Triumphant VBAC'ing -- Against the Odds
***Disclaimer - This is incredibly long and detailed, but I hope that the following story could serve as a bit of inspiration to any woman who ever finds herself in my situation.
Thursday, May 15 was my last day of work before maternity leave. I went in that morning in great spirits, though on the train ride in I was feeling a few contractions, pretty typical of what I had been feeling for weeks. At 8 am, I sat at my desk joking with my boss about how many times I’ve felt contractions that turned out to be nothing.
At 8:30 am, I felt a pretty painful contraction that was definitely unlike any others I had felt. Then, I felt a little ooze, but I assumed I was imagining it. I went to the bathroom, and there was my mucous plug! I have never been so excited to see something so gross! Since my first birth was an induction at 41 weeks with absolutely zero signs of labor, I was so thrilled to see my body showing the “signs.”
I had another hard contraction on the way back from the bathroom, so I stopped by my boss’s desk and said “um… I may need to leave soon… I’ll let you know.”
I sat back down and painful contractions started immediately. I figured I’d try timing them and sure enough, they were 3 minutes apart, 60 seconds long. I was still able to talk through them, so I called my aunt to have her keep me company on the phone and distract me while I counted them. I decided to count them at least until John got to work at 9 so I could tell him if anything was happening.
By the time he got in at 9, I told him I thought we really needed to leave. Shortly after, He came over to my desk and we took a look at the train schedule to figure out which train would get us home. I had wanted to labor at home as long as possible before going to the dreaded hospital. As we sat there it became very clear that the contractions were so hard and close together that there was no way we were going to make it home. Since we were already downtown, the hospital was only a half hour cab ride away.
We went downstairs and flagged down a cabbie (who was NOT thrilled about letting a laboring woman into his cab.) We arrived at the hospital somewhere right around 10 am, and at that point I could not talk at all through the contractions, and there was almost no break between them.
Holly, our doula, met us there. The resident checked me and said I was completely effaced, 0 station, but only about 2 cm dilated. Right away we got me into the shower to try to ease some of the pain, but the hospital shower was more like a cold water closet – absolutely no relief at all – so I only stayed in for about a half hour. The nurses were supposed to be getting the tub ready for me, but they never got around to it. Once I got back to the bed, the contractions were so hard and fast that I was yelling through them and the urge to push was unbearable. Holly couldn’t believe that I was only at 2 cm when I was having transition-type contractions along with the urge to push, so she ran out to get someone to check me again while I was screaming in pain. We all thought I had to be in transition, but when they said I wasn’t even close, I started begging for the epidural. I wanted to go without it because I knew it would complicate my delivery, and my previous epidural experience was awful, but I just couldn’t bear that much pain for another minute. I was starting to lose it. Of course, I felt so guilty because I wanted to do this naturally, and I was so scared that it meant the beginning of the end of my “attempt” at VBAC. I felt like a failure in front of Holly, but she was great about it and said that she didn’t blame me one bit with the type of contractions I was having and it being so early. I couldn’t have lasted like that for another 8 cm, and I’m so glad that she made sure I didn’t feel weak for giving into the pain management.
At 1 pm, I got the epidural, and within a half hour I started to feel like a human being again. After that, labor actually got pretty fun! John, Holly and I all sat around joking and talking while I painlessly had contractions every 3 minutes, and by 6 pm I was at 7 cm dilated and +1-2 station. I was so excited that I was so close. I kept joking that if labor would be like this, I’d have ten more kids! Then, a bunch of my family showed up and the roomful of people started to get really overwhelming. I started to forget why I was even in the hospital at all.
Let me say that until this point, baby’s heart tones were completely perfect, and my body temp was a steady 99 degrees.
At 7 pm, the staff shift changed, and that ended up being the beginning of the bad news. The new resident came in to check me and said I was at 5 cm. I said “but the last doctor just said I was 7 cm – did I go backward?” He said “No, that can’t happen. She was wrong, you were never at 7 cm.”
I instantly became very sad and discouraged. 5 cm was all I got to with my first labor, and I suddenly felt so terrified that my body couldn’t dilate past 5 cm at all. When he left the room, Holly reminded me that yes, a woman can go temporarily backward, which I knew from all my reading to be true. Then, my actual OB came in to see me for the first time and started telling me that we needed to consider augmenting my labor or giving me another c-section. Then I started getting panicky. I could see where this was going.
I told him that I wasn’t interested in that – he knew that because he had my birth plan – and maybe all the commotion from the visitors made me lose focus, and that I just needed to refocus my energy back on my labor and get things rolling again. He told me that my “focus” had nothing to do with it and I probably just wasn’t able to get past 5 cm. I said that one of the doctors told me I was 7 cm, and he also said “she was wrong.” Even though I was scared of that being true, I told him that I hadn’t had enough time and I was not going to even consider giving up so soon. He said something about him having been there “all day” and wanting to go home, so I told him he better go on home and come back to check on me in the morning because I wasn’t going to end my labor just because his day was over. Things started to get heated and I couldn’t believe I was even having that conversation. It was obvious that he was annoyed with me, but I didn’t care. So then he started with the scare tactics – “but the baby is becoming tachycardic” and “your water has been ruptured for more than 8 hours, you both might get an infection.”
I told him that Jules heart rate had been perfect all day (which he should have known) and it was only getting a little higher because I was getting stressed out. I needed to be left alone so I could get back to laboring. He rolled his eyes and said he’d be back in the morning.
So, because the official pressure was on, John, Holly and I all put our heads together and got back to work. Holly left John and I to be alone so we could reconnect and do some nipple stimulation. John and I sat in the dark for an hour or so just being together, and things definitely picked back up again. At midnight we decided to call it a night and start fresh in the morning. John slept, but I couldn’t. I laid awake all night long staring at the fetal monitor, talking out loud to Jules and asking him to please keep his heart rate baseline below 160. It was amazing the way he responded to me. His heart rate baseline went back to normal and stayed that way all night long. I was so proud of him for hanging in there with me. I felt like my baby and I already had a real connection. We were a team.
The next morning at 6 am, I had my second wind and was ready to get the show on the road. I woke John up and told him to get himself fed and cleaned up so we could seriously get our game faces on. Holly was back and ready to go, so our spirits were lifting. The resident from the night before (the same one who told me I was 5 cm) checked me and said I was 6-7 cm. So, that at least meant that I had progressed 1-2 cm overnight while doing nothing but laying flat on my back. I felt like this was great news, but just then a nurse came in who completely ruined our mood. She asked me if I had considered Pitocin to get things moving. I told her I wasn’t getting Pitocin, and she started arguing with me. This is the nurse, by the way, a person who has absolutely no right to advise me medically one way or another. She said I should think about getting the baby out healthy, and I told her he was healthy. I watched his heart tones all night long and he was perfect. Then she said “Well, I’ve seen fetuses with good heart tones be born with APGARs of zero” – meaning dead. I got pissed. I couldn’t believe this woman just tried to throw a “dead baby” scenario in my face, especially when nobody is in any danger. John could tell I was getting really upset again (who wouldn’t?) and he jumped in and told her she needed to stop. She tried to apologize, but it kept coming out like “well, I don’t mean to upset you - BUT…..” Thankfully, once we got her out of the room I didn’t see her again for the rest of the day.
Around 10-ish, my doc came back and said I’d had enough time and he wanted to do an internal pressure catheter. I told him I was making progress and he said I hadn’t because I had been 7 cm since 5 pm the day before. Now, that didn’t even make sense because he was the one who agreed with the resident the night before that I had never gotten to 7 cm. Now he was saying that I had “stalled” at 7 all night. He was getting very heated with me and kept trying to say that I needed to listen to him. He said that my uterus – I kid you not – “just might not work” so I needed to have a c-section. He said I’d had enough time and my “trial of labor” had failed. He said it was a case of “failure to progress” at which point I shot back “No! It’s a failure to WAIT.” He wanted to do an internal pressure catheter to measure the strength of my contractions, and if they were adequate it would mean that they obviously weren’t effective so I needed to be sectioned. The other side of the coin was that my contractions were inadequate, which meant that he would give me 6 hours for them to become adequate or I needed to be sectioned. Well, I didn’t like either of his scenarios. I told him I just needed for people to stop stressing me out and let me labor. He thought I was being “reckless.”
After 10 minutes or so of arguing back and forth, I told him I just wanted more time. He left in a huff, and came back about an hour later with another doctor, telling me he had spoken to every doctor at that hospital, along with a doctor from another nearby hospital, and the hospital administration and I only had one of two “options.” I either had to sign the c-section consent form, or sign a “Waiver of Liability” meaning that the hospital was no longer liable for whatever happened to me and the baby. I couldn’t believe he was standing there threatening me. I know my rights, and I told him so. Nobody could force me to sign anything.
John asked them to leave the room so we could discuss our options, and total panic took over the room. I started bawling and pleading to Holly and John that I just could not have a c-section. They both knew that, but I just needed to cry. I was having a complete breakdown. Here I am in labor, and more sad and scared than I have ever been in my life. I know all my legal rights, and I knew the hospital could not force me to sign either one of those forms. We started thinking about ripping all the IVs out of my arm and just leaving the hospital. We started trying to call local chapters of ICAN to see if anybody could offer any advice (nobody ever called us back.) I alternated from sobbing to shouting angrily. I tried to think of any lawyers I knew who I could call for instant representation, or at least advice. I couldn’t believe that there I was, having to deal with that while I’m trying to birth a baby.
An hour later, the doctor came back and told me time was up and I had to sign something. I told him we were making phone calls and until I knew what the best thing to do was, we weren’t signing anything. Insert more crying and panicking for another solid half hour until I just made up my mind that I wasn’t letting them bully me for one more second. I was too upset to even try to keep talking to them so I told John he had to handle the situation, so went into the hall and talked to the doctor. John basically told him that I wasn’t signing anything, and that’s all there was to it. The doctor then said that I was pretty much asking for my baby to be born with “cerebral palsy,” and started scaring John into submission. He spouted off “statistics” to John about everything that may go wrong to cause us to have an unhealthy baby. Well, I am not a statistic. I am a human being who deserves to be looked at as an individual, and not some number. John came back in to report what was said, and it was clear that he was starting to buy into what the doctor was saying. I reminded him of all we knew about these scare tactics, and that we could see the fetal heart monitor for ourselves. There was absolutely no reason to be concerned about the baby at that point. The only problem with the baby was that his mother was being forced to fight a legal battle during her labor. Through my tears and anger, I convinced John that he had to get out in that hall and go to battle for his wife. He wanted a VBAC just as badly as I did, but he was cracking under the pressure, and I just couldn’t have that. I needed him to be strong at that moment more than I ever needed him before.
John left again – and Holly just sat with me while I sobbed. She was a rock throughout the entire debacle, and she reminded me that I wasn’t being reckless at all. She reminded me of how much I loved my baby and that I wasn’t going to do anything to put our lives in danger. Then she asked me what my ideal outcome would be. Holly is great at breaking up the clutter, forcing you to think, and getting back to the big picture. I told her that my “ideal outcome” would be for the doctor to magically decide to leave me alone and let me labor on my own until I had the baby vaginally, no matter how long it took. Of course I knew that was highly improbable, but it was good to refocus on my goal whether or not it looked like it might happen.
edited to add *** In the middle of all the fighting, my in-laws came to the hospital with Jonas, my older son. My whole face was swollen from crying so much, and I was an emotional mess. Well, when I saw him, I broke down even more because I thought "Here sits this perfect, beautiful, healthy boy who came into the world by c-section. He's FINE! Why am I fighting so hard to have a vaginal birth?!?! I'm so selfish! Who cares how my baby comes out!! I'm going to end up hurting us both because I'm so stubborn!!" After that I made them take Jonas away because I didn't want him to see me in the shape I was in. Right at that moment I almost called the doctor in and told him to go ahead with the section. But, when I thought about those words coming out of my mouth, I got angry again and kept on fighting. I knew I'd regret that c-section, and the pain would only be doubled. I also knew that I owed it to Jonas and Jules both to get my VBAC so their mom could get her head straight again. ***
But then, John came back with surprising news. The doctor had finally cracked, admitting to John that Baby’s heart tones weren’t worrisome, and said that he’d leave me alone to keep laboring as long as I promised to let them intervene if anything did become worrisome. I couldn’t believe it. I was so relieved, but so still so scared at the same time. John had found a way to make the doctor understand how important the VBAC was to me, but at the same time I wasn’t trying to be a martyr. He managed to convince the doctor that it wasn’t some personal attack on him, and that what I needed more than anything was for everyone to stop putting such an excruciating amount of stress on me so I could just do my thing. Somehow, John’s words worked, and the doctor softened.
John brought the doctor in, and he tried to make up with me. I cried my eyes out when I tried to explain to him how important it was that I didn’t leave that hospital with another uterine scar wondering what could have been if only I’d had a little more time. I promised him that I would be open to the cesarean if it became obvious that was the only choice. I made him understand that I had no intention of hurting myself or my baby, but there was no way I could submit to a surgery that wasn’t medically necessary at that point. Then, he left me alone to get back to business. He was obviously still annoyed with me, but I think John helped him perhaps feel a slight bit of empathy for me too.
By that point, it was 2 pm on Friday and contractions were down to 10 minutes apart. I sat and concentrated on breathing to bring my heart rate and the baby’s heart rate back down. John and Holly agreed that I needed to take a nap and start fresh when I woke up. Holly ran home to take care of a few things, and we all just tried to settle in to change the tone in the room. I didn’t feel like I could nap, but I knew that somehow we had to put a break in the day and change the energy in the room. At that point all I could do was sob and I knew if I didn’t change my mind frame soon, things were going to get very bad.
Just then my friend Kelly called and said she was stopping by. It was so nice to see her, and she really helped distract us from the hell we had just been through. She stayed for a couple hours before she had to go to work, and by the time she left we were feeling a lot better. I thought maybe I could take a nap then, but as Kelly was leaving, my friend Kathryn (who was in town visiting) called to say she was stopping by. I did get concerned for a second that I was getting distracted, but luckily those two friends are the most low-maintenance people I know, and they were both really helping to relax me. Right before Kathryn got there, Holly came back with some fresh things she’d learned about stalled labor. She said that my cervix may have swollen from sitting up, so I should try alternating laying on my sides to bring down the swelling. She had also suggested a few times that I turn down the epidural so I could feel things, and I finally listened to her then. I was really afraid of feeling those horrible contractions again, but I knew she was probably right. I laid down on my side and then Kathryn came in. We all just sat and talked and slowly the mood of the room shifted.
At around 5:30 pm, contractions started getting pretty intense. I went from being able to carry on a conversation with Kathryn, to needing to stop and breathe through each rush. Then it steadily became more and more intense. Within an hour I was feeling full labor again, and contractions were long and strong. They checked me and I was at 8 cm. Progress! Then the pain got worse, and worse, and then 9 cm! Pretty soon I was screaming again and having the unbearable urge to push. I asked for another little shot of the epidural because I was so scared of the pain. I begged them to check me because I didn’t want to push if it wasn’t 10 cm yet. After what seemed like an eternity, the resident checked me and said I was “complete” so I could start pushing! Kathryn asked me if I wanted her to leave, and I told her no. I was so glad she was with there with me.
At 8 pm, I start pushing. At first the pushing wasn’t very fruitful because I had made the mistake of getting more epidural. I couldn’t feel the rushes as strongly, and the urge just wasn’t there like it had been right before I got the epidural dose. For about an hour, I pushed without a whole lot of progress. I was still so terrified that my pushing was going to fail and they’d call for a c-section – after all that work. Then I changed positions, and right about that time the epidural started to wear off. The more I could feel, the more I realized that I felt like Jules head was stuck on something. As the pain became unbearable, I started screaming for them to send in the doctor to see what could be done to help get the baby down. When my doctor finally came in, he realized that Jules was almost out, but I was pushing against an anterior lip (a little part of my cervix was swollen.) Pretty soon, the room was filled with equipment and people; the stirrups were out, and the doctor was in position to catch the baby. I had always hated the idea of pushing on my back, but there I was – feet in stirrups and nurses holding my legs back – pushing as hard as I could while the doctor yelled “PushPushPushPushPush!!” All I could think of was what I knew about that being the least effective position to push in, but I was literally in no position to do much about it. And as I laid there pushing as hard as I could, I was still terrified that the doctor was going to find some reason why I wasn’t pushing good enough, and call for a c-section. I couldn’t concentrate on anything except how scared I was of something going wrong, and I knew that I had to get the baby out before the doctor invented another reason to section me. I was watching Jules head come down in the mirror, and begging myself to get him out.
After 5-6 more contractions, with about 4 pushes each, Jules was born at 10:01 pm. As I sit here writing this, I still cannot believe it’s real. The nurses put him on my chest, and John cut the cord. I laid there in total wonderment while the doctor stitched up my 2nd degree tear. I finally passed the placenta 45 minutes later, and the whole 38-hour ordeal was finally, finally over.
Within a couple hours I was up showering. The difference in recovery between a vaginal and cesarean birth is like night and day. We left the hospital 36 hours after Jules was born (the earliest possible moment that they’d let us go) and at only 3 days postpartum, I feel almost completely back to normal. No, I feel much better than normal. I feel like Superwoman.
The sheer thought that I got my VBAC, after 2 years of c-section depression and a 38-hour hard fought labor, is completely overwhelming to me still. I wish every woman in the world could experience this feeling, and I hope all other women in my situation are able to have their VBACs too.