Andrea's CBAC of Johnathan

This is Andrea’s story of her CBAC birth of baby Johnathan.  Andrea exerienced a complete uterine rupture, which both she and Johnathan survived.  When commenting, please keep in mind the incredible strength and courage it took for her to share her story so publicly.

When we found out that we were expecting another baby, our emotions were all over the place. Of course, we were happy.. but at the same time, we were very scared. Scared that we might not be able to care for two children. Scared that Alex might not respond well to a new baby. Scared that we wouldn’t be able to love them equally since Alex was our whole world. It was really hard trying to wrap our heads around it all. Alex was only 9 months old, still a baby himself. But as time went on, we saw this new baby as a gift, especially to Alex, that was coming our way. The idea of having two small kids was growing on us, but we were still scared. I guess that’s normal though. We had no idea how the transition from one kid to two kids would go. All we knew was that they were going to be close. Really close. And we really liked that idea.
                           I was a lot sicker with this pregnancy than with my first. I was always so tired and I  never wanted to do anything. Everyone told me that I was going to have a girl because my pregnancies were so different. But I think everyone just thought that because I already had a boy, I had to be having a girl now. From the very start, I knew that I wanted a VBAC. I knew that I did not want to go through what I went through with Alex again. There was no way I was going to get cut open again. Thankfully, my midwives supported me 100%. There were no questions asked, and there was nothing in their eyes that would prevent me from birthing this baby naturally, which was awesome. I didn’t know at that point that some women had to fight for a VBAC–I thought all providers we this great. I know the truth now, and I see how lucky I really was.

Time kept going by, and I kept getting bigger. The fatigue started to hit hard and I started to realize that it was not easy to chase after a toddler while being pregnant. Alex’s crazy amount of energy never failed to wear me out. Still, I had to keep it together for him and be the best mommy I could be…because he needed me.

     We went for our 20 week anatomy scan and found out that we were having another BOY! Exciting but very unexpected. I had a feeling that I was going to have a girl this time. I guess not! Also, the perinatologist explained to us that during the ultrasound, they found a bright spot on his heart and a cyst on his brain. Those signs together could indicate Down’s Syndrome. My odds almost doubled after that scan and we were offered an amniocentesis to see if he had it for sure. We declined and chose to wait to find out. They wanted to see me again in about a month to see if the markers went away and I was told not to worry. Not to worry? Seriously? I worried for a long time. I tried to mentally prepare myself for taking care of a special needs child. I knew I was capable, it was just all so new to me. I just wanted my baby to be healthy, just like every parent out there. I will admit that deep down, I knew everything was going to be fine. I would try to prepare myself, but it was like my mind was telling me that there was no need to. M was a lot more worried than I was though. I had to constantly remind him that everything was going to be okay. As life got busier, we let those worries slip from our minds. Until the next ultrasound, of course. And that scan showed us that our boy was perfectly healthy. Both markers disappeared. We were overjoyed!

     Throughout my pregnancy, Johnathan was going back and forth between being head down and being oblique (head at my hip) and I was always so good at telling where he was. After many attempts at trying to get a midwife to feel him oblique, we finally caught him. I was told to get a belly band and wear it tightly all day to try to get him to stay head down and engage. I also spent a lot of time on the yoga ball, trying to get him in a better position. I do wish I would have done more about it though. I know now how important positioning is, and I didn’t know that before. The midwives told me that I could still try for my VBAC, but since he was malpositioned, they were not going to push my body too hard. And they wanted me in ASAP if my water was to break, since the chance of cord prolapse was greater.

     So fast forward to the day I went into labor. It was March 3rd, 2012. A Saturday. M had just gotten off of work and we were having dinner–it was around 6:30 PM. I can’t quite remember what we were having though. I remember a gross feeling “down there.” I went to the restroom and peed, and as I got up, I discovered bloody show!! I literally screamed “OMG!” and went to go tell M what had happened. I was shocked, but since I was just a bit over 37 weeks when I had Alex, I knew I was going to go early again. And I did! I was told that they found I had a bicornuate uterus during my c-section, so the babies literally run out of room to grow anymore in there, making me go into labor a bit early. Contractions started at around 10:00 PM, pretty mild at first. M offered to put Alex to sleep that night since I was “in labor.” I was still in denial, as always. M started playing StarCraft since things were still pretty easy for me. I sat at the kitchen table, feeling my contractions get stronger and stronger. I started feeling this intense scar painp–I’ve never felt pain at my scar so it was pretty alarming. It was very strong while I was standing up, and never really went away, even between contractions. It was a sharp pain that went through my entire incision site. It burned.. a lot. But when I sat down, I didn’t feel anything. I guess that was the weird part for me. I was really having a hard time straightening my midsection out. Something was not right, and I was starting to get nervous. I actually tried to avoid sitting down because I didn’t want my contractions to slow down or stop. At this point I told M that I needed to go in and get checked. He then told his game buddies that we were off to have a baby. I filled him in on the pain I was having and how I felt about it. I decided to go ahead and call the midwives. It took me so long to get in touch with someone, which was really odd because I’ve never had to call them more than once. M had fallen asleep on the couch and I was pacing back in forth in the living room trying to get a hold of someone. After a few pages, I got a call back. She said for some reason her pager was not working properly. My contractions were not consistent, but I still felt like I needed to go in. I explained everything to her and she said that I was probably in early labor and that the scar pain sounded normal. I sure didn’t feel normal. She heard me breathe through a contraction and gave me the option to either come in or wait it out. But she was sure that I was fine. I opted to go in and get checked anyway. I woke M up and told him we had to go. His mom was “on call” for us since they live down the street. It was around 3 AM. He tried to call his parents multiple times, and no answer! He ended up having to go to their house and jump the fence to get her to wake up. While he was gone, I got all of my toiletries and bags ready. Finally, M’s mom was here, I kissed Alex and we were on our way.

     On the car ride there, my contractions were starting to fizzle out. I had maybe a couple the entire drive there. I kept making sure M knew that I just needed to be checked, and that we are better safe than sorry. I didn’t want him to be disappointed if we got sent home, since I was sure we wouldn’t be admitted. We got to the parking structure and started walking towards the hospital. I didn’t have ANY contractions on the way up. I was still very sore though, so we had to take it easy. We got to L&D and it was pretty empty, so we got into our room right away. The nurse gave me my robe and said she was going to set everything up while I was changing. As soon as I walked in to the restroom and started changing.. bam!!  Contractions hit again. And they hit hard. I walked out of there in a lot of pain and for once I thought that this could actually be it. I got all set up on the monitors and his heart rate looked perfect….what a relief. They confirmed that I was having contractions every minute and a half, and they were lasting long. Really right on top of each other. The nurse said that we had to get a few minutes of the contractions on paper and that she was going to call the midwife down. It was hell laying on that bed, I was not getting any breaks from the pain. Finally the midwife came down. She said she was going to check me so I took my underwear off. I had a pad on and I felt embarrassed so I explained that things felt very “weird” down there and it felt like my water was going to break any second. She waited untilI was not having a contraction and then proceeded to check me. She said “oh yeah, you are preeeetty dilated”. I was so expecting her to say I was 2 cm, maybe 3 cm dilated. But no, I was a whole 8 cm dilated!!! I was thin and soft with a really big bulging bag of water. I guess that’s when it really hit me, I was going to give birth in just a couple short hours. I couldn’t believe it, M and I were in shock. It had taken me SO long to dilate last time that I just couldn’t believe it. It was literally a dream come true because I always said that I wanted to show up super progressed to the hospital this time. And it happened! All without me even knowing I was in labor to begin with. I guess I probably hit transition as I arrived to the hospital.

     So this part still kills me. The midwife was starting to walk away and she said she was going to make some phone calls and get all of my paperwork set up. I asked her if she thought it was a good idea for me to get the epidural. She said “Yes! that is a good idea” and walked out of the room to call anesthesia. I have no idea what brought me to ask her that. I was set on a natural birth and everything was going so perfectly. I blame it on fear. But on fear of what? I have no idea.. and I still regret it to this day. I guess I needed someone to tell me that I didn’t need it and that I was fine without it. I can’t even begin to explain what was going though my mind at that point. I think that has to be the moment I most regret. But I do know I needed relief form those piggyback contractions. They seriously never stopped. At this point, two nurses come in to place my IV. I was so not in the mood for these idiots. I could tell from the momentthey walked in that something weird was going to happen. They start talking about I don’t even know what.. maybe how their weekend went? Something like that. One starts my IV, oh so slowly. And I’m over here in transition, in bed, and just not comfortable. As she goes to put the tube in, she does it too slowly and blood gushes ALL over. Mostly all over her though. Her clothes, her hair, her arm. And they start cracking up. Still, I was not in the mood and really wanted them out of my face. The other one tells me that I have to forgive them, it was 4 am and they were just exhausted. I sat there as she finished up with tears rolling down my cheeks because I was just that annoyed and in pain.

     So the anesthesiologist gets in, and he’s basically god to me at that point because the pain was excruciating and just was not going away, even in between contractions. I have two new (awesome) nurses at this point and one was holding me as I leaned over the side of the bed to get my epidural placed. She helped me breathe through all of the pain and helped me stay still enough to get the needle in. Everything wasplaced and I was a happy camper. My new nurses went ahead and put my catheter in and M went to go get the bags out of the car.. because we were staying!!

     One of my nurses wasnamed Gloria and she was just the best. The epidural was nice for awhile but eventually started fading. They had to call the anesthesiologist back in over and over again to keep uping my dose. It just kept wearing off. Even the little button they gave me to push (for more medication) was not working. The anesthesiologist’s name was Johnathan, pretty cool since that was the name we had picked out for our baby. He didn’t have a problem with coming in so much to help me. We were all pretty confused as to what was going on, since he was confident that it was placed right. After awhile, it felt like I didn’t have any pain relief at all. And of course, the contractions never let up. I was checked again and I was at a 9. One more cm to go, I was so excited. So I continued to labor and I continued to get medicine placed in my IV for the pain. During the check, I was also told that baby’s head was still very high, and kind of off to the side. People were starting to get concerned about my contractions. I guess it was weird to see NO breaks at all in between them. My uterus was working extra hard to try to get that baby in the right position. Everything went by so quickly to me, so I don’t remember exactly when I got checked.. but I know that I was stuck at a 9 for awhile. The new midwife whose shift had just begun was scared to break my water because she didn’t want the cord to come out. She called in an OB to do it for her. They were hoping that would help me dilate that last cm. I was told that was supposed to be the easiest dilation, and that I was not supposed to get stuck at that point. The OB checked me before she was going to break my water, and during the check, my water broke on its own. She kept her hand in there for awhile just to make sure none of the cord came out. Of course I was still at a 9 and he wasn’t engaged. I was told that there was A LOT of fluid. M said he saw, and it was basically a waterfall!! The fluid was nice and clear.

     So I was still in a lot of pain and the anesthesiologist kept giving me more pain relief. It was just an ongoing cycle. The closeness of my contractions was starting to get everyone concerned. I remember a test being done, I’m just not sure what it was called or what was done. My mind is not remembering it for some reason, but I think it had to do with checking to see if there was a mixture between maternal and fetal blood. I’m not sure if that was it exactly, or why they did it, but it came back normal. The midwife said that she wanted to put internal monitors in me and check to see if the problems were because my contractions were not strong enough. I didn’t feel so good about that, so I declined. I changed my position as much as I could being somewhat numb in the legs. Then the midwife offered pitocin. Really? Was this lady really trying to give me pitocin, when my contractions were already coming at a dangerous rate?? Of course I said no thanks. Even Gloria thought she was crazy, she told me that she was NOT going to let her give me any of that. I have no idea why that was even suggested. I think it was around this time that I had a break down. I cried about the fact that I couldn’t progress, I cried because I was in so much pain. I was ready to give up. I did not want this to end up like Alexander’s birth, my main goal was a healthy baby. I didn’t care at this point how he got here, I just didn’t want to go through that trauma again. Everyone in the room tried to convince me that everything was okay. Gloria said that we were going to have a VBAC in that room,  and soon.

     At around 11:40 AM, on Sunday March 4th, I made the decision to go in for a repeat c-section. I was just not comfortable laboring anymore. I was a mess, I just wanted my baby out and in my arms. It was a hard pill to swallow. I talked it over with M, who really wanted me to have my VBAC, and we agreed that it was time. Neither of us were happy about it though. I told the midwife and she said she would have me into surgery soon and the anesthesiologist gave me another dose of medicine. Before the midwife walked out of the room, she had my lay in a position on my side, with one leg up, in a last effort attempt to get me dilated.

     Almost as soon as she left the room, Gloria and a few others rushed in. They seemed so calm, I didn’t think anything of it. They told me that they needed to adjust the monitors. I turned all of the way on my side, and then to my back, as they searched. I started to feel a bit scared. More people came in and someone threw an oxygen mask on me. They told me that I needed to breath deeply. I was checked one more time (I was called COMPLETE and +2!!!) and an internal monitor was placed on baby’s head. The midwife yelled “Well baby just made up his mind for you!”, which was not true because I had asked for the c-section right before that. Anyway, they started getting my bed ready to go and I was freaking out. I thought I had lost my baby. I thought he was dead. No one was telling me anything, and chaos was happening all around me. Right before they wheeled me out, I grabbed M’s hand. He told me everything was going to be okay. As they are rushing me down the hallway, I’m bawling. I felt so sick to my stomach and scared. I was hoping that it was all a dream, it felt like a dream. The doctor was going over the risks with me, as her and a handful of other people flew me to the OR. When we got there, they stopped my bed right next to the operating table. They told me that I really needed to get on it. So without even knowing how I did it, I jumped with numb legs onto the table. I just knew that I needed to be fast and there was no time to waste. They did a quick ultrasound and said his heart rate was in the 30’s. That was the first thing I heard the whole time about the situation. I knew he was still alive, but for how long? I was checked to make sure I was numb enough, and I was. So the surgery started. It was literally a few seconds till I heard “baby is out” and I heard the sweetest little whimper. He was okay. I breathed a sigh of relief but was quickly brought back to fear as I hear “complete uterine rupture!” Really? You have to be kidding me. The only thing that I was told over and over was so rare actually happened to me? The doctor was yelling as she was operating “what is this?!,” “is this cervix?” and even “where does this go?” Everyone was just in awe. I begged them to save me. I had two little boys who needed their mom. I had to live for them. I continued to beg, and to cry. I started to pray. I needed strength, I needed to live. I was getting IVs put in both wrists, on the bottom sides of them. It was extremely painful, but my arms were being held down by other people so all I was able to do was cry some more. It was then that the anesthesiologist took off my oxygen mask and put another one on. I asked him if that one was oxygen as well, he said yes. I was then put to sleep.

     I woke up at around 3 pm to people all around me. I was confused, but soon remembered what happened. Before I even said anything, they reassured me that my baby was okay. That he was fine, but he was in the NICU. I can’t even begin to explain how much joy and relief I felt at that moment. I was freezing and as soon as I was able to talk again, I asked for a whole bunch of blankets. My throat was so sore from the breathing tube they put in, and my voice was so raspy. I wasn’t in the regular recovery room, I was in a big empty room with empty beds along the walls. One of the nurses went to get Michael. He told me about our baby. He showed me pictures, and I cried some more. They had him in the NICU for monitoring, because he was shocked at birth and wasn’t breathing. Johnathan Samuel was born at 11:52 am, weighing 7lbs 7oz and 20.5 inches long. I found out that his heart rate dropped to the 40s out of nowhere. The heart monitors saved his life. And when the doctors cut me open, they didn’t have to cut my uterus to deliver him. There was a huge hole in my uterus. His arm, cord and body were hanging outside of my uterus in my abdominal cavity. My entire previous c-section scar had opened and the rupture extended down all of the way through my cervix and into my vagina. The surgery took almost 3 hours, but they were able to save my uterus. I had an in-surgery consult with urology, because there was suspected injury to my bladder. Everything turned out fine with that though. I experienced uterine atony on the table and lost a lot of blood. I was injected with a shot of pitocin directly into my uterus, which caused my uterus to contract and stop bleeding. I received two blood transfusions and one bag of plasma while asleep.

     After I spent awhile in recovery, I was taken back to my L&D room for about an hour. My dad was in there waiting for us. M had called him while I was in surgery. He stayed for a bit, but didn’t go see Johnathan because he was getting over a cold. At around 6:30, I was finally wheeled down to the NICU. A place that I never thought I’d see again. I had promised myself that I’d do everything possible to prevent another birth like Alex’s, but it happened anyway. I saw my sweet little baby asleep in his bassinet. He needed help breathing for a few hours, but  by the time I got to see him, he was fine. He did have an IV in because I was running a teeny tiny fever during my labor, and they wanted to treat him just in case. His cultures all came back negative though. The nurse handed him to me and I started crying. I couldn’t  believe he had pulled through. My true miracle baby. Everyone was looking at me with a sad look in their eyes. I’m assuming everyone had heard that I had a UR, because all the nurses in the NICU took time out to tell me congrats. I was so in love with him. He looked a lot like his big brother, just perfect.

     I tried to start skin to skin contact as soon as I could, even though he was already almost 7 hours old. I offered him my breast and he actually latched on. I cried again as he nursed like he was starving, like he was so happy to have me holding him. After having breastfeeding fail with Alex, I really wanted to make it work this time. Even after all we had just gone through, it was a very magical moment.

     We are so beyond thankful to have our little blessing with us today, because I know he was so close to death, and a lot of other moms didn’t have the outcome I did with such a large rupture. I just can’t wrap my head around how lucky we were. There was a lot of survivors guilt there in the beginning, when I was in contact with other UR moms whose babies passed away. Why did Johnathan survive? I’m 100% sure he had an angel watching over him that day. The whole thing brought a lot of emotional pain, trauma and questions. Why did this all happen to us? What did we do to deserve that? I grieved over the fact that I was told not to have anymore children. That was very hard to hear. Not only did my VBAC fail, but I was never allowed to try again, when all I ever wanted was a positive birth experience. It was a ton to process at one time. That one thing that is so rare happened to us. It was unbelievable. I’m very very very thankful for the staff who were on-call that day. He was born 12 minutes after the first sign of rupture, and that was almost not even fast enough. The longest 12 minutes of my life.They all worked so fast, with minimal “decision to incision” time. I couldn’t have asked for better doctors or nurses. I have realized that even though my baby survived, UR is not something you can just get over. The scars are not only physical, but emotional as well.. if not more emotional than physical.

     Now Johnathan is a happy and healthy 10 month old baby. He is such a joy to be around and a complete mama’s boy. We have a wonderful breastfeeding relationship still and I am so thankful for that. I can’t imagine life without him. His big brother Alex just adores him. I have had the best time watching them grow in to being best friends and I’m excited for our future together as a family. I thank God everyday that he’s here with us. As for me, I’m still working through the pain. I still think about it all every day and often replay my story in my head, trying to figure out where I went wrong. I wasn’t as prepared as I should have been. There are so many things I would have gone back and changed. BUT, there is no use thinking about all of that now–I’m still in the process of learning how to make all of that stop.