A VBAC Birth Story

I don’t usually blog about births I’ve attended but I am still on such a euphoric high from the one I attended yesterday that I had to write it down. Almost two years ago I was “M’s” doula for the birth of her first baby. After 40 + hours of labor and 9 cm. of dilation there was a shift change and the power hungry doctor who came on immediately diagnosed “M” with CPD (cephalopelvic disproportion--- meaning her baby was too big for her pelvis) and ordered a section. FHTs (fetal heart tones) were fine, mom was tired but still eager to continue with labor, there were no other indicators of danger to mama/baby but this doctor wanted to get the show on the road so she insisted that a c-section would be the only way to get this baby out healthy.

We were all devastated. Most of all “M” of course, who had been through all of that work just to have it end in a surgical delivery. Her baby girl weighed in at a *whopping* 7 lbs. 8 oz. so it kind of compounded her frustration when she realized she’d consented to surgery based on a complete misdiagnosis.

Cut to this week: “M”, now pregnant with baby two, has chosen to go with a Nurse-Midwife this time knowing that her goal of a healthy VBAC (Vaginal Birth After Cesarean) would be more likely realized with a midwife than an OB. Her Midwife practices out of St. Joseph’s hospital in Phoenix which is a 30-45 min. drive from their house in Mesa but it was well worth the drive to have the benefits of the midwifery model of care.

Sunday night “M” called me to tell me labor had started but that it was still early on so she was trying to go on about her regular routine. By bedtime labor had settled down so she decided to go to bed. Fortunately she was able to get a pretty good night’s sleep because her labor eased off almost entirely. Monday morning as soon as she was up and around it started back up and by Mon. afternoon her membranes had ruptured which started labor in earnest.

I drove in from Queen Creek to meet up with “M” and offer support and to be closer since we were in for such a long drive. After I arrived I watched “M” through a few contractions and timed them for an hour and when I could see that she was having about 8 an hour I decided to stay. We just took it easy all day. “M” realized that whenever she was active her labor would pick up so she and her husband “J” took a couple of long walks around the neighborhood.

A little after 9 pm, “M” expressed that she was starting to feel frustrated and antsy about not making the kind of progress she was hoping she would. I think she started to see the clock looming overhead and was worried that she was going to end up with another section for FTP (Failure to progress.) We had a long pep talk about the fact that any progress was good progress and clearly she was in a good labor pattern. I reminded her that she could do this and that this time she was going to have an awesome delivery. After the pep talk I suggested that they hide out in the bedroom and watch a movie to take some of the pressure off about progress since it seemed to be stressing her out. About an hour later “M’s” mother in law and I were chatting when “J” came down the hall and said, “M needs you for a minute.”

When I got to the bedroom “M” was looking very uncomfortable and said that things had REALLY picked up. She was having a contraction and I could see a vast difference between this one and the ones she’d been having. We decided it was time to go in to the hospital since we were so far away.

We arrived at L&D triage about 11pm and they were so busy that it took a little over 3 hours just to get a room. In triage at around 3am we found out that “M” was dilated to about 5cm and 80% effaced. She was disappointed because she thought she’d be further along. Around 4:45 after checking into her room a second check by the Nurse-Midwife on call revealed little to no change and her contractions had slowed up again. I wasn’t terribly worried though because I see that a lot. It’s a classic flight or fight response. Many animals in nature will cease laboring altogether if they sense danger or interference, as a defense mechanism against predators trying to get their babies. Many, many women who go to the hospital in labor, find that when they arrive their labor slows up.

A lot happened over the next16 hours but it was mostly a lot of watching and waiting with gradual and steady progress. We joked a lot and the mood in the room was light and optimistic in spite of the tedium. Since “M's" membranes were ruptured they didn’t check her very often trying to minimize the risk of introducing infection but she did get checked at around 6 am where she was found to be 6cm and 100% effaced and another check at about 10am showed that she had reached 8 cm.

Finally during the 11:00 hour she started to feel pushy during contractions but we worked on blowing those away some. She started saying, “Ow, ow, ow.” So I asked, “What is it that is causing the ‘ow’, your back, your hips?” She emphatically nodded when I said hips so I started applying counter pressure on her hips squeezing them together. At this point I was really happy because I had to assume that if she was feeling her hips spread that the baby was really engaged in the pelvis. I assured her that this was good news and that since this was an unfamiliar sensation to her that she was clearly further into this labor than she’d gotten with her first baby. She seemed relieved to know that things were finally happening.

Pretty soon the Nurse-Midwife came by to check on her and she could see that we were past the point of no return. She said she was going to do a couple of more rounds and that we should call if there was any change before she came back. She had only been gone a few minutes when “M” said she really, really felt pushy so I took a peek and she was definitely right. We hit the call button and the nurse and the Midwife were both back in no time. “M” had been on her knees bent over the back of the bed and really didn’t want to change positions so when the Midwife came back I said, “She’s pretty happy like this. Are you comfortable with this for birth position?” The Midwife kind of smirked and raised her eyebrow in thought and said, “I haven’t done one of these in years but yeah, I can do that. I actually gave birth to one of my own babies this way and I loved it.”

On the next contraction I could tell “M” was still trying to hold back from pushing so I told her she didn’t need to do that anymore and that she should give it her best. She started pushing with a vengeance and I could tell that she wasn’t just pushing for this baby but also for her first one that she never got to push out. It was so fulfilling to get to watch her live out her dream. She was having the time of her life. She only pushed for a few contractions (I couldn’t count because she didn’t seem to have a break between them.) and had her baby out at 12:06 pm.

I confess that I also had some selfish enjoyment from this particular birth since I was able to basically assist the Midwife with the catch. It was just she and I at the end of the bed, the awesome nurse we had just stepped back and let “M’s” team (“M’s” husband, mother in law and myself) have free reign of things. When the baby was out the Midwife wanted to hand him through “M’s” legs to her but he got tangled up in all of that goofy surgical draping so I was able to untangle him and try to lift “M’s” leg to help get him through and then the Midwife and I both saw the problem at the same time and jinxed each other when we said, “His cord is too short.” We both kind of laughed at that and then she clamped it so “M’s” husband could cut it. Finally we kind of simultaneously flipped “M” over so that she could hold the baby and the Midwife handed him up to her.

That was an awesome moment as I realized this mom; ecstatic to meet this new baby; was almost equally ecstatic to have proved that she was capable of giving birth to her baby despite what she’d been told. We looked at each other for a second and I just said, “You DID IT!”

When all was said and done, “Baby J” was 8 lbs. 3 oz. A full 11 oz. bigger than the baby she was supposedly too small to give birth to. What vindication for “M” and how awesome that she was able to experience what she had longed to experience for so long. It was two long days of exhausting work but she did it and it was all worth it. It was a totally amazing experience that I will never forget being a part of so Thank You to “M and J” for letting me bear witness to your miracle.