I'm finally getting some time to sit down and type this out. I've been so busy with baby and toddler that I put it off longer than I wanted - I'm hoping I can get all the details straight. I will be requesting my records for this birth again, just so I can have every bit documented!
Bronson Andrew was born 12/20/10 at 6:36 pm via successful VBAC! 8 lbs 0.2 oz, 21.5 in long.
As some of you read in my earlier post, I had about a week of prodromal labor. The contractions got increasingly more intense each night until the last few nights before I actually went into labor (40w3d). They weren't as timeable or as uncomfortable the last few days. I had lost my plug at midnight on my due date (12/17) and was just sure I would have him that day. With my daughter that was the beginning of labor. It wasn't the case this time. The contractions continued to fizzle out in the morning and come back in the evening. Finally on Monday morning (12/20) around 2 am they started back up again and were 5 minutes apart from the get go (much closer than they had been for a longer period of time). I got out of bed and made a cup of tea to see if they stuck around. Previously when I got up, they went away. They ended up sticking around and went in intervals from 5 minutes apart to 3 minutes apart. I kept reminding myself that I needed to stay home as long as possible. It made me a little nervous considering I had to call my mother to make a three hour drive to come watch my toddler. I didn't want to call her and have her drive in the middle of the night if it was a false alarm.
By 6 am, I woke up my husband and told him I was going to call my mom and get her moving. At this point the contractions were moving into the 3 minute apart range. My mom is slow as molasses, so we decided to call L&D to see what they had to say in case we needed to make a move. The contractions were uncomfortable but not unbearable at this point. As I expected, L&D wanted me to come in because of the contraction timing. I had discussed with my doctor coming into his office to get checked out before going to L&D and since it was getting close to time for his office to open, the plan was to see him first. My husband started getting paranoid about me delivering in the car because some contractions were coming 2 minutes apart. We decided to call his mom (lives in town) to come watch our daughter until my mom got there and head to the doctor's office/hospital.
At some point on the car ride over, the contractions got more painfull and I decided that I probably didn't need to go to my doctors office and that we'd just head to labor and delivery. They are located in the same complex, but I just didn't feel it was necessary. We get checked in to labor and delivery triage sometime around 8am and hooked up to the monitors. I was definitely in labor so they wanted to contact my doctor. I was optimistic at this point, until the nurse gave me an internal and I was still 2cm dilated but was now 100% effaced (barely up from 2cm/80% at my 39w visit). I was feeling a little defeated considering all of the nights of contractions but knew it was just the way my body was handling things. My doctor came into triage about 45 minutes later and I was 4cm. My spirits were up at this point, but the contractions started to hurt like hell. Up until this point, my plan was to go unmedicated but my plan was slowly fading
The hospital was JAM PACKED with CS, inductions, spontaneous labors, hysterectomys, tubals, you name it. Because I was planning on going unmedicated, my doctor wanted me to labor in triage until they could ge a large room open for me so I could have the birthing tub out. I needed something for relief - I was tired of waiting with excruciating contractions for the tub, or a shower, or anything. I remembered being in the same exact amount of pain at the same dilation with my daughter and was ready for the epi. I would have liked to go med free, but I realized it just wasn't for me.
Once I put out the word that I wanted the epi, things got on the fast track. I was put in a room between 30 minutes to an hour (longest wait of my life) and the anestesiologist bumped two patients to get me my epi (I can only guess I was visibly/audibly in more pain to the nurse, instead of a patient that showed up with the immediate intention to get the epi). The nurse checked me again and I was at 5cm. At this point, I'm guessing it was around 11 or 12ish everything was looking good and we thought we were on track. Dilation was happening as they like to see it, and baby was tolerating the contractions well (wasn't the case with my daughter).
My doctor came back and checked me a few hours later and I was still at a 5. I had been stuck at a 5 for several hours and his head wasn't engaged so after much discussion, we decided to break my water. This is where the problems started. The actual act of breaking my water was fine, but I had meconium in the fluid. I felt my heart break a little when the nurse said to me, "Do you know what it means when the water is brown?" I replied that I did and we went from there. The nurse checked me, still at a 5 and baby was sunny side up. My doctor came back and checked me, still at a 5. I am really gettting stressed and emotional at this point. We discussed the benefits of starting pitocin at the lowest level (2) and seeing if it helped. My contractions appeared to be strong enough and very close together but figured maybe the pitocin would give me the push to strengthen the them enough to get his head onto my cervix.
At next nurses check, I was still at a 5 and my cervix was starting to swell. She talked to the doctor and they turned my pitocin off but at this point I was starting to worry the I wouldn't dilate any further due to the swelling. The time frame from this point on gets fuzzy, but when the doctor came back to check me and stepped out for a minute, baby had a decel that caused a flurry of nurses to come into the room and start me on oxygen and position changes. This was the point in labor with my daughter that was the decision point for my doctor to go forward with CS so in my mind, it was all falling apart with this labor.
My doctor came back in and checked me and I had progressed to a 7 which brought back my confidence, but then let me know that it appeared that my baby had passed more meconium and my body needed to start dilating fast. There would be no more baby on my chest immediately after delivery - respiratory therapy would have to be present to intervene, or of course there could potentially be another CS. I was just trying to breathe and focus on him coming down and out. Baby's heartrate was starting to spike with the contraction and dip with the lull - which is opposite of what they want to see. Apparently my placenta was not up to the job any more and it wasn't providing the oxygen and protection from stress it was intented to provide. Things aren't looking good at this point. I put myself in my doctors hands and stayed focused on my body and my baby.
Next time the doctor came back I was almost complete with a slight lip. I almost cried when I heard that we had almost made it. He had me push through a contraction as he held the lip out of the way, and there it was: 10 cm, time to push. I pushed for an hour and a half with everything I had in my. My doctor coached the hell out of me, and my nurse and husband did everything they needed to do to help me on my way. At points, the doctor was concerned I would need some sort of assistance (vacuum) getting him out, but continued to push me to push harder. He was about as hell bent as a doctor can be on seeing me VBAC without being reckless. I had to stop pushing for several minutes at the end while waiting for the respiratory therapist team to arrive for delivery. It was the first time since getting my epidural that I felt any sensation down there. Pressure! I stared at my babies head in the mirror as I anxiously awaited his arrival. At 6:36pm I gave my last push and Bronson was born as I watched. It was the most surreal thing I have ever been through in my life (unless you count the drug haze I was in for my CS - that was pretty surreal too!)
My husband was able to cut the cord before he was brought to the respiratory team, and I was able to hold my baby within the hour as opposed to the two or three hours with my daughter. I had a second degree tear, and got some wicked hemorrhoids but the recovery has been so much easier than my CS. I am so thrilled and blessed to have been able to successfuly accomplish this goal. I am overwhelmed with thanks to my husband, doctor, and L&D nurse for their positivity and faith in me.
My advice to anyone attempting VBAC:
1) Do your research, but prepare to see it all go out the window. Don't get such a distaste in any intervention that you don't use it to your advantage. Conversely, don't give in to intervention unless you truly believe it to be of benefit you. You don't want regrets regardless of what happens
2) If your doctor isn't on board, you won't have the experience you want. Same goes for the rest of your medical team. At all the low points in labor, I felt that if I needed the c-section, at least I had a doctor that went to bat for me and pulled out all of the stops. I was lucky enough to have found a fabulous doctor and a L&D nurse that was hand picked by my doctor to care for me.
3) Try to stay within the recommended weight gain guidelines, and remain as active as you can possibly be during your pregnancy. I truly believe it benefitted me to be in such good shape for labor and pushing. My last workout of the pregnancy was on my due date.
4) See the chiropractor and/or accupuncturist, take the evening primrose oil, drink the red raspberry leaf tea, sit on the birthing ball daily - EVERYTHING helps.