Logan's successful VBAC! XP from Aug12, long with PIP

Twizzle · August 2012

My official due date was Wednesday, August 15. After going to bed on Sunday, August 12, I woke at about 3am to contractions that were mildly painful--more so than the Braxton Hicks I had been having. The contractions kept me awake for the next few hours. I was trying to go back to sleep, but they were regular enough to keep me awake. Finally, I fell back asleep about 6am, only to have to wake up shortly to get ready to go to work. I wasn't sure what to do, but I figured if I had no more contractions while showering and getting ready, then it wasn't the real thing. I didn't have any more contractions, but I did pass some bloody mucus.

Nothing else happened that day, but the very next night I woke at about 2am to contractions again. This time I started timing them and they were 9 minutes apart. Again, this continued for 2-3 hours as I tried to go back to sleep but then stopped. I also continued to have lots of bloody show so I contacted the midwife on call. She wasn't concerned about the bleeding as long as I wasn't bleeding heavily while up and about. Since the bleeding had turned into spotting, I wasn't concerned either. However, I was extremely tired! It's tiring enough to be 9 months pregnant but even worse on only 4-5 hours of sleep a night. So on Tuesday night I decided to take a Unisom to help me sleep. It worked pretty well because I didn't have any more contractions that night, or if I did I slept through them. I also had a chiropractor appointment on Tuesday afternoon which helped me feel better.

All day Wednesday, my due date, I was pretty active--going on walks, going swimming with Cameron. I felt better rested after a good night's sleep. That evening Andy and I had planned to go out to dinner to celebrate the due date, but I was too tired and also didn't have much of an appetite so we decided to watch a movie at home instead. Towards the end of the movie I started feeling a few contractions again but I figured it was just the nightly pattern of contractions starting a little bit earlier. Then at about 10:30pm I felt a little trickle of fluid coming out. I thought it could be more bloody show and then I felt a popping sensation in my uterus. I rushed to the bathroom and a big gush of fluid came out. When I stood up, fluid continued to trickle out. I went back to tell Andy, I think my water just broke! We were both in shock and just stared at each other as we tried to comprehend what was happening and decide what to do next. I was a little concerned because the water seemed to be a little yellowish and brownish. I went to the computer to Google more about water breaking and I started to have pretty strong and regular contractions. Every time I had a contraction more water would come out. I wasn't timing them because my brain was just racing. I paged the midwife on call and had several more contractions while waiting for a call back. After talking to the midwife, Jessica, she wanted me to come straight to Labor and Delivery, even bypassing the triage. I talked to my doula and I told her I was going in and having contractions but I didn't think they were very long. We decided that she would wait to hear what the midwife said before joining me at the hospital. As soon as my mom arrived to take care of Cameron, we left for the hospital. It was surreal because I always imagined I would labor at home much longer before going to the hospital.

On the way to the hospital I had several more contractions. They were getting stronger and closer together but we still weren't timing them. Got checked into a room and hooked up to the wireless monitors so I could still move around. The midwife wasn't there yet, but after 15 or so minutes of monitoring, I asked the nurse if she thought I should call my doula. She said that I was having strong contractions that were 2-3 minutes apart, so yes I should bring my doula in. The midwife arrived and checked my cervix, but I asked her not to tell me where I was at. I didn't want to get discouraged if I hadn't had much progress. Later I found out that at this point I was 3cm dilated and 100% effaced. They weren't concerned about the discoloration of my water and figured it was just tinged with old blood. The contractions were getting harder to deal with, and I also was feeling nauseated and even threw up, so they suggested I get into the tub. As I was getting in my doula arrived, I think it was about 1am. I now had nurse Jessica, midwife Jessica, and doula Jessica attending me. While in the tub, I started having a lot of negative thoughts and feeling really defeated. Looking back, I think it was because I was planning water birth and the water did not seem to be helping, only making me cold, and also because they weren't setting up the big birth tub. I knew that they wouldn't set it up until I was at 5cm, so in my head I was thinking that I wasn't progressing and things were getting stuck just like they did in Cameron's labor. I was even wishing to myself that they would find something wrong that would force me to have another cesarean right away just so I could get it over with.

After awhile I was just too cold and uncomfortable in the tub so I got out. What really made me feel best was to be standing and leaning on the bed, but I didn't think that I would be able to keep this up for long. We tried several positions and ended up sitting on the birth ball, leaning on a stack of pillows on the bed. I was even falling asleep between contractions. At some point, maybe about 4-5am, the midwife checked me again. I had only gotten to 4cm. Fortunately, I still didn't know my progress--I think it would have really discouraged me to know that it had taken about 4 hours to dilate 1cm. The midwife encouraged me to try some different positions at this point, as well as try to use the bathroom. When I went to the bathroom I started feeling an urge to push with every contraction. It was almost impossible to stop this urge but I had to because the nurse and midwife told me that pushing at this point would cause my cervix to swell, which would make it impossible to get my baby out. One thing that can be done if the urge to push comes too early is to try some gravity-neutral positions. That meant I had to get off the birth ball. I tried hands and knees, but that felt exhausting and like I was being split open, so I settled on side-lying in the bed. The midwife checked my cervix again just to make sure that I hadn't somehow dilated all the way to 10cm. I still didn't want to know where I was at, but later I found out that I was 6cm, so I was progressing faster than I had been before.

It was now about 7am, which meant it was time for a shift change. Midwife Nikki and nurse Meghann took over for the Jessicas. I was still having a lot of trouble with feeling the urge to push with a lot of the contractions. I was able to manage the pain of the contractions fairly well, but having to fight the urge to push at the same time was extremely difficult. Meghann was really firm with me about this. She got close to me and told me that if I let myself push, my cervix would swell and I had to breathe through it. I remember her standing over the bed coaching me to breathe through the urges. I kept this image of her in my head even after she walked away. It really helped me to have the strength to keep fighting the pushing urge.

After a couple more hours I was really beginning to feel exhausted and a little defeated. Breathing through the contractions and fighting the urge to push was so difficult--I hadn't anticipated it or even known this could happen and I was not at all prepared to deal with it. I was still throwing up occasionally too. i asked my doula if there was anything else that I could do to get through this. She checked a labor book by Penny Simkin and said that the recommendations were gravity-neutral positions, which we had already tried, or pain relief like epidural. It was actually a huge relief to hear the word epidural. I had been starting to talk myself into an epidural and hearing this made it seem like more of a feasible option. Before making a decision about it, I wanted to talk to the midwife and see how much longer it might take. Nikki came in and checked my cervix again and this time I opted to find out where I was at. I had dilated to 7cm, but there was a little bit of swelling. I asked how much longer it would be and she said there was no way of knowing. Everyone was very supportive, telling me that they thought I would be able to get all the way dilated by myself. I had a few more contractions to think about it and to see if I really thought I could keep going like this. I decided that I didn't want to keep it up with out some pain medication. Although I was a little sad to be giving up my plan of a medication-free birth, I was already feeling successful because I had dilated all the way to 7cm! This meant that my cervix really was not stenotic and my body was working! I also felt that since I was already at 7, the epidural wasn't going to significantly slow down my progress.

The anesthesiologist arrived quickly and the epidural was in by 10am. Immediately I felt better. I even have a better memory of everything that happened after this. I wasn't feeling any pain at all from contractions and everyone took the opportunity to get some rest. I dozed for about an hour and a half and then I started to feel the pain of contractions again, but at a lower intensity. Just after noon Nikki checked me again and I was at about 8-9cm. It was getting close! I was feeling really hungry at this point but unfortunately because of the epidural I couldn't have anything to eat other than a popsicle. The epidural seemed like it was wearing off as I started to feel the contractions really strongly again, including the pushing urge. The anesthesiologist came in to add some narcotic to the line but it didn't seem to help. I kept feeling like I had to push. Nikki checked me again and I was almost complete, but there was a little lip of cervix in the way. She asked me to push with the next contraction while she tried to hold the lip out of the way to see if I could push past it. Unfortunately, that didn't work and she also noticed thick meconium staining the amniotic fluid for the first time. The meconium prompted a change in plan. Nikki recommended that I get some Pitocin to get me progressed to complete as quickly as possible. The birthing would also have to be different--if baby did not come out screaming, they would need to have a pediatric team on hand to suction the meconium out so he didn't aspirate any of it. I wouldn't get to hold him immediately and no delayed cord clamping. Of course, I agreed to this since the most important thing was his health.

I got the pitocin and continued feeling like I had to push. Nikki checked me one last time and declared it was time for pushing at 2:20pm. I had Andy put on some more upbeat music and started pushing. It was a huge relief to not have to hold back the pushes through contractions but to really push with all my might. It was really hard work though! I hadn't really done any work to prepare myself for pushing. I just kept talking to my baby and telling him we were going to do this. I had not come this far to give up now! After pushing for an hour and a half, Logan Michael was born at 3:50pm. Because of the meconium, they took him immediately to the warmer where the pediatric team suctioned out all the meconium. It only took a few minutes and then they brought him to me for skin to skin bonding and nursing. We just stared into each other's eyes for a really long time. This was the big reason that I wanted a VBAC. It was the most amazing feeling in the world to hold my newborn baby after doing all that work. The first breastfeeding attempt went well and I really feel like we bonded immediately.

The recovery has been night and day from the cesarean recovery. I did end up with a second degree tear and stitches, so I have a little pain when sitting on a hard surface, but it's no big deal compared to the pain of having my abdomen cut open. I'm able to walk around much easier, I can pick up and hug my three year old, and I can easily get out of bed. Not to mention that my mental and emotional state is so much more positive. I really think this was an absolutely wonderful birth experience.