub before I made it to the bed for them to check me.

9:40am
I was 10cm and +2 station!

My pushing contractions were uncontrolable.  I could do nothing less that what my body wanted me to do.  Oh, and I yelled rather loudly too.  I never screamed, but I did yell.

9:50am
Four pushes later, my baby girl came vigorously screaming into the world.  The NICU staff that had flooded in at the end because of meconium, streamed back out just as quickly as they had come.  Leslie had asked me if I wanted to pull out my baby, but I declined and just pushed her out into Leslie's capable hands, who placed her immediately on my belly, where she proceeded to pooh on me twice before I delivered the placenta.

Oh, and to all those folks who didn't want me to do it, who didn't think I could do it, who told me I was too fat to do it, and who told me I was too old (36) to do it, this baby girl was bigger than both of my boys (7lbs 12oz) by half a pound at 8lbs 4oz, and she is perfectly healthy (just plain perfect).  Smoke that in your pipe!

And thanks to all the people (my mom especially) who supported me in my decision!  Most importantly, my husband who watched natural birthing videos with me and went to another childbirth class.  Thank you, Katie, for sharing my experience with me and for taking all these beautiful photos of my daughter's birth and my triumph.  Thank you family and friends for listening to me talk about this journey endlessly during my pregnancy.  Thank you VCU midwives and staff - you guys rock!  Thank you, Sara, my doula for helping me to ask all the right questions.

If I had not had the midwives overseeing my care, I would never have had my VBAC.  Most importantly, if you look at my labor, I was still 4-5cm an hour and a half before my baby was born, and I had practically labored for an entire day by that time.  No OB would have let me labor at the pace that I labored.  I didn't progress the 1 cm every 2 hours that they expect even with modest use of pitocin to regulate my contractions.

Conclusion
Having my VBAC was/is a glorious feeling.  I have recovered so much more quickly, postpartum blues have been much better, and breastfeeding my baby has been easier.

The bottom line is if you are having a baby, I recommend that you shop for the care that you want whether that is natural childbirth or pain free.  Make sure this experience is one you want to remember for the rest of your life.

My goal in writing this post is to provide another empowering VBAC story for other women who have the same goal and to encourage other women to choose a path to the birth experience they want, whatever that may be.  Speaking from experience, there are not enough VBAC stories and information out there for those of us who don't want to just schedule a c-section, and I did not do enough to make my first 2 births what I wanted them to be.

Sincerely,

Kelley

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