Friday, October 7, 2011

Special Scars, Special Women

If you have read my blog for a while, you probably know that my first c-section resulted in a "special scar", an inverted T incision.  I wanted to take a moment and explain what a special scar is, and talk about an incredible organization in its infancy that has formed to support women who have them, educate them on their options, and to spread awareness.

A special scar is any unusual internal incision, other than the standard and common low transverse incision. I personally have an inverted T, which basically looks like an upside down T on my uterus. (My external incision is low and horizontal.)  Sometimes the OB cuts them that way, and sometimes the uterus tears while the incision is being spread and stretched to deliver the baby.  Sometimes they are necessary because of a malpositioned baby (like breech or transverse) and sometimes they are used because of microprematurity.  Click here for a great article explaining different types and how they affect the birthing woman.

Now onto something that makes my heart smile. :) When I was pregnant with my VBAC baby, I came across an amazing source of support by the way of Jessica Tiderman's Life after Inverted T yahoo support group.  Before then, I had never met anyone who had an incision like mine, and even farther from my mind was the prospect of meeting someone who had VBAC'd after one.  It was an extra boost of confidence I needed to propel me toward my own VBAC!  Eventually this group became Special Women, Special Scars, and earlier this year, Jessica formed a non-profit organization in an effort to support, educate, and spread awareness.  I consider it an honor to sit on this board as membership director and help assimilate moms into the support group and help meet their needs. Jessica is one day soon hoping to do some medical studies on the risks involved with special scars, as the studies that exist are small and lacking, although hopeful.

The website is a link to information and support.  There are articles, links to relevant studies, birth stories from some of our members, and links to our support groups for those who need them.  Oh, and the ever-important survey, in an effort to begin to collect information for future studies to be done.  If you know someone who has a special scar, whether they VBAC'd on it or not, we want to hear about it! 

This is important work that helps moms all over the world like me, so spread the word!  And if you can, please donate something to the cause! :-)

Scars remind us where we've been. They don't have to dictate where we're going. It's a shallow life that doesn't give a person a few scars. ~ Garrison Keillor

VBAssC birth, a VBAC after a preterm classical incision

Ruth is one of those amazing mums (speaking Australian here lol!) who throws herself into doing the absolute best in everything she puts her hands to.  I met her through our Special Scars support group, and even though we are on complete opposite sides of the world from each other, I just absolutely love this girl and felt that heart connection.  She wanted to know everything she could about the possibility of VBAC'ing on her preterm classical incision, and committed herself to passionately researching.  Then she took her stack of studies, after being convinced that VBAC was not only possible, but that the benefits far outweighed the risks, and brought her armory of evidence to her opposition, a stern-faced panel of OBs at the hospital in which she intended to deliver. Obviously this was not received well, but firm and fiery, she stood her ground and eventually was passed to the supervising OB who would take over her care.  

Below she shares her birth stories, all of them in fact, to give reference and honor to the journey she has walked. It's a bit of a long read, full of difficulty, including loss of a twin, and the trauma of delivering a 25 weeker via classical cesarean and his long precarious NICU stay, but I promise worth every second, and at the end of it all, I cry tears of joy at her triumph and healing, and praise God with her for His grace and favor. The bigger the struggle, the greater the triumph.  And this indeed is triumph. <3

~The Birth of Jackson Lucas~

The birth of our third baby has been so healing, in ways that words cannot fully describe. The heartache and pain of our losses, of our preemie experience and of the surgery that brought our prem into the world has been with me daily. Since delivering our third baby, those pains and the distress they brought have gone. This birth has been such a blessing, and I am amazed and overjoyed at what my body has accomplished. It is such a natural act, yet that is too often taken from us during our experiences of labour and birth. Delivering our son was the most empowering and awesome experience, more than I could have asked for. God has given us such a gift!

I am looking at our precious baby boy and all I can do is smile. The birth was perfect, absolutely amazing and unlike anything I could have imagined! To know just how beautiful this birth was, you have to know about my previous pregnancies and births.

Our daughter Caitlin Rose was delivered 5:09am 30th March 2009. The pregnancy was tough, I needed progesterone injections the whole way to maintain the pregnancy, I had hyperemesis gravidarum and I felt movement super early. We had not planned to have a baby, so it was a great adjustment for us after only 3 months of being together! (And me being told I was infertile…ha!) I had antenatal depression sparked by the shots, and an irritable uterus causing daily painful contractions. There were episodes of bleeding and mucous plug loss, and the whole pregnancy was rather less than enjoyable. I felt overwhelmed at being pregnant and the prospect of being a mum. But that changed the instant I held her in my arms! The labour was 2 days, she was a posterior baby. Thankfully I laboured mainly at home (well, at the beach, then hosting dinner for my sister-in-laws at home) as I wasn’t convinced I was really in labour. My husband had to demand that I get into the car to drive me to hospital as I wanted to stay home longer. We allowed a student midwife that I had met previously to come to the hospital for the birth, and we had a midwife taking care of us. That was great! We did wind up with a lot of people in the room as our baby girl became distressed and she was stuck for a long time. The staff were being prepped to take me to theatre, thankfully with some hands on assistance (manual dilatation) my student midwife and midwife delivered her. I had been labouring to my comfort, in the shower, hands and knees, swaying, squatting, however I felt I needed. And we had planned to deliver her in a good position. Unfortunately I was not in a favourable position for the delivery, but we avoided the caesarean so it was a small price to pay. Only 6 hours after arriving and she was in my arms. And she melted my heart! I finally felt right about being a mum, it was such a breathtaking moment for me to have her handed to me. Despite emergency surgery a week following her birth (due to retained placenta) I thought I had experienced a wonderful natural delivery. She was birthed without drugs, and it was a spontaneous vaginal delivery at 37 weeks.

We then conceived a baby shortly after her birth, but the pregnancy was lost. We conceived fraternal twins when our daughter was 5 months old. Sadly we also lost one of the twins, and had a lot of complications during the pregnancy. On top of the daily injections, there was severe haemorrhaging from subchorionic hematomas, PPROM at 18+5 (when we were assured we would lose our surviving baby, thank the Lord that He kept our son safe!) infection and placental abruption. Our boy Jacob Kenneth was delivered via emergency classical (vertical) caesarean at 6:10am on March 2nd 2010. He was just 25 weeks + 2 days. I was in hospital on bedrest from 23+6 until his delivery, as 24 weeks is considered viable here. There was just 3cm of fluid surrounding our son, and as he was breech, we opted for the caesarean. The labour was horrible thanks to hospital staff, and also being strapped to monitors, catheter in place and unable to move with IV lines. When I knew I would be delivering him I called my husband. (I knew as the contractions were quite surprisingly as painful as those of my first labour. The pressure was centred on the cervix but the intensity was the same). As he slept next to me, the doctors on call loudly discussed my situation and the fact that I had refused narcotics to stop the labour. I had already been informed that such drugs would not prevent birth when the mother was already labouring, but could prevent a labour from beginning. I knew I was in labour, so I declined. They insisted that I would cause an unnecessary caesarean and potentially the death of our baby by refusing the drugs. It was very distressing. Another doctor examined me soon after and I was rushed for the caesarean, as I was indeed in labour at 6cm dilated. Because our baby had not flipped, we knew the chance for survival was slightly higher with the caesarean. The surgery was awful, I felt a lot of pain throughout and we did not know if we would be welcoming a live baby or not. He was delivered, we were told he was a boy, then I was left alone as my husband went with our son (and was promptly asked to leave NICU, so our baby and myself were both alone. Hubby didn’t know his rights as a parent to stay with our son at that time). A further 15 weeks and a lot of preemie issues elapsed before I was able to finally take our son home.

So I had now experienced two very different labours and deliveries, and was quite convinced I did not want surgery again. What I did not realise is how different spontaneous vaginal labours could be. When we found out I was pregnant again, I began researching vaginal deliveries after classical caesareans. Months of studying went into this, and many discussions with medical staff. I found Jessica Tiderman’s site Special Scars which prompted us into further research. Between Jessica and another special scar mum Katie Perez, I was given a lot of support and encouragement. My husband and I decided to try for a vaginal delivery, and conferred with our obstetrician to make this as safe as possible. Our obstetrician was fantastic, he took on our care against hospital policy, and had us sign a waiver after explaining the risks and benefits of a vaginal delivery in our situation. He was always respectful and encouraging while stating his concerns and helping us to create a birth plan. A great change from the experiences we had until he took us on! So we now had a birth plan in place for a vaginal delivery following classical caesarean. And we also hired a beautiful doula who we were hopeful would guide us through this birth.

At 1am on September 26th 2011 I was up walking around the house with contractions. They had been there for over a month, the same pain as my previous labours and could be timed 1-2 minutes apart, lasting 2 minutes. The joys of an irritable uterus! Our baby was beyond engaged and had been for a long time and I was getting around an hour sleep per night. And then my water broke. I had a quick panic when I thought I had peed myself, and then realised my waters had ruptured. So I called my Mum and asked her to come over to watch the kids. We knew they would be fine waking up to my Mum without us being there. Then I woke my husband to let him know it was time to head in. I would have laboured longer at home, but we had decided to head in early in the labour to have the cannula placed in case of complications. We called our doula to let her know we would be heading into hospital as my contractions were steady. At 3am we left the house and arrived at about 3:30am. A midwife took us through to the maternal and foetal assessment unit. I had to laugh when she insisted that a vaginal exam (which we declined) was necessary for her to let me know if I were in labour or not. I let her know that I would be birthing that day. She asked us about continual foetal monitoring, which we also declined, and a male staff member came in to insert the cannula. He was unable to get it in between the wrist and elbow, so the midwife sent us through to the labour suite where we would try again. I had dropped into a hands and knees position by now to deal with the contractions, and our doula set up the ground for me to be more comfortable. I had to get up and onto the bed to let the man attempt the cannula insertion again, so the bed was set up reclining and I was on my knees leaning against the bedhead. The contractions were lasting only 45-60 seconds, but they were coming on top of each other. There was a great deal of pressure, which I had only experienced with our other babies when they were descending. This was so different, very intense and more painful, but it much more natural and therefore comforting than my other labours. I extended my arm between each one and gave permission for him to insert the cannula wherever he could find a good vein, as he looked rather panicked about not being able to get it in! The midwife we were assigned bandaged it for me and bloods were taken. The midwife then asked to check the baby with a doppler, and I agreed. On the next contraction, I needed to make my way to the shower to cope with the pain. I was surprised at just how painful I was feeling them, it felt like the end of my first labour in comparison and I looked to my doula and told her I wasn’t sure that I could actually get through it this time. I wasn’t stressed, or losing control, just quite aware of how painful they already were and I thought I would need some form of pain relief to get through the rest of the labour. She smiled and said I would do just fine.

Our doula continued with her encouragement and gentle reminders to relax my pelvis and breathe into my belly. Once we were in the shower I was able to focus on the contractions knowing our doula was between the medical staff and my husband and I. That was so important to us, it felt like our birth space was protected by a woman we trusted and felt comfortable with. Very soon I thought I felt the need to empty my bowels, so I asked everyone to leave. The midwife went to get a doppler and my doula asked if I were sure I needed the loo, or if the baby was coming. Both my husband and I thought we had many hours of labour to go, but she insisted I keep my hand close just in case. And she was right! Once I realised my bowels were empty and it was indeed our baby, I made my way back to the shower immediately after the contraction. I called my husband into the bathroom and knelt down, one hand waiting for our baby, one hand on the floor supporting my weight. The force of the contractions was unbelievable, I finally know what the ejection reflex is! With our other babies, I could not control the pushing, but I could choose to bear down with them or not. This time, I had no control at all over the force. I was aware of how quickly the baby was descending yet I could not lessen the pushing. It was amazing! I delivered the head, which was rather blue just as my daughter’s had been, and I watched our baby turn slightly. It had taken a few pushes to get the head out, but one more forceful contraction and while still guiding the head I delivered the body with my other hand. I was able to bring our baby straight up onto my chest, and discovered that we had another son!

Our doula had notified our midwife of the imminent birth, and two midwives arrived after I had delivered him. One of them was a bit too quick to cut the cord (we had hoped for the benefits of delayed cord clamping) as our son was not yet breathing, despite being attached to the placenta and without any compromise. He cried within seconds of being pulled away from me and was promptly handed back. It was such a beautiful delivery, bringing my own baby up to my chest while my husband was by my side. This was the first birth he had actually witnessed, although he was present for all of them. That was just amazing and still brings tears to my eyes that he was able to watch his wife deliver his baby. It was so lovely to have our doula present also, she gave us both a lot of confidence and I believe having her present allowed my body to relax fully and experience a labour the way it is meant to be. What a wonderful difference to my previous labours!

Our son Jackson Lucas was born at 5:08am, September 26th 2011. I was 39+4 weeks into the pregnancy, far further than anyone had expected us to make. We have been abundantly blessed with this birth. The Lord Jesus had such mercy to give us this perfect birth, which has been so healing for me. From a pregnancy that began with the specialists not wanting to prescribe progesterone as they believed I was miscarrying, to make it not just to viability, but to term, was such a relief and a fantastic thing to experience. There had been complications with the pregnancy again, and I was very sick too, but I cannot find a single thing that I would choose to change about the labour. It is surely how I was meant to birth.

I needed surgery following the delivery due to retained products that were vascular, resulting in major haemorrhaging (one blood clot alone was 500mL!). I lost 1600mL by the time I was done in theatre. There was talk of a blood transfusion, and iron infusions. But thankfully the Lord saw us through without either as we had chosen to decline them unless I had another large loss. God blessed us greatly with the surgery, as we had our obstetrician take over my care and perform the surgery. My husband had requested him when I became upset at needing surgery, and I am so thankful! Our obstetrician did a wonderful job, and the theatre team were just lovely with me. They had me laughing, and the anaesthetist even played music for me on his phone. When I came out of surgery, I was met with our now qualified midwife who was our student midwife with my first birth. She is a beautiful young woman and it was an absolute pleasure to find her as my nurse. She was also on call the following morning, so she was there to book us out of hospital. It was great to see her and let her see our other children again. Given that the surgery was necessary, I could not have asked for better than to have both our obstetrician and our (ex student) midwife caring for me. And I was able to leave the morning following the birth. It was awesome to walk out of the hospital with my husband and all three of our children. And with my health. My scar was very thin, we saw this on the ultrasound that was performed to confirm the retained products. And my endometrium was presenting unusually.

We know we are not willing to have any more children now, as we believe the risks are too high after discussion with our obstetrician. Which makes it so much more meaningful that I was able to experience such a perfect birth. I had asked the Lord for a positive birthing experience for my husband and I. There could have been nothing better than the experience He gave us! No unwanted interventions, no foetal monitoring, no invasive vaginal exams, no managed third stage, and the joy of discovering we had another son for ourselves. Just a birth, completely natural and unassisted.  Despite the surgery, and initially needing to express breastmilk again (I had to pump exclusively for both our other children due to tongue tie and prematurity) until our son’s tongue tie was snipped, I am still so thrilled with the delivery. It was painful, it was intense, and it was perfect. There is not a moment of the whole labour I would change. It felt so natural, and to deliver our son into my arms the way I was able to was so beautiful, I wish that every woman could have this kind of experience in childbirth. I am sitting here with my son right now, our other children are in our room sleeping, and the way I feel is amazing. I have no signs of post natal depression, which I developed very quickly after delivering our other babies. Our son feeds well now and actually sleeps well too, which is a first for us. A nice first! I love wearing him in the sling and sleeping next to him (as we all sleep in our room). He loves it too. I finally understand the term ‘babymoon’ now. I was very scared becoming a mum to our daughter, and the NICU experience was extremely challenging with our son. To have another baby at term, healthy, and thriving is just lovely. And the birth, I will never forget how amazing that felt. The Lord certainly blessed us with His great mercy and kindness!

Wednesday, October 5, 2011

VBA3C, An Amazing, Victorious Birth!

It was a warm June evening in 2010 and I was glued to the computer, literally facebook stalking a fellow ICAN mama, hitting the refresh button over and over again every few minutes for updates. She was going for a VBA3C, and I was sitting in my upstairs game room, my heart aching for it to happen for her. Prayers going up, believing she COULD do this, and anxiously awaiting any update.

And then it was there, and it said ***VBAC!*** Another VBA*3*C!! Ahhhh, I was completely over the moon for her! My husband is giving me strange looks while I do my happy dance, and wow, I just praised God and just sat in awe of this amazing mama at what she had just accomplished.

It's long overdue that I post this particularly triumphant birth story, she has quite a story, going for the natural birth over and over and over again, dealing with the agony of two "failed" VBAC attempts, putting the pieces together to solve her own mystery, assembling the right team and PERSEVERING in spite of it all.

This story is amazing in its own right, it was not easy, and my friend fought the battle for her VBA3C in a way that was very different from my short and sweet VBA3C. It seems birth comes easier for some of us, but when it is SO HARD, the victory is especially sweet. She truly is a BIRTH WARRIOR, here is her story:

~The birth of Ava Sophia, A VBA3C~
You know that definition of insanity? Doing the same thing over and over and expecting different results. Yep, that one. I’ve gone over that saying so many times in my head. Am I crazy? Why do I even want this so badly? Am I willing to go through hours and hours, maybe days, of labor to possibly end up with another c-section? I could, and according to about 99% of Obstetricians, should have scheduled a c-section anyway.

I don’t know if I’m crazy so much as really, really stubborn. I wanted this “natural birth” in 1996, 14 years ago. That plan was foiled when my teeny baby girl stopped moving in utero and had to be cut out of me. It felt more like a tumor removal than a birth. I was terrified there was something wrong with my baby but the doctor reassured me that I would be able to wear a bikini after the surgery because the incision would be low. Sweet relief. My troubles were over! (Try to keep up, that’s sarcasm!) Yep, that was my welcome to motherhood. Sitting alone in that postpartum room pumping milk like crazy listening to other babies crying in the rooms next to me, while I had to wheel myself down the hall to visit my little girl. (Read the long version here.)

In 1999, I almost got my “natural birth”, but after contracting for 5 days and reaching 9 cm, my cervix swelled and I was absolutely at my limit. I consented to c-section…firing my doctor in the process (He acted like a jerk the whole time I was in labor…all 12 hours it took for me to get from 6 to 9 cm) Anyone else would have done the same thing in my situation. The new doc who came to actually do the surgery told me that my pelvis was shaped like a “funnel” and I would never birth vaginally. So I guess my diagnosis was ‘failure to progress’ due to ‘cephalopelvic disproportion or CPD’. (Long version!)

I never paid any attention to that. Doctors do and always will misdiagnose…some more than others, they are human and humans make mistakes, doctors are no exception. I wish I had a dollar for every time a woman has had a c-section for a “big” baby and then VBACed an even bigger baby.

I didn’t make great choices for my next birth in 2005. I was very distrustful of OBs and hospitals. I decided that I would attempt a homebirth (An HBA2C). I was due Christmas day and hired a couple of midwives that I really didn’t feel 100% comfortable with. I just didn’t know of anyone else who was going to attend a VBA2C. It ended unfavorably. I started contracting on the 19th and kept going and going and going…just like the last time. On the 22nd I had reached my limit and was so exhausted, emotional, devastated. Upon realizing I wasn’t going to get the support I needed from my midwives, I reluctantly headed to the hospital, hoping for some intervention to help me birth. Unfortunately, the on-call OB gave me no choice and told me I had to have a CBA2C. So, I did what I knew I had to do and asked for an AMA (against medical advice) form and went back home. I continued laboring through the night and the next day around noon, surrendered, decided I was done and went back to the hospital to meet my precious little girl. (Read the whole story here.)

In 2009, I find out that I’ve had a fused sacrum my whole life. In other words, my sacrum won’t move. My pelvis is still normal in the front, but birthing for me is a whole other ball game. Labor will probably be longer and more painful. That had already proven to be true.

I felt a little robbed. Whatever. The only thing that information changed was that it gave me validation for what I’d been through. No wonder my labors were so long. No wonder I haven’t been able to get a baby through! I’m not having any more babies anyway.

I’m pregnant. (bet you didn’t see that coming!)

I’m pregnant and I cannot, no way, no how, can I just schedule a c-section. It’s not in me. No matter how I look at it, no matter how much easier it would be, I just can’t bring myself to be ok with it. I can’t even say it out loud. Just thinking it makes me throw up in my mouth a little.

Ok. I probably am a little crazy…or a lot, when it comes to birth.

I’m at a crossroads. I want a homebirth so badly I can taste it but knowing what I know, I feel like I’m going to need an intervention beyond the capabilities of a midwife. I met a wonderful OB at an ICAN meeting some months before becoming pregnant. He was warm and kind and very human (not doctor-ish at all) and he said to me “you’ll have another baby”. At that time, even though I wasn’t planning to, I knew if I ever did, I would go and see him.

I’ve slept through the whole pregnancy. At 29 weeks I had an ultrasound that showed a smallish, golf-ball sized fibroid right in the front of my uterus. I’ve got so much built-up anxiety about this birth.

My “due date” is June 12, and while I’m not afraid to start labor, I’m afraid it will never end. I’ll be in labor forever. I really, kind of, believe that this baby will not make it out of my vagina. I did start having contractions on the 11th but ignored them as long as I could. On the 12th, I went and ate crab legs (contracting about every 3 minutes…probably 60 seconds long), went to the park with the kids, bending over a picnic table every few minutes. They continued to beat me down, well into the night. I’m handling things, but start thinking about the length of time it has taken me to get from point A to point B in my previous labors…oh wait, I never made it to point B, at least not on my own.

Now I’m beginning to feel foolish. Its 2-3am and I can’t sleep. I’d rather someone poke me in the eye with a hot needle than lay down or recline. I’m really beginning to doubt myself. I had to have a good cry…whine to my husband a little. He hugged me and loved me as only he can and I decided to suck it up, wipe my tears and get myself together. No matter how I looked at it, my baby would be here in the next couple of days.

I did some belly lifts and made and intricate arrangement of pillows on my bed so that I could take an ambien and sleep in as close to the hands-and-knees position as I could get. I used a long thin heated rice sock under my belly and a large square one on my low back. I guess I slept some because I had really weird dreams…maybe more like hallucinations. I was in Alice in Wonderland. There were bombs planted all around me and when they went off, I had really strong contractions. I got up quickly and practically ran out of my room to get away from the “bombs”.

It was morning and I must have totally relaxed allowing my baby to move into the optimal position because the contractions were coming hard and fast. I was able to check my cervix and realized that I was dilating and my mucus plug was dislodging. A couple of hours later, I was already at about 3 cm. I was excited but not too excited because I couldn’t really allow myself to focus on much more than the contractions.

I wanted to go ahead and head towards the hospital, yes, at only 3 cm. It was a 45 minute drive (the doctor made it worth it!) and I didn’t want to be in the car during transition…even though I was still technically in “early labor”. I went by my chiropractor’s house to get a quick adjustment. I know that she thinks I’m crazy for going so early in labor. I had to sit on my nursing pillow because it was so uncomfortable for me to just sit on the seat.

I waddled up to the nurses station at the hospital, get checked into a room and the nurse tells me that MY doctor is not on call.

Um. The other doctor will give me a c-section. I’ll just wait for him to call me back.

He’s not answering his phone. He was at the hospital 36 hours yesterday with another VBAC.

We will leave if he doesn’t call back. But I know he will call back so I’ll just wait.

The nurse is “ok” with me waiting because after checking my cervix (which seems to be in my throat) she assessed that I am still in “early labor” and at 3 cm. She asked me if I had a birth plan. I said “my birth plan is to VBAC, that is all.” She set me up with a heparin lock and put me on the monitors for a 20 minute strip. When she left the room, I ate a protein bar. My doula and birth photographer arrived and I went and walked/squatted in the hallway.

The nurse called me back in the room, my doctor was on the phone. He asked if I wanted to leave the hospital and go labor elsewhere. Ummm, no. I really don’t want to go. I really want to stay. I really don’t think I can handle leaving and coming back. These contractions are really strong and long and on top of one another. He said “ok” and he’d be up later.

My doula raised the bed into what looked like a throne to me. I started quoting Alice in Wonderland…being the Red Queen. “I need a pig here!” “I like a warm pig belly for my aching feet.” She pushed my knees toward my sacrum during contractions…It felt wonderful!

My contractions started spacing out a bit, and were perfectly manageable. This was the nicest labor ever! I got up a few times to go to the bathroom having a couple of contractions en route and on the toilet. My doula became concerned that I was losing steam and labor was slowing down. She suggested I leave the hospital to labor or take a nap. I was NOT leaving. Not now. She and my photographer went to get something to eat and my hubby took over the knee presses. I ate a honey stick and kept cracking jokes. This was so easy! I took a trip to the toilet and decided to check my cervix. WHOA! This was different! It was actually opening…a lot! Soft, slimy, at least 5-6 cm and my bag of waters were bulging out. I hurried back to my throne. The nurse came in and checked me and SAID I WAS AT 7cm and gone from -3 station to -1 station!!! I’d been at the hospital for about 3 hours! This was probably the happiest moment I’ve had in a very long time. I was ELATED! I started to tear up and told the nurse “You have no idea what this means to me!”

About an hour later, my wonderful doctor walks in and says “you were 7 an hour ago; I thought you might be complete by now.” I’m thinking, How do you know I’m not?...

At that moment, a contraction came on fast and furious. It only seemed to last a second and then fizzled out really quickly. It felt very different and made me nauseous. I said “Ew, that was weird. That one just made me want to puke.” I was ready to start pushing and my doctor knew it. He said “keep it up” and left the room.

I started to feel kind of drunk. Everything is getting hazy. Contractions just shifted gears and made me feel HOT, sweaty, and sick to my stomach. I made lots of references to Alice in Wonderland and continued making jokes even though I was feeling so weird.

I got in all kinds of positions to push. I followed the directions of my doula but wasn’t really loving pushing. I was in on my hands and knees and a contraction started that really hurt, I guess it was the pressure because all of a sudden my water exploded all over the bed. I laughed because this is probably one of the coolest things that have ever happened to me. It was a huge victory to have my water break all on its own. It felt awesome to have all of it gushing out. Now I could focus my energy into making the water move from my body and know I was pushing in the right place.

Also, just to clarify, these contractions hurt, they sucked, and I only pushed because it felt better than not pushing, but I did NOT like it.

My doula instructed me to get into the ‘dangle’ position. The bed is up as a chair and my husband sat in the chair. I get to wrap my arms around his legs and hang limp, letting my lower body completely relax during contractions. YUCK! This felt AWFUL, so it must be getting the baby down, right? I got suckered into doing that for 5 contractions. There were more Alice in Wonderland references for this one since it looked like I was doing the ‘futterwacken dance’. I told my doula “This is the best birth you’ve ever been to!” then I though about that for a second and added “Today, anyway.” I guess the pain made me goofy.

The baby had been having some heart decelerations and my doctor wanted to see where her head was. I was up on the squat bar when he checked me. It HURT! He informed me that my cervix was high and around the baby’s face. She wouldn’t be born if I wasn’t able to move it down around her head. Great. I had to lean over the squat bar, facing the bed, do a pelvic tilt and push to save my life during the next set of contractions. It felt like I was doing this forever because it hurt so bad that the endorphins must have really kicked in. I felt like I was floating. I flipped around to face the other way on the bar and kept pushing. All of a sudden there was a mention of oxygen and people started moving fast. I heard “lay on your left side!” “Wait!” (I’m in the middle of a contraction. I can’t move.) I was quickly thrown onto my side anyway and my leg lifted up. Baby’s heart rate came back up, but that really sucked!

At this point, I’m in and out of half-asleep mode. Things are really hurting, I’m working so hard and everyone starts saying “it’s time to really start working now.” WHAT? I’m working harder than I ever have in my life!! I’ve got my eyes shut and even though my doula told me to open them, I kept them shut. I couldn’t focus on pushing with my eyes open. Everyone starts saying “PUSH!” “I AM pushing!” I honestly don’t know how this could get harder.

It did. A lot. The nurse starts reciting my baby’s heart rate with each contraction. That can’t be good. My doula got a towel for me to pull on while I push…to help the head move under my pubic bone. That took so much concentration, and strength. And it didn’t even work.

My doctor says “Abbey, I might have to use forceps to help the baby come down.” I said “ok, do what you have to do” I really didn’t care, I wanted to be DONE. I asked him if he’d have to cut an episiotomy and he reassured me that he hardly ever does them and no, just because he was using forceps, didn’t mean he would.
Of course, it wasn’t going to be over until it got even harder. I was instructed to NOT push for 3 contractions. Yes, in other words, eternity. (This was to give the baby oxygen before her descent through and out the birth canal.) After all I’d done to make it to this point; I honestly didn’t know if I could just DO NOTHING for a few minutes. I started to hyperventilate and was told to slow my breathing…oh yeah…I forgot that I was breathing. OK…that’s done…what’s next?
Somebody says “it’s time to really start working now.” Who said that? If I wasn’t completely incapacitated I would be in a very lively argument with that person right now. But I can’t think straight, can’t see straight, not even sure I’m still in my body.
My doctor put in a quick catheter to drain my bladder before a contraction starts and he positions the forceps. Push through the pain has a whole new meaning to me. I cannot begin to describe the power and force, the inhuman strength it took to do what I was doing. I needed everyone yelling “push!” to keep me going. That contraction ended and the forceps were removed. The baby’s head is under my pubic bone and I feel tons of pressure.
The baby’s head is down and I have another contraction. One of the nurses started counting and I yelled at her “no counting”…she says “then you have to push”…I say “I am!” Everyone is yelling at me. “Push through the pain!” “Push her out!” “Grab your legs!” “NO!” “Wait!” “NO!” I think my doula grabbed my hands and put them under my knees even though I needed just a second to catch my breath, there was no time. My doula asked my doctor if I could touch the baby’s head and he replied “no, I need her to push”. It was ok, I didn’t want to anyway. I really didn’t care. I just wanted it to end. (The nurse is reciting the heart rate, in the 50’s and dropping) My doctor tells my doula “I’m sorry, I have to do this” she tells me, “Abbey he’s going to cut an episiotomy” I say, “ok. That’s fine.” I have never been so ready for anything to be over in my life.
5:13 pm. Suddenly, it was done. It was probably the quietest moment of my life. There was so much energy, so much force and then right at the moment of birth, it seemed so still, so quiet…it was time for me to rest.
I hear my doctor tell the nurses “nuchal cord x2 and tight body cord”
A few minutes pass, I felt like I’d just been hit by a truck. My eyes are still closed and my doctor is working on my vagina... Whatever he is doing is awful. He says, "Here comes your placenta." I was pretty much ignoring him, at least trying to. He gets my attention, I look up at him and he says “Abbey, I’m holding onto your fibroid.” Oh, that’s nice. The placenta tore to pieces and his entire arm is inside me. My fibroid is the size of a SOFTBALL!!! The placenta had attached directly to it! NO WONDER I had a hard time pushing her out!!! (As soon as he was able, he drew a picture of what my uterus looked like with the fibroid and where the placenta was. Unbelievable.
I am in disbelief and a bit of shock. I laid there not able to sit up because I would have passed out…I couldn’t believe how light headed I was. I think I had lost quite a bit of blood (because of the fibroid), but my doctor still didn’t require I take the routine pitocin after delivery since I had preferred not to.
Wow, that was hard and painful and certainly not intervention free. But the interventions used, I was grateful for. I still did it without pain medication! I got my “natural birth”!!! It was not at all what it was ‘supposed’ to be like. But I did it. I FINALLY did it! I have had a combined 250+ hours of contractions adding together my 3 attempts at VBAC. This was a long time coming. I could not be happier. Nothing is going to steal my joy. (Not even the hematoma I developed a week later and 3 weeks postpartum had to have surgically removed. My anesthesia was a spinal. The same kind used for c-sections.)

I decided I’d better call my sister and tell her I’d had the baby.
She didn’t answer, but I left her a voicemail. It went something like this;
“I just had a baby. Out of my VAGINA!!!!” I think I made a few more phone calls making that announcement. I took great joy in saying those words!
Ok, so that wasn’t the ideal birth, and would probably be way more traumatic for lots of women than a c-section…but it was MY birth and like an ugly child with a face only a mother could love, I am so happy it was what it was. I just had to do it…and according to my “birth plan”, I got everything I wanted. I couldn’t be more thankful.

So maybe my new mantra will be, “if at first you don’t succeed, try, try again”. That’s much better than the definition of “insanity.”

Abbey is a doula (still on maternity leave), passionate VBAC advocate, and is very involved with our local ICAN chapter and our local birth network, the Tarrant County Birth Network. Here is blogsite,, and the direct link to her birth story here.

also, here is a link to her birth slide show.  I cry still every time I watch it!