CAM Birth Story #3: Gavin's Birth Story – VBA2C

In honor of Cesarean Awareness Month 2010, we will be filling the blogosphere with stories from real women (and their families) who know first-hand the consequences of a 32% cesarean rate. Each day we will post at least one birth story submitted by these women. Prepare to be moved (hint: grab a box of Kleenex)!

From Lisa…

This vba2c was a long time coming, and I worked so hard to achieve it.  Therefore, much of this story actually took place way before I ever went into labor.

Baby #1  – Born January 2000

With my first pregnancy, I was “measuring big” at the end, so after an ultrasound predicted an 11 lb baby, my CNM & the consulting OB recommended that I have a scheduled cesarean.  They told me about the risks of birthing a big baby (shoulder dystocia, tearing, etc.) and that an induction probably wouldn’t work anyway.  My 9 lb, 10 oz daughter was born at 39 weeks by scheduled cesarean section.  I never labored, and no one told me the serious risks to me, to the baby, and to future pregnancies.  My daughter had some breathing issues and extremely low blood sugar, which I now think were the result of her being born too early.  She spent 4 days in the NICU.  Quite honestly, I wasn’t that upset about the cesarean.  I trusted that it was the best thing for us, and I was a bit relieved to be able to avoid the “pain of labor.”  I was in pain for awhile after the surgery, but I recovered relatively quickly.

Baby #2 – Born September 2004

During my next pregnancy, I found ICAN and learned a lot about vbac and normal birth (and that’s when I started to get upset about my first birth!), and I hired a doula.  I traveled to another town to get midwifery care from a CNM (since I couldn’t find a midwife here who would take me as a patient), and I planned a hospital vbac.  I fully expected to have a vaginal birth this time.  I thought that if given the chance, my body would know just what to do.  Once I got close to my “due date,” the consulting OB strongly recommended another scheduled cesarean because of my insulin-dependent gestational diabetes and my age (I was 36).  I declined.

At 40 wks & 1 day, my water broke.  30 hrs later, I was only dilated to 2 cm, exhausted, and in serious pain.   I allowed myself to be coerced into a cbac by Dr. Evil.  My perfectly healthy 7 lb, 13 oz son was born at 40 wks & 2 days also by cesarean.  Based on the pain I was having, my lack of progress, and the marks on his face when he was born, I’m guessing that he was malpositioned during labor.  I am still angry (I’m sure I always will be) about how I was treated by Dr. Evil and disappointed about the cbac, but I was happy to have worked so hard and to have given this baby the gift of labor.  I had no regrets about having pursued a vbac, even though it ended in another cesarean.  But sadly, I felt slightly “broken.”  My recovery from the surgery was harder than the first time, but I didn’t have any unusual problems.

Baby #3 – Born January 2007

When I got pregnant with my 3rd baby in 2006, I assumed I would try for another vbac.  My research told me that a vbac was just as safe or safer than a repeat cesarean, and I did not want to be recovering from surgery while taking care of 3 kids, including a newborn.  I just didn’t think I could voluntarily get up on that operating table again unless it was a dire emergency.  The challenging search for a health care provider began!  I would have preferred midwifery care, but I could not find a midwife to attend the birth because of the previous 2 cesareans plus the gestational diabetes.  I interviewed and/or called every single OB practice in town plus several family practice doctors.  Some practices wouldn’t even schedule me an interview without me actually transferring my care to them.  Several OB offices just said no over the phone because they “don’t do vbacs after multiple cesareans.”  I tried to meet with the one OB in town with a smaller practice, but he wouldn’t see me even to give me a second opinion.

When I could get interviews/consultations, I took in my own research summary of why I felt a vba2c was safe (including a lengthy bibliography) and a copy of the Landon 2006 study concluding that vbac after multiple cesareans should remain an option.  Some OBs were nice, but still said they couldn’t help me.  Some were rude and demeaning and lied about the risks.  A family practice doctor said he wanted to help me, but without a previous vaginal birth, his OB consultants “would never allow it.”  One OB said yes in our meeting, but then called me later that day to tell me no.  I was shot down over and over again.  I even considered signing up for a repeat cesarean with one of these OBs.  I was so discouraged and emotional, and I just didn’t know if I was capable of continuing this fight.

At this point (about 20 wks along), I scheduled an appointment with Dr. Reasonable from my previous midwife/OB practice.  They had already told me no over the phone, but an ICAN friend had used this same OB for her vbac and highly recommended her.  I figured that I had nothing to lose.  This doctor understood my desire to vbac and said that she would be willing to take me as a patient!  Of course, she still wanted to put some ridiculous limitations on me during labor because of the vbac, but I figured that I could deal with those things when the time came.  (And I knew that I would stay at home for as long as possible during labor.)  I transferred my care to her immediately.

The rest of my pregnancy was relatively uneventful.  I got to see Dr. Reasonable for every prenatal visit, which not all practices around here “allow.”  (Most practices make you rotate through all the different doctors in the office.)  I feel that it helped me emotionally to see someone every time who actually believed I could do this.  I did have insulin-dependent gestational diabetes again, but my blood sugars were very well-controlled with diet and insulin shots.  My endocrinologist believed that with well-controlled blood sugars, there was no additional risk to the baby.  The baby was measuring “the right size,” and I was Group B Strep negative.  I declined ultrasounds to check the baby’s size, and I declined vaginal exams.  I took a Hypnobirthing class to prepare for labor and to deal with my birth baggage and my fears.  I went to the chiropractor for regular adjustments.  We hired the same doula that we had last time.  I read positive birth stories and surrounded myself with supportive people.

On a Friday (38 wks & 3 days), my water broke at 12:30pm (standing in a fast food restaurant… lovely!).  Over the next 24 hours, we tried many to things to get labor started…  acupuncture, rest, massage, walking, chiropractic, eggplant parmesan, Hypnobirthing, and a nasty mineral oil concoction recommended by my Hypnobirthing instructor.   It was “against the rules” to stay away from the hospital this long once my water had broken, but I was completely comfortable with it.  I didn’t have a fever, I was Group B Strep negative, but most importantly, no one was sticking their hands in me to do vaginal exams.  I knew the risk of infection was low.  As time went on, I felt like I would never actually go into labor.  About 26 hours after my water broke, I pulled out the big guns and drank castor oil.  I drank it from a measuring cup in the Walgreen’s parking lot, which was about the most disgusting thing I’ve ever done in my life.  I still get nauseous just looking at that particular measuring cup.  After that, we walked some more, and then went home to wait.

I spent some unpleasant, but brief time on the toilet, and then around 5pm on Saturday, I had a contraction.  Within 15 minutes, I knew I was in labor.  I went from no-labor to full-blown-can’t-talk-through-them contractions in about 45 minutes.  I tried to use my Hypnobirthing to relax, but it was really hard.  (I remember thinking, “Screw Hypnobirthing!  This isn’t working!”  But in retrospect, I think it was VERY helpful.)  Within a few hours, I begged my husband to take me to the hospital so I could get an epidural.  I assumed that I wasn’t dilated very much since this hadn’t been going very long, and there was no way I could do this for another 10, 15, or 20+ hours.  (I know now that this is a normal reaction when nearing transition.)  When our doula arrived, she agreed that it was time to go to the hospital because she noticed that I was doing some involuntary pushing.  I didn’t realize what I was doing at the time, but I was happy to head to the hospital because I thought I’d be getting that epidural.  We spent 45 miserable minutes driving to the hospital then got checked in.

The good news…  I was checked by a nurse at 10pm, and I was dilated to 7cm!  I was thrilled that I was this far along.  It didn’t even occur to me to ask for pain medication, and the nurses were respectful of my birth plan and didn’t suggest it.  The bad news…  The on-call OB was none other than Dr. Evil.  I asked for another doctor or a midwife instead, but there was no one else.  I decided to just deal with him the best I could (it’s not like he spent much time in our hospital room).  I received a hep-lock and was hooked up to the fetal monitor, but that late in the game I was okay with it.  I tried to walk around the hospital room, but I felt most comfortable laboring in bed.  At 11pm, Dr. Evil checked me, and I was dilated to 9cm.  (This is when he suggested a cesarean or an epidural, but I had no problem yelling, No!”)  At 11:45pm, I was complete!

Pushing felt great.  The pain lessened, and it felt like I was accomplishing something.  After an hour of pushing, I started to get a little worried.  After 2 hours of pushing, I was terrified that the doctor would suggest forceps or vacuum or cesarean, but I kept pushing.  This part was REALLY hard; I was so tired, but I could also tell that the baby was moving down.  At one point I could reach down and feel his head, so I knew he was almost out!  Around 2:00am, Dr. Evil wanted to cut an episiotomy because he “could get the baby out faster,” which I declined.  At 38 weeks & 5 days gestation and after 38 hours with broken water and 2 and a half hours of pushing, I delivered my 7lb, 5 oz son Gavin!  We did it!  Holding that wet, slimy baby on my chest is a memory I will always cherish.  I don’t love my other children any less, but I will always mourn that their first minutes of life were not spent the exact same way.

During the delivery, I sustained a 3rd – 4th degree tear.  I suspect that the tear had something to do with the way Dr. Evil stuck his hands up in me to grab the baby.  And then he had the gall to give me the I-told-you-so lecture about how an episiotomy would have prevented the tear.  Lunatic.  The fact that I was able to delivery vaginally with that particular doctor felt like such a victory.  He had bullied me during my 2nd birth, but this time I stood up to him, and it was so empowering.  I was nervous that he would be the one at the birth, but that turned out to be part of my healing process.

The recovery from my vba2c was easy.  It’s difficult to express the huge difference between my cesarean recoveries and my vaginal birth recovery.  With a vaginal birth, I felt connected with my baby and with other birthing women and had a “vbac high.”  I was the best, proudest, happiest version of my real self with a sore bottom and a few stitches.  With my cesareans, my entire body felt injured.  It took ages to physically feel like my real self again.

I think many things contributed to my ability to have a vaginal birth this time.  I was more educated and more determined.  The Hypnobirthing class and the chiropractic care were so helpful.  I had a great support system in my ICAN friends, my husband, and our doula.  It was valuable for me to see the same supportive OB at every prenatal appointment even though I didn’t know what doctor would be there at the time of delivery.  Arriving at the hospital so late in labor was beneficial too.  If I had gone in soon after my water broke, this story most likely would have had a very different ending.  And of course, luck played into it as well.  I gave birth 9 days before my “due date.”  If I had been “overdue,” there would have been lots of pressure to have another cesarean.  But most of all, I had more trust in how my body works.  Apparently, my water breaks a few days before I give birth.  That’s what is normal for ME.

My baby is now seven months old, and I have been completely healed from my tear for months & months.  I am so grateful that I was able to experience a vaginal birth.  I think it was the healthiest thing physically and emotionally for me and my baby.  This birth has helped me heal a great deal from the births of my first 2 children.  Some of the healing was because of the vba2c, but a large part of it was because of the journey.  I worked as hard as I possibly could to do what I knew was best for me and for my family.  I don’t think I’ve ever worked so hard for anything in my entire life, and I feel great about that.

Originally posted on ICAN of Central Iowa’s website.