International Cesarean Awareness Network

Northern Virginia Chapter

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Maria's HBAC

Hana's Birth Story: July 23, 2007

I have been working toward this birth since my first pregnancy. I had hoped for a natural low-intervention birth with my son, Hiro, but I was naive and scared, which ultimately lead to my c-section. Before I was discharged from the hospital with Hiro, I knew I did not want to have another c-section. Josh and I both wanted more kids, but there had to be a better way than an elective repeat c-section. Once we knew everything was OK with Hiro's health, I started to do some research into VBACs (Vaginal Birth After Cesarean). Around this time, my sister-in-law, Rachel, had a successful homebirth with her daughter Eva. This was my first introduction to a homebirth. Even though Rachel had a long hard posterior labor, just like I did, she had a skilled midwife who helped turn the baby so she could be born vaginally. I truly appreciated the difference a midwife can make in a birth after hearing her story. This was the better way I was looking for.

Through the Internet, I found ICAN, International Cesarean Awareness Network. At the monthly meetings, I met other women who had similar c-section stories. All these women who had successful VBACs and HBACs (Home Birth After Cesarean) had educated themselves on the research behind medical procedures, risks and advantages of various options and had taken charge of their own bodies and the birthing process. While I wept through the telling of my own c-section story, I saw that the women around the room really understood my frustrations, anger and disappointment. Through this group, I found such resources like VBAC friendly doctors, books on VBAC, research results, homebirth support, and midwives practicing in the area.

This is how I met Tammi, the midwife who attended Hana's birth. I also heard about Dr, Tchabo, one of the few truly VBAC friendly doctors in the area. I decided to have parallel care, meaning I have each prenatal appointment with both the midwife and OB (obstetrician). It would mean double the appointments but I felt it was vital to have a strong back up physician for my own peace of mind. Once we had chosen our care providers, we went for several tests to rule out possibilities of birth defects, particularly heart defects (my son was born with a hole in his heart). Once all tests came back clear, we were fully committed to our homebirth plans.

The rest of the pregnancy went on quite well. At around 35 weeks, both the Dr. Tchabo and Tammi commented that the baby was sitting crooked in my belly. I had noticed this myself and was beginning to grow concerned because this was the same position Hiro was in for the last few weeks, and in the end he turned posterior and asynclitic. I was not looking for a repeat performance of my long back-labor. At Tammi's suggestion, I went to see a chiropractor. Even though I was a bit skeptic going in, I noticed a difference from the first appointment. Dr. Sean found tension on the left side of my middle and upper back, and after each adjustment, the tension eased and the baby spent more time in optimal position. At least twice a day, I spent about 15 minutes doing the stretching exercises prescribed by the chiropractor, including some yoga poses that use gravity to encourage the baby to stay in optimal position.

I continued to go to work until 1 week before the due date. Since Hiro was right on time, I felt there was enough time before the birth for me to have a few days of rest and relaxation. The following weekend, I was extremely tired and sleepy. The baby felt lower in my belly and seemed to be telling me to take a break so I did just that. Sunday evening, I went to bed looking forward to going to lunch and a movie on Monday, the first official day of my maternity leave.

I woke up Monday morning at 5am with an intense need to go to the bathroom. After I emptied my bladder, the pressure moved to my pelvis. I went back into bed and got on my knees and elbows (child's pose in yoga) and let my belly hang. After an hour and about 5 contractions later, I realized they must be about 20 minutes apart and this might be it. By this time, Josh started to get up to get ready to go to work. I promptly told him this may be it and that I wanted him to get Hiro to day care as soon as possible. Since labor with Hiro lasted over 20 hours, Josh didn't feel the urgency in the matter and went ahead with his morning ritual. By 7am, the contractions were so intense, I was moaning through them and having a hard time staying still. There didn't seem to be any position that was comfortable. Josh applied counter pressure on my sacrum during each contraction, which helped greatly. I repeatedly asked Josh to call Tammi, but Josh kept insisting on timing "one more contraction"much to my dismay. He had expected a long early labor just as I had and it was hard for him to comprehend just how quickly this was progressing. Although I knew instinctively that there was little time to waste, he expected another long labor and didn't want to act too hastily.

By 8am, Josh had dressed, fed and taken Hiro to day care and left a message for Tammi. 15 minutes or so later, Tammi called us back. She asked to speak to me, but I was breathless and incoherent. "How are you doing?"asked Tammi. "It's 'really' intense" came my reply. "Can you talk through your contractions? What?... What was that?..." Tammi got on her way. By this time, I was kneeling next to my bed with several pillows piled up to lean against. Josh hurriedly got the bed sheets set up with the plastic liner and got out the manual for the Aqua Doula. However his progress was slowed by my need for his counter pressure every few minutes. I kept pulling him away from the pool to apply counter pressure on my back, but I was also growing increasingly impatient with the slow progress in getting the pool ready. I needed three of him that day. This was also about the time all sorts of thoughts of self-doubt came up for me. "This is why epidurals were invented! If I was at a hospital now, I would be begging for one about now! What am I doing at home, I should be at a hospital. I can't take any more of this! I was supposed to go see a movie today!"

Then, before Tammi arrived, I had a very different contraction than the ones I had been having all morning. I suddenly screamed, "I want to push!!!" I never had this urge to push with Hiro because I was on epidural by that time. It was an undeniable urge that I could not suppress. After a couple of contractions like this, Tammi arrived. She immediately kicked into gear and helped finish setting up the pool and helped me get in even before the water was full. Aaaaaaaaaaahhhhhhh, what a relief. This is why women choose waterbirth. Although the contractions were still intense, I did feel a sense of relief and relaxation spread through my body that gave me strength to go on. I labored in the pool, switching positions a few times. Lori arrived at about this time. I pushed and pushed and felt every fiber of my body working to get this baby out. I also talked to the baby through the contractions, urging her to come out. My pelvis was spreading so much that I felt as though my legs were going to pop out of their sockets. Thank goodness they didn't. Tammi and Lori kept checking the baby's heart rate and it maintained a good steady beat. Through it all, I kept concentrating on the contraction at hand, hoping it would be the last, telling myself, "Just one more push," even though more kept coming and coming. Tammi, Lori and Josh all encouraged me to keep pushing and told me that everything was fine, the baby's fine, and that I'm doing great. After a few more pushes, Tammi told me to feel the baby's head crowning. All I felt was flesh, I couldn't quite recognize it as her head. I wasn't even sure which parts were mine and which were hers. I pushed and pushed, hanging onto Josh with all my might, but the baby was not coming out. Tammi reached in and tried to open my perineum to give the baby more room. This hurt immensely and I believe Tammi was attempting to help me tear, but it was not happening. The baby's head just could not pass through. Tammi and Lori conferred with each other quickly and decided it was time they gave me a little help. They eased me out of the pool and got me back on the mattress set up on the floor where Hiro sleeps (when I'm not having a baby on it). They explained to me that they are going to give me a little snip to help make room for the baby. I was so exhausted that I welcomed the offer of help. After Lori's careful episiotomy, Hana popped her head out with one push, and the rest of her came out with a final push. It was 9:47AM, less than 5 hours since I felt the first contraction.

Hana was immediately placed on my chest where she stayed for the next hour or so while the crew got to clean-up duty. Hana was all pink and alert from the instant she popped her head out. She nursed right away with a very strong latch while looking directly into my eyes. The cord was cut about an hour after the birth, once Hana had taken in everything she needed from it. Josh cut the cord to separate the baby from the cocoon she lived in for 39 weeks, something he did not get to do the last time around. Hana weighed in at a healthy 6 pounds 14 ounces, only 3 ounces shy of her big brother's birth weight. After everyone took a little break and got something to eat, I was stitched up and cleaned up. I was even allowed to shower right away, a pleasure I was not allowed for several days after the c-section. Once I had eaten (I was ravenously hungry) Tammi and Lori left with big hugs. I tried to sleep the rest of the day, but my adrenaline was still running high and I was in disbelief over the rapid progression of events. The whole labor and birth kept playing over and over in my mind and I was in awe of the little baby in my arms. As hoarse as I was from all the vocalizations, I called family and friends to spread the news. I wanted desperately to talk about it with anyone and everyone to make the experience real to me, otherwise I was afraid it would have all been a dream. But it wasn't a dream. It was very real, as the after-pains reminded me during each feeding. While I was slightly disappointed with the episiotomy, it was a judicious use of an intervention that was required in this case. It took a frustratingly long time before I was able to walk properly and sit without pain. However, I was elated over my HBAC and happy to be in the comfort of my own home. I had never imagined this scenario when I was visualizing the birth, but it was very satisfying and incredibly exhilarating. This was the birth that birthed not only Hana but I felt reborn as a mother, because I took charge of my body and the pregnancy in a way I didn't before. Thank you to Tammi, Lori, Josh, Hiro and all my family, friends and members of ICAN who helped me on this journey.

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