Visions of a VBAC

I Did It!! Hospital VBAC Success!

2008-04-23T19:59:00.004-04:00

I don't know if anyone is still reading this or not because I haven't been updating regularly, but I had my baby, and I did it vaginally!

My daughter was born on April 14th in a hospital. Some interventions were necessary and I opted for an epidural (God bless those of you who go natural; I could NOT handle it). :)

Here is her story:

C’s Birth Story

We spent the weekend before her due date walking around the mall. At my last doctor’s appointment I was not dilated at all. She was predicted to be a big baby and she was posterior or “sunny side up”. Neither factor would have ruled out a VBAC, but they could make it more difficult. So we walked, hoping to encourage her to make her grand entrance. I had visited the website www.spinningbabies.com and for weeks had been trying the exercises said to help babies change to a more favorable position, but nothing was working.

At the mall on Sunday I started to feel a lot of pain and pressure in my pelvis, and I thought it felt as though the baby was trying to change positions. We got home around 7 pm. I decided to go to the grocery store so my mom would have a stocked refrigerator while she stayed with our son L. just in case labor was near.

We all went to bed at about 10:30, but as usual, I couldn’t sleep. I went downstairs and began to feel contractions, but I didn’t get too excited because I had been having them for days. After about an hour though, I realized that these were different. They were getting stronger, more painful, and closer together.

I woke my husband W. up and we sat together and timed them for about an hour. I was torn because I wanted to call the doctor, but I was afraid to bother him with a false alarm. Finally I paged him and when he called back I told him what was going on. He said it was probably early labor, but that we should head to the hospital to get checked out.

We called my parents and my mom said she would be right over. By now it was around 1:00 am. We began getting all our stuff together and by the time my mom arrived my contractions were quite strong.

We got to the hospital at about 2:00 am and they put me in a triage room. I was hooked up to the monitors so they could track my contractions, and the nurse checked me to see if I was dilated. I wasn’t. I could not believe that the contractions, which were coming 4 minutes apart, had done nothing to change my cervix.

The nurse called the doctor and he told her to check me again in an hour to see if there was any change. If not, they were going to send me home with some sleeping pills. I was in so much pain I could not imagine going back home. I didn’t think I could walk to the car. I was also extremely discouraged to realize that I evidently had no tolerance for pain whatsoever. If I could barely tolerate these early labor contractions, how on earth would I make it through hours and hours of labor?

The nurse came back and checked me again. I was dilated to 1! Whoopee! W. and I were excited—but the doctor still felt it was too early for me to be admitted. And I knew it was too early, which is what made it even more frustrating. I wanted to cry. The nurse called him again and said something to change his mind—probably something like “this lady is such a wuss, if we send her home she will probably collapse in the parking lot”. So I was admitted!

They put in an IV and then gave me some Nubain at about 6:00 am which helped me relax until about 8 am. They gave me a second dose that did nothing to help me with the pain. I clung to the bedrail and couldn’t answer any questions or talk to anyone. I don’t remember discussing an epidural with anyone, but the next thing I knew a soft-spoken, very gentle and empathetic anesthesiologist was standing at the foot of my bed. It was at 9 am and I was still only dilated to about 3. He put in the epidural and it seemed to take forever, but when it kicked in I couldn’t feel a thing and I was completely relaxed.

For the next half hour or so, I dozed off—until a team of nurses came swarming in to slap an oxygen mask over my face and push me on my left side. The baby’s heart rate had decelerated, which is exactly what had happened after I got an epidural with L. This time, though, it wasn’t the epidural that had caused the decels. For some reason I was contracting extremely hard and fast, with no break in between contractions, and it was too stressful on the baby. I contracted with no break for 8 minutes straight! They gave me a shot of Terbutaline to stop my contractions and her heart rate quickly stabilized. But now they had to give me Pitocin to start the contractions again, since they had stopped the ones that my body was naturally producing.

A couple of hours later the doctor came in and broke my water. There was meconium in it, so they called the pediatric team to alert them that they should be there for the delivery.

I continued to doze on and off for a couple of hours until the team came rushing in again. The baby was experiencing more decels. The doctor came in and assured me that all was well and they were able to stabilize her heart rate quickly, but that if it happened again we would need to think about a c-section. Luckily, I was continuing to dilate, so I had that in my favor.

At about 2:15 pm they checked me again, and I was complete! I had gone from 5 to 10 cm in about two hours. They began to get the room ready for delivery and W. got out the video camera until I told him it was probably going to take a long time.

I began pushing--3 times per contraction, for ten seconds on each push. Between contractions, the doctor used baby shampoo (which he referred to as “WD-40 for babies”) to lubricate and help her rotate her head. She was still posterior and just did not want to turn.

After about two hours of pushing the doctor decided to use the vacuum to help me push her out. He said that I could probably do it on my own but that it might take another 2 hours and I did not have it in me. After one test push with the vacuum the doctor told us that she would be born with the next push. W got so excited he went for the camera again and in the process he dropped my right leg (which was a dead weight from the epi) and I kicked the doctor in the face.

When the next contraction came I pushed with all I had left, and our beautiful daughter came into the world face up at 4:41 pm on April 14th. She was 8 lbs, 4 oz and 20 inches long. The doctor quickly cut the cord and handed her over to the pediatric team, who quickly got her screaming! She scored 8/9 on her Apgars, and in only a few moments I was holding my daughter.

She had a major cone head and a very big contusion from the birthing process. That and the fact that she and I have incompatible blood types (called the Coombs factor) contributed to her jaundice and she spent a few days under the bili lights. 3 days later we got to come home, and I am amazed at how much easier my recovery has been so far compared to my c-section recovery.

She latched on right away and is a fantastic nurser, just like her brother. We are all in love!

I know my story is not the best VBAC story for many of you who believe the ideal birth experience is one that is intervention and drug free. But it was ideal for me, and I am thrilled to have experienced a vaginal delivery. Maybe my story will inspire those who want to VBAC but are afraid to leave a hospital setting.

Good luck to all the hopeful VBAC candidates out there!

Update

2008-03-10T10:48:00.003-04:00

So, here I am, at 35 weeks pregnant. Things have been progressing well (I hesitate to type this for fear of "jinxing" myself).

I had a growth ultrasound a couple of weeks ago and the baby (still nameless) looks great. My blood pressure has been normal. She is head down. I am seeing the OB every other week now and no one has said a thing about scheduling a c-section.

We made good progress on her room this past weekend and are doing our best to prepare our 32 month old for his sister's arrival. So it's just a waiting game now.

I can't believe we are so close to meeting our baby girl!

The End of Something Good

2007-12-05T11:44:00.000-05:00

To my son:

You won't remember nursing, but I will. There are many moments of your first 29 months have that already slipped away from me, but I know with certainty that my memories of nursing you will be with me forever.

I knew I would nurse you. I read about breastfeeding while I was pregnant with you. I learned that it would be hard and that it might hurt, but I was determined to succeed. My reasons weren't all selfless; I wanted to lose the pregnancy weight faster and I didn't want to bother with bottles. But I also wanted you to be healthy and to have what was undeniably "best".

You lost a full pound of your birth weight before my milk came in. The nurses in the hospital began to mumble things about dehydration, but I knew the colostrum would tide you over. I stubbornly refused to give you formula until the fourth day, when we were back in our own home. I cried, fully convinced that I was broken and you would starve. Daddy went to the kitchen to prepare you a bottle. I reached down to check one last time, and there it was. My milk had arrived quietly, and just in time.

In the first several weeks I nursed you so often that I felt I had somehow become an extension of the recliner in our living room. I watched the days and nights slip by me. You were happy and content as long as you were at the breast, so that's what we did. I remember the quiet of the house and the streets outside, and I remember looking into your eyes and realizing that I would never, ever be the same person that I was before you came into my life.

Eventually I got skilled at nursing you in public, so we spent afternoons walking aimlessly around Target or the mall. You nursed while being carried in a sling, and no one could tell. It was our secret. It didn't have to be, but it felt more special that way.

We gave you your first taste of solid foods when you turned 6 months old, and I was afraid that "real food" might interfere with your desire to nurse. But it didn't, and you nursed just as enthusiastically as you always had. Solids were messy and took time to prepare. Some days you liked pureed sweet potatoes, and some days you spit them out in disgust. I realized again how easy breast feeding was in comparison.

As the months went by, we developed a routine--or more accurately, we learned to exist without one. We both functioned better when I let you nurse and sleep when you wanted to. This meant you nursed often throughout the night, but since you were in bed with us, I barely noticed and usually slept through your nursing sessions.

We had some setbacks--somewhere around 15 months you "fell off the growth charts". The pediatrician encouraged Daddy and me to fatten you up with olive oil, cream, eggs, and lots of cheese. I worried that your all night breast feeding sessions might be interfering with your intake of solid foods, but hours of obsessive Internet research eventually alleviated my fears. I was certain that you were getting what you needed nutritionally. Blood work at the doctor's office confirmed that you were indeed healthy, and simply smaller than the majority of American babies.

Then there were the endless months of constant night-waking, where you screamed and could not be consoled, even at the breast. I knew something was wrong and I felt certain your stomach was bothering you. Our ever-empathetic pediatrician gave us a prescription of Zantac to see if silent reflux might be causing the problems. And voila--we all started sleeping again.

Right around your second birthday, people started asking me when I was going to wean you. I knew that many of our friends and family already though it was "weird" that you had nursed until two. To them, my decision to continue nursing you beyond the age of two officially made me one of "those women"--a fanatic boob Nazi or an over-attached mother who was nursing for herself rather than the needs of her child.

Once again I turned to the Internet, and learned about the multitude of physical and emotional needs that breast feeding was continuing to offer you. Ideally I wanted you to self-wean, though I admit that the thought of nursing you beyond your third or even fourth birthday was not very appealing to me.

2 months after your second birthday, I discovered that I was pregnant with your sister. First trimester exhaustion hit, and nursing you became incredibly painful. I decided, reluctantly, to try night-weaning. I relied on a plan laid out by Dr. Jay Gordon, a well-know pediatrician and (male) lactation consultant. We followed his plan loosely, adjusting it slightly to meet our own family's needs.

Amazingly, night-weaning was much easier than I had anticipated. You adapted well and still nursed happily a few times a day. You were in the middle of your Busy Phase--always on the go, exploring everything, and very, very curious.

A couple of months after we night-weaned, I noticed that nursing wasn't always the first thing you turned to when you were hurt or upset. Sometimes, when you skinned your knee or bumped your elbow, you came over to me and asked for a kiss instead of nursing. It was strange at first, but I realized that often you just didn't want to stop what you were doing long enough to breast feed. You needed a bit of reassurance from me, but then you were content to carry on with your play.

We went from nursing 3 or 4 times a day, to 2 or 3, to once a day, before nap time. And then a day would go by here and there when you didn't nurse at all. There were lots of kisses and hugs doled out by both of us during this time. At night, often you would snuggle up close to me and whisper "gimme hugs". Those quiet moments reminded me of the ones we shared in our very first days together. Only now you were giving me back even more, an independent little person with a sense of a humor and the ability to express things with words.

Five months after your second birthday, I realized that you had gone for 3 days without nursing. I wondered if you would ask for it again or if we were done. Thanksgiving came and went, and in the busyness of the holiday I didn't think much about it.

When 2 weeks had gone by with no nursing, I accepted the fact that nursing, for us, was a thing of the past. One night as we snuggled together in the recliner (our nursing chair), you reached up and gently touched my breast. I looked down at you and when we made eye contact, you said "that's your nursing".

I said "yes", and nodded, and blinked away tears.

You smiled, and leaned your cheek against my chest, and I knew then that you were remembering. For now, the memories haven't left you, though some day they will.

But I won't forget any of it.

I know that I will remember nursing you forever.

Long Time No Blog

2007-12-04T10:23:00.000-05:00

I decided to take a blogging break for a few weeks. I was getting hit with the anti-OB, anti-hospital mentality everywhere I went and it was turning me off from my original goal. It's my own fault, really. I have this habit of immersing myself in whatever my current interests are, and as I result I frequently either get sick of the topic or totally overwhelmed.

I had my 20 week anatomy ultrasound and we found out we are having a girl! DH and I are so excited. One of each sex is such a blessing. And, oh, the baby girl clothes. One could go broke buying them! I've practiced impressive restrain thus far. I've only purchased 5 little outfits, and they were ALL on clearance.

At the used bookstore last weekend, I bought Husband-Coached Childbirth : The Bradley Method of Natural Childbirth. It's a recent edition, and I'm hoping that it will give us some more insight into the method so DH and I can determine whether or not it's "for us". I also contacted a "doula in training" who is working with clients for free as she earns her certification. I haven't met her in person yet and am actually feeling some anxiety over the idea of a doula in general.

I know they exist solely to advocate for and support the mother, but I am a private person (despite the public blog) and I'm worried that I might end up resenting her presence during my labor. Leave it to me to worry about absolutely anything. It's so hard to guess what will be the most helpful to you during a monumental event that hasn't occurred yet. Am I a Bradley person, a hynobirthing person, a doula person, or some combination of the three? I really have no idea.

More thinking to do. As usual. ;)

Discouraged?

2007-10-29T09:48:00.000-04:00

I never really got to experience true labor pain. As soon as my contractions started becoming intense, the nurse convinced me to get an epidural to "stay on top of things". I don't even know how dilated I was, but I don't think it was much at all. I thought she was being helpful and I'm sure she did too. She was fantastic, attentive, and incredibly supportive. But the decision to get an epidural led directly to my c-section, as I explained in my first post.

I am in the process of researching natural birthing approaches for myself (Bradley, hypnobirthing, the assistance of a doula).
Every time I read a drug free birth story I am in awe. I'm inspired, overwhelmed, and incredibly impressed. I am also scared out of my mind.

Doubt is really, really hitting me hard right now. I am questioning my reasons for wanting a VBAC. There are some obvious ones--no surgery, a shorter hospital stay, a faster recovery, a shorter time away from my firstborn.

However, I must admit that part of me simply wants to experience labor. I want to go into labor on my own, to time contractions, to pace around the house with indecision. I want to go through the rite of passage. What does that say about me?

And I wonder--is my desire to VBAC at its base, a simple desire to "control" things? And if so, is that a bad thing? If I have a need to control the birth process (or at least its outcome), how will I handle the pain? In the end, is it necessary to relinquish control, or seize it, or both?

It is a mental and emotional challenge for me at this point. Sometimes I think I need to stop reading.

My Love Affair With Prenatal Yoga

2007-10-27T12:29:00.000-04:00

I am taking a prenatal yoga class. I signed up for it in the hopes that it would help keep my pregnancy anxiety at bay. Little did I know how many other wonderful benefits it would have.

First of all, how often do we get an entire hour to concentrate on relaxing? The concept was so foreign to me until now. No one ever tells you that relaxation is a learned behavior. At least it is for me. Breathing may be something involuntary, but who knew that breathing slowly and deeply could have such a profound affect on my body and mind?

We are practicing poses that will be helpful in labor. All week, I look forward to having an hour just for me. And as an added benefit, I am really enjoying the company of the other women in my class. Last night we got to talking about birthing classes. I mentioned that I had learned that it was important to take a class independent of the hospital in order to avoid simply being taught to "be a good patient".

Our instructor knows someone who teaches Bradley classes and is going to bring her contact information to the next class. Any thoughts on Bradley? How about other techniques, such as hypnobirthing?

16 Week Appointment

2007-10-26T12:40:00.000-04:00

Well, actually it was 15 weeks and 5 days, or maybe even 15 weeks and 3 days if you go by my first ultrasound. But who's counting?

I met the only female doctor in the practice today (there are also 2 male doctors and 1 female nurse practioner). I had heard that the female doctor (Dr. Z) was very nice, but not quite as personable as the males.

I actually liked her quite a bit, but maybe I caught her on an especially good day. She asked me if I had talked to to any of the other doctors about whether or not I wanted to VBAC. In fact, everyone I've seen so far as asked me about my labor plans. I'm taking this as a good sign.

Since she brought it up, I decided to ask the question I had intended to save until my next appointment with Dr. H. (who owns the practice). I asked about numbers. Specifically, how many successful VABCS the office has delivered.

She thought for a moment, and then said "Hmmm, I'm not sure if I can answer that".

She went on to explain that the practice's VBAC success rate is actually higher than the nationwide average, but that she attributed that to their selection process. In other words, they have a high VBAC success rate because they try to weed out patients that "probably won't be successful".

This had me worried. I asked her what situations would indicate that a patient wasn't a favorable candidate. She explained that the best case scenario would be one in which the patient goes into labor on her own. She said inductions often led to c-sections. I knew this to be true, so that was good.

I asked how long I could go before they would insist on an induction, and she said 42 weeks. I am actually OK with that--it seems longer than what most OB's allow. It's certainly longer than my last OB would have been comfortable with.

Dr. Z. said another scenario that could potentially limit the success of a VBAC would be "if [I] were carrying a 9 lb baby". This had me concerned too, because I know that ultrasounds and other measurement tools are only estimates, and women are fully capable of birthing big babies anyway.

However, she didn't say it would prevent me from trying--only that it might limit my chances of being successful. And she stressed at least twice that the end result would be my decision. So then I asked why this office was willing to do VBAC's when so many others in the area won't.

She answered honestly.

"It's because we've been fortunate enough not to have been slapped with a malpractice suit". And she knocked on the wooden door as she said it.

I don't know. I felt comfortable with her answers when I left. Either the practice is full of bold faced liars or they really do support a woman's right to make decisions about her own delivery.

We shall see.

On another note, I get to schedule my fetal anatomy ultrasound any day after November 11th. DH wants to find out the sex and I think I want to be surprised. It's probably not worth battling it out thought--when I get there I doubt I'll have the willpower not to find out!

Am I a Walking Contradiction?

2007-10-24T16:04:00.000-04:00

I've signed up for a few VBAC message boards, and I'll be vague so as not to get myself kicked off of any for copying and pasting specific information.

Essentially, I don't get it. I just read a post written by a woman who was devastated that her cousin's wife had a c-section. She tried to warn the cousin's wife several times that her OB was "c-section happy". The poster also attempted to convince this woman that she needed to do her research regarding the dramatic rise in c-sections in the United States.

However, the cousin's wife ignored her and ended up with a c-section (the details as to why are vague). I would really love to quote sections of this woman's post so that I could accurately convey her disgust with her cousin's wife, but again--I'm not looking to get kicked off.

Today, I'm struggling with the idea that c-sections equal failure--that having one means that I somehow failed as a mother, and as a woman in general. Am I pissed that I had one that might have been unnecessary? Yes, definitely. Am I angry with myself for not doing more research? Well...sort of. But I trusted my doctor. I thought that's what I was supposed to do. She had the degree, after all.

It bothers me that many proponents of VBAC's and vaginal births in general have this extreme mistrust of the medical profession. Am I naive to think that my former OB jumped the gun with my c-section, but that not all doctors are that way? Am I foolish to think that I can trust another doctor to guide my care based on what he or she honestly thinks is best for me, rather than according to his or her lunch plans?

I guess what I'm saying is that I think it is my job to do the research (now that I know better). It is my job to find a doctor I trust. It is my job to check to see that his VBAC stats support what he says to my face, and to stay as healthy and as active as possible. And then it will be my job to let go. I think in the eyes of some people, this means I am setting myself up for failure.

In certain situations, I believe doctors dole out unnecessary advice--say when it comes to promoting sleep training in babies. I have been on the receiving end of such parenting advice (from a former pediatrician), and I did not appreciate it.

However, the ultimate decision of whether or not I need surgery is different, isn't it? If I do everything to set the stage for a VBAC and in the end my baby simply can't tolerate the labor, wouldn't I be insane to refuse a repeat c-section?

I do not see myself becoming a militant VBAC proponent who spouts off the evils of c-sections to any one who will listen. I think the reason is because doing so would feel wrong to me. I believe in freedom of choice, particularly when it comes to one's own body. Some people schedule c-sections according to their vacation plans. Truthfully, I happen to think this is bizarre. But if you have tickets to Belize and need to have a baby beforehand, by all means--schedule away.

Does my belief in another woman's right to choose her care make me less worthy of a VBAC or less dedicated to having one? And if I choose to trust my new doctor, have I already failed?

What Really Matters?

2007-10-20T11:20:00.000-04:00

I shave my armpits and my legs. Well, ususally. On the days that I get a chance to take a shower. I have been wondering if this somehow makes me ill-equipped for a VBAC.

I recently dragged my husband to a screening of The Business of Being Born, Ricki Lake's documentary about midwifery in America. We were expecting lots of armpit hair and the overwhelming aroma of patchouli.

To our surprise, most of the people there looked--well, like us. Young couples, pregnant or with small babies, casually dressed in clothes that probably came from the mall.

The documentary was shown at a Cinema and Drafthouse (which was, by the way, one of the reasons I was able to convince DH to go with me). I wanted to go not because I plan to have this baby with the help of a midwife or because I was interested in a home birth, but because it was sponsored by ICAN: the VBAC people.

I knew from checking out their website that they hold meetings once a month at a local library, but I wasn't ready to go to one just yet. I needed to check out the people--to see if my vision of a "VBACer" was realistic. And as I've mentioned, for the most part, it wasn't.

Still though, ICAN has somewhat of a reputation for being "militant"--much like The Le Leche League. I consider myself a lactivist (I still nurse my 27 month old about once a day), but when it comes down to it, I really don't give a crap whether you do or not. Unless you tell me that you think breastfeeding my toddler is "gross", in which case, it's on.

I was afraid that the ICAN people would corner me and shove literature featuring bloody c-section scalpels at me. But they didn't. They had plenty of literature about things such as the dramatic increase in c-sections and the risks of uterine ruture in VBACs compared with the risk of a routine c-section. But if you wanted to read it, you had to pick it up off the front table.

I soaked all this in, while sipping my Sprite and wishing I could indulge in a beer like my DH.

And then the film started. I watched most of it with cautious interest and fascination. The women who had home births were strong, and educated, and funny. They expressed doubts and fears and were cheered on by husbands and midwives and doulas.

But then they started talking about c-sections. As I watched a woman describe the events that led to her c-section, I was shocked to hear her describe the birth of my own first child: from the first intervention to the last, and ending in emergency surgery.

The rational part of me began to shut off the feelings of anger and sadness--and violation, frankly. Because I have a healthy son who got here safely, and as everyone knows, in the end, that's all that really matters. Right?

Except I don't think it is the only thing that matters.

I think it also matters that my OB started "preparing" me for the possibility of a c-section when I was 20 weeks pregnant. And I think it matters that I was admitted for an induction at 36 weeks 6 days pregnant because of protein in my urine that wasn't there by the time I got to the hospital. It matters that I didn't get to hold my son for more than 5 hours after his birth because he was in the NICU and I was unable to move to get to him, having been recently been cut open and all. It matters that he was in the NICU in the first place because he had fluid in his lungs that would have been squeezed out had he gone through the birth canal.

I, like most women (I imagine) always pictured the birth of my child in my head. I pictured hours of difficult labor, coached my my supportive husband. I knew it would be hard, but I couldn't wait for the end result--the doctor placing my squirming, slimy baby on my chest. I pictured holding him and being the first one to look into his eyes, the first one to count his fingers and toes, the first one to tell him how much I loved him, as I had for so many months when he was inside me.

I pictured placing him to my breast for his first feeding and watching as he watched me. But I didn't give him his first feeding. Some nurse in the NICU did, despite my specific instructions that he not receive any bottles. I couldn't nurse him for 24 hours because I was on Magnesium Sulfate to counteract symptoms of Preeclampsia that I may or may not have ever had.

I think those things do matter.

Which brings me to now. I am 14 weeks and 5 days pregnant with our second child. My goal is to have a VBAC. I found a new OB who says I can try. I'm not sure what that means, or if I fully trust him.

The ICAN people say a lot of doctors will pull the "bait and switch" on their patients. They'll tell you that you can have a VBAC, and then at 37 weeks they come up with a reason why it isn't safe. There is much research that I still need to do, and many preparations to be made.

I have some time on my side for now. I figured I'd keep a blog of my experience, so I could have a place to keep track of all the millions of thoughts that creep into my head. Fears and doubts, and hopeful anticipation. Things that matter.