Friday, October 23, 2015

My VBAC Birth Story

I wrote Noelle's birth story down in the first few weeks following her birth, and I admit, I've kept it to myself intentionally. A year ago, I experienced something life-changing, and I held it close, to enjoy it, to soak it in. But I always intended to share it, and I'm ready now. I hope it encourages anyone out there who finds themselves feeling the same way that I did.

Disclaimer -- this post is not intended to be medical advice of any sort, and should not be misconstrued as such. This is simply my story, and the thought process I went through based on my own personal circumstances. All decisions made were based on in-depth discussions with my various medical providers. 

Here we go...



My VBAC Birth Story

I didn't want another c-section. That's where my story starts -- I wasn't even pregnant yet and I knew I wanted my next birth to be different. I wasn't quite sure what that would look like, but I knew I didn't want it to end in surgery. My c-section recovery had been long and painful, and I couldn't imagine going through that again with two children to care for. So, I started researching this concept of VBAC, or Vaginal Birth After Cesarean.

Let's move to a lighter subject, shall we? A few days before I learned I was pregnant, we tried out a new (to us) gourmet mac 'n cheese restaurant in Oakland, called Homeroom. I devoured my AMAZING sriracha mac 'n cheese...and spent the rest of the day feeling uncomfortably bloated and tired. And devastated -- I thought I'd never be able to go back to this glorious mac 'n cheese institution again if I felt THIS gross. Three days later, I still felt like a hot air balloon -- man, that mac 'n cheese really did a number on me! I was heart broken. Day 4 post-mac and still feeling like I might float off the earth, I realized I was late (and not in Alice's white rabbit sort of way). I promptly took a pregnancy test, and was thrilled to learn that (1) my son would be a big brother and (2) the mac 'n cheese was NOT to blame for my unreasonable flatulence. Gotta love that good ol' pregnancy gas! Anyone up for some mac ‘n cheese?

So, now that you and I have reached the comfortable, talking-about-farts-and-using-the-word-"vaginal" stage of our relationship, let's get back to the story. I kicked my VBAC research into high gear. After a tremendous amount of reading, including understanding the recommendations and precautions of the American College of Obstetrics and Gynecology, I came to three conclusions:

1. I, without a doubt, wanted to avoid a repeat c-section, unless it was truly medically necessary.
2. I believed my best chance to achieve said VBAC was through a completely natural (no drugs, no intervention) delivery.
3. I would have to fight hard to VBAC in a hospital.

I quickly learned that my VBAC-tolerant hospital would not allow *me* to VBAC in their facilities, simply based on the fact that I did not have a "proven pelvis." My OB stated I was a perfect VBAC candidate otherwise, but that my lack of a prior vaginal birth was making my "VBAC score" too low. I'd have to deliver at a hospital over an hour away (in traffic, it would easily be 2+ hours away). Awesome. The one loophole I could leverage to deliver at my hospital would be to show up pushing, but I'd be subject to many limitations based on hospital policies that actually impede the birthing process. Not exactly the supportive environment I was hoping for. I also couldn't help but think my hospital probably doesn't do many VBACs if it's *this* hard to "qualify." Turns out, I was right about that, but that's another story for another day. Do I really want to birth some place with such little VBAC experience? But the bottom line is that for me and my particular circumstances (not speaking for anyone else), a VBAC was safe and appropriate, according to ACOG, over a repeat c-section. 

I realize the prologue of this birth story is getting long. We'll get to the good stuff soon, I promise.

After even more research, talking to local doulas and experienced hospital VBAC-ers, and a whole lot of prayer with my husband, we decided to investigate HBAC, or Home Birth After Caesarean. We met with a midwife who came highly recommended and had a tremendous amount of VBAC experience. Wow. The feeling of peace we felt after that initial meeting was incredible. Her approach to childbirth was exactly what I wanted, and she had a thorough plan outlined for handling emergencies. I could go on and on about the reasons why we felt home birth was the right choice, but I don't think that's why y'all came to read my story. All you need to know is that we made this decision very carefully, prayed through it, and felt incredible peace about it.

For those who remember my son's birth, he was born at exactly 34 weeks. So, naturally, I wanted more than anything for this pregnancy to go full term. I had a healthy, normal pregnancy with no signs or risks of again delivering prematurely. Until the evening of the 35 week mark -- exactly one year ago today -- when my water broke without warning at 11:15pm, exactly as it happened with my son. Unfortunately this meant I would not be able to deliver at home as I had hoped, but I still felt confident this birth could be different. We called our midwife and worked out our plan to labor at home (many precautions were taken to ensure there was no risk for infection). She prayed over us and made plans to come to our house in the morning to see how my labor was progressing. She arrived around 10am the next day and spent several hours with us, running tests, checking my vitals, and talking us through our options. I had maybe a handful of very minor contractions since my water had broken, and had felt about the same number of tiny leaks of water over that time frame -- a part of me hoped that meant my water bag was resealing and that I could remain on bedrest for two weeks until I became full term. But deep down, I knew that wasn't going to be the case. I was in the very early stages of labor. By afternoon, my contractions were coming in regular intervals, but only lasting 20-40 seconds. Around 10pm, they were 7-8 minutes apart and growing in length -- and intensity. I now needed to "take a moment" to get through them, though it was certainly not unbearable yet. My midwife returned to our house at that point and stayed with us throughout the night. Our amazing friend Lori (she’s an angel, seriously) showed up around the same time to spend the night and watch our son in case we needed to leave in the middle night. I labored throughout the night, with contractions coming every 5-7 minutes and lasting 60-90+ seconds. The intensity became such that Brian coached me through each and every contraction all night long, helping me stay relaxed and make low, open sounds with my mouth. He rubbed my back, legs, did counter-pressure....everything and anything I needed to get through the contractions. I honestly don't even remember him taking bathrooms breaks, though I'm sure he must have. He was there at every moment I needed him. He continually reminded me that I could do this.




I wish I could accurately describe how I felt in this moment. I felt frustration that I didn’t make it full term, yet I felt peace because I had everything prepared for the baby by 34 weeks, just in case. I felt relaxed to be at home, with my husband and midwife caring for me. I felt this strange awareness that I was in the midst of doing something that scared me and that I was going to finish it, someway, somehow. It wasn’t fear in the sense of being afraid of pain. It was like this: I had spent the duration of my pregnancy convincing myself I was capable of a vaginal delivery just like any other woman, that I was carefully crafted to do this, that the broken trust between me and my body would be redeemed. But now as I labored – REAL labor, that I had only ever experienced before as a miscarriage – I had inklings of doubt sneaking into the back of my mind. It’s amazing, though, as the contractions grew in intensity, how easy it was to lose focus of the fear and doubt. It wasn’t long before I was solely focused on getting through each contraction as they came, and grasping for little moments in between to rest. I drank a lot of coconut water throughout the night, and nibbled here and there on scrambled eggs my midwife had made for me. By morning, I was really in the heat of active labor and we decided it was time to head to the hospital. We had planned to go to Sacramento (an hour away), but at the very last minute I insisted we take our chances at our local hospital where I had our son via c-section two years prior, which was just 12 minutes away. I just didn't think I could make it to Sacramento. The contractions were unbearable. I just knew I was very close. And trust me, nobody dares cross a women in active labor!

My husband, midwife, and I arrived at the hospital at exactly 9am, under the cover of a beautiful rainbow -- the icon of God's promise as one of the last images I remember before entering the hospital. In true, overly dramatic Alison-form, I had a contraction just as the double-doors of Labor and Delivery were swinging open for us, which brought me to my knees screaming in front of the awaiting nursing staff -- what an entrance! As the contraction eased, I thanked the staff profusely for getting us to a room so quickly, and apologized for being so dramatic. They later told me I apologized a lot in between contractions. I was checked and found to be 5cm and 70% effaced -- I was overjoyed! That was more progress than I had made with Samuel. But joy quickly faded with the next few excruciating contractions, which were getting harder and harder to manage (sorry, Ina May!! I tried!). The pain of contractions was taking over. It wasn't long before I was screaming for an epidural, which (for those of you who are still reading are aware) was NOT part of my original plan. Luckily, God is the King of strategic stalling, and I did not get the epidural.

The on-call OB arrived, decided I was actually 4cm -- not 5cm -- and sternly explained to me that she does not perform VBACs, but she would see if the other doctor on call would be willing to take me, since I was clearly in labor. She left the room. I remember not feeling any worry that they would turn me away or force me into a repeat c-section, but my husband and midwife felt differently, as did my primary L&D nurse, and the three of them began quietly praying over me. I screamed again through a contraction for pain relief, and my nurse raced out of the room to retrieve narcotics. Suddenly, labor intensified tenfold. Whatever deep-seated animal instincts I had buried within me exploded in full force. I shrieked, moaned, and growled through back-to-back-to-back contractions, writhing and shaking the hospital bed, digging my nails into my poor husband's arms and even attempted biting his arm a couple of times -- not because I was "blaming" him for my pain, but because I was simply out of control of my own body, out of my mind, succumbing solely to animal instincts. Turns out, this is what they call "transition." In minutes, the urge to push was becoming more than I could bear, and I cried, "I have to push, I can't stop it!!" My midwife muttered a few Thank You Jesus' and told me, "So push. If your body is telling you it's time to push, don't ignore it. It will get you dilated the rest of the way." That was all I needed to hear. My whole body went limp with a freeing sense of relaxation. I let my body push. My nurse returned at that moment with a syringe of fentynol, but quickly put it aside upon seeing my state. She grabbed a pair of sterile gloves, confirmed I was 10cm, and sighed, "Praise you Jesus," and then told me, "You're going to have this baby." Afterwards, my nurse confirmed it had been exactly six minutes between my 4-5cm check and the 10cm check. Whew!! No wonder I was in so much pain.

The on-call OB hustled back in with a much more supportive demeanor, a change in attitude that could only be God's doing. She told me, "Don't worry about a thing, I will deliver your baby and will take care of the hospital politics. You don't need to worry." Out of the corner of my eye, I noticed tears fill Brian's eyes. Out of the corner of my other eye, I noticed a familiar face from the NICU nursing staff enter the room -- Jane. She'd be assessing my baby once she was born. She was present at my son's miracle birth two years prior. I just love when God sends little reminders of His providence.

I sat up and prepared to push. I no longer felt pain -- no joke. I could feel contractions, but they were working for me instead of fighting against me. Pushing felt so satisfying, such a welcome relief. It still hadn't occurred to me yet that I was doing it. I was pushing my baby out. I was VBACing. Drug free. Natural. It was happening. So, with my midwife holding one leg, my nurse holding the other, and the doctor "manning the helm," I channeled all of my energy downwards while Brian counted down from ten during each push.

I pushed for about 30-40 minutes. My birth team encouraged me so much during this time, giving me updates and assuring me that I was "doing it right." I can't say enough wonderful things about my dear husband, who was a natural coach and supported me so perfectly, it brings tears to my eyes just remembering his focus and selflessness. I'll never forget how his voice sounded when he told me he could see her head emerging -- his baby girl, his precious daughter. I reached down to feel her head -- wow, I was really doing it!! I was pushing out my baby! I took a moment to let that sink in. I was doing what centuries of women had done before me. And still no pain – not even during the "ring of fire." After another push or two, they had me stop pushing and my body took care of the rest. My baby girl Noelle emerged and became a part of this world at 12:16pm. It was life-changing. My whole body radiated with energy. Words can't describe this Heaven-on-Earth experience. She was perfect, weighing 5 pounds, 8 ounces and receiving a ten Apgar score. She needed no NICU time. Did you hear that? None. Absolutely perfect. 

They placed her in my arms, and after some time, Brian cut the umbilical cord. She's been a mama's girl ever since, and I'm out-of-mind in love with her. Where Samuel makes my heart absolutely melt, like a hug that could go on forever, Noelle makes my heart race, like the energy of first love. Our family is complete. Our tender Samuel and our determined Noelle -- they have brought us unparalleled joy. 








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