How to prevent another failure (or, more positively, how to achieve success!)

[AGSmomma]

Hello fellow moms,

I'm new here. I want to briefly share my story and ask for advice on preventing CBAC, specifically how to manage difficult labor.

With my first pregnancy, I worked with a CNM at a birthing center and had planned a nice calm waterbirth, like so many women desire. To my surprise and dismay, my labor started out extremely painful. From the very beginning the contractions were overwhelming but unproductive, and since my son's head was "sunnyside up" the spinal pain was severe. I was vomiting every few minutes and couldn't even breathe through the contractions. After hours of trying different positions, birthing ball, walking around, on all fours, etc. I was only 1.5 cm dilated and totally unable to manage the pain. None of the breathing techniques I had learned were of any use and I was totally unreachable and inconsolable. When I went to the birthing center, hoping to remain there for the rest of the time, I was given a pain shot and sent home. Looking back, this seems like the beginning of the end. My labor did not progress at all and when I returned to the birthing center hours later the midwife saw how I wasn't able to manage the pain and told me that I was a good candidate for an epidural. So off to the hospital I went, but she did not accompany me because it is her policy to only accompany medically necessary transfers. I had no advocate at the hospital and the cascade of interventions began. Epidural, catheter, Pitocin, oxygen mask, internal fetal monitor...unable to change position -- I felt scared and alone, even though my husband was there with me. He didn't know what to do, and when my labor completely stalled at 4cm and they suggested a c-section, I had no more energy left to argue. They had convinced me that my baby was in distress and that he would not fit through my pelvis. This, of course, is not true, but at the time I didn't know that.

To add insult to injury, I had insufficient anesthesia during the operation and suffered a great deal of pain.

My son is healthy and amazing and I have come to grips with the fact that my birth experience was not the one that my heart desired. I am lucky to have a beautiful baby who is now 17 months old.

My husband and I are planning a second baby and I am determined to avoid another unnecessary c-section. I would like to have a homebirth and I have begun researching and reading stories from HBAC moms. The thing is, none of the stories I've read mention any of the problems I had during the early stages of labor. For most people early labor seems nonexistent or not very painful. Why was it so unmanageable for me and how can I prevent the same thing from happening? I know that I need a lot more emotional support than I had before. I am convinced that was a major factor. My anxiety level was through the roof and I felt like I had no one cheering me on. So, I plan to have a doula as well as a midwife, and hopefully this time my mother can also be in attendance (we currently live far away from family but are soon moving closer).

Can anyone give some honest advice on the psychological/emotional difficulties that can occur in extremely painful labor? I am truly desperate to avoid another hospital experience, although I understand that real emergencies do occur. But my previous hospital transfer did not constitute an emergency and I deeply regret it.

Thank you! I hope to participate in these forums a great deal now that I've found this site.

[CookAMH]

A doula can greatly help. I think your midwife failed you in not helping you with more positions that the laboring mother might not think of herself. I had a situation with a couple similarities to yours and I am fully confident that had I hired a doula and had my midwife been more helpful with positions, DS could have turned from being posterior late in labor. My hospital transfer from the birth center also wasn't an emergency and neither DS or I had any distress when the c/s occurred.

I have read that posterior babies can cause labor to "stall".  Their position can only dilate the cervix so far, but if they could turn, labor would progress.

I chose a homebirth for this coming baby (april) and am very confident in my ability to birth despite my first labor.  You can be too, especially if you have the right support instead of, here take a pain killer, go get an epidural. You needed pain relief, but you also needed a lot of expertise and hands on physical support to get you into the positions to get the baby turned. It requires time and a lot of support.  And there are physical hands on things your support people can do for you for the pain.

And I am SO sorry about the pain of surgery that you were made to feel.

[AGSmomma]

Thanks so much for your reply. I look forward to reading about your upcoming birth (I hope you'll share the story!) and I feel so encouraged that you had a similar experience and are now planning a home birth.

Looking back, there were so many factors contributing to my stressful labor, it's pretty unbelievable. I didn't get to choose my midwife because she was the only one in the area who accepted Medicaid. I'm a graduate student and the school insurance doesn't cover maternity so I was forced onto Medicaid -- a typical situation for students, unfortunately. I never felt a strong connection with her and was anxious about this as my due date approached, but since I couldn't do anything about it I just tried to put it out of my mind. This time (we are not yet TTC but will be soon) I will be able to choose my midwife, and definitely a doula as well.

And who knows, maybe an acupuncturist, massage therapist, hypnotist...I need all the help I can get. ;)

[LisaSedai]

I'm sorry you had such a traumatic delivery.   Posterior babies are tougher to deliver, hope your next little babe is more cooperative. The spinningbabies website has info on how to help get the babies in a good position (recliner chairs are bad apparently). I took a Bradley course for my first and I don't think it was very helpful (although my DH was not helpful either) I was on pitocin and the doctor had ruptured my membranes so I was trapped on the bed too. I just cried and writhed and cursed through the contractions. I only got to 5cm before I gave up.

Make sure you find yourself a provider who is supportive of VBACs and not just doing "lip service."

This time, I used hypnobabies b/c I wanted something to help me cope better with the contractions. It was really relaxing and used to put me to sleep alot when I was supposed to be practicing. Many people who use it have awesome results. I didn't practice it enough ( I was so sure I was going to be overdue!) but it did help. My best pain relief was my doula- she was trained in hypnobabies and massage and there was such a difference when she was helping me deal with the contractions. She kept me focused on what I needed to do to get through each contraction, and during the pushing stage when I thought I was never going to get the baby out she kept encouraging me and telling me I *was* making progress.  I would recommend all VBAC hopefuls to get an experienced doula, especially one who has done VBACers before.

Good luck :-)

[AGSmomma]

Thank you for telling me about the spinningbabies site -- I will definitely take a look at that. I think you're right that the doula will be the best pain relief, but the hypnobabies method sounds like it's worth looking into. Mostly, though, I want to surround myself with supportive women so that when I think I can't manage I can be brought back from the brink. And, I truly hope the next baby is not posterior!

Congratulations on your successful VBAC!!