My VBAC Birth Story

A few disclaimers: This is choppy and has typos because I wrote it when I was pretty sleep-deprived and over the period of a week. This also mentions female parts of the body (it starts with a V!! oh noo!!). I also put in pictures of the actual birth (taken by Jami, my doula!) and no private parts - Jase coming out bloody and part of my leg is all you will see. If these things could be offensive to you, that's your problem since I warned you ;) 

Lastly though I am thankful to have a VBAC I am not so militant about VBAC to the point where I think all women who have had C-sections should try. I am all for women having the facts and making their own decisions that is best for them. In fact, I nearly scheduled a repeat cesarean the day before the induction. Ok now that I've gone to great pains to not offend anyone I'll actually get to my story!

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Jase Emmanuel Guthrie was born December 31st at 12:17 AM weighing 8lbs 12.9oz and was 22 inches long. I was 42 weeks along!

Since his birth I've had time to process it but also been super busy with my two boys and spending extra time with David, pretty much taking care of Carson and Jase! It's only been five or so days but I am still so floored that I had a VBAC! Even in the midst of the long induction process I doubted if I would happen. When the moment came to push I was totally excited! But going from doubting it would ever happen to pushing was a long and kind of stressful process. 

If you haven't read my previous posts on VBAC in this blog and my old one, I'll just summarize them by saying that I learned early on in this pregnancy that I am an excellent candidate for it (which is obvious now) and that things are not as they seem in the world of obstetrics. I experienced a lot of dissillusionment as my first OB tried to scare me out of a trial of labor, but on the same day handed me the ACOG pamphlet that says I should definitely try; or as another OB told me that since I wasn't dilated at 39 weeks he didn't think I could deliver a baby vaginally, a statement obviously not grounded in any medical fact! The more books I read and research I did the more I prepared and planned to have a VBAC. But the most stressful part in all of it was my own worries and expectations of myself and my body, accompanied by my apprehension of having to fight for what I want while in labor. (I now know that while in labor and not on pain meds I would have absolutely no problem fighting for what I want! Haha Plus I know that because I chose such great care providers at 39 weeks, that fighting was not necessary.)

At WomanCare there are two OBs: Dr Wright and Dr Grady. They oversee three midwives, Beth (who I saw at 40 and 41 weeks and part of my labor), Allison (who delivered Jase) and Damara, who I have yet to meet. Jami Moffatt is my doula.

Anyway, my birth story starts on Sunday night the 29th as I checked in to get induced. The plan as discussed with midwife Beth was to use a balloon catheter for 12 hours overnight to dilate my cervix. I had David and Jami with me for this because it had been a painful procedure for those who I know who did it. The nurses were super comforting in answering my questions about it, and even showed me a picture of the catheter filled up with saline as it would be in my cervix area. Below is a cartoon of it :) it has two chambers. 

So the morning of the 30th Jami returned, the nurses checked me and removed the catheter. I was told that I was at 5cm, but a "mechanical" 5cm. The outer oz was at 5 but the inner oz was still at 2. (Apparently an "oz" is a layer of the cervix and I may or may not be spelling that correctly!)

I had been hoping that this catheter would get me into active labor but it didn't. So I was given more options to kickstart labor. With the nurse's and Jami's guidance I chose to pump, which usually gets contractions going because it naturally produces oxytocin. But after a few 20 minute sessions of this, the contractions would fade back to the very occasional and inconsistent pattern they always had been. My only next option was something I had not ever intended to use, that Dr Wright would not have used: Pitocin. 

The midwives had found very low doses of pit to be helpful in VBAC labors but they do not go over the level 10. Since I did not want my water broken yet this was my only option. They started me on 2 and went up by twos until they got to 8. The contractions did get a little stronger, and I walked the halls and did all kinds of positions to encourage baby to drop, since he was still high. Some of the contractions I definitely had to breathe through and I found this encouraging for progression. But still labor was stalling. 

By this time it was mid-afternoon on the 30th. Of course I had been sneaking snacks throughout the day. No one who is 42 weeks along should be made to starve when trying to get labor going! And medically, I had done my research to know the risks of eating, which are low. 

I updated some friends: "So we've upped the pit every once and a while and the max we can go is ten. We're at 8 and it barely feels worse to me. also ctx are barely consistent. But I am having tons of bloody show! Without going to the max of ten I'm allowing them to break my waters in an hour or two when Alison the midwife comes. I know this will really speed things up! The ctx are stronger and it helps to breathe through them and enjoy the relaxed feeling in between. I've also taken another nap and feel better about all of this."

While my physical strength was fine, my emotional strength was pretty brittle before that nap. I was constantly holding back tears of frustration, fear and sadness. I had intended to have my body do all this for me, but why wasn't my body producing the necessary mix of hormones to get this baby out? Why wasn't my body responding to all of these gentler, natural ways of induction? I was so thankful to have such a patient nurse and midwife tending to me. Most Drs at this point would push for me to have another section. 

Another update: "At this point we've tried every thing- positions, walking, pumping, resting, napping, squatting, all fours, birthing ball... Lol. :) it's been fun"

The real fun was about to begin at they broke my water (artificial rupture of membranes). The main thing I didn't want in labor was AROM. I truly think that this was the first of many things I allowed with Carson that was wrong. Of course with Carson I was only 2cm and not effaced, and not closely watched nor had all my options explained to me. This time I was already at a 5 and having good contractions. I was still terrified of this moment but knew it had to be done! 

The way that the midwife Alison went about breaking my waters was very professional and caring. I was so hesitant that even as they had me set up in position on the labor bed, gloves on, I told them to stop. I was so scared and didn't want to go forward with it! They gave me a minute, and David and Jami talked to me and told me this was the right thing to do and that I had exhausted my other options and that I was doing a good job. Alison gave me time and told me to tell her when I was ready!

I finally told her I was ready. She told me she was going to put her hand on my thigh, and then I could tell her when to go ahead and break the waters (I had read about this in a book by Ina May Gaskin concerning cervical checks and was very very comforted she did this!!!). I told her to and it took her a minute but as soon as it was done I had a total meltdown. I just started weeping uncontrollably. I think this was just the stress of all of my failed expectations coming out, and the tears I had been holding in afternoon all coming out as well! David told Alison and the nurses to leave the room and just held me while I sobbed. It took me a few minutes to get over it but once I did I got to work!

The contractions at this point were much more effective! I felt that Jase had dropped and felt tremendous pressure on my anal/tailbone area. Within an hour the contractions were significantly more painful and I really had to concentrate to get through them. When David tried to talk to me I told him to shut up (that's one indicator that things are progressing, haha). I did deep groans and breathing. Soon I had Jami helping me with massage and pelvic squeeze. David also tried it. She did the squeeze first with her hands and it was super effective, almost eliminating the pain of the contraction! She also did the squeeze with a rebozo (a super thick textile) but her hands were much more effective. The pain continued to increase and I continued to persevere through each contraction. The pressure also increased and so did the pain in my back during contractions. Soon the pain even stayed in between the contractions. I asked them to fill the tub and they did, but I didn't want the water too hot because I was nauseous and very hot myself! 

I got in the tub and reclined back to immerse my back, but was quickly told to change positions because Jase's heartrate had dropped to 90. This rendered the tub useless because it was relatively shallow and unless I reclined, the warm water could not soothe my back. So I soaked my pain-free legs uselessly in the water while I groaned and breathed and barfed through my back labor over the side of the tub. 

Interestingly enough throughout this whole thing I preferred to keep some kind of clothing on! I really wanted to be covered up in front of the nurses, my doula and David combined. I don't know why, but whatever made me feel comfortable I went with. 

At this point I'd say the labor pain was definitely worse than my kidney stone pain! I got out of the tub and went back to all fours on the bed so that I could labor there, Jami could use the pelvic squeeze and I could get my dilation checked. The contractions were absolutely nuts. I hated them. I did the groans and breathing, and wanted Jami to squeeze my pelvis through each contraction, but that was no longer helping with the pain. The pain and pressure on my back was very intense! It was around this time, either leaning over the tub on in the bed, that I asked for the epidural. This was about two to three hours after AROM.

I had read up on the epidural from several authors and doctors, and taking my first experience into consideration, I knew that I would probably want to use the epi once I felt labor had progressed, baby had dropped and I needed a rest. All these things were happening. The nurses asked me if I was sure since I had told them I was going natural as long as I could, and I told them without hesitation that I was.

Of course I had to endure another hour (maybe?) while I got more IV fluids in me before I could get the epi. I just groaned and breathed and demanded the pelvic squeezes as far as I can remember. David gave me the soft blanket I'd chosen for Jase at Target and I snuggled it by my head. 

At this point or shortly after getting the epi placed, my cervix was checked and I was still at 5 cm, though in both layers and the cervix was much thinner! Alison was able to stretch it to 7cm. Then I laid on my side with the peanut ball in between my legs, and nurses would come in every hour or so to switch sides. The relief and peace I felt at this point was wonderful. I was so relaxed and probably dozed here and there. David took a nap, and Jami and I watched Cake Boss. 

I updated: "Breaking water was super effective, but I had tons of nasty back labor, Pitocin, and no change in dilation since the cath was removed. It was nuts and after trying all these labor positions, doula helps, and the tub, etc, I got the epidural! I can still feel the ctx but with no pain. I can even move my legs. the midwife found that my cervix was super thinned and stretched it to a seven. We are both doing great and resting for now. I'm using the peanut ball too, which is a fine invention to keep my pelvis open. The best part is is that I'm now feeling pressure directly on my vagina instead of tailbone, back etc. hopefully not much longer."

That last sentence is key, that the pressure was now intense on my vaginal area instead of tailbone! In fact, while laying on my left side chillin, I was shocked to feel Jase's head coming into the birth canal (I love that the epidural was a low enough dose to feel all of this! Also, I hadn't had it but 2-3 hours when his head started coming down). I was in disbelief. I had only just gotten the epidural. I laid there making sure I wasn't imagining this, but also getting extremely, extremely excited! I waited for maybe 15-20 minutes before I said anything just to make sure I was actually feeling it. But with each contraction, I felt his head move a little bit more! 

I yelled for David to wake him up (He was so tired!) and paged the nurses asking to be checked. They were there within minutes and sure enough, I was ready to push! Already! They got out everything necessy, dropped down the end of the bed, and Alison came in and was putting on her gloves, when another nurse came in and said that another lady was about to push as well. But this was was going all natural and had had previous children so was probably coming quicker. 

It was truly not a problem for me to wait, though time wore on. Time felt longer as the blood pressure machine squeezed my arm every 15 minutes, so even if I didn't look at the clock I knew how much time had passed. The only hard part was this pinching rib pain I had on my left side. I discovered that it was Jase pushing on my ribs with his feet because if I pushed down on it, the pain went away. (seriously: I'm short-waisted and this kid was 22 inches long! lol)

When it got to 45 minutes and I had kept feeling his head sliding down with each contraction, and I kept pushing his feet down, I was losing patience... lol. I paged the nurses again and said, "I need to PUSH!". They came and checked me and his head was still 1/2 cm from crowning so I was "okay". haha. My nurse, Heather, said she'd peak in on Alison and see how the other birth was going. At this point I just continued to wait excitedly, "laboring down" as Heather put it. I ended up waiting an hour and a half, and I think this also turned out to my advantage when Alison returned. 

I began pushing at 5 minutes before midnight while it was still December 30th. It was hard work! It was very hard to get adequate breaths to get a good push in because of his feet pinching my ribs. But the harder I pushed back on his feet and the harder I tried, I eventually got big breaths and was able to get three pushes in per contraction. 

They pulled up some kind of handles for me to hold onto instead of my own legs. This made pushing more effective. Then as Alison talked to me she told me I should push like I was pooping. I tried to gauge with her in what "direction I should poop, on you or across the room?" 

The pushing felt like it was taking a while because Alison had said at first (before the 1.5 hr wait!) that it would only take "a couple pushes" to get him out. After about only 15 minutes I knew I was close, but felt so exhausted. He had crowned at this point and I was told I could touch his head! Heck yes I wanted to touch his head. It was squishy and slimy of course, but it was motivational to feel it for sure!

I continued with all of my strength to push and push! I pushed even when I felt like I had no air left and made my face blue. I even kind of screamed or something. Finally I got to the last push and Alison told me to ease into this push slowly so that the baby could come out nice and smooth. I did and they put him on top of me!

Alison and David helping!

 

 

So happy! I did it!!!

Alison also showed us the placenta, but I honestly wasn't too interested in it. I'd seen pictures of placentas. Plus it was already obvious to me that this boy liked to cry a little more than Carson! And now, 11 days later, I can confirm that that is true. haha. 

As you can kind if see in the picture, Jase's cord was wrapped around him -- Jami later told me it was wrapped around his neck and belly! I am also glad that I was not told while pushing that I was tearing (only 2nd degree) or that during each push Jase's heart rate went down, then up after each push. :)

A few closing thoughts: I had planned to let labor come on its own and even expected to be spending Christmas in the hospital, but Christmas came and went. I even went through a half day of very convincing false labor a few days after my due date. It fizzled to nothing. I tried all, I mean all, forms of natural induction home-remedy style except castor oil. I even got acupuncture. Never thought I would do that. 

Nothing went as I had planned or read or researched. All the things that I was avoiding in order to ensure a successful VBAC happened during my labor. But if you were attempting a vaginal birth in order to avoid and cesarean and were trying to get induced, what would you do? Choose a cesarean or choose pitocin? I chose pitocin against my original plan, and it was what my body needed. I chose to go along with the midwives about not waiting past 42 weeks. I chose the epidural and it actually helped my labor. 

Sometimes, readers, God does things we don't expect or plan for. He chooses the things that are stupid or powerless in the eyes of human wisdom to achieve his ends. I prayed and prayed before, during and after labor, and reached the end of myself (as you can see in my previous posts) and surrendered it all to God. I really wanted a natural labor but God had other plans. In his goodness I did NOT have a C-section though! I honestly don't have time to feel disappointment over this birth experience, nor to defend myself or my decisions any further than this blog entry! 

So I'm done for a while! I'm moving on now that I've written my birth story here. I hope to not think about giving birth for at least 3 more years, Lord willing. Sigh. 

Jase, 1 week old