Hey, guess what? It's long!
A bit of a back story to explain why there were a few ?unknowns? until toward the end, and some decisions I made.
Right before we found out we were expecting, my husband found out he was losing his job (and of course, benefits). A few months of unemployment later and he landed an amazing opportunity several states away, so we accepted and relocated the family. I was approximately 32 weeks along. The nature of his career is planned (and sometimes unplanned -- with only two hours notice) travel. The week I was due happened to be a very, very large trade show week for his employer. The trade show was several states away and required frequent travel.
In addition to the travel complication, my goal was to have a VBAC. My first had been a surprise breech (she flipped sometime between my last office visit internal and labor). By all my research, I was a perfect VBAC candidate: my labor had begun spontaneously with the first, it was only one Cesarean, the procedural incision was transverse/horizontal, it would be two years since the first birth etc.
The last major surprise is that I realized about a week from the due date that I would not be a candidate for an epidural. With my first, things happened very quickly when the doctors determined my daughter was breech. Unfortunately, because of the speed, we never received full details. But when they started preparing me for the Cesarean, they had to give me general anesthesia -- I had had back surgery many years prior and have rods fused in my spine. A week away from the due date, and with research, I discovered that epidurals are rarely, if ever, effective with a patient with these particular rods. While I didn?t necessarily want an epidural, the fact that it was no longer an option flipped me out.
Flash forward to meeting the new provider, and discussion about decisions.
When I met with the new obstetrician, she appeared willing to try a VBAC with me. It sounded as if the office hadn?t had lots of experience with VBACs, possibly due to recent state recommendations. But I explained that I felt I was a good candidate, and she agreed. She said the office would let me go a week beyond my due date before requiring a repeat C-S. I was excited -- most people had said their providers would not let them go more than a day or so beyond the due date to attempt a VBAC.
About a month ahead of our due date, my husband was looking at the calendar and realized that the trade show fell on the same week as our expected due date. I sat and considered for a long time. I certainly didn?t want to risk my husband to be out of town when I began labor. But I certainly didn?t want another Cesarean. Not only would the recovery be longer, but we live in an area with limited help (no family, don?t have a strong friend network yet), and in an apartment on the second floor (no elevator). I didn?t want to THINK about dealing with stairs, a newborn and a toddler while recovering. I spoke with the OB about it, and considering an induction. I was not a candidate for a Pitocin induction due to increased uterine rupture risk. She was willing to perform an amniotomy induction (breaking water). She explained that I had to agree that if there was limited progress, a repeat C-S would be performed after a predetermined time. It didn?t make me 100 percent happy, but a) my husband would be present and b) at least my body could attempt the birth I wanted, as opposed to an automatic procedural birth -- so I was happier.
A date and time was scheduled for the amniotomy -- a midnight induction with a 9am scheduled Cesarean. Only nine hours to labor? I called and asked if there was a possibility that I could be scheduled for an earlier amniotomy, and was given a 6pm induction with the 9am scheduled C-S the following day.
We decided not to tell anyone except for our parents what the day would be (St. Patrick?s Day) because we wanted it to be as ?normal? as possible, with as many surprises as possible for everyone waiting.
For whatever reason, I was not scheduled for an appointment the week I was scheduled. On the morning of the 17th, I slept very poorly. I attributed it to Braxton Hicks and tried sleeping more. At 830, I called the OB office to ask if I could get an appointment for them to check my progress and strip my membranes to possibly jumpstart the induction that evening. Around 1030am, I started reconsidering what I thought was Braxton Hicks -- these were stronger and more regular. I began timing them, and they were consistent in duration and frequency. Unfortunately, about three hours later, they petered out. Around the same time, the doctor?s office called -- they wouldn?t let me come in to strip my membranes because I was ?only 1cm? and the ?doctor doesn?t strip them that early.? Nevermind the fact they were looking at the records from a week prior.....
Around 3pm, my sister-in-law showed up -- she was going to watch my daughter while we were in the hospital. As soon as she got in, I headed outside to start walking. I would have gone sooner, except my daughter was napping.
We headed to the hospital for the amniotomy around our scheduled time. I brought some entertainment, with the assumption that it would be a while after they broke my water that the party began. They didn?t do the deed until about 830, but it only took about five minutes for the contractions to start. It didn?t take too terribly long for my body to make progress.
Because of the risk of cord prolapse, I was required to be monitored. The attending OB wanted to give me an internal monitor, but knowing that I could not have an epidural, I wanted to be able to shower to relax. I knew I wouldn?t be able to do that with an internal. They were hesitant, but I agreed that if there were any indication of a problem that I would permit an internal. Of course, it didn?t take long for the baby to indicate a heartbeat deceleration and the internal monitor was required. I wasn?t happy, but wanted to make sure the cord didn?t slip down, so an internal was placed.
Around 5cm, the nurse offered me IV meds and explained that are most effective the first time they are administered, and subsequent administrations have reduced effectiveness. The first administration did not appear to be helpful. My contractions were strong, and unfortunately many of them didn?t quite ?finish? prior to the next one -- they were long and plateaued but were still there as I entered the subsequent contraction. While it had been my goal to be able to move around as much as possible, I was surprised that I didn?t want to leave the birthing bed (with the exception of the shower, which I was not able to have!). The nurse had me labor a few times on the ball, which was fine when I was finally on it, but I did not enjoy getting out of bed to get there!
Somewhere around 6-7cm, the doctors determined that the baby was posterior. I labored several contractions while they tried turning the baby by placing a rolled towel under my back. Fortunately, the method worked and the baby turned, but it was an extremely uncomfortable way to labor!
It wasn?t too much later that I was feeling the urge to push during contractions. Again, not the most comfortable way to labor! Part of my cervix was in the way, and the doctor and nurse didn?t want me pushing. At this point, my contractions were very strong, but they gave me time in between to relax. I would say in a way that this was the easiest part of the labor -- I could actually catch my breath between contractions! The nurse administered another dose of the IV meds as well.
I was finally fully dilated and given the okay to push. I was in shock -- after waiting so long, I could hardly believe it was time! It only took about three or four contractions and pushing for our baby girl to be born! At 2:10am she was six pounds, four ounces and 18 3/4 inches, she was barely bigger than her sister was at birth.
After about 36 hours of the outside world, we decided on the name Heidi Alice. I wanted her to represent my late grandmother (Alice), but we preferred the pronounciation of "Elise" with Heidi. So we had to be the folks to switch up pronounciation.
She's awesome and her older sister, Hailey, is awesome with her. I hear "Hold Heidi?"about 10 times a day from Hailey. Love them both!
VBAC on track,