I am now a mother of two sweet boys! The first was a cesarean birth and the second was a VBAC (vaginal birth after cesarean). This is the story of my second and I’m writing it to document the experience, celebrate what happened and encourage other moms.
With my first pregnancy, my husband and I took 12 weeks of Bradley natural childbirth classes. I wanted to give an unmedicated birth a try. When I reached my due date, an ultrasound estimated my baby to be close to 10 lbs and also appeared to show that his shoulders were wider than his head. My OB said the ratio put me at risk of shoulder dystocia – baby’s head getting stuck on the way out – and with a second opinion from another doctor, they both said they would only feel comfortable delivering my baby by c-section. I was heartbroken and cried since it wasn’t the birth I wanted, but scheduled the c-section for two days later. My mom made her way down from Minnesota the next day, which happened to be Halloween. I spontaneously went into labor that night, which was just hours before my scheduled c-section. I arrived at the hospital dilated to a 4, but they proceeded with the c-section due to the shoulder dystocia risk. My son Tommy was born at 7 lbs. 13 oz. – very average! His shoulders didn’t look wide or disproportional to me. I am overweight but otherwise healthy and felt that the doctor had assumed that my baby would be big because I am big. While I was so happy to have a healthy baby, the first 2 weeks of recovery were awful. The surgery and pain medication wildly confused my body, throwing my hormones off, making me depressed and sleepy, and delaying my milk for 5 days. Breastfeeding was a struggle for weeks and weeks. I knew I wanted it to be different the next time.
With baby #2, I switched doctors because my first doctor would only do more c-sections on me going forward. I joined the local ICAN group (Int’l Cesarean Awareness Network) on Facebook and got recommendations for VBAC-supportive providers. I knew I had found the right doctor when new OB said that she felt my previous c-section was unnecessary and said I had an 80-90% chance of a successful VBAC. When I asked the ICAN group for their advice on achieving the birth I wanted, everyone said “Get a doula!” So I did. That proved to be the BEST decision. My goal was to have an unmedicated birth or at least delay the epidural as long as possible not just for the sake of doing it, but because everything I read indicated that an early epidural could reduce my chance of having a vaginal birth. Interventions like that would confine me to the bed and could slow down my contractions and lead to the use of pitocin. While I was nervous about the pain of childbirth and had an inkling of what I was in for since I had now experienced contractions, I gained courage by reading books and birth stories, talking to friends, journaling and praying.
Like my first pregnancy, I went into spontaneous labor 3 days past my due date. My mom was already at our home and ready to watch our toddler when it was time to go the hospital. Contractions started on a Saturday afternoon and quickly became 3 minutes apart but they only lasted about 30 seconds (as opposed to the 1 minute length I was watching for). Since I am impatient and my worst fear was being pregnant weeks past my due date, I was excited that labor might finally be starting. I laid down for a short rest but quickly got up again and kept moving in order to keep labor progressing. In fact, with my first I had gone shopping to Old Navy at this stage, so for some reason I went to Old Navy again to get a couple new pieces of comfy clothing. I was walking across the parking lot crosswalk and around the store having serious contractions, but no one knew! I texted with my doula throughout the evening and found that standing and leaning on something was the best way to work through each contraction. My husband also applied counter-pressure on my lower back and I tried lying down for awhile and also drinking water. My toddler wanted to play with me and jump on my back, but we had to explain that I wasn’t feeling well. I kissed my son goodnight, hopeful that he’d wake up in the morning with a new sibling. The contractions seemed to be strengthening and after one that was particularly strong, I called my doctor at about 10:30pm. She said I should head to the hospital. An hour later, I was checked at triage. I was 100% effaced, dilated 4 cm, and the contractions continued 3 minutes apart. My blood pressure was very high which I think was due to the pain and anxiety I was feeling. They said my blood pressure HAD to come down quickly or else I would get an epidural. I almost felt my plans for an active labor where I could move around slipping away from me.
With my doula’s support, I relaxed and gained some confidence while I was admitted to a labor and delivery room. Thank goodness, by the time I was moved at 1:30am, my blood pressure was more reasonable. I had also made some progress and was dilated to 5.5. I wanted to try getting in a warm tub. By phone, my doctor said that was fine, but that they would have to wirelessly monitor the baby’s heartbeat during the tub time. The warm water and jets felt good, especially on my lower back where much of the pain was concentrated, but the nurses had a hard time picking up the baby’s heartbeat in the water. After a half hour of trying, we gave up and I got out of the tub. After that, I tried some different positions on a birth ball, but standing up leaning on something still felt best.
By 2:30am, the pressure was really building and contractions getting stronger and stronger. I was checked again and found to be dilated to 6.5. I was making progress! The surges kept coming every 3 minutes, and my doula guided me through each one by moaning with me in a low “o” sound. That gave me something to focus on. My husband was there supporting me as well. They both rubbed my arms, legs and feet and encouraged me. Without them, my fears would have overcome me and I would have given up. It really felt like a matter of survival that they were right next to me for each and every contraction.
At 5:00am, after several more hours of intensity, I was checked and they said I was dilated to a 7. This was super disheartening to me as I had already been going over 12 hours and felt I had very little strength left in me. I knew that I had gone as far as I could and needed an epidural. When my doula and nurse asked if I wanted to talk the epidural decision over with my husband, I said, “I don’t need to ask him. He’s very pro-drug and would have gotten one hours ago!” We laughed.
It took at least 20 min for the nurse anesthetist to arrive and another 20 minutes for the epidural to take effect. It was a VERY long 40 minutes and those 10-15 contractions were some of the worst of the entire night since I was so mentally done! Finally I started to feel a sense of relief. I was able to lie down with a peanut ball between my legs and doze off for a little nap. The rest didn’t last long though – the epidural left one big area on the left side of my uterus where I still felt everything. That lingering sensation continued to grow over a couple hours.
At 8:00am, I was “almost complete” (dilated 9.5 cm) and my bag of waters was bulging. They recommended breaking my water so the baby’s head could move down further; so far, he had been suspended up a little higher in his cushiony amniotic sac. While there were some risks that come with that – including dilation possibly regressing a little bit – it was very quick, painless and worked exactly as they had hoped; the baby’s head was now putting a lot more pressure on my cervix. The nurse said that based on the baby’s station, I should continue laboring as long as possible and delay pushing because I had about 2-3 hours of pushing ahead of me. I know she was trying to realistically set my expectations, but I thought “oh hell no!” She repeated the 2-3 hour projection several times and I buried my face in a pillow, not wanting to hear that bad news over and over again. The epidural wasn’t working well and I truly didn’t have much left in me.
At 9:35am, I knew it was time to push. The nurse had been so certain of her 2-3 hour projection that she said the baby was expected around noon, and my husband texted that update to our moms. I felt every bit of the urge to push. When I yelled and groaned, the nurse told me to put that energy into pushing instead of talking. That was frustrating (let me express myself, I thought!) but I knew from my reading that there’s some wisdom to that and again, it gave me something else to focus on. The baby was coming a lot faster than they expected. The nurse told me to breathe fast in a hyperventilating way to distract myself from pushing and slow him down so I wouldn’t tear. My doctor wasn’t there yet, but the room was filling up with people in preparation for a baby. Subconsciously I felt that we must be getting close. And after only 33 minutes of pushing, my baby came out! Raleigh Jacob was born at 10:08am weighing 9 lbs. 6 oz. and 22 ¼” long. (His name rhymes with “jolly” – we named him after the city in North Carolina where we met and married.) It was so surreal, shocking and amazing to see him right as he was born – messy and straight from the womb! – and he was immediately put on my chest. I had a second degree tear from the fast exit that had to be stitched up. My doctor came a few minutes after the birth and was there for the placenta delivery and the stitching; a different doctor based at the hospital had been there for the baby’s delivery. I had done it! I couldn’t believe it. I was so happy, proud and relieved and mostly just in shock that it really happened. My baby boy was cleaned up a little and nursed for 40 minutes. He never left my side.
The recovery has been the complete opposite of my c-section recovery. I was up walking within 2 hours, felt like myself instead of a patient recovering from major surgery, and was just so HAPPY! My milk came in in just 2 days and breastfeeding has been a much smoother, enjoyable process. I am so thankful to my doula for supporting me as I made my VBAC dream come true and birthed without (or despite) fear!