International Cesarean Awareness Network

Northern Virginia Chapter

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Eliza's Hospital VBAC

Joining ICAN was pivotal in my journey after C-section. I owe many thanks to the many members who have provided and still provide so much support to me.

My first baby, Theo, came via C-section 9 days after his due date, after about 30 hours of contractions, half of which were spent on my back in the hospital after my epidural. He was posterior ("sunny-side up") and despite two and a half hours of pushing when I was dilated to 9 centimeters, he never made it down. A quick slice across my belly and he was out, safe and sound. But I had wanted a natural birth, and so when I became pregnant again a year and a half later, I joined ICAN at the recommendation of a friend. I knew I wanted a new OB but wasn't sure who, so over the course of several months I tried out three OB offices for my prenatal visits, meeting with 6 OBs in all.


At the beginning of my third trimester I ultimately decided to go with Dr. Tchabo on the recommendation of many ICAN members. Although he didn't do much at the delivery (he basically showed up at the end and instructed the resident who caught my baby), every time I met with him at my prenatal appointments he boosted my confidence. He said that if anyone could have a VBAC, I could. He told me, "You were made to do this." Maybe I could have hired someone else to tell me that, but hearing it from a doctor when so many others had told me I probably couldn't do it was the boost my psyche needed.

I worried throughout much of my pregnancy, mainly that maybe my body couldn't physically push out a baby. I had tried labor and had failed. I wasn't like many VBAC moms I knew, whose C-section babies had been breech and whose ability to labor hadn't been tested until their successful VBACs. I wondered if I could really do it.

My second pregnancy went great. I exercised, tried to eat well, and tried to get enough sleep. Matt and I hired a doula. Since I had gone to the hospital too early with my first birth (I was at a 4 with contractions 10 minutes apart), I decided to stay at home for as much of my labor as I could stand.

I read Birthing from Within by Pam England towards the end of my pregnancy. Henci Goer's The Thinking Woman's Guide to a Better Birth was a good complement to that, because she focused on facts, but Birthing from Within helped me in the way I needed most: confidence that no matter what my doctor or nurse did, I could have ultimate control over my actions and reactions. The mantra "Labor is hard work - it hurts - and you can do it" from BFW stuck in my head and I wondered if maybe I could do it. That hope and belief were what I needed most in those final weeks.

My 40-week OB appointment was on a Friday. Throughout my pregnancy I had been feeling a ridiculous amount of movement, but it had started to slow down that week. Nothing alarming, really, but I mentioned it to Dr T, and he immediately asked if I wanted a non-stress test. My immediate reaction was NO! since my last NST, a few days before Theo's birth, turned into a horrible marathon day at the hospital. So, he suggested I do kick counts instead (count the baby's movements within an hour).

Still, the suggestion of an NST at only 40 weeks made me nervous. I was extra nervous because the baby had moved to my right side, facing left, which may indicate a face-up position at birth, which was one of the problems with my first birth. Dejected about the position and the suggestion of an NST, I e-mailed my doula. She told me to do the kick counts but try to relax, do something for myself, do lots of pelvic rocks, which are supposed to move or keep the baby in the proper position, and enjoy this time with my family.

I spent the rest of the daylight hours in a frenzy of cleaning. To give you a peek into my afternoon, I scrubbed every single miniblind on the two gigantic windows in our bedroom. Blind by blind.

After going to bed with an excruciating headache on Saturday night, I woke up with a start at 1:30 a.m. to an even bigger contraction. I lay there for a while, thinking, "Well, maybe this is it." It was my official due date and I was pretty surprised, having expected to go several days over again. Theo's labor had started with contractions about 10 minutes apart, which didn't get closer together for almost a day, so I thought I should try to rest in case I had a similar labor in front of me. Imagine my surprise when a couple of minutes later another contraction came, and then another. The baby was still facing the wrong way, so I could feel them in my back too. I dragged myself out of bed and tried sitting on my exercise ball. I tried various positions. I couldn't get comfortable and Matt was asleep. I decided to try a bath to relax myself so that I could sleep.

I started falling asleep in the tub despite contractions and hoped that feeling would transition to my bed, but it was not to be. Matt woke up on his own...I was being kind of loud in my "coping"...and I instructed him to go sleep on the couch so I wouldn't keep waking him up. So he moved to the living room and I continued coping. After a half an hour, probably less, I couldn't take it anymore and went into the living room. I woke Matt up again and told him, "I can't do this by myself." So he turned on the light and started counter-pressure and timing.

After a few hours, the contractions came faster, some even on top of each other, about a minute long each, and the baby hadn't rotated, so I asked Matt to call our doula at around 5:30 a.m. She instructed him to have me crouch with my head down for an hour...a last resort for rotating a baby during labor. Matt also called my cousin to come watch Theo.

I lay on my bed on my left side with my eyes closed throughout most of my labor at home, the most comfortable position for me, despite Brenda's suggestions to get up on all fours. I remember Brenda kept telling me, "This is what you want," which was one of the affirmations I told myself during pregnancy ("This is what I want" - meaning a natural birth to increase my chances for a VBAC). It got so annoying that finally I told her, "No, this is not what I want." After an hour or two of thinking to myself, "This is a crock. I want an epidural," I gathered up the courage to inform Matt and Brenda of this decision. They didn't refuse, but instead suggested I try getting through a few more contractions. This exchange would repeat itself several times over the next few hours.

I started a funny little routine (which my husband and I now joke about) of calling out, "Help!" as soon as I could feel a contraction coming. Then Matt would push against my back and Brenda would kneel by the side of the bed and talk to me. In between contractions I was tired enough that I dozed off for a few seconds each time. At around 8:30 a.m. I got into the tub at Brenda's suggestion. I hoped this might help and it did not. Being in the tub felt awful and I was super-cold. So I got back out and lay back on my side. Soon I began feeling the urge to push when my contractions peaked. I remember asking Brenda, "I can do this, right?" What I meant was, "I can still have a VBAC with an epidural, right?" (She had had her first VBAC with an epidural.) But re-reading the birth story Brenda wrote for us, I see that she thought I needed her to tell me I could do it without drugs. At any rate she started telling me "You can do this," and regardless of what she meant, it was helpful.

By 9:30 or so I was convinced that I was going to deliver this baby right there on my bed so Matt called Dr. Tchabo. I told Brenda I felt like pushing and she said, "We need to go to the hospital now." We got up to walk to the car, a feat I was entirely unsure I could accomplish. Matt sped the whole way there and I lay on my side on the back seat, pushing my feet hard against the side door and twisting Matt's arm with every contraction. He even ran a few red lights (so did Brenda) and it was pretty much your stereotypical rush to the hospital.

We arrived at the hospital and Matt helped me walk to the elevator. We went to the check-in desk and the nurse was like "Blah blah blah, something something, insurance card" until I yelled, "I have to push!" Then they wheeled me to a room right away. They offered me a hospital gown and I said no thanks. A resident checked me. For some reason I thought she had broken my water and I started yelling at her, "Why did you break my water??" "Ummm, I didn't break your water" but I didn't believe her.

And the verdict: I was at a seven. I was astonished that I wasn�t at a ten. I had been convinced the baby was about to take its first breath as I sat in a wheelchair.

Anyway, so the circus continued for about 2 more hours. The nurse put various consent forms in my face and kept putting them there until I signed them..."signed" them, I kinda just hit the paper with the end of a pen a few times after making sure I wasn't letting the hospital keep my baby or something. Did you know that legally you don't have to sign any of those things? However, if you decide to refuse, they will keep putting them in your face anyway.

The nurses, the resident, Matt, and Brenda all encouraged me not to push, although I really, really needed to. I yelled a few times and again, a nurse told me not to - so that I could conserve energy. I think I was a little bit sassy with her. Despite my insistence not to be monitored continuously, they stuck one on me "until Dr. Tchabo comes." Fortunately I barely noticed it. I also had to have a heparin lock IV (not connected to the pole), because I was beta strep positive and needed antibiotics, although I didn't receive any fluids. I was glad we went to the hospital so late, because I was still pretty sure I was going to get an epidural. Convinced, really. Then Dr. Tchabo came in around noon, checked me, and just when I took a breath to suggest yet again that we call the anesthesiologist, I heard him say, "You're complete. Push when you want."

My pushing phase with my older child, Theo, was awful. It was absolutely the worst part of labor. With Theo, I pushed for 2 hours with absolutely no progress, my epidural having worn off after 24 hours of labor. But this time around, when it was time to push I hopped up on the bed like a woman with a mission. It felt amazing. Contractions stopped hurting, I had no concept of time, I was euphoric because I could feel the force of the baby inching down and I knew I was doing what I was supposed to do.

On my first or second push, my water broke with a rush and I thought frantically, "This is it, this baby is coming out!" Not so much, but it still felt good to push and I didn't mind. I think by this point I was kneeling or squatting on the bed, eventually leaning over the back of the bed. At some point a nurse put an oxygen mask to my mouth because there was meconium in my water. People stuck Popsicles in my face. I pushed when I felt like it. I yelled a lot. This went on for about 20 minutes. Then Dr. Tchabo broke down the bed and asked me to sit at the edge and a nurse told me to hold my breath as I pushed. "Nope, no, I'm not doing that," I answered. "I am not holding my breath. Last time I did that it ended in a C-section." By this point the room was full of nurses and residents and doctors (probably around 8 in all) and they all laughed. "This is definitely not ending in a C-section," someone said, and that was the first time I believed it would actually happen. I had spent hours dreaming, thinking, praying, talking about it, but never knew until then. Matt kissed me and said, "You're doing it. You're doing it."

Face-up baby, "narrow pelvis," scar on my uterus, I was doing it.

I pushed and yelled and it was over. They put the baby on my lap. For the first time since before labor started I thought, "Boy? Girl?" I looked for the evidence. I can still remember how I sounded and felt when I saw her and said to Matt, "It's a girl!" They took her away pretty quickly because of the meconium, but she was back within moments, all weighed and wrapped and ready to be hugged and kissed. She was normal. She was healthy and perfect.

I proceeded to instruct the student and resident that they should encourage VBAC for healthy moms in their future practices. I nursed Ida and barely noticed delivering the placenta. After 12 hours of feeling so, so bad, I had never felt so good. I was a chatterbox. I was probably kind of annoying actually. It was amazing how the worst pain I could imagine went away as soon as she came out.

So, it hurt a lot. It wasn't magical or dimly lit with candles and incense. It was pretty crazy and I hated much of it. But in the end when Ida was almost here and I felt her moving down, turning inch by inch into the proper position, all those feelings of exhaustion and helplessness vanished. I could never have prepared for that abrupt change. Certainly the most exciting, probably the craziest, possibly the best day of my life.

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