My Birth Story: A Long, Natural VBAC
I was pregnant with my second child, due to be a boy. Ever since having my daughter three years before, I had been planning to try for a vaginal birth after cesarean (VBAC). My daughter was born five weeks early because I had very suddenly developed severe pre-eclampsia. They tried to induce me, but things didn’t progress quickly enough. I was so sick they had to deliver immediately via c-section. She was 4 lb. 3 oz. and was in the NICU for 10 days before we all went home. By six weeks and after much medication, my blood pressures were finally back to normal.
Throughout my second pregnancy I was confident in my suitability for and ability to have a VBAC. I never really had much labor with my first, so there was no reason to think I couldn’t get through it. I had really hoped to have a natural birth the first time, when everything went so totally off track. So, I was even more determined to have one this time, if possible.
The pre-eclampsia was the biggest potential obstacle. Doctors do not like to induce labor in a potential VBAC because it increases the risk of uterine rupture. So, if the pre-eclampsia kicked in again this time, it could very well have meant a c-section. Because my pre-eclampsia was severe, my chance of having it recur in subsequent pregnancies is 25 percent. But it often happens later in the pregnancy and is less severe. So I just had to hope we would be luckier this time around.
There was a scare right before Thanksgiving, but nothing came of it, so here I was approaching my due date with flying colors. About a week or so before, I had the doctor strip my membranes. I had gone from 1 to 3 cm dilation with that and started having my first contractions. They were regular for a little while, but petered out over the next day or so. When I went for my appointment on Friday, Jan. 5, the doctor did a vigorous check. She determined I was still 3 cm dilated and fully effaced, with the head low and engaged. She thought I would probably go that weekend. (My due date was Sunday.)
Within 45 minutes I started having contractions again, only this time they never stopped. I was able to keep going and do all the usual things, but I did make some calls to give my labor and childcare support people a heads-up. Donna Galati, my doula, told me to call her around 10 p.m. if I was still up, to give her a status report. I was still having fairly regular contractions by then, but I knew I needed as much rest as possible, so I went to bed around 10:30 p.m.
I woke up a little before midnight with contractions about 5 minutes apart. I could no longer sleep through them, nor could I fall asleep between them, so I went downstairs to lie on the couch and read. I was casually timing the contractions every so often. By about 6 a.m. they were 3 minutes apart. I called Donna and [after assessing my stage of labor over the phone] she suggested I take a shower and try to get a nap. I stood in the shower until the hot water ran out then did manage to get a short nap. My husband knew I had been up, but he slept through most of it. That was okay, I was managing fine by myself and I knew he would need to be rested.
Later that morning relatives came to care for my daughter and I continued to breathe through contractions. Because Donna is a CNM (Certified Nurse Midwife), she was able to do vaginal checks and to use a Doppler to monitor the baby, which most doulas do not do. We wanted to continue to labor at home as long as possible, so to be sure the baby was handling the contractions okay Donna came over and listened to him. He was fine and she stayed to labor with me for a while. I continued to eat and drink normally. My Mom laughed because she said I would be talking, then stop and breathe quietly for a minute or so, then pick right back up where I left off. After lunch, Donna left – seeing that the baby was great and I was doing well. We knew then we still had a ways to go.
I spent most of the day on the couch and sitting on the birth ball while family life happened around me. I was able to get another catnap that afternoon, and by evening we called Donna to come over again. We went upstairs to the bedroom and Donna, my husband, and I labored in private for a while. I got in the tub for an hour, which was nice. After I got out of the tub, the contractions were stronger and harder to handle. Donna determined I was 6-7 cm, so we called the doctor to come into the hospital. I ate a little more (knowing I probably wouldn’t get much after we got there) and got dressed, which was a bit of a task by this point. Everything takes longer when you stop for contractions every couple of minutes.
Donna drove us to St. Joe East, which was a very short trip. We got there around 10:20 Saturday night. I declined the wheelchair and we went upstairs to get settled into a room. I got an IV and they hooked up the monitors. All this was part of the VBAC protocol and one of the reasons I wanted to stay at home for a while. The nurse couldn’t figure out how far I was, so she called in another one. They determined I was 8 cm or so. I was thrilled, thinking we were getting close. I labored another couple of hours, with things going hot and heavy. There were stretches with contractions coming almost with no space between them. At some point after midnight I was dozing between contractions. I could hear my husband ask incredulously if I was sleeping. Donna told him my body was trying to conserve energy. The nurses kept checking every so often and telling me I was 9 1/2 cm or there was still a “lip” all the way around.
Around 2 a.m. we asked for the doctor to come and break my water. When he did, he saw a lot of thick meconium in the fluid. They inserted an intrauterine pressure catheter, then pushed fluids through it to thin out the meconium and help prevent aspiration. The baby still sounded okay on the monitor, but I knew I would not get to hold him right away when he was born.
I had another couple of hours of really hard labor. Breathing was not nearly enough, so I was vocalizing to get through the contractions. I’m sure I was getting very loud, but no one said a word to me. (I ended up straining my throat a bit, though.) Being in labor was like your body was being ripped in half and you were supposed to sit back and let it happen. The key to progressing is actually for you to do nothing.
After that I finally started feeling like I had to push. Think freight train coming and you can’t get out of the way. Despite how many times you've heard it described, there's nothing like feeling it for yourself. I was so happy when they finally suggested I could start pushing, because then I felt like I could finally do something.
I pushed for over an hour and he was making slow progress, but not coming out. We finally called the doctor back in to possibly use suction to help get him out. By this time it was almost 5 a.m. on Sunday and I was getting worn out. Donna said I could have been pushing for another hour and we were worried I would just wear out. The pushing was very physically demanding and took a lot of energy. I felt like I could have kept going, but that the pushes would be less efficient and would take even longer.
The doctor came in and numbed me a little bit locally, which I didn’t even feel. Then it looked like he was about to do an episiotomy. My husband told him I didn’t want it, so the doctor basically tore me a bit and the baby’s head popped out. I had no idea most of this was going on, because I was in my own world, trying to push out my baby with the contractions. I didn’t even know the head was out until they told me to rest for a minute while they suctioned him very well.
There was more hard work in store to get out the shoulders, which I felt being rotated and guided out (weird!), and Donna told me to open my eyes and look down – there was my baby boy sliding out. Finally, the hard work was over. Shaun Allan was born at 5:03 a.m. on Sunday, Jan. 7, 2007 – his due date. My husband cut the cord, then they immediately took him over to the warmer to work on him. All I kept thinking, over and over, was, “Thank goodness, I’m done.” Shaun weighed 8 lb. 9 oz. and was 21 in. long. Everyone was shocked because they were expecting 7 to 7 1/2 pounds. He did have some breathing problems, so they took him to the nursery and my husband went with him. It took about another hour to deliver the placenta (also weird) and stitch up my third degree tear. Ouch!!!
After that, I finally got some sleep. Other than an update on the baby, who was recovering well, they left me alone until around 8 a.m., after which I moved to a postpartum room, ate breakfast, took another nap, and finally got to hold my son. He was doing fine and latched right on and nursed beautifully. It was wonderful, especially after the difficulties I had had with my daughter. I think there is a huge advantage to having a full-term baby, as far as nursing issues.
I was very happy that I had a successful VBAC and did it naturally. I couldn’t have done it without Donna – she was so wonderful and supportive the whole time. Over 29 hours of labor I channeled Anne [from prenatal yoga], “Soften where you can soften and do nothing extra.” Also, her tip about relaxing your jaw to relax everything else was very helpful.
If you are considering a VBAC, don’t let anyone else’s doubts and consent forms get to you. Assuming you are a good candidate, the odds really are in your favor. And if you want to have a natural birth, I wouldn’t do it without a doula. My husband totally agrees. He said he would tell anyone to hire one. He said I let Donna tell me things that I never would have listened to if he had said them. And she was a big support for him throughout the long ordeal, as well.
It took a week or so before I could sit up straight (ouch!), but things have gone very well. Having two kids hasn’t been as hard as I feared, so I hope it continues to go well.
