My first baby, Quentin, was born in November of 2004 via cesarean section due to breech positioning. Also, he was huge (over 10 lbs!!). I had planned a natural in-hospital waterbirth with my CNMs, so I was already on board with a lot of natural concepts at that point. In the aftermath, I was constantly reading and researching natural birth, home birth, VBAC, etc. When we decided to have another baby, we also decided to try a home birth VBAC with a midwife. She dated my pregnancy based on my LMP, giving me a due date of 1/13/08.
The way things transpired in our lives, my midwife care got discontinued after an appointment at the end of July. We moved to another state and I had just gotten approved for state aid and was about to find a midwife when my water started leaking around 10 p.m. on Monday night, December 10th, at what I thought was 35.5 weeks gestation. I wasn't sure the leak was actually amniotic fluid, so we decided to go to bed and reassess in the morning.
By morning, I had been leaking heavily enough all night I knew it must be my water. I sent Luke (DH) to work and started calling the VBAC-friendly midwives I'd found in my search, trying to figure out what was best to do - come into the office to be checked, go to the ER to be checked, wait it out, etc. The midwife who helped me the most said I really should go to the ER to be sure it was my water. She told me if my water HAD broken, I should plan to stay in the hospital until I had my baby, because I was unlikely to be released. She told me that in my situation I was unlikely to be able to VBAC at any hospital nearby and gave me the name of two hospitals in the City where she knew the heads of the OB department were VBAC advocates.
I began calling my SIL (our childcare 3 hours away) to come and watch our son at the hospital, updating the Internet on what was happening, and packing our bag for the hospital. The whole time I'm packing, I'm crying "I don't WANT to go to the hospital!!!" Like a 3-year-old who detests his nap.
Finally, around 2:30 p.m. on Tuesday, Dec. 11, we arrived at Mercy hospital in Chicago. I was expecting to be checked in ER before being send up to L&D, but nope. They wheeled me right up. Turns out they don't let children under 16 on the L&D floor AT ALL. So my kid wouldn't be allowed to visit me as long as I was there. BOO.
I knew every hour my water had been broken would be one more hour off of my chance to VBAC, so I fudged the numbers a little and told them at Mercy they had broken at 10 a.m. that morning. My nurses were WONDERFUL, incredibly supportive and excited for me and my potential VBAC. They had me on continuous fetal monitoring, but assured me I'd be able to be mobile at least as far as the cords would reach. Mara (my first nurse) assured me they had birthing balls/stools, etc.
I spent a lot of time declining procedures. I declined an IV, declined a Hep Lock, declined pitocin augmentation and a pitocin shot after delivery. Declined a cesarean (just in case), declined all kinds of crap for the baby. Also declined any internal exams except a sterile speculum, because HELLO, infection risk.
I found out they take the baby from you after he's born as standard procedure and take him to the nursery. Dad can stay to watch from a window IF the baby doesn't need to go to NICU. In NICU, the curtains are closed. Um, Excuse me???
Evidently my crazy hippie ways attracted the attention of the head resident. She came in to lecture me, making sure to tell me first that she had been a CNM for 25 years. Insert Eyeroll here, I perfectly well know some CNMs are no better than OBs as far as interventions go. She was incredibly condescending, lecturing me about how "dangerous" I was being (and how my midwife had "promised me things" that "were danerous"). She insisted on a sterile vaginal exam, which I eventually consented to mostly out of curiosity. I was at 50% effacement and no dilation. They did an u/s to determine size and position, because I was measuring big (41 cm) and palpation led them to believe he was big. Turns out I'm around 40 weeks and he's probably around 8 lbs (they said 9 but you know how that goes). I believed that assessment, since my last period was a little shorter & lighter than usual. Based on my PREVIOUS LMP, my corrected due date would have been 12/14.
The resident bullied the hell out of me, honestly. She wanted to get me on pitocin right away to get things moving. I was terrified, since my SIL just had tons of problems with her induction, and I know augmentation is bad for VBACs, increasing the chance of uterine rupture. Plus, when your body's not ready, it doesn't work! And I would have ended up with a cesarean.
When I pressed, she told me they would only give me 8-10 hours on the pit before demanding a section, and I about threw up. "Isn't 24 hours from ROM the normal waiting period?" I asked. No, she said, we want the baby OUT in 24 hours. So I told her, ok, I'll try the pitocin. But I want you to understand I'm NOT going to consent to a c-section later on just because you decide time is up. I will not consent to a section except in the case of an emergency.
She practically SCREAMED "dead baby" at me. I tell you what. I'm well read, educated, and supported in my ideas about natural birth. I know what the hell I'm talking about. I can't imagine being a woman with less information and less, well, thick-headedness being in that situation and not caving. I felt terrible as it was. She kept saying, "is that what you want? Is that what you want for your baby? Oh, I wanted to slap her.
In the end, they said I had "tied their hands." She said I had come to them for care but wouldn't let them give me the care they thought was best. So it was best that I found a different hospital. I about died of relief. I didn't want to be the one to say, "LET ME OUT OF HERE!!!" because I could see the establishment construing that as negligence or something stupid.
We returned home to await labor to begin naturally. After a day or so, I was feeling under a lot of pressure to get things moving. After trying walking, swinging, stair climbing, etc., I eventually decided to try Castor Oil. I'd heard bad things about it, of course, but I'd also heard it is the closest thing to failsafe. And I figured it'd be better than Pit, if it worked.
Contractions started up that night (Wednesday the 12th). They continued on through Thursday, then began to slow. Never having labored before, I wasn't really sure what to expect contractions to feel like. Now that I've been through it, I suspect the "contractions" I was feeling Wednesday and Thursday were actually just after-effects of the Castor Oil. Ah well, hindsight is 20/20.
When my "contractions" started slowing Thursday night, I decided to return to the hospital. But a different hospital!! We arrived at the University of Illinois Chicago Med Center around 1 p.m. on Friday 12/14. In L&D triage, they confirmed my waters had broken, double-checked the dating with ultrasound, and agreed with Mercy that I was most likely term. I was given a sterile exam (1 cm, 50% effaced) and admitted into L&D.
The residents and attendings at UIC were more wonderful than I had dared to hope for. EVERYONE was incredibly supportive of my wish to VBAC. They were all amazed that my water had broken 3 days earlier, and a little concerned, of course. The baby and I were monitored closely for signs of infection/distress/fatigue. I was to be started on Pitocin and antibiotics, and they told me they'd give me 24 hours and evaluate things further at that time. My sigh of relief was probably heard in Mexico. They did a surprising amount of vaginal exams considering, but since they were monitoring carefully, and giving me the opportunity I wanted, I didn't put up a fuss.
Pitocin was started around 4 p.m. (12/14), I think. I labored for 12 hours on the pitocin before they checked me again. It was ok at first, but quickly became pretty horrible. Being on continuous monitoring (their telemetry equipment was on the fritz) meant I was confined to the bed and the 2 feet surrounding the bed, seriously limiting my pain management techniques. I spent a lot of time laboring in a rocking chair, and a lot of time hanging off of Luke, swaying my hips and moaning, trying to remember to breathe and relax. At some point in there, I was put on an internal contraction monitor since nothing seemed to be happening - they wanted to make sure I was having "adequate" contractions.
I was checked again around 3 or 4 a.m. (12/15) and I was still only 1 cm dilated, but 80% effaced. I was devastated
. The monitor said my contractions were adequate (should have been causing cervical change), but no change. All of that pain, and I wasn't even in active labor (which starts at 4 cm). I finally asked for an epidural. I knew I needed rest, and I knew I couldn't handle much more of this.
It was about an hour before the epi was in, and in the meantime, I had a 20+ minute long contraction. The baseline on my internal monitor was about 18. During those 20 minutes, contractions got as strong as 90 and never went below about 30. I thought I was going to die, it was just AWFUL. I was given a shot of terbutaline and the pit was turned off. It took a long time for things to slow down and I continued to have contractions, but they weren't as horrible and I did get a break.
Finally, at about 5 a.m., the epidural was in place. It was a "walking" epidural, so I could still move my lower body, feel the baby, and the contractions (they turned the pit back on a lower dose once the epi was in). But it was MUCH more manageable, like bad menstrual cramps instead of my uterus exploding. I was able to sleep for a couple of hours and regain my composure somewhat. At around noon, I was checked again. I had dilated to 2-3 cm. The resident said she'd give me two hours and check me again for progress. They said as long as I was progressing and not showing any signs of infection, they'd continue to allow me to labor.
At 1 p.m., the resident came back. I said (rather desperately), "don't I have another hour?" I was terrified nothing would have changed. After all, 12 hours of labor hadn't made any change! She said she'd check me now and give me another 2 hours regardless. I was so grateful. As it turned out, I had already progressed to 4 cm. HORRAY!
I have to say, despite all my natural birth tendencies, that FOR ME, I think the epidural made a difference. I wasn't able to use natural pain management techniques effectively, and was having a hard time relaxing. I suspect I was tensing a lot and probably working against my body. With the epi, I was allowed to relax and let my body work.
The epi had a button to allow me to dispense more medication to myself as the dose started to wear off. I wouldn't push it for a long time, trying to be strong and honestly feeling a little guilty I had the epidural at all. But there came a point where I was feeling a lot more pain than I wanted to, and I asked to be re-dosed. The anesthesiologist told me it probably wouldn't have worn off so much if I'd used the button. Oh well.
At around 3 (right before or after my epi was dosed again, actually, can't remember which), I was checked again. I was hoping with all my heart I'd made some progress. Give me a 6, at least, I thought. Imagine my surprise when I was told I was at 9 cm dilated!! I almost cried. I was going to get my VBAC. Everyone was cheering and just thrilled for me. I had progressed from a 4 to a 9 in TWO HOURS!!
Fifteen minutes later, I was feeling serious pressure, thinking my body would start pushing on its own soon whether I pushed or not! They checked me one last time, and I was complete. There was a huge rush and influx of people. I wasn't thrilled about that, but oh well. Luke, my nurse, the resident, the attending OB, and a med student were all clustered around. Peds was waiting nearby just in case. I started to push.
The resident wanted me to hold my breath and push to a count of ten. SCREW THAT. Luckily, my nurse was familiar with open glottal pushing and helped me with that. I pushed for a total of about 25 minutes, I guess.
After the first few pushes, a head started to emerge. I reached down and touched the soft hair of my baby's head. It was probably the most amazing experience of the entire thing. There was a baby in there, getting ready to be born!! I pushed some more, stretching, hollering. I asked for perenial support, but didn't really get it. The resident was trying to do perenial massage but it mostly just hurt. I made her stop.
Everyone was telling me to keep pushing, that he was almost there. I was expecting the head to be born, followed by a short rest before the body. Instead, I felt a really strange sensation, like there were several hands reaching into me to pull the baby out. I screamed "WHAT IS THAT?!" and the response was, "It's the baby!!"
I was still pushing through that and then there was my baby. They put him up on my chest. He was incredibly blue and quiet. After a minute, he cried, a very weak, gurgley cry.
Luke got to cut the cord (horray!) and they took the baby over to the table to suction him. He ended up needing oxygen, too. I had two small tears requiring just one stitch each. They showed me the cord, which had a big knot in it. I had been wondering why they were so worried about his not breathing - as long as he's attached to the placenta, he's getting oxygen, right? Well, not when there's a knot in the cord!
He recovered well and quickly, though, his APGAR rising from 5 to 9. I got to nurse him pretty quickly, and they didn't take him from me for awhile. A little over an hour after his birth, we named our baby. Jude Owen. Shortly thereafter, they took him to a section of the NICU get some bloodwork done, but I was ok with that, since Luke got to go with him. It didn't take long, then he was back and we were able to transfer to recovery.
Born December 15, 2007 at 4:27 p.m.
8 lbs, 7 oz, 19.5 inches, with a full head of dark golden hair
My beautiful and perfect VBAC baby
It was a long and exhausting labor, especially when you add in the days between my water breaking and the birth. I am so incredibly grateful to the awesome team of doctors who supported me in my wish to VBAC. I'm thrilled I was able to have this experience, and I'm definitely DONE having babies.