Three months ago, I had a successful VBAC that was way more than 9 months in the making. In fact, I have to go back 3 years, to the night my son was born. This was my first birth and so I had dreams of how birth would be. I went into labor 13 days past my due date and after hours and hours of labor, I’d stalled at 4cm. My OB was baffled why the baby wouldn’t come down and even though we tried different positions, breaking my water, and walking for what seemed like hours, we decided to go with a C-section. At the time I was too exhausted to be devastated….that came later. I spent my recovery days in the hospital in a sort of denial, refusing to let myself process the birth I had versus the birth I wanted. I was holding it together with the thought that there was nothing I could’ve done because my large, posterior-positioned son (8lb 15oz) had gotten himself stuck and couldn’t come out any other way. But then we prepared to leave and I went to sign my discharge papers…there on the bottom where it said “reason for C-section” were the words “dysfunctional labor”. I know now it refers to the fact that I never got past 4cm and that’s just what they call it. But for someone who wanted nothing more than a pure, natural, drug-free, intervention-free birth….it was devastating. I’d been grasping desperately to the idea that it was my son’s size and position that “caused” the C-section and not anything I did “wrong.” Reading those words crushed me and I fell to pieces on the inside feeling that it was my dysfunctional body that “caused” the C-section. My body had failed me.
My “failed” birth (how I felt…not reality) was followed by a difficult physical recovery and an even more challenging breastfeeding experience. For various reasons I had a hard time nursing my son, but was determined to make it work. (And in retrospect, I suppose I was so determined to make it work because I felt my body had failed me once and I wasn’t going to let it fail me again. We eventually overcame our challenges and 3 years later he’s still nursing.) These difficulties compounded the “normal” baby blues and were made even worse by our upcoming move to Pittsburgh (from North Carolina). With all the difficulties and depression, I remembered my OB telling me the morning after my son was born, that I would be a good candidate for a VBAC if I wanted to try in the future.
Within a couple months of his birth, I was already researching VBACs and trying to educate myself not only on the reasons for my C-section, but what I could do to avoid another one in the future. I knew we were still years away from a second child, but I never stopped thinking about and planning for a VBAC. For me, I wanted it (or maybe needed it) to truly heal from the devastation of the C-section. A little over 2 years later we decided to start trying for our 2nd. We got pregnant quickly and I began seeing a midwife group, as I felt it was my best chance at being supported for a VBAC. My pregnancy was uneventful and smooth but I the idea of a VBAC loomed over me, especially as my due date approached. My due date came and went, and with each passing day, my belly grew with what I was guessing to be a pretty big baby.
At 11 days past my due date, I went for my checkup with a heavy heart that I had not even started dilating or any other signs of early labor. My midwife said I was dilated enough to try a membrane sweep to get things going, but they still put me on the books for an induction 3 days later (42 weeks). I spent the rest of the day having mild cramps and walking a few miles around the neighborhood. By nighttime the cramps had diminished, along with my hope. I went to bed discouraged that this once again would not go the way I hoped.
The next morning (41 weeks 12 days) I woke up with more mild contractions but they were very irregular. I spent the day walking around as much as possible as the contractions slowly became stronger and a little more regular. By mid-afternoon I was sure this was labor and was walking, swaying, and breathing through each contraction. They were still pretty far apart so I knew it wasn’t time to call my midwife or doula yet. For now my Mom would be enough until my husband got home from work. When he got home I told him what was happening, showered, and then called the midwives to check in. While my contractions weren’t close enough together for them to want me to indicate active labor, I do live about an hour from the hospital (and as it was nearly rush hour, they suggested I come in. We packed the last of our things and around 5pm, said good night to our 3 year old son and my parents, assuming when they came to visit the next day, there would be a baby.
The hour and a half ride (yes there was traffic) was uncomfortable to say the least but my contractions were getting stronger and holding a pretty regular pattern. We arrived at the hospital, filled out the necessary forms, and were brought into triage, where I was hooked up to fetal monitors. My contractions were still fairly strong, but the longer we had to wait in that tiny room where I could do little more than walk a few paces or sway side to side, the more irregular my contractions became. By the time the on-call midwife came to check me, the monitor charts indicated irregular contractions indicating I was still in early labor (how was that possible?!). A vaginal exam confirmed this, as I was still at 1 cm (the same as I was at my checkup the day before). Nearly 10 hours of contractions and I was still 1 cm. I felt deflated when she said they would normally recommend sending me home….normally. It was then we learned that I was leaking amniotic fluid. My membranes hadn’t ruptured, but there was likely a slow leak. This information combined with our distance from the hospital convinced the midwife to admit me. It was now after 10pm. Finally, I thought, we’re getting somewhere. Our doula arrived shortly after we moved into our LDR room and we all settled in. I felt calmer just being in there knowing we’d really be able to focus on the labor and get to work….no more guessing “is this it?”
Within a few minutes the nurse hooked me up to their wireless monitors to I could go for a walk in the halls. As she was hooking me up she and another nurse joked that they were surprised the monitors were even working, since apparently they malfunction often. After a few minutes of walking my contractions seemed to pick up a little but I was already tired and thirsty, so we headed back to my room to take a break and use the birth ball for a little while. About 5 minutes after we returned to the room, a nurse came in the room to look at the monitor read-out and said the baby’s heartbeat looked a little irregular. She asked me to get in bed for a few minutes to see if it calmed down. No sooner had I climbed in, than a team of about 10 nurses, doctors, and who knows who else rushed into my room. We (my husband, doula, and I) thought it was a mistake, but when a nurse came toward me and put an operating cap/bonnet on my head, we knew something was up. For a minute there was a lot of “What’s going on?” “Who are you?” “What are you doing in here?” (mostly my husband, who was standing protectively over my bed). I felt fine, the baby was dancing around inside, so this didn’t make sense. My midwife sat down on my bed as the OB came over and said “we need to do an emergency C-section. Sign this form so we can put you under [general anesthesia].” Ummm, excuse me? My shock of how sudden this was happening had me keep asking “why?” “What’s going on?” The OB, who clearly expected me to just say “Ok” and sign the papers, seemed quite put out that she was having to explain to me why I needed emergency surgery. When I insisted I get an explanation before I signed anything, she finally told us (in a very condescending tone) that the monitor was indicating I might be having a uterine rupture and that the baby was in distress. I kept insisting that I was confused because all along they’d been saying how unreliable the wireless monitors are (not just that night, but always). While this wasn’t my plan, all my questions and confusion served as an important delay. After a couple minutes of confused explanations, my midwife interrupted to point out that I was in no pain and asked me if the baby was moving at all. I repeated that I felt fine and that the baby was as active as it ever was. She pointed out that if I was in fact having a uterine rupture I would be in a lot of pain and the baby would likely be quiet. The OB begrudgingly agreed but still recommended I agree to an elective C-section. As she put it “You’re only 1 cm and when [not if] this happens again, we won’t be able to put in an epidural and you’ll have to go under for it.” It was clear she was trying to bully me into an elective C-section so she didn’t have to deal with me (my words, not hers). We asked her to leave a moment so my husband and I could discuss this with my midwife and our doula. We knew it was our decision but it was so unexpected I was still a little in shock. While I might have been shaky on the outside with a racing pulse, I felt strangely calm. In my gut I still felt that everything was okay and I wanted to continue with my trial of labor. The question was how to get the doctors off my back so I could continue doing what I needed to do. Our doula suggested getting an epidural in place at the lowest setting. This way I could move around in my bed a bit and IF they felt I needed the emergency section, I wouldn’t need general anesthesia. While this wasn’t the OB’s recommendation (and she made that clear), she said she could live with my decision to continue and left the room (I never saw her again).
I really have no concept of time past this point, only that it seemed we were in for a long night. After they set up the epidural our midwife suggested we all try to get some rest, as it appeared we were going to be there for a while. At some point we all fell asleep and got some rest and were only awoken when our midwife came in to talk at the end of her shift. A couple hours had passed and apparently that’s exactly what my body needed. I’d finally started to dilate more. She left us quietly with a few encouraging words and we all slept a little more.
When I woke shortly after dawn, I knew I was approaching the 24 hour mark, but still felt calm in my gut. The epidural was taking the edge off, but I still had to breathe through each contraction. I was focusing on my years of yogic relaxation techniques and the voice in my head that said “you can do it”. For most of the day I was pretty unaware of what was going on around me. I was focused on my baby and visualized my uterus opening. The words “down and out” played over and over in my head with each contraction. What I do remember was a nurse occasionally coming in to check on me and ask if I wanted to “up” the epidural (“No thank you”); my husband getting me juice, ginger ale, and ice chips to sip on; the new midwife checking me occasionally and calmly reassuring me that it didn’t matter how slowly I was progressing as long as I was just progressing; and my parents bringing my son (dressed in his “Big Brother” shirt) to hopefully meet his new sibling. Every once and a while I would come out of my “trance” to change position in the bed, interact with those in the room, and apologize for being like a boring filmstrip they were forced to watch in history class. Then I went “inside” again. I’m sure everyone thought I was sleeping during these times (and I’m sure sometimes I was), but more than anything I was turning inward to focus all attention on my baby and my body’s ability to birth it.
At some point in the afternoon, my midwife checked me to see if we could get a sense of the baby’s position and told us I was at 6 cm (2 cm farther than I’d gotten laboring with my son, so I was thrilled). During this exam my membranes ruptured and we discovered meconium (no surprise considering I was 13 days past my due date). My son had meconium too so I wasn’t all that concerned. I knew it would mean I wouldn’t be able to delay the cord clamping or have immediate skin to skin, but that something I could let go of.
A little while later during the next exam, my midwife informed me that 1, I was about 8cm (yay!) and 2, she thought she felt something tear (sigh!). She seemed pretty calm so I wasn’t going to get worked up just yet. The OB came in to exam and confirmed it was a cervical tear but wasn’t at all concerned (that it happened more often than people realize and that it was an easy repair after the baby was born). Phew! As he was leaving the room someone asked about the baby’s size, and without blinking an eye he said “oh, don’t worry, women rarely grow babies they can’t birth.” I loved him for saying that and with this reassurance I went back to work, focusing my energy inward and on my baby and body.
As we approached evening, my parents left to take my son home (I hadn’t seen him and he could only be entertained by the fish in the pond for so long), and our midwife’s shift was ending soon. I had been at the hospital for over 24 hours (though I had no concept of time still) and had no idea if there was an end in sight. After another exam my midwife announced words I’d been waiting to hear: “fully dilated and effaced….you can start pushing.” Having never pushed before, and having the epidural, I didn’t know what the “urge” felt like or what to do, so the nurses and midwife coached me through a few contractions. After pushing for a while (again, no concept of time), I began to feel the natural urge women always talk about, but I started to feel deflated again. I was uncomfortable and tired. The baby was kicking me in the ribs and I couldn’t get a deep breath to really push. Pushing on my side was uncomfortable and they were worried I was too tired to squat (even with support), so on my back it was. As the midwife’s shift was ending, she informed the next midwife of everything happened in the past 24+ hours, including the fact that I had been pushing for 2 hours (I had no idea). I pushed for a little longer and then sensed some concern in the room among my midwife and others. Apparently the baby was getting stuck and moving out and then back in with each push (no real progress). Knowing this was probably my last chance, I summoned all my strength (who knew I still had some left?) and gave a few pushes that could have moved mountains and prayed they worked (I knew I only had a few of those kinds of pushes in me). A few pushes later baby girl was here…..all 9 lbs 10oz of her. (And they said my son was “too big to fit”?)
I knew I couldn’t have her on my chest because they needed to check her lungs (meconium), but I was quite frankly too exhausted from 34 hours of labor to be that upset. “I did it!” was really all I could think of. I was so relieved, so excited, and so exhausted….and the night was far from over.
While the nurses check her over (she was fine), the room was still buzzing over me. I had apparently lost a lot of blood between the cervical tear and a 3rd degree perineal tear and they were worried about my blood pressure. The room was too crowded to repair the tears so they asked if they could bring me to the OR, but not before I had some time to hold my new daughter and nurse her for the first time. She latched immediately and nursed like an old pro.
As I held her and watched her nurse so expertly, I felt not just the stress and exhaustion of a drama-filled lengthy labor melt away, but also the pain and disappointment I’d felt for nearly 3 years because of my first “failed” labor. It certainly wasn’t anyone’s dream birth, but I’d done it. I kept calm throughout the labor, even through the 4 times when other’s thought we might be heading for a section. I’d trusted my body’s ability to birth the baby it had grown. And while there was still some drama to come (difficulty repairing the tears, inability to stabilize my blood pressure due to blood loss, worry over my uterus not contracting (until I suggested I go back to my room to nurse my baby for a while to see if it helps….it did)), I look back at those first few hours of nursing her and holding her in my arms, and felt peace and healing. Whatever was going on in the room was all peripheral. We looked into each other’s eyes and I could hear her spirit telling me “I knew you could do this, Mom.”
In the hours, days, and weeks that have passed, I have reflected on this experience. I needed time to process it all and let it sink in. And while I feel many, many emotions, one stands out: gratitude.
I’m grateful for everything I learned following my C-section, as it empowered me to learn more about birthing options AND gave me the drive to not give up on breastfeeding my son in the beginning.
I’m grateful for our move to Pittsburgh, as it gave me access to a great midwife group in a great hospital.
I’m grateful for a loving and supportive husband who saw me struggle through depression over my first birth and helped me fight for the VBAC I wanted.
I’m grateful for my support team during this labor and delivery, who stayed calm when others wanted to rush into big decisions.
I’m grateful for the midwife who spoke up to the surgeon who wanted to rush me off to emergency surgery and told them to stop and look at the patient not the charts.
I’m grateful for my doula suggesting the epidural to get the OB off my back about a C-section and let me labor in peace.
I’m grateful for another midwife quietly encouraging me and not becoming concerned that my progress was painstakingly slow.
I’m grateful for another OB who didn’t panic over a possible cervical tear and added that he was confident my body would be able to birth the baby it grew.
I’m grateful for yet another midwife not giving up on me after 2 hours of pushing and telling me she knew I could do it.
I’m grateful that after great blood loss, I was allowed to hold, nurse, and bond with my daughter for over 20 minutes before I went to the OR, a bonding time I never got to have with my first birth.
And I’m grateful for this opportunity to share my story and finally let go of the pain of my first birth and find peace.