Christine's CBAC Story

Not So Sweet

Thinking back, I probably started thinking about my VBAC at my 6 week post partum check up. My first son’s birth was not what I expected & immediately after, I knew that I was naÔve going into it.

I found out I was pregnant with Logan in September of 2007, then I followed the steps outlined for me: Buy & read from cover-to-cover ìWhat to Expect When You’re Expectingî, join pregnancy forums, visit Babies ìRî Us weekly (okay, sometimes bi-weekly or more), attend birthing classes, & envision the perfect labor & delivery. I did it all! In our birthing class (I guess I’d say it’s just a mainstream birthing class, I don’t remember it being a specific type.) there was 10 couples. I remember the Doula who taught the class saying that 1 in 4 pregnancies would end in a c-section, but it didn’t really mean anything to me. I looked around the room & wondered for a brief second which women would be the unlucky 2, but it was a fleeting thought & after that class, it didn’t cross my mind again. When the so-called ìpregnancy bibleî discussed c-sections, I skipped over them. I was young, healthy, my midwife once said I had a textbook, perfect pregnancy. C-sections were not something that I concerned myself with.

So when I went into labor & things started to go awry, I stayed calm knowing it would pass & before I knew it, I would be pushing my baby boy out. But that’s not what happened. When I saw the nurses & doctors start pouring into my room, I knew something wasn’t going as planned. Why didn’t I read anything about this in the book? So when I saw my Midwife in the corner shaking her head, I knew what was coming. A few seconds later she said it; ìSectionî. That was it, I was out of the room, my bed being pushed into the OR. I scribbled my signature on the consent paper as the door closed to the OR & waited for them to cut my baby out of me, hoping harder than I had ever hoped for anything before that he would be alive, healthy, crying. He was. He was perfect, healthy, breathing, got an 8/9 on his Apgar, he was & still is an absolutely gorgeous boy. Just like I had planned for.

When the 6 weeks PP rolled around, I knew my first question to my midwife was going to be whether or not I was doomed to have c-sections for every delivery from thereon out. When she told me I was a great candidate for a VBAC & that she would support me & help me when the time came, I was ecstatic. The one & only stipulation was the doctor in her office would also be involved, as it was a requirement for VBACs. But that was no biggie, he also performed my c-section with my first son, so I knew him & was pretty comfortable with him. He was incredibly sweet.

Fast forward to 2010, when I found out I was pregnant with my 2nd baby, I was looking forward to going back to my midwife, who I was so comfortable with & trusted fully. Timing wasn’t quite on my side as my husband had been recently laid-off work, so I was on Medicaid for insurance, required to go to the Health Dept. for my first check up while I waited for the insurance to kick in. I remember when they first questioned my as to what my previous birth was. When I said he was a c-section, the midwife looked at me & said with absolute certainty, ìYou know you will have to have another c-section with this one.î No question, just an asinine statement. So I replied, just as smugly, ìNo, I will be having a VBAC with my midwife from my last pregnancy.î When she asked me who it was & I told her, she told me with equal certainty that it wasn’t possible, they did not do VBACs. I laughed at her in my head.

Around 12 weeks pregnant, I started seeing my midwife from my first pregnancy, finally, I was back in my comfort zone. I had put up with everything from the Health Dept., the rude remarks, the poor care, & my reward was going to be a truly caring midwife & doctor team who would help me get my VBAC. Things went well for a long time. My memory is notoriously horrible, but I would guess that around 26 weeks was when I got the first unexpected piece of news. That was when I would start seeing the doctor every other appointment so he could get to know me. My midwife assured me it was a good thing for him to get to know me so that he would start really caring about me & would be more likely to make sure he’s around when I went into labor. That was the first question mark for me. I was stunned & terrified at the idea of him not being available when I was in labor, I thought that was a given? But then I felt like instead I would have to be very careful about when I went into labor to make sure it was a convenient time. I remember fighting the urge to call & request his schedule to make sure I went into labor at an opportune time. In retrospect, that was probably one of the least of my problems.

He was a very nice doctor. Says all the right things, answers questions like he has all the time in the world, just wonderful. He assured me that he had many successful VBACs. He was the only doctor at the office who allowed VBACs & he was a homebody, so there was a very slim chance that he’d miss out on my birth or be unavailable. He was comfortable with women going until 41 weeks before he would start considering a repeat c-section. And since I went into labor on my own with my first son, it would unlikely be a problem.

At our second visit, the stipulations started. I think that was the first time he mentioned that if I wasn’t showing signs of going into labor on my own, it probably wouldn’t happen. And by signs, he meant if I wasn’t dilating or the baby wasn’t low enough by 41 weeks. Okay. Well, that’s still longer than most doctors let women go, right? I had heard wonderful things about him, he was so sweet.

Then a couple weeks later, it turned into 37 weeks. Well that’s strange, especially since I had already had one baby, gone into labor spontaneously, so the odds were higher that I wouldn’t dilate beforehand or the baby wouldn’t drop until the onset of labor. But he assured me he was still confident I would get my VBAC, everything looked great. Except for the frequent contractions I would get, so he instructed me to go to the hospital when/if they got very close together or didn’t let up.

In both of my pregnancies, I experienced a lot of early contractions. With my first, I had some episodes of pre-term labor. With my second, I thought the same was going on, but as it turned out, they were just persistent contractions, they were not in fact causing any changes to my cervix. But I went in to the hospital a few times, as instructed, when the contractions went on for hours at less than 4 minutes apart. Each time I was given multiple injections of Terbutaline & monitored. After the third time, they gave me Hydroxyzine to take at home to help. I never felt comfortable taking it (I was familiar with it from working at a veterinary clinic) so I just did everything possible to avoid getting more contractions & refused to go in after that. I didn’t want anymore black marks on my record, nothing to get in the way of my VBAC (and healthy baby, of course).

So I glossed over the contractions at the rest of my visits with the doctor. My midwife was aware of them, but she wasn’t threatening with them, whereas I felt he was. The conversation with my doctor would go something like this:

Him: Are you having any more contractions?

Me: Yes, I get them regularly a few days a week. They come every 3 or 4 minutes, but subside after about 6-8 hours.

Him: Well there is no cervical change. I would expect you to dilate some from all those. That might not be a good sign.

Me: Maybe I should try to make them turn into something stronger instead of trying to get them to go away.

Him: We’ll see where you’re at around 37 weeks.

Hence why I just wouldn’t bring it up.

My midwife knew I was worried about it. In my mind, I was a ticking bomb, I could just go into serious labor at any time, especially since I was having contractions all the time, how was I supposed to know which ones were real & which weren’t? I was more comfortable with her, we’d known each other for so long at that point & I trusted her completely. She asked how my son was doing, what things I was making that week, we really got along. I whined about how much my baby kicked, HARD kicks. You could see all of the little movements in my belly like it was see-through, the movements were so strong, so protrusive. She would commiserate with my & remind me of all the things my baby might do with those strong legs one day. A soccer player? A swimmer? A runner? Who knew!

I told my midwife I was really worried that he wouldn’t be available when I finally went into labor OR that it would take so long, he would have to leave & I would be sent off for a c-section. In retrospect, she never really gave me a reason not to be scared of those things, because I think she knew it was justified & possible. Or maybe she knew the odds of my VBAC happening were low anyway. She gave me tips, things to check in case I went into labor at home, she let me know that if I was really worried, I should stay home as long as possible. She gave me a lot of information to feel better about staying home. I feel like it was a sign, like she was trying to tell me not to go into the hospital until I was ready to push, but I ignored it.

So things continued normally, the contractions weren’t that bad, they would come & go, but I was used to them. I went in to see my midwife one week, my doctor the next. He told me at 37 weeks that the baby hadn’t dropped yet, which wasn’t a good sign, but we’d keep our fingers crossed.

At 38 weeks, I went in for my regular visit to see my midwife. The night before, I had contractions that lasted about 10 hours, every 2-3 minutes, even as close as every minute for hours. But they stopped, like they always did. I remember laying in bed the morning before my appointment, watching the baby move in my belly. Amazed by the strong movements. I thought my first son moved a lot, but he was nothing like this baby! I cannot describe accurately enough how strong, pointy, & large the movements were. Then eventually I left my happy cloud of pregnancy bliss & headed off to my appointment. Nothing out of the norm, I waited to be called, peed in a cup, then waited for my medical assistant to come in & let me hear that heartbeat.

When she came in, we talked about plans for Valentine’s Day while she looked for the heartbeat. I wasn’t worried at all, I had felt my baby moving all day, while I was laying down waiting for the heartbeat in fact. But she couldn’t find it. She found mine, but couldn’t find baby’s. So she said she’d get my midwife, she must have just been having bad luck. My midwife came in & kind of rolled her eyes at how she couldn’t find that giant baby’s heartbeat in my belly. But then she couldn’t either. She listened & listened until finally she picked it up. But it was really low, so she listened awhile longer. Then the gymnastics started. He moved his knee up & it protruded from my belly at least 2.5î inches out & she said that was strange. Not to me, of course, this had been going on for quite awhile. I kept telling everyone that this kid moved like no other. But she said that was a sign of low fluid. This is probably the point that alarms started ringing in my ears. Everything is a whirlwind for me from here on out. I remember bits & pieces, but the timeline is fuzzy. She said she wanted to do a non stress test immediately & a biophysical profile. She was trying to find out if we could do it in office, she really didn’t want to send me to the hospital (next door). She had told me about how old fashioned they were, they freak out over minor things. When she left to find the machine for the NST, she told me to keep in mind that if this didn’t go well, I’d be having a c-section.

At that point, I said my husband was out of town. She said to call him, just in case. So they had me strapped down & got the test going while I tried to get the words out to my husband, but I had a hard time, so my midwife talked to him for me. Baby was showing decels & a low heart rate on the NST. Then we were off to the ultrasound. I have always been so ecstatic to have an ultrasound. I LOVE having that moment to see my baby bouncing around. This time was different. The ultrasound tech (I’m still not sure what her official title was/is) was so incredibly nice. The test didn’t go well. Out of a 10, baby scored a 2 on the biophysical profile. My midwife said she would go get my doctor. They came back & said I needed a c-section right away. My doctor said he knew it wasn’t what I had hoped for, but the most important thing is a healthy baby. The ultrasound tech was so caring, she told me how sorry she was, how good I was doing, etc. She gave me a bunch of pictures from the ultrasound, pointed out all the cute parts of the baby. I remember standing there just stunned. I asked when the c-section would be & my midwife asked how long until my husband would be here. I think I told her 6:00pm & she said that’s when it would be. She gave me some papers to take next door to the hospital with me as well as instructing me to tell them I hadn’t eaten or drank anything that day. I remember asking her why & she said they were old fashioned. If you drank or ate anything, they wouldn’t let me have the c-section until tomorrow. A tiny, fuzzy part of my mind was asking how I could have to wait if it was an emergency, but it was shoved aside when more talk of having a healthy baby came about from my doctor. That’s the most important thing, right? I asked if I could go home first, I didn’t have anything with me, but they said no. I needed to go over & get my IV started, fill out a bunch of paperwork

I walked over to the hospital (literally right next door to my doctor/midwife’s office) & was shaking. All I wanted was a few minutes to myself, to cry for everything happening. But instead I walked in & took the elevator to the floor I would be having my surgery on & sat there waiting to be let in. I called a friend & asked her to please go over to my parents house (they were watching my 2 year old son) & install the car seat in the car for them. I called my Mom & asked her to get all my things & most importantly my camera. Then I called my friend who was going to be with my throughout labor & asked her to come right away. Once all my ducks were in a row, I sat there in bed, waiting. My friend made it to the hospital in about 10 minutes. She stayed with me & told me stories to keep my mind off everything while we waited for my husband to arrive. The nurse came in & put in my IV, I remember thinking about how much more it hurts when you’re not having contractions. Then the anesthesiologist came in to ask me if I wanted an Epidural or Spinal. A choice? I hadn’t had one of those before. I had an Epidural with my first in place prior to the c-section & they were pumping it up while he was being cut out. So I got the Spinal this time, he said it would work better, since I could feel a lot with my first. My husband arrived at 6:15ish & as soon as he got there, the crew came in to take me to the OR. I walked in this time.

Once I got up onto the table & curled over into the position for the Spinal, everything really hit me. I was looking around the room (the best I could) amazed by how big it was, how much was there. This was the same room I was in with my first son, but I have absolutely no memories of the room from that birth. I was in a complete haze, but this time I was coherent. Scared, but coherent. The Spinal hurt. I didn’t feel the Epidural with my first son, I swear I didn’t feel it for a second, but I felt the Spinal & it hurt. I laid down on the table & suddenly felt the familiarity in the room. There was the blue drape going up, there was the nurses rushing around, my midwife came in, then finally my doctor alongside my husband. The anesthesiologist was next to my head, explaining everything going on. I am pretty sure the anesthesiologist I had with my first did the same, I remember him being by my head the whole time & trying to comfort me because I was sobbing & shaking from meds, but I don’t remember anything he said. This time, he told me what they were doing. I wasn’t crying or shaking, I was calm, numb. I kept thinking to myself, “All that matters is a healthy baby, right?” He asked if I wanted a mirror to see him come out. That was it, I was bawling like a baby. For the first time, I felt like I was involved in one of my baby’s births. There he was, a beautiful baby boy, and I saw the whole thing. They handed him off to the baby nurse, I remember my husband saying, “He has dark hair!” so different from my little red haired boy. Everything was right in the world again.

We had a smooth recovery for the most part. I think we were in the recovery room for about 2 hours because I was bleeding too much, but nothing horrendous, I don’t think. Breastfeeding was a given for me, I knew we would do it, the c-section never had a role in our breastfeeding. Everything went off without a hitch from there. He was & still is healthy, perfect in every way

After the delivery, I expected to be ruined. I thought I would be horrified by the experience, distraught that my VBAC didn’t happen. But I wasn’t & I’m still not. I am thrilled with the birth itself, I am ecstatic with how I felt watching him come out, even though it wasn’t the way I planned. I love that I was coherent & can actually remember laying with him in the recovery room & the rest of the hospital stay. Those are things I don’t have from my first birth. So it was amazing & I mean that truly, from the bottom of my heart.

But there were problems. Things that I couldn’t see when I was going through them. Like the signs that my sweet doctor was turning on my plans for a VBAC. The expiration date for my pregnancy that moved up from appointment to appointment. The “all that matters is a healthy baby propaganda.” Okay, small print on that one; A healthy, living, happy baby IS the absolute most important thing to me & I would wager every other good mother in the world. However, there is a way to say it that is less considerate & more antagonistic. My doctor fell into the latter by the end of my pregnancy. I wish I had been able to see the signs when they were happening, but all I could think of was how nice he was. I had heard so many good things about him. But I ignored the fact that he increasingly added stipulations to having a VBAC. Our appointments grew shorter & quicker as I got further along. There was more talk about the downfalls or things going against me having a VBAC than the good things going on, but they were cushioned by a friendly, “I’m sure everything will work out” sentiment before he left.

I read about people looking for a VBAC friendly doctor now & want to scream at them when I see the same or similar warning signs. But I know how I felt when it was happening to me, I know I would have been shocked & more than shocked, probably hurt. The best way I could think to help is to share my story & hope that if someone else is going through something like this, dealing with a doctor, midwife, or office who is supposedly VBAC friendly, baiting you in, but switching out rules or giving excuses why it cannot happen as you progress, that you’ll be more aware of the subtle signs. Just because people are nice to you, doesn’t mean they have your best interest at heart. It doesn’t mean they don’t have ulterior motives. It certainly doesn’t mean you should trust them without questioning. I did. I trusted the things my doctor & midwife told me, instead of asking as many questions as I should have.

But I’ve learned & hope to have an even better experience next time. This birthing experience was amazing & life changing for many reasons, but trust in my doctor (or midwife) was not one of them. I hope that it is next time.