VBAMC Stories:
Vaginal Birth After 2 or More Cesareans
by KMom
Copyright © 2000-2007 KMom@Vireday.Com. All rights reserved.
This FAQ last updated: January 2007
DISCLAIMER: The information on this website is not intended and should not be construed as medical advice. Consult your healthcare provider.
CONTENTS
Is trying for a Vaginal Birth After Cesarean (VBAC) a reasonable option after you've had 2 (or more) c-sections? Most authors conclude that it is, but a few authors do not, and many OBs are reluctant to consider it, especially recently due to a VBAC backlash movement. Because many doctors have been reluctant to consider it, most medical literature and collections of VBAC stories have concentrated on VBAC after 1 cesarean. There is an urgent need for information, analysis of medical literature, and stories of VBAC after multiple cesareans.
This web section details personal stories of VBAC after multiple cesareans. It mostly contains personal VBA2+C stories others have decided to share here, but it also has resources for finding these stories in books, videos, and online. There is another web section on this site that analyzes the medical literature on the subject, looks at the chances of success, evaluates the risk of rupture, and also examines emotional issues that may be involved, hints for healing, etc. (the VBA2C FAQ). The two web sections are meant to be complementary and should be considered together.
Readers are urged to do their own research in order to reasonably evaluate the various factors in VBAC vs. elective repeat c-section decisions. There are many factors to consider in deciding. Excellent VBAC information can be found online; readers are directed to the resources at www.childbirth.org/section/, www.gentlebirth.org, www.ican-online.org, and the many medical journal abstracts available online at www.ncbi.nlm.nih.gov/PubMed/. Be sure you understand what you are reading and the potential biases of the writers!
Other valuable resources include the following books:
Further resources can be found in the References section of the other VBA2C FAQ, as well as in the FAQ on Great VBAC Resources on this site.
The purpose of these FAQs is not to convince you that VBA2C is the right option for you, or that VBA2C is not the right option for you. It is simply to gather together in one place more information about the difficult-to-find subject of VBA2C, to explore its various issues, both medical and personal, and to share VBA2+C personal stories and where to find them.
However, it's important to remember that this is simply a sharing of information by and for health consumers. Kmom is not a medical professional and does not offer medical advice, nor should any be inferred from this website. Readers should always be very cautious about any health information they get online (or indeed, anywhere else!). Remember, YOU are the one ultimately responsible for your own healthcare decisions. Be thorough in your researching and explore all your options before making decisions. Just because this was the right decision for these mothers does not necessarily mean it would be the right decision for you.
The focus in this web section is primarily on VBAC after 2 c-sections because few women have more than 2 or 3 kids these days, and because few women with more than 2 c-sections are given the opportunity to even try a VBAC. However, that does not mean that VBAC after 3 or more c/s is inappropriate, impossible, or has never happened. In fact, a number of women have had VBACs after multiple cesareans (VBA2+C, or VBAMC).
Unfortunately, most of the stories in this FAQ so far deal with VBA2C but we have begun to add some higher order VBAC stories as well. More of VBA3+C stories do exist, but they are not always easy to find because most women are forced into automatic repeat cesareans after 2 or 3 cesareans. If you want to find more VBA3+C stories, most of them are found in books like Silent Knife or on the paid website of www.birthlove.com.
You may note that many VBAMC stories below take place outside of the hospital. Some medical professionals may find this alarming, since they are usually taught that birth outside the hospital is dangerous and tantamount to child abuse, and particularly so in the "high risk" scenario of VBAC.
However, the prevalence of homebirth in these stories simply reflects the fact that many VBAC women have found that they have had to leave the mainstream medical model in order to have a natural, normal birth, especially now with the anti-VBAC climate sweeping the world. Because many hospitals have banned VBACs altogether, for many women the choice is between being forced into surgery against their will or choosing to birth outside the mainstream medical model. For other women, VBAC in the hospital is still possible but comes with so much restriction and hassles that VBAC becomes nearly impossible. This is why so many women are choosing to birth outside of the hospital, particularly in the VBAC context.
Please note that Kmom does not promote or condemn homebirth for VBAC moms; she simply reports on the experiences of VBAMC moms. Please also note that it is possible to have a VBAMC in the hospital, and there are many stories of hospital births in this FAQ. However, many women are choosing to birth outside the hospital, and this FAQ simply reflects that trend. No endorsement or condemnation of these practices should be inferred.
Finally, Kmom would particularly like to note that she strongly dislikes the terms, "Trial of Labor," the British alternative "Trial of Scar," and "Attempted VBAC." It implies being on trial, a pass-fail 'test', a judgment, a tentative attempt. Kmom feels that a labor after previous cesarean should be viewed and treated virtually like any other labor. Kmom particularly dislikes the term "failed trial of labor." This is NOT a failure. However, this is the terminology used by the medical studies reviewed in this FAQ, and often even in VBAC books. Alternative terminology is cumbersome or not standard, so Kmom has reluctantly utilized these terms in this FAQ. Readers should be aware that its usage herein does not constitute approval! Words do matter, and obstetrics is full of misogynistic and condescending terms as it is. We can use these terms for ease of use and because it is standard, but we should also be aware of the weaknesses and subtle underlying implications of it.
Reading a Frequently Asked Questions list (FAQ) about childbirth issues is often like negotiating a minefield full of unfamiliar terms and abbreviations. Because it was not practical to write out each term each time, the following is a brief guide to the terms and abbreviations you might see in these particular FAQs.
vertical scar/"classical scar" - up-down scar from near navel to pubic bone; all c/s used to be done this way but vast majority today are done with low transverse incisions, which is safer. A classical scar is more likely to rupture than a low transverse. A third type is a "low vertical" scar, which is up and down but only in the lower uterine segment. This is also less likely to rupture.
There are several resources that can help you if you are considering a VBA2+C. The best of these are listed in Kmom's FAQ called "Great VBAC Resources" on this site. Rather than repeat that information here, Kmom has included a link to that FAQ instead.
However, there are two resources that should be highlighted. The first is the International Cesarean Awareness Network, or ICAN. Its URL is www.ican-online.org. It contains many answers and helpful articles for those seeking support after a cesarean or who are considering a VBAC. It also has an online email support group that many women find extremely helpful. Information for joining can be found at the main ICAN website.
There is also an ICAN-offshoot group specifically for VBA2C moms. Here is the information for joining:
Are you a vaginal birth after 2 cesareans hopeful? Have you had a vaginal birth after 2 or more c-sections? Please join the VBA2C Yahoo Group and share experiences, hopes, questions and stresses. We can get through this together! Click the link to join: http://health.groups.yahoo.com/subscribe/vba2c
Many women, including Kmom, HAVE had vaginal births after 2 cesareans, and some after 3, 4, 5 or even more cesareans! (We now have a VBA7C story on the website!!) Kmom highly recommends reading as many VBAC stories as you can, both 'successful' and 'not', for inspiration and understanding (whatever you decide about pursuing a VBAC). You can find many of these stories in books, online, and from women in specialized groups such as ICAN.
Kmom believes it is helpful to read both stories of VBACs that ended in repeat c/s as well as those that ended in vaginal birth. Both can be illuminating. However, a list of all types of VBAC Trials of Labor would be prohibitive. Readers can find stories of VBACs that ended in repeat c/s as well as those ending in vaginal birth in books such as VBAC Experience and Artemis Speaks. The main purpose of this section is to list VBA2C stories that did end in vaginal birth.
Here is a summary of the VBA2C stories Kmom found.
You can find good VBA2C stories ('successful' and 'not') in Silent Knife by Nancy Wainer Cohen and Lois Estner, The VBAC Companion by Diana Korte, The Vaginal Birth After Cesarean Experience by Lynn Baptisti Richards, and Artemis Speaks: VBAC Stories & Natural Childbirth Information, written and compiled by Nan Koehler.
Another particularly helpful book might be Natural Childbirth After Cesarean by Karis Crawford and Johanne Walters, two women who experienced Vaginal Birth After 2 Cesareans themselves, (two each, in fact!), including some under very unusual and complicated circumstances. Johanne Walters had her first c/s after she broke her back in a car accident; her baby turned breech from months of braces and corsets and bed rest. Her second c/s was a mandatory repeat c/s; at that time VBAC was truly a rarity. For her third child, she opted out of being forced into another c/s and found a caregiver somewhat supportive of VBAC an hour away. She had her first VBAC after a long difficult labor with a posterior baby and forceps delivery; although she was thrilled to have a VBAC the birth had a lot of intervention and was not easy. She had her second VBAC with her fourth child in a new state; although this hospital also interfered with her labor and birth she managed to have the baby without drugs or forceps and it was much more satisfying.
The other author's story is even more complicated and amazing; Karis Crawford had two VBA2Cs, despite a list of complications and risk factors that even today would have doctors running for the operating room. Her first c/s was for a breech baby, but the baby was stillborn. Her second c/s was a truly necessary one at 35 weeks for an abrupted placenta and baby in a transverse lie with a cord prolapse; fortunately her baby lived. However, due to the circumstances, her doctor had to use both a horizontal and vertical incision (a "T" incision), which many doctors would rule out for a VBAC. Also, the surgery revealed the source of all the problems; she had a bicornate uterus (the top third had a kind of partition, which made her placentas tend to bleed a lot due to difficulty attaching well, made the baby tend to assume breech or transverse positions because of space problems, and put the baby at risk for stillbirth). This would probably tend to make all future pregnancies complex.
Incredibly, her OB was the one who suggested a VBAC! However, in the interim, the couple struggled with the husband's infertility, and even when Karis did conceive eventually, the pregnancy was troubled by a great deal of bleeding and a breech presentation associated with the bicornate uterus. However, she used visualization, prayer, gentle pressure, and a flashlight to get the baby into a head-down position. Her waters broke 10 days before her due date; after 8 hours without labor, they called in an acupressure specialist, and labor started within a few hours. She went on to labor naturally and without meds, and had her baby vaginally 12 hours after the acupressure treatment.
Karis' fourth child (second VBA2C) was born a few years later, despite further struggles with infertility. Once again the baby was breech, but she turned him again with gentle pressure, visualization, music, and a flashlight. However, she went into labor at 33 weeks, and despite trying to stop it for several days, the decision was eventually made to let labor progress. She had her baby after an 8-hour med-free and mostly mild labor; the baby needed resuscitation and extra care but did well (the labor probably helped his lungs prepare; he might not have done as well with an elective c/s, although it's impossible to know for sure).
So this book contains the stories of 2 women who had VBA2C against all odds, and contains their thoughts about preparing for VBAC, both physically and emotionally. It is an excellent book. The authors are supportive both of women who have successful VBACs and those who end up with repeat cesareans after a trial of labor. They state that "We know the grief associated with repeat cesarean, whether the surgery was medically necessary or not. If you want more children, VBAC may still be a viable option for your next birth [as it was for them]...[But] for those of you who have completed your family...laboring for a VBAC, even if it ended in cesarean, was a noble work, by which you probably have come to a better definition of yourself as a person...You don't ever forfeit your dignity as a woman because of the way you have given birth."
Here is a list of specific VBA2C stories to be found in various childbirth/VBAC preparation books. For ease of reference, the page number and a brief summary of the story is listed, but be aware that different editions of a book may change this information. Enjoy!
Silent Knife - Nancy and Lois report working with 24 women (as of 1983, when the book was published) with more than one previous c/s; 21/24 had VBACs (an 88% VBAC rate). One woman had a home VBAC after four previous c/s, and two other women had hospital VBACs after four previous c/s. They also report of a woman who had her sixth baby by VBAC after 5 previous cesareans. In their chapter called "Letter from VBAC Mothers", there are numerous stories of VBACs after multiple previous cesareans.
Artemis Speaks - 4 VBA2+C stories
Natural Childbirth After Cesarean - Authors' stories, plus 3 other VBA2+C stories
Vaginal Birth After Cesarean Experience - 6 VBA2+C stories
There are any number of VBAC birth stories that can be found online. www.childbirth.org/articles/stories/categories/vbacstories.html contains many VBAC stories of various types. In particular, www.birthlove.com contains many stories of VBAC after multiple cesareans, including quite a few of VBAC after 3, 4 and more cesareans. Unfortunately, the Birth Love site is not free; there are free sections on the site, but full access to the site requires membership. However, membership is not terribly expensive and is well worth the investment, especially for VBAC moms.
Of the online VBAC stories out there, some are specifically about VBA2+C; the ones Kmom has found are listed below. There are probably many more to be found; if you see one not on this list, please email Kmom with the information and URL. We need as many stories as possible to inspire us on our journeys!
The video, "Gentle Birth Choices" (produced by Barbara Harper), has the videotaped story of a woman having a VBAC after 2 prior cesareans, both for "CPD." She gives birth at home. This video can be purchased from www.waterbirth.org.
Kmom also requested VBA2C success stories from her ICAN online group (International Cesarean Awareness Network) and others. The following are a few of the stories that were shared. More stories will be added over time, so keep checking back if you are interested. If you want to add your story, please follow the format given below, add your birth story (no attachments please!), and email it to kmom@plus-size-pregnancy.org.
Unless specifically requested, all identifying information has been removed or changed to protect the privacy of the participants. In some cases, Kmom has edited the stories for clarity, brevity, and format, but most stories are told in the exact words of the mothers.
All stories are copyrighted; none may be used elsewhere without specific written permission from both Kmom and the mother involved.
Kathy's Story (c/s for distress/cpd/ftp, ERCS, VBA2C)
Kmom's Notes:
Birth Story
My First Birth (1982): I went 11 days past due. At my checkup that morning I was still tightly closed and thick. I suspect the doctor tried to mess with my cervix because I did have some spotting after the exam. I started into labor that night with contractions immediately 5 minutes apart and painful. I think we went to the hospital within an hour of the first contractions.
I was the typical first-time mother---got to the hospital, wasn't dilated AT ALL but they decided to keep me for observation, because we lived 50 minutes from the hospital and "he wouldn't know when to tell me to come back, because the contractions were already 3-5 minutes apart." I decided the contractions hurt too much after walking for about 1/2 hour. I got into bed and tried doing the lamaze breathing. I laid there, on the monitor, breathing for the next 5 hours. I did dilate some, so they admitted me.
After 10 hours I had gotten to 5 cm. I couldn't imagine doing it for another 10 hours (no one told me that you can go from 5-10 much faster) so I got an epidural. Soon after that, they ruptured my membranes. Within minutes, the baby went into distress---low fetal heart-tones---60s? The room filled with people throwing me this way and that to try and stabilize the baby. They were yelling for the doctors---who was in surgery. (I think they were anticipating a crash c/s.) Finally the Fetal Heart Tones (FHTs) stabilized and he came running in and did a blood check on the baby to see if the oxygen level was still okay. It was.
I continued to labor. Had another short blip in FHTs which resolved quickly. After 18 hours I was 7 cm (according to my records---I was never told that I had gotten past 6 cm). It was 6 p.m. on a Friday night (wonder if the doctor had plans?). He sat on my bed and told me that this just wasn't working. I had been scared to death by the fetal distress (though the baby was fine now) but he recommended a c/s. I said okay.
It turns out that the baby's cord was 2x around the neck AND tied in a true knot (most likely the reason for the distress---they broke my membranes, he dropped, the knot tightened). I believe that if left to labor without interventions we would have done fine, but I don't feel anger over the decision. I was involved, and with what I knew at the time, the decision made sense. Recovery was normal but painful. Had a small baby boy---6 lbs. 11.5 oz.
My Second Birth (1985): I had heard that it may be possible to have a vaginal birth after cesarean, but didn't know anyone who had. I talked with the doctors about it, and they agreed to let me try. I was shocked when they told me that my c/s diagnosis was CPD and FTP. I insisted that it was because of the cord. They said no. At 40 weeks, the baby was riding high, cervix thick and closed. The doctor discussed VBAC with me. Said he didn't see any positive signs of labor going differently. Said that a scheduled c/s was easier than labor followed by a c/s and that some women think it is easier than a difficult labor. Made some sense. I felt pressure by my DH and mother to know when the baby was coming. Easter was also coming and I was worried about leaving my firstborn unexpectedly in the night, and being away from home on Easter. In addition, the anniversary of my miscarriage was later that same week. I didn't want to labor on the same day. All dumb reasons which made sense at the time. I agreed with a heavy heart to schedule my c/s---as far past my due date (4 days past) as I could and still be home from a c/s by Easter. April Fool's Day was the day chosen (a message there?).
I cried all weekend. I cried the whole drive to the hospital. I cried for hours as they prepped me and I awaited the surgery. I wasn't even sure why I was crying. I just know that it didn't seem like that right way to have a baby. I was very sick during the surgery---my blood pressure dropped to 70/50 and I was extremely nauseated. I kept saying, "I'm going to pass out---I'm going to throw up" and couldn't enjoy the birth at all. I was thrilled to learn that I had a baby girl. She was 6 lbs. 12 oz. I fell in love immediately and tried to put the birth behind me. But recovery was MORE painful and slower than the c/s after labor. I felt cheated and somewhat betrayed.
My Third Birth (1987): Baby number three was a surprise--a happy one for me, I wanted a third child. But I was so depressed about the thought of another SCHEDULED C/S. That was my biggest issue. I didn't want it to be scheduled. By luck, I brought it up with the new young female OB. Couldn't I wait until labor started to have the c/s? And couldn't I be checked to see if things were different this time? She said she couldn't see any reason why I couldn't have a trial of labor. I was so overjoyed that I started to cry.
After that, I realized that it was up TO ME to make it work. I couldn't count on anyone else. I found SILENT KNIFE at the library and my life changed after that. It lived on my nightstand for the next four months. I found a VBAC class which helped my husband more than me. I found a CBE [childbirth educator] who knew my doctors and knew my hospital and could give me pointers on working with the system. Whenever I was discouraged or worried or had a bad OB appointment, I got on the phone with one of them. I'd get "recharged". I was so thrilled to be "allowed" to go into labor that I was really looking forward to it. I wanted to do things differently this time. I was determined to stay home longer, to walk, etc.
I had to agree to schedule the c/s for a week past my due date. I pushed it to ten days past. I was ready to try castor oil if I didn't start by the 9th day. My c/s was scheduled for Tuesday after Labor Day. On Saturday, I enlisted my DH's help (same way we started the baby). By afternoon, intermittent contractions started. Yea! They continued through the night and all day Sunday. Sometimes they would get to be 5 minutes apart for a couple hours and I would get my DH up and dressed for the hospital, then they would slow down. I did this about 3 different times. I walked and walked. Soaked in the bath, ate light stuff, drank tons of water. Took naps, read inspiring things.
On Labor Day, it was the same thing. We agreed that it was time to have the doctor check us out. But I was emphatic that if I wasn't at least 4 cm, I would be going home. I knew as soon as I got there (and the "wrong" doctor was on duty) that it wasn't "time". He checked me and I was just a fingertip dilated---the same as I had been for 3 weeks! I was a bit discouraged, but determined to get out of there. I knew it would be a disaster to stay. I told the doctor that I was going to leave since I obviously wasn't in active labor. I agreed to stay and be monitored for an hour. I was fine, the baby was fine, and I was outta there (had to sign a form to leave).
I was so disgusted that I made my DH take me out for some real food. We went to Ponderosa and I think I ate some of everything on the salad bar. Then I went home, took a long bath and a nap (all the while still having intermittent contractions). By evening, they started to feel a bit different---stronger, more regular. I had to stop and lean on something and breathe slowly through each contraction. By 9 p.m. I knew it was different and by midnight I was ready to go back. One way or another, it was time to have this baby.
I was upset to see the same doctor there---the one who didn't agree with my plans to have a VBAC after 2 c/s. At 1 a.m. I was checked---4 cm dilated, baby as high up as they can measure (-4 station). Hey, 4 cm is pretty good! The doctor left and my nurse said that I could "call the shots". I just laid there after the exam and my DH asked me if I wanted to walk (Walk? How can I? Oh yeah, I HAVE TO walk). So I got up, and we walked and walked and rocked and walked. I would stop with each contraction and hang on the railing having my DH slow breathe with me.
Three hours later, I am still walking and my legs are trembling, and I'm sweating and cold. I said, "I can't do this anymore. I might have to get an epidural---I can't get an epidural---but I can't do this anymore." My angel nurse said, "Well, let me check you and then you can decide." She says, "You're 10 cm! You can push!"
Oh my God, I AM doing this!! I had her get out the squatting bar and started pushing in a squat. My water broke in a pop---I got to have my water break by itself---Yea! Pushing was incredible. No mind involved---all body and instincts. All power and grunting. The nurse yells for the doctor---and calls for him 2 or 3 more times. I'm pushing and pushing. Who is going to catch this baby? Oh the nurse can---that's fine. She starts to get me ready for the conservative doctor---shoves in an IV, puts me back on the bed, legs in stirrups (my mind's saying "no", I'm saying nothing---good reason for a doula). Baby's coming. Doctor runs in, washes his hands and catches my VBAC baby barehanded. 20 minutes of pushing. From 4 cm, -4 station to birth in 3 hours!
There was no support on my perineum as I was instructed to PUSH, PUSH HARDER, so I did tear. Doctor handed the baby to the nurse for all the junk they do---I got her about 10 minutes later. This part wasn't perfect, but in the larger scope of things, a smaller disappointment. I would do many things differently now. Most of all what I know about birth, I learned after my VBAC. I haven't ever been able to apply it to myself, but have used it with my childbirth education classes and my doulaing---all of which came about as the result of this empowering experience.
I would never consider labor and birth without a doula again, and I would seriously consider planning a homebirth, but all in all, it was wonderful. It changed my life. I hope the same for you.
Jacki's Story (c/s for failed induction/ftp, ERCS, induced VBA2C)
Kmom's Notes: Jacki's first c/s was for "failure to progress" after being induced for being 2 weeks overdue. She never got past 2 cm but also never had any very effective contractions. Her second c/s was a scheduled repeat c/s because her doctor convinced her that it was too risky to try a VBAC. She says, "I was so uneducated about the whole thing and I assumed that Dr. knows best."
Her labor for this VBAC baby was also induced (at 41 weeks) because in her state you can't be attended by a midwife after 42 weeks of pregnancy and she was sure that if she had an OB she would end up with a c/s. Jacki's baby was malpositioned; his head was cocked to one side, which is called 'asynclitic'. This may well account for the difficulty in dilating that she had, as well as the intensity of pain that she had. In the end, she felt that the induction was the right thing to do. "We opted for the induction at 41 weeks. It's a good thing we did because I KNOW I would have had another c/s if I had not."
Birth Story
Well, I had my baby boy. What a beautiful boy, what a beautiful experience.
I had gone to have gel put on my cervix and was sent home, then went back again the following Monday and was sent home again. My midwives asked if I wanted to try low-dose pit, and I was very hesitant but after thinking and discussing it with my husband we decided to go for it, only because I was 3-4 cm and 80% effaced.
So I went in Wednesday to be induced. I started contracting very slowly; it was very low-dose. It picked up a bit as they slowly turned it up. It never really got horrible until about 10 hours after they had started it. My midwives don't like to check you until they feel like you are showing signs of change physically. Anyhow, they finally checked me and after being in labor all day I was only 4 cm and still 80%, though I had changed from posterior cervix to anterior. I was so devastated. I couldn't believe I hadn't changed at all. I cried so much. My midwives said we should turn off the pit and let me sleep at the hospital and try again in the morning. I love these women; any other doctor would have put me up on the cold hard table [for surgery]!!! They said as long as the baby is okay we could wait.
So I was started again on the pit on Thursday at 5 a.m. These contractions felt completely different than the ones the day before; they were low and man, did they hurt. I had gone into this wanting no epidural. Come to find out my platelets were so low that I couldn't get one anyhow. That meant if I were to have a c/s, I would have to be under a general---that scared me so much. I was starting to feel defeated. Thank God for my doula and supportive husband and stepmom, they kept me going.
My midwife came in a few hours after they started the pit to check me, still no change. I was ready to scream at this point, I was so sure I was gonna end up cut. She suggested we break my water which I didn't want to do at all. But after thinking about it I decided I couldn't go through another day of labor. This was the 4th day.
So she broke my water. The very next contraction was much more intense. I was in so much pain. I started losing track of time. I kept my cool and stayed on top of them with the help of everyone. A few hours later my midwife checked me; I was at 6 cm. I was so happy to hear that, I thought maybe I can do this! Man, did things get hard; Wow, I couldn't have imagined how hard labor was. My doula kept me focused; I wanted out of my body. They gave me some Nubain but it didn't really help at all. My midwife came back an hour later to check on me and she saw how I was and said "I'm gonna check you, I think you're in transition." So she checked and said I ahd gone from 6 to 9 in one hour!!! If I hadn't been in so much pain, I would have been ecstatic!
She said we are gonna start pushing in a few minutes; half an hour later I started pushing. It was so hard. I found out later it was because the baby's head had cocked sideways against his shoulder. They didn't say anything to me; they put me on my side and held my leg up and made me push. This felt so much better. I felt the urge to push; it felt so good to push. I pushed for almost 2 hours and out came my beautiful son.
It was the most awesome feeling once he came out. I can't describe the joy in my heart that I had my VBAC. I was in shock that my body actually did work. They put him on my chest and he looked at me with his blue eyes. I was in love immediately. What a beautiful experience it was. Hard but wonderful. The recovery was amazing; an hour later I was up taking a shower and walking, joking, feeling high!! What a difference from my 2 c/s. I tore a little bit, not too bad.
I want to praise God for the birth of my son, and thank all of you for your support. And of course, my wonderful midwives whom I truly love and admire, and my doula and supportive family. One more thing, I went in saying I wouldn't do pit or let them break my water, but sometimes you have to change your thinking. I know that it made a difference in my labor; always keep an open mind. Of course think long and hard, but make the best choice for you. And once again Praise God for my wonderful experience and family.
Pamela's Story (2 elective c/s for herpes, VBA2C)
Kmom's Notes: Many women with herpes are sectioned unnecessarily. Women with herpes need to carefully research the issue before making their decisions.
Birth Story
I have 3 wonderful boys. The first was born in 1993 by cesarean. I have herpes, and was so afraid of what that disease would do to my babies. Near the end of my pregnancy, my blood pressure went up, just slightly. It was enough for the doctor to suggest a cesarean and give me a way out. The epidural left me with a window, and I was drugged senseless. I don't remember my first few days with my baby.
My second son was born in 1995 by cesarean. I wasn't so afraid of the herpes this time, but I was still worried. I got sick at the end of the pregnancy, losing weight instead of gaining it. Indigestion is not an indication for a cesarean, but the doctor suggested one. I was supposed to get another epidural but instead received a spinal. The anesthesiologist was new and didn't do it right. I got a spinal headache and they did a blood patch to "fix it." I laid there and cried. I felt I was being punished---I had been in a relationship I shouldn't have been and now I was paying for it. It had been seven years, and I was still paying a heavy price.
When I got pregnant with my third baby, I realized I had been mistreated--once by a former boyfriend, and again by my OB. My boyfriend should have told me I was at risk to get a disease when I was with him. My OB should have told me the risks involved with the cesareans. Neither did. I realized I was fighting for more than a vaginal birth. I was fighting to gain a sense of self-worth. I was fighting to say "I can do this, in spite of you." I was trying to get over my past.
I had two babies and had never labored. I was determined to have my baby, my way. I brought up the subject of VBAC with my OB (the same OB all three pregnancies). He said, "Sure, but your big problem was the herpes." He was playing on my fear. He is responsible for my suffering with this disease--as much or even more than the idiot who gave it to me is. Never once did he suggest natural ways (such as L-lysine) to prevent an outbreak. He did, during my third pregnancy, suggest the prescription drug, Zovirax. He talked about measures they would have to take to monitor for a rupture. When I asked about being more lenient on some of these things, he said, "You are lucky I am even letting you try to birth vaginally after two cesareans." The jerk, he never said anything about this when he suggested the second cesarean. He didn't tell me how hard I would have to fight to birth my baby the next time if I didn't even try to that time.
I hired a doula. I read books. I worked for my VBA2C. I got it without him. At 36 weeks, I interviewed and began seeing a midwife with a doctor backup. She would deliver at the hospital, and would care for me the entire labor. She listened to my concerns. She was understanding. I felt relieved---I had found a supportive caregiver. My water broke about eight Thursday night. With my husband, doula, and midwife's support, I gave birth vaginally, naturally, even joyfully to a conehead baby. My son N was born on Friday, five minutes before noon. I was on a high for days. The high was a natural one---not from drugs. I had done it! It truly was an empowering moment in my life. My baby just turned a year old, and I am still breastfeeding him. He is a content and happy baby.
As for me, I have changed, grown. I feel a burden of guilt has been released. I am a better mom, wife, and woman. I have completed a part of the circle of life that I had skipped before. Doctors say it doesn't matter how your baby comes----that is a lie. The difference is powerful, awesome, and life-changing. I feel a responsibility to support other women who need encouragement. I have started a chapter of International Cesarean Awareness Network in my state, and serve on the national board. I am grateful to those who supported and encouraged me when others thought I was crazy. I did it and it was worth it.
Maddy's Story (breech c/s, 'failed' TOL c/s, hospital VBA2C, home VBA2C)
Kmom's Notes: #3 is another posterior baby story. She used a combination of patience, homeopathic remedies, rocking the hips, and the 'all-fours' position to turn the baby, plus a tub to help cope with the pain in the meantime. Labor stalled at 6 cm, common with posteriors. But because they were willing to wait things out and not force the issue with pitocin, their proactive measures did turn the baby and resulted in a VBAC; in most hospitals this would have turned into another c/s.
Birth Story
Baby #1 was a 42-week planned c-section for breech. The doctor wasn't comfortable trying to deliver her, and couldn't turn her (the cord looked like it might be around her neck). No labor or cervical changes at all.
Baby #2 was also a 42-week baby, an attempted VBAC with "midwives." (Hah! I trusted in the "midwife" label, but they really knew next to nothing that could have helped me.) Spontaneous labor began the day before I was to be induced, but I was "only" progressing 1 cm every few hours, which wasn't fast enough. By the time 30 hours had passed, I was "stuck" at 6.5 cm, and had a beta-strep infection, so I consented to a c-section. The hospital was horrid, and I vowed never to go back there, no matter how far I had to travel. Later, I learned that not eating, and being tied to the bed to "get a good reading on the monitor" had probably significantly contributed to my "failed" VBAC effort.
With Baby #3, I searched everywhere for a caregiver that would give me the benefit of trusting my body to do its job. I needed to move, I needed to eat, I needed to progress at my own pace. I called everywhere, and visited two local practices. One doctor took a look at my chart and told me, "You're overweight, you're out of shape, you failed at labor twice before, you don't progress, and you're going to end up being sectioned anyway. This is a waste of your time and mine." I picked up my jaw from the floor, and moved on...
I was ready to drive almost two hours to a midwifery practice, but one more doc was recommended to me, just across the state line (about 15 miles away). He was wonderful! He calls himself "a midwife in a doc suit," and it's *so* true. He truly believed I could do a VBAC, and was willing to work with me.
Because the first two babies were 9 pounders at 42 weeks, I consented to using a prostaglandin gel to see if we could coax a smaller baby to come at 40 weeks. For three days, I had three gel treatments a day, doses of castor oil, herbal tinctures, homeopathic remedies (pulsatilla and Kali Carb 30) to turn a posterior baby... I had decent labor during the day, went home at night--not too bad, except that by the third day, I was still only about 6 cm dilated--the same place I got stuck last time.
I consented to having my water broke, even though it was a bit earlier than I would have liked. My contractions completely stopped for almost six hours! They suddenly returned though, hard and heavy, at which point, I used a tub (what a lifesaver, especially in getting my own weight off of my back!), and a lot of hot compresses on my back. After three hours of hard back labor, the baby rotated around from her posterior position. Another two hours, and I had dilated the final 3 cm, and she was born!
It was the most wonderful, exhilarating experience of my life. I did it! I actually conquered the beast within, and my body worked as it should, to birth my baby. Funny thing was, even at 40 weeks, she was right at nine pounds anyway! But I did it, with no pain medication, no pit drip, no c-section!
My doc said, "You had the most functional dysfunctional labor I've seen... way to go!" I know I would have been sectioned eight times over anywhere else. The staff was so supportive, and no one made any of those horrible comments like the one nasty doctor had made. (I did want to take my baby and hold her in his face and say, "How's THAT for a waste of time?!?!")
Here I am, almost three years later, with a midwife (new to my area, and absolutely terrific!) who "doesn't see any reason whatsoever why I can't have a home birth." I'm still the same size, but I'm a different woman... I'm confident, I know my body can do it, and I'm looking forward to a great home birth!
Update: Maddy had her home VBA2C just recently! She had another girl, and this baby was 9 lbs. 11 oz. Below is her short version of the birth story.
I had labor off and on all week, so my midwife came Wednesday afternoon to see what we could do to get long and strong and steady labor. I agreed for her to strip my membranes, and things kicked in quickly then. From 7 p.m. to 1 a.m., I dilated from 5 cm to 9-10 cm. I would contract well for an hour or more, then they would slow down and I'd sleep for 45 minutes of so, with contractions spreading out to 5-10 minutes apart. Then my friends would get me up and get me back to work again.
I started pushing about 2 a.m., in the bathroom on all fours, then with one leg half on the toilet seat and me sort of crouching over, then standing....you name it, I tried it!! She was moving down but would NOT crown! My perineum is like vinyl, they said. ;-) She was "right there" for over an hour, and in spite of hot compresses and massage, she just wouldn't crown completely. So my midwife snipped (her second episiotomy EVER!!!), a tiny, tiny little snip, and let me tear from there.
I pushed her out slowly---her head stopped AFTER crowning, but before it was out, and I got a great look in the mirror, and FELT her head finish delivering!!! It was SOOOO cool!!! Then the rest of her came out, again with me feeling her descent and move out---one shoulder at a time...and then it was DONE!!!.....She nurses like a pro, and we're doing well.
Bonnie's Story (2 c/s, insulin-dependent VBA2C)
Kmom's Notes:
Birth Story
I had the most powerful, beautiful, incredible experience of my life. And it only took 4.5 hours from start to finish. Not counting the nine months beforehand, of course.
My first contraction started at 4 p.m. and our 3rd daughter was born at 8:27 p.m. She weighed in at a bountiful 10 lbs., 2 oz. So I guess God said to me, "My child, you have worked hard enough at this pregnancy. You may have the blessing of a speedy labour." Not to say that it was terribly easy. In fact it hurt a whole heck of a lot. Kind of surprised me, actually---don't know why.
I seem to be starting at the end. Let me back up a bit. We all decided that because Dr. M was on call this weekend and I had hit my due date we were going to actively pursue having this baby. At 9 in the morning we went to the midwife's office where I had a quick internal exam and stretch & sweep. I was still four centimeters dilated and 80% effaced. We made a plan to try a castille soap enema, then a castor oil treatment. If that didn't work we would try rupturing my membranes. At any rate, the suitcase was in the car.
We went out and finally found the enema kit, and trooped back to the midwife's office. They had gone out to run errands and do a home visit for another client. The first try didn't work, so the midwife siad to start the castor oil, and then to try the enema again. I took the first dose of castor oil at 2:40 p.m., the enema about a half hour later, and then the second dose of castor oil a half hour after that.
At 4 p.m. I started to feel some contractions along with a lot of cramping (uggghhh, not a pleasant experience, that!). We called my friend to come and get my daughters because I was feeling distracted and needed to be able to focus. At first I had wanted my children around me, but then I wanted them to go. A was really anxious about the pain I was experiencing. Good thing she left when she did. T wanted to stay. I made sure that she knew that things were probably going to get rough.
By 5 p.m. the contractions were getting painful, and still less than 30 seconds duration, but they were only a few minutes apart. I still wasn't totally sure that these weren't just more cramps. DH paged the midwives around 5:25 p.m., and one spoke to me on the phone during a contraction to hear how I was coping. I guess that what she heard reassured her, so she told me she would be right there. DH called my doula at around the same time. I was worried that we were doing all this too soon, but in retrospect I'm awfully glad we did. The midwife arrived at 6 p.m., and not a moment too soon! I was sitting in an office chair and she was kneeling beside me as I had a couple of contractions, and then, whoosh, my water broke at 6:10 p.m. What an incredible feeling! The first thing I said was "I did it myself!" (I guess I was really anxious about having AROM.) What a neat feeling, and it actually relieved a lot of pressure. Everyone commented on how clear the fluid was. (There is some controversy about meconium in the baby when a mom has a castor oil induction.)
At this point, things really started heating up (as if they weren't already!). The contraction felt like they were just ripping my pelvic bones apart, and there was barely time to catch a breath between them. I sat on the birthing ball, squeezing DH's fingers during every contraction---he tried to move his hand once and I almost freaked---I just *needed* his hand. I leaned on the doula, she was just so comfortable and comforting. She spoke to me so quietly, and she said everything I needed to hear. I felt so much trust in her. As I made noises that became high-pitched, she told me to "find my tone", and bring the noises down low. She encouraged everything I did. I felt like I was doing everything right. Between contractions she made sure to help me relax my shoulders (she knows that's where I 'carry' my tension). It was absolute perfection. Looking back, I remember how quiet it was in the room while I was 'working'. What an incredible amount of respect they showed for me.
My daughter sat there quietly the whole time with huge round eyes. She actually got a few minutes of contractions on video, for which I was later thankful.
At around 7:30 p.m., the midwife checked me and I was 6-7 cm. Shortly thereafter, someone suggested I try to get up and go pee. I think that was the turning point. Crashing pain jolted me along the short distance to and from the washroom. I returned to the birthing ball, where the contractions just double-ended one after the other. Around that point, I started asking for an epidural (sheepish grin). The doula got firm with me then, looking closely into my eyes and reminding me of my wishes. I kept saying that I was so tired, and just wanted to sleep for a few minutes, just take a little rest. After a few more minutes of that, something changed.
It didn't hurt as much, and then my body made me make a grunting noise. The midwife asked me if I felt like I needed to push. I said no---and then I grunted again. 8-) She decided to check me again. I remember clearly that she said, "I can't feel the cervix---she's fully!" That sunk in through the pain, and I felt renewed strength. C knelt down in front of me, looked me directly in the eyes and said, "That was transition." Everyone started scurrying around packing things to go in the various cars. It felt so surreal as I looked through the fog and watched all these preparations go on around me. All I was required to do was to stand there. DH was assigned the job of "helping" me get my shoes on. I'm afraid I didn't assist him much, and I stepped on his fingers heavily. Poor guy.
We headed down to the street, where, limelight-hogger that I am, I stood on the sidewalk in my pyjamas and had a very noisy contraction. It was 8 p.m. on a Saturday night in downtown---there were quite a few people to witness the spectacle. I made my way to where the van was, doors standing open. During the 10 minute trip to the hospital, I kept making those grunting, pushing noises, and my doula kept firmly telling me to open my eyes and blow. DH drove, white-knuckled, as quickly as possible, but I don't think he broke one traffic law!
We pulled up to the hospital and walked in at about 8:10 p.m. It was a short ride up to the 6th floor in the wheelchair. I made sure I made lots of noise all the way, so people would hear me coming! ;-) Dr. M popped his head in for a moment, but didn't interfere in any way. Nurses stepped in, too, to bring equipment, but left quickly. I think C spoke to them in the hall and told them their presence wasn't needed.
I still can't believe how undeniable the urge to push was. After the midwives helped me turn on to my side, it was clear sailing (well, almost). The doula moved my hand down as the baby's head crowned (will I ever forget that feeling?). I told them I didn't want to push anymore after the baby's head was half out because I was too tired, and almost in unison they said, "You HAVE to push!" It's a good thing I am so obedient (smirk). The shoulders were slightly stuck, and C moved in to rotate the baby while the backup midwife pushed on my pelvic bone---quite the bruise I have there too, I might add. It was the most amazing feeling as she slid the rest of the way out of me on to the bed.
I was totally surprised as I looked around and saw everyone crying. They put my baby on my chest and covered us with blankets. I was shouting---"I had a baby, I had a baby!" I don't think I have ever been more proud of myself---or more happy. It was the achievement of the biggest goal I had ever set for myself.
We had been at the hospital for 20 minutes. DH, in a choked voice, was the first to announce her sex, and he cut the umbilical cord. I had her at my breast within 5 minutes of her birth.
To my dismay, the midwives wanted me to push out the placenta---I didn't want anything to do with that because I was starting to feel pain after the adrenalin wore off. I thought that was bad, until they wanted to check me for tearing. Oy! I had a second degree tear, and needed 2 internal stitches, and 3 external---all in different places. It was incredibly painful as they discussed the optimal number and placement of stitches and then proceeded to stitch me.
The midwives took blood, and I figured this was a good time to check the baby's blood glucose. I used my own glucometer because it was more accurate than their strips. Her sugars were 3.3 (kmom note: 59 mg/dl), which isn't bad. The pediatrician had told me they would recommend supplementation if the sugars got below 2.2 (~40 mg/dl).
After about an hour and a half, it was over. We were left alone in the room, with only DH's parents (who had arrived while I was being stitched and waited patiently in the hall while they overhead me complain about the pain of the stitches) and my other friend.
The midwives asked us what we wanted to do next. They didn't particularly want us to go home because of the distance if anything should go wrong. Staying in the hospital, with a private room, would cost about $175 because we don't have private insurance. We decided to take a room at one of the nicest hotels in the city. Believe it or not, the rate was only $150! After a total of 5.5 hours, we rolled out of the hospital.
I was still euphoric as we walked (I rolled in a wheelchair) into the splendor of that hotel. We got a room for DH's parents, and by chance the rest of us ended up with a suite. It was incredible. I sat in the living room of our suite, eating pizza from room service and nursing my baby until 5 a.m. I didn't sleep much even after I went to bed, because I couldn't believe this was all real. The baby slept between us in the queen-size bed.
When I called down to the desk to arrange for a late check-out, I spoke to the assistant manager. i explained that I had just had a baby, and we had spent her first night there. The woman was suitably impressed and gave us permission to stay till 3 p.m., with her congratulations. A short while later, a knock came at the door. It was a waiter with a lovely tray of fruit and candies. There was also a card, addressed to the baby. It said, "Dear baby xxxx, Thank you for spending your very first night with us here at xxxxx. We hope you will come visit us again when you get older." It was signed by all the staff at the desk. I cried at the thoughtfulness of it.
Later in the morning, we ordered a room service breakfast for the family as we waited for the midwives to arrive for a pre-arranged 'home' visit. The waiter arranged the white linen cloth, crystal, and fresh flowers on the oak dining table in our suite and set out the covered plates. I sipped my fresh-squeezed orange juice and devoured the most delicious scrambled eggs, home fries, and sausage. How much better than the hospital is this?
The midwives check me and the baby. We had check her sugars two more times and they were holding stable at 3.6 and 3.3. (65 and 59 mg/dl) She had also been nursing almost constantly. All was well.
It is now a week later, and I think we have settled in nicely. The two older girls both seem to love their little sister. I could wish for more sleep, but in the end I am awed by the strength and alertness of a healthy, full-term baby, having never had one before.
I have had 2 previous cesareans. I also had insulin-dependent Type II diabetes. I am 5 ft. tall. I worked very hard at normalizing this last pregnancy and I trained as if I was going into a marathon: good food, lots of exercise, saw all my caregivers regularly. But do you know what I think the most important thing was? I educated myself, and made all my own decisions. It can be done.
Teresa's Story(2 prior cesareans due to malpositions, VBA2C)
Kmom's Notes: A story of malpositions! Her first probably had a malposition (postdates, distressed baby, water broke, terrible back labor, no descent of baby), and her second was stubbornly breech.
Her third probably also initially had a malposition (went overdue, water broke, back labor, labor too painful lying down, transition-like labor but stuck in early to mid-labor, baby not engaged, sudden change in labor probably indicating that baby had resolved its position, quick dilation and birth after that, baby had bruised forehead from where it was probably stuck for a while). Since this malposition was able to resolve on its own, she went on to have a lovely VBAC.
Birth Story
Baby #1 (cesarean): Water broke at 42 weeks with meconium, went to the hospital, shaved practically from the neck down, pitocin to start labor, HORRIBLE back labor, got the epidural that I swore I wouldn't get, could feel absolutely nothing, got to 10 cm and tried pushing for a couple of hours but couldn't feel anything so I'm sure it wasn't very effective. After 2 hours of pushing had a c/s for 'failure to progress,' 'CPD,' and distressed baby. (I was 20 and very naive--the doctor and hospital staff scared me into thinking the baby was in grave danger.) Baby was perfect, 7 & 9 apgars, no complications with the surgery. Had mild to moderate post partum depression for about a month. I'm now convinced that she was probably malpositioned. [Kmom note: She notes that she was not heavy for this pregnancy.]
Baby #2 (cesarean): I had divorced and remarried. Baby was breech from 32 weeks. Tried everything including version and standing on my head to get her to turn, had c/s at 39 weeks. Baby was perfect, 8 & 9 apgars. Still stubborn as a mule!
Baby #3 (VBAC): Even though my daughters' births were joyous occasions and resulted in two healthy and beautiful babies, I felt like I had missed something. I had always wanted natural childbirth and for my third (and most likely last) birth, I wanted it desperately. As crazy as it may sound, I longed to feel the pains of labor, to feel my baby emerge from my body, and to hold my baby while he was still warm and slippery with amniotic fluid, instead of hours later after a dozen or so people had laid hands on him. So I did everything I could to attain that goal. I read every book ever written on VBAC, scoured the internet for information and statistics on the safety of VBAC, went to Yoga class, made my husband read about natural childbirth, hired a doula, and generally drove everyone close to me a little crazy, including my wonderful and VERY patient husband.
The last and probably most important step I took to ensure that I got the birth that I wanted was to change doctors at 34 weeks. I didn't feel I was getting the support I needed from the doctor/midwife team I was seeing. My office visits were with the midwives, but since I had had 2 cesareans I was considered 'high risk' and so the doctor (whom I never actually met) became involved in my care. The 'rules and requirements' of my labor changed from visit to visit and became more and more conservative the farther I got along. There seemed to be too many conflicting opinions on VBAC. I felt that whoever ended up on call when I went into labor would determine the fate of my child's birth. The emotional burden of that was too much for me to handle. I needed to know that everyone around me wanted the same thing that I did and BELIEVED that I could get it.
I found a wonderful and much smaller doctor/midwife team. During our consultation visit the doctor explained all the risks of VBAC that I had heard many times before. He asked me how I wanted to proceed and, after that initial visit, cesarean section was never mentioned to me again. I was treated just like any other pregnant woman---not one who might expire at any moment. I think the changing of doctors changed the odds of success in my favor----both emotionally and physically.
For the first 6 months I developed severe allergies and asthma. I couldn't get out of bed without being out of breath. I coughed until I thought my eyes would pop out. I was on about 5 medications, which worried me a LOT. At about 7 months is just sort of went away relatively suddenly. Very weird.
My due date came and went. I was becoming more and more depressed because of the possibilities of inducement, the baby being too big, etc. Even though my providers hadn't mentioned these things yet, all the things that could sabotage my hopes for a natural birth were floating around in my mind. One evening 8 dates after my due date, about 10:30 p.m., I felt a little pop and thought my water had broken. About 10 minutes later came a little gush of fluid, but not even enough to wet the bed. I got up and went to the bathroom but there was only a little trickle and I felt a little contraction. I went to my husband and told him I thought my water had broken but I wasn't sure.
My DH got out his stop watch. We walked around and I was having small contractions but nothing I couldn't walk and talk through. I still had a slow trickle of fluid leaking so at around 11:30 we decided to call the midwife. She said to try and get some rest and see if things picked up, but to come to the hospital around 6 a.m. regardless of what was happening since my water had broken. We called the doula and the grandparents. I kept having contractions; they seemed to be close together but they weren't very strong so I sort of dismissed them. We tried to get a little sleep, but as soon as I laid down the contractions got harder and I had to start my yoga breathing. We timed contractions but they didn't really have a pattern at all. Around 1 a.m. I got too uncomfortable to lay down anymore so I got up and walked a little bit. Things seemed to me to be speeding up so we called the doula. She came and put us at ease right away. She thought I was still in early labor and should try to get some more rest. As soon as I lay down, I'd have to get back up---the theme of my labor. I decided to get in the bathtub to try and pass some time and relax. I told my DH to take a nap. I filled the tub with water as warm as I dared and turned on the jets----ahhhh heaven! I stayed in the tub for at least a couple of hours and just tried to control my breathing and relax, and I think I even dozed off at some point. By the time I got out of the tub I was using yoga sound to get through my contractions.
I waddled back to bed, had a contraction, and got back up. Things started getting more serious. A little while later we woke the doula. She had me sit on the birthing ball and helped me through some contractions. I was holding a lot of tension in my shoulders and she laid her hands on me there and was talking to me in her low, calm voice. She made me some toast and juice but I only managed to drink a few sips of juice. By this time it was around 5 a.m. I really felt like things were getting faster and felt an urgency to get to the hospital. I think my husband felt it too. My doula said she thought I was around 4 cm dilated and I was satisfied I'd done enough work at home. We prepared to go to the hospital, making all our phone calls, finishing packing our bag, etc. The grandparents took my younger daughter, and the older one went to the hospital with the doula. I expected the drive to be the worst part of my labor but it actually turned out to be one of the calmest moments I had during the entire labor. It was dawn and there was a thick, heavy fog. It felt like we were driving through a dream. I had my eyes closed most of the time and just concentrated on my breath, relaxation, and humming along with my contractions on an "O" sound, and also with a closed mouth hum.
We arrived at the hospital around 6:30 a.m. When I got there, the nurse told me I was fully effaced but only 2 cm dilated and the baby was at a -3 station. My first thought was, "Where are the drugs?" Needless to say, I didn't find the nurses' evaluation of my progress to be very encouraging. Fortunately, my mind didn't have time to dwell on that information because my body went into overdrive. Between the exam room and the L&D room, I had to stop for a half-dozen or so contractions and was making a considerable amount of noise. My nice controlled "O-O-O-O" ended up sounding like a very loud "O-O-OUCH."
We made it to the L&D room and the nurse wanted to hook me up for the 20 minute monitor strip and the heparin lock I had agreed to in case of emergency. At this point I was leaning with my contractions---on my DH, the wall, the bed, the birthing ball. It wasn't my intention to be difficult, but lying or sitting in bed was TOTALLY out of the question and the nurse was very anxious to get the monitor strip going. The doula suggested I sit on the birthing ball for the monitor strip. I tried that but couldn't really sit through the contractions. I ended up leaning against the cabinet the monitor was sitting on for about 10 minutes and making a lot of noise. I'm sure the nurse thought I was insane because I was only 2 cm dilated and all. DH was taking his job of birth advocate very seriously, going over the birth plan with everyone who walked in the room.
After about 10 minutes of ineffective monitoring and loud chanting of O-O-Os, I suddenly had an absolutely overwhelming urge to go to the bathroom. I expressed this to everyone. The nurse suggested I leave the monitor belt on and go use the bathroom. I said NO, take it off, I need to go NOW. The doula took my eldest daughter to the waiting room, as she wanted to be there but didn't want to see everything happen, and things were getting intense pretty quickly. DH asked me if I wanted to go to the bathroom by myself and I said yes so he left me there. Everything unnecessary for giving birth to a baby came out of my body.
My yoga sounds started changing. What started out as O-O-O was now ending up as a ferocious growl. I had a tremendous urge to push and the contractions were coming one right after another. I was still sitting on the toilet growling through my contractions, while DH was outside 'discussing' methods of IV insertion with the nurse. I didn't care. He checked on me to see if I was alright. I told him I didn't think I could do this anymore. He told me later that when I said this he was really happy because he knew that one of the signs of transition was self-doubt. (I just knew that Bradley book would come in handy!) He helped me back to the room where I ended up on the birthing ball again. I think more than one person was telling me to quit pushing, to blow through it. I couldn't have quit pushing if you had paid me a million dollars. At this point the nurse brought in release forms because I guess she was convinced she wasn't going to get her 20-minute monitor strip or an IV. I signed. My doula whispered to me that it was okay, I definitely wasn't at 2 cm anymore. Believe it or not, at this time we had only been at the hospital for about 1.5 hours.
My midwife arrived and said something like, "How are
things going?" I think I growled at her. She smiled and told me
I was doing fine. She wanted me to get on the bed so she could check my
progress. I asked her if I could stay on my hands and knees and she said
sure, we'll try it. I ended up on my knees, leaning up against the propped
back of the bed with my elbows. This is where I stayed for the rest of the
birth. I had
actually listened to a birth story in yoga class of a woman who used this
position, but never thought I would end up using it.
In retrospect though, I think it kept me focused and uninhibited because
I was totally oblivious to anyone else in the room besides Adam, Sabrina and
Sara.
The
midwife checked
me and not only was I completely dilated, the baby was now at +2 station. It was really happening.
This registered with me and I think I said something like, “The
baby’s really coming?” I was
too busy growling to really be all that excited about it.
The doula was talking to
me even though I couldn’t tell you what she was saying.
DH was crying now and
told me my how good I was doing.
I
was growling and pushing and growling and pushing.
The doula was soothing me
and rubbing the top of my back. The
midwife was putting warm compresses and some sort of oil or gel on my
bottom and rubbing the lower part of my back.
DH rubbed my feet a
little and watched in amazement as the first glimpse of baby started to appear.
My midwife told me I was
going to hurt my throat if I kept growling like that.
(Unfortunately, it was already too late for my throat.
I could barely talk for about a week after the baby came.)
She told me to bring it down. Bring
it down to the baby. I tried to do
that and then suddenly I could feel the baby moving down.
I could actually feel it – it was the wildest thing – all the sound
went inward and I could feel the baby moving down.
When each contraction ended I would feel the baby move back up a little
and I would think, “No – go down, go down.”
Then, as things progressed the midwife told me the baby was crowning.
She didn’t really need to tell me because I felt the RING OF FIRE,
which you read about, but cannot truly appreciate until you have experienced it.
At that point I was thinking, “Go back up, go back up!”
But there was no turning back now, the baby was almost here.
All during this period the nurse was still trying to check the baby’s
heartbeat with the doppler. I
can’t even imagine what we would have done if she couldn’t have found it.
I wanted her to just leave
me alone, but I was having to concentrate too hard and couldn’t really convey
that message.
The
midwife asked
DH if he wanted to help deliver the baby. He
was the first to touch the baby. My
baby’s first experience with the outside world was his daddy touching his
little head. With the position I was in (upright but leaning over), the baby
came out with his face pointing up instead of down, and the first thing the baby
saw when he came out with his eyes wide open was the same person who was
touching him, his daddy. After the
head was delivered the rest of the baby came within one or two more pushes and
it was amazing. All the pain was
instantly and totally gone. My
midwife announced, “It’s a boy!” and at 8:43 a.m. my son officially
entered the world weighing in at 8 lbs 6 oz (bigger than either of my c-section
babies).
I
turned around so I could see and hold my new son. DH kissed me and told me
how beautiful we were. I was too
shocked to even cry. All I could do
was look at the beautiful, naked little being that was still attached to my body
and say, “We did it, little man. We
really did it.” I think I said
that to everyone.
I
held the baby and DH cut the cord. I
held my baby while they cleaned him up and checked him out.
His forehead was a little bruised from coming so fast, but otherwise he
was perfect. [Kmom note: The bruised
forehead probably indicates the malposition!] I tried to nurse
him. It didn’t take him long to
catch on and I nursed him for a little while.
They brought me a warm blanket for the baby and we lay skin to skin
covered in a nice warm blanket for a while.
My doula went to get my
oldest daughter and tell her the good news.
The midwife checked me
out and - can you believe it – NO tears, no stitches required.
She did think my cervix might have a little laceration, so she had the
doctor check me out. Luckily, it
was only swollen. Our nurse was
quite impressed with us, I think, and let us have extra time in the
labor/delivery room with the baby before they took him to weigh, measure and
bathe him. She was a good sport and was very happy and proud for us,
even though I’m sure we were her nightmare patients. Everyone, including us, was amazed that we had only been at
the hospital just a little over two hours.
We were still signing release forms after it was all over with.
The midwife told me later
that when she arrived at the hospital and heard me (I imagine the whole
maternity ward could hear me) and checked my chart she told the nurse, “This
is either really, really good – or it’s going to be a REALLY long day!”
It was really, really good.
I
had a natural and pure birth. No
drugs, no IV, no monitor, no cutting of anything.
It was the most amazing thing I have ever done.
Was it easier than having a cesarean?
No – absolutely not. But
it was completely satisfying, and perfect, and exactly as God designed it.
I was a participant – not a spectator.
I did it. With the help of
three loving and wonderful people, I did it.
The recovery period was easier than a cesarean, no contest.
The birth was powerful and intense and that’s exactly how I felt when
it was all over: powerful and energized. After
being awake all the previous night, it was almost 24 more hours before I slept.
I went home the next day to be with my family.
I had the most perfect birth I could have dreamed of. It meant more to me than I can even put into words. It was the difference between giving birth and having surgery. But it was more than that. I didn’t have a horrible experience with either of my c-sections, so it’s very difficult to explain the psychological impact that they had on me. My quest for a natural birth was about being whole, instead of cut in half. It was also as much about healing the scar on my belly as it was about bringing new life into the world. It was about trusting myself and my body - and even God.
Honestly, I had expected to have a huge emotional response when the baby was handed to me right after delivery. I fantasized about that moment almost daily while I was pregnant. As it turned out, all I could do right after delivery was stare in amazement and shock at my baby. The emotional response came a few weeks later when I got a note from my midwife thanking ME for letting HER be a part of the birth. I had also gotten a call from my doula telling me how wonderful the birth was for her. To know that the birth had touched other people made me realize just how amazing it truly was. As I read my midwife’s note, all the tears of hope, joy, fear, and relief that I had been wishing and praying for during the last nine months washed over me. I thanked God and I wept.
Julia's Story (c/s for non-progress, distress; ERCS; VBA2C)
Kmom's Notes: This mom is from the United Kingdom. She says she was treated as if a VBA2C was unheard of and that she was expecting the unattainable. Ha!
Birth Story
My first birth [was an] emergency c-section, 10 days before my due date. After suffering with a severe headache for several hours, I called my midwife. She arrived, and after taking my blood pressure, advised me to go into hospital immediately. The starting of pre-eclampsia was mentioned. I was induced with a suppository (can't remember the name of it) that evening. After several hours of mild contractions, on a VERY VERY busy maternity ward, I was advised to take a sleeping tablet so that I would be rested for tomorrow, as it would all be happening then. (In hindsight and now being less naive, I believe because the ward was SOOOO busy.)
The next morning I was strapped up to a monitor and induced by pitocin. After around 4 hours of contractions, I was checked and found to be about 1.5 cm dilated. After a couple more hours my waters were then broken, to speed things up. Then a couple more hours I was checked again. At this point I disagree with what was recorded in my notes. I'm SURE I was told, only 1.5 to 2 cms dilated. Absolute horror. I could not believe it. I can remember thinking the labour will take 2 or 3 days, at this rate. (My medical notes say that the second check I was 4 to 5 cms. dilated!!!)
I then asked for a C-Section. (This was at the back of my mind all along, as I was uneducated in childbirth. I am a dress size UK 10 and was afraid it would hurt too much.) My wish was granted, after the medical staff quickly justified that the baby was slightly distressed too. Or maybe because it was around 7 p.m. on a Friday night?
I believe the medical notes say the baby was sunny-side up [posterior]. This may explain why there was apparently "slow progress.' Recovered reasonably well after the operation.
My second birth [was an elected C-Section]. Booked in for the ERCS at 1 week before due date. I was advised to have a Trial of Labor. But all the old fears were there, could I do it, still uneducated in childbirth, but also had the added complication that I had a dermoid cyst on my ovary that needed to be removed. In my eyes the TOL could fail. I didn't dilate very fast in the first birth, and would probably need another C-Section anyway, and I needed an operation to remove the cyst. Seemed easier to have 2-for-1, remove baby and remove cyst at the same time. (If I had known the pressure I would be against for a normal birth for baby number 3, rather than another C-Section, maybe I should have tried a bit harder for a normal birth for this baby.)
My waters broke on their own accord, one week before the planned c/s. After contracting for several hours we went into the hospital. I was asked again if I wanted a TOL, as I had dilated to 4-5 cms. Oh, I didn't know I could do that. I still said no. Baby and cyst and ovary all removed at the same time. Baby was in perfect position for delivery, i.e., not sunny-side-up. The recovery after this operation took a lot longer this time. Probably due to the cyst/ovary being removed, as well as an active 3.5 year old to look after.
My third birth was my successful VBA2C. I thought it would be for the best, physically and emotionally, to prove to myself that I was a 'normal' woman who could actually deliver a baby. I educated myself on childbirth (at last) and decided to try for a VBAC. Easy, I thought, they had offered me a TOL before, they should do it again.
But after the first visit to see my midwife at 15 weeks, the midwife had stated along the lines, "Oh, the consultant won't allow a normal delivery, not after 2 c-sections. But we could try." I started reading up on VBAC and all the dangers (?). For the whole of this pregnancy I felt I had to be one step in front of the consultants, and at times the midwives.
I met my consultant at around 18 weeks. Without even discussing the delivery with me, he read "2 previous c-sections" on my notes and started to write "ERCS" again. I stopped him and said that I wanted to discuss my plans with him. I told him I had read up VBAC extensively, and I was prepared to continue with my initial plan for a TOL. He relented, but stated that the pregnancy and delivery had to be normal, with no complications. He implied he would not agree to a breech birth, or if the baby was too large, went over-due, etc. He planned to see both myself and my husband to further discuss the birth plan at 36 weeks.
At 20 weeks I had a slight bleed. A scan revealed a possibly low-lying placenta, with veins covering up the cervical Os, and that possibly one of these veins had burst. After the initial worry that I was miscarrying, I tried to prepare myself mentally for the visit from my consultant. The first thing my consultant said to me was along the lines, "Well, these complications throw your TOL out of the window!" Having had a low-lying placenta with my second child, I knew that this could change significantly and correct itself in the later stage of pregnancy. So I told him.
At this point I had stopped trusting the NHS [National Health Service]. So I had a private, more detailed scan at 25 weeks, in the hope this would reveal if I definitely had a low-lying placenta, and what had caused the slight bleed. This private scan showed the nearest vein to my cervix was 6.5 cms away, that the low-lying placenta had indeed moved higher up, and that there was no complications. Oh yeah, and we were expecting a girl.
Expecting a confrontation at my 36 week check-up with my consultant, in a strange way I was slightly disappointed that he agreed I could have the TOL. He did strongly recommend that once labour had been established that I was continuously monitored. I wanted an active birth, and everything I had read had encouraged this to reduce the possibility of a repeat c/s. I was a little non-committal about this and said I would think about it more. Save that one for another day.
Three and a half weeks before my due date I started having contractions. Apparently these were only "ripening of the cervix" pains. After two days of these pains, with very little sleep at night, I started having proper contractions. After several hours we went into hospital. Once there and settled into the labour room, I was checked after 4 hours. I was 3 or 4 cms. This was going well, not too much pain. No drugs at all. Then the discussion for continuous monitoring was raised again, as I was in established labour. I said I needed to think about it more, and needed to discuss it with my husband. The midwife and assistant midwife came back after 30 minutes and because I still had not agreed to it, suggested the duty consultant have a word with me. He turned up shortly after and tried to convince me. I expressed my concern that if I was continuously monitored I could not walk around, and that if there was a slight problem with the baby's heartbeat, everyone would overreact and that I would immediately be taken for an emergency c/s. (At this point I think I was unduly pressed into continuous monitoring, and the fear that I could be harming the baby was mentioned.) I said I would still think about it, and would have an answer soon.
The pains were starting to get really painful now, and I was checked again. I was about 8 cm. I had actually made it this far!! It was going well, but I now needed "gas and air" for the pain. I agreed finally to the continuous monitoring. I was duly strapped to the monitor, and because the monitor did not appear to be working very well if I was standing, it was easier to lie on the bed. After about an hour, the midwife and assistant midwife became concerned with the baby's heartbeat. Apparently she wasn't recovering very well after a contraction. The consultant came in to examine me and could not determine how the baby was lying.
After a quarter of an hour or so I was wheeled into the delivery room, where there was quite a large gathering of doctors and nurses. The consultant tried to find out internally how the baby was lying. It was excruciatingly painful. It didn't appear to work because he still didn't know. He then told me he needed to perform an episiotomy, which he then carried out. He then said I was fully dilated, and that it was urgent to get the baby out as quickly as possible, and that he was going to use the suction cap [vacuum extractor]. I did hear him muttering to the others about checking the operating room was ready, just in case.
Oh great, I've come all this way and now this. When he told me to push, I really really pushed. After two major contractions, with him pulling and me pushing, WOW, the proudest moment of my life, I delivered my little girl. I had done it. After a quick check she was passed to me. My gorgeous girl.
As the last stage of labour was so quick and with the force used with the suction cap [not to mention the episiotomy, which often extends into worse tearing---Kmom], I did tear very badly. When I asked the consultant how many stitches he was putting in, as he seemed to be taking a long time sewing, he said he had lost count (!). I did also lose, if I remember correctly, half a pint of blood, and had to take those awful iron tablets for two weeks after the birth. But the recovery was MUCH MUCH easier and quicker than a c/s.
My daughter had an Apgar of 9 at one minute, and an Apgar of 10 at five minutes. So why all the urgency to 'remove her immediately?' I was minutes away from another c/s. Did these 'professionals' overreact because of the continuous monitoring? If I had not been monitored would I have ended up needing an episiotomy, or an assisted delivery? I can only guess.
Rachel's Story (2 prior cesareans for "big baby" and "unstable lie;" VBA2C)