My Road to a VBAC

The line ‘Life is like a box of chocolates, you never know what you’re gonna get’ from Forrest Gump has never rung so loud in my ears as it has in recent years for me. I have been on this windy road for almost 8 years. It has been riddled with the tightest of curves, blinding fog, the highest of mountaintops and the lowest of valleys. It has been one that I wish I had never been forced onto but yet I am simultaneously grateful for the various experiences I have obtained because of it.

My journey started during my second pregnancy. Two pink lines…here we go again!!! My first pregnancy was completely uneventful, could have been considered boring to some, and though at 41 weeks my labor was augmented and excruciatingly long, my son’s entry into this world was quick and comparably easy. I had no reason to expect any less with my second…until placenta previa was discovered early in my second trimester. A decision had to be made. Up until that point, I had received my care at the local health department but now I was eligible to start receiving benefits from my employer. I had to find a provider. Even though my son’s delivery was successful and vaginal, it was a horrendous and tormented labor. I knew I did not want to seek care from an obstetrician because of their love of Pitocin and interventions. At the same time, I knew that a midwife would not be able to deliver my baby if my placenta proved itself to be half as stubborn as I am. I interviewed co-workers on their experiences and attempted to interview some of the OB nurses. I wanted to know statistics, who preferred cesareans? I knew I was at risk of being sectioned, and in the case of a placenta previa when the time came, there would have been no argument, the goal is a live baby and a live momma, but I didn’t want an added inherent risk simply because one liked to have dinner by six while another tended to be patient. I finally made my decision.

The weeks went by we soon learned we would have a daughter and several weeks later after going into pre-term labor at 33 weeks, I learned that my placenta had shifted and my cervix was clear! Wahoo! Unless an unforeseen emergency arises, no section for me! Though my labor was able to be stopped, I contracted every day and/or night dysfunctionally for the next 7 weeks until I finally reached 40 weeks. To say that I was anxious, of course, but my nerves were shot, it had been a long 40 weeks and though I wanted her out, she was quite cozy and stood her ground for an additional 2 weeks. The doctor would ask me at every visit about an induction and I would refuse it. Finally at 41 weeks and 5 days, I knew it wasn’t safe any longer and agreed to an induction. The following day I was already scheduled for another ultrasound so off we went to see our little girl for the last time on the screen, the next time I would see her would be in my arms! Beautiful little face, sweet little lips suckling, her little fingers balled up in a fist and her little feet nestled deep under my ribs. She was gorgeous, I already knew! They studied the monitor, reading the information on the screen then proceeded to tell us that she was expected to weigh in at 9 pounds 15 ounces. I cringed.

A few hours later we walked up to OB for my scheduled induction. The doctor came in shortly after me and went on to explain my daughter’s expected excessive weight and that macrosomia can cause very serious difficulties. I would be allowed to attempt a vaginal delivery but I would be forced to sign multiple waivers. After discussing the situation with my husband and my mom, I decided that I could not live with myself if my daughter were born with cerebal palsy simply because I was stubborn. So, scared, crushed and overwhelmed, I reluctantly agreed to the cesarean. The next morning they woke me up bright and early. It was 42 weeks and to be her birthday. They prepped me for surgery then a little bit later wheeled me in. It was so cold, I’ll never forget. I sat on the operating table hunched over to allow the anesthesiologist adequate access to my spinal column. Little sting and pressure. Ah, there’s that warm, numb feeling sweeping over my body. I hurried and lay down before it took complete effect. The doctor came in, tested the anesthesiologist’s work then started cutting into my abdomen. They let my husband in to sit next to me and a couple minutes I heard the suction of the fluid and felt the pressure…it felt like an eternity, then I heard my daughter’s cry. The most beautiful sound! They brought her over to me, I kissed her sweet little face, then they took her to the nursery and I fell asleep, but not before I heard her ‘monstrous’ weight of 8 pounds 9 ounces. The rest of that day and most of the next couple are a huge blur. I have virtually no memory of my son meeting his sister; I was in so much pain and was so drugged. Thank God for photographs! I knew I never wanted that again.

Four years passed, and a lot had changed in our lives. My husband and I had gotten divorced and I had become reconnected with an old friend. We were a perfect match. Within five months we were pregnant! VBAC became my favorite search topic online. I was on a hunt, a hunt for a provider who would ‘go out on a limb for me’ and allow me to attempt a vaginal birth after cesarean. When I contacted my previous provider to request they transfer my records, I was convinced to come in and talk to her. She knew me and she knew how important it was going to be for me to do this. I decided to stay with her. There were risks, I was told. Not huge, but they were there. As well as knowing the risks, I needed to be aware that induction was no longer an option for me. It would be too dangerous a procedure for my scarred uterus. If I failed to go into labor as my previous experiences had proven, I would be left with no choice but to have another cesarean. I understood. The weeks turned into months and I was nearing the end of another uneventful pregnancy, we knew our child was another daughter and I feared the doctor was going to attempt to scare me with the ‘Big Baby’ card again. Knowing how fast they gain weight at the end, I decided at 40 weeks 2 days, that I would self-induce at home with Castor Oil. I drank my concoction at 11 pm and went to bed. Two hours later I woke up with contractions. It worked! I used my labor ball and started lightly breathing through them but noticed that they were coming on top of each other knowing that we would have over an hour’s drive to the hospital, we decided to leave. We dropped off my two children with family and headed in.

As soon as we arrived, they wheeled me upstairs to OB. Upon being examined, I was thrilled to learn that I was 5 cm and 75% effaced! I had officially gone farther in a much shorter period of time than I had with my first. I was ecstatic! I was admitted into my room, given an IV amd hooked up to the monitors and kept doing my labor thing, just working on my contractions. By noon that day my contractions faded away, I simply hadn't been able to move around enough to help my labor. We tried acupressure, the nurse tried stripping my membranes, then, and finally the doctor broke my water. Nothing worked and several hours later the doctor convinced me that my body simply wasn’t interested. I would be prepped for another cesarean…my failed VBAC. I was devastated.

Shortly after 7 pm, I would again be wheeled into the same, cold OR. My partner would soon join me and together we would absorb the sounds as the gowns on the other side of the screen delivered our baby girl. We heard her cry. Again, as upsetting as her birth was, we were thrilled with her. She was a perfect mixture of us, our beautiful little angel! My recovery this time was much easier. I can remember my older children seeing her and holding her, my memory of those moments are ones I treasure. We were a family!

Almost two years later we got married and within three months of our wedding, we were pregnant again. We were so happy and feeling completely blessed with another little miracle but inside I was sad too. I knew I would be calling around, finding an OB and within a few months I would be scheduling another cesarean. I did not want another surgery. As much easier a recovery I had the second time than the first, I had a much more difficult time with urination. I had lost all sensation for the first couple months following my surgery. I would time myself. I had to pay attention to the clock and make sure I visited the restroom every couple hours because I would not feel it and would eventually pee on myself. This was not a thing that I wanted to be plagued with. I did not want to be thirty and depending on a clock and the level of absorbency of my diapers. I also felt trapped, as though my chance had passed, I would be forced into the OR again, I wouldn’t fight it this time; I wouldn’t waste my energy.

I was about 7 weeks and in a conversation with a friend discussing our future and my baby’s delivery. She was the first one who introduced the idea of a midwife. I wasn’t sure; I knew how difficult it would be considering I’d been the lucky winner of two cesareans. The following week I called the Birth Center of Gainesville. Of course my suspicions were confirmed when they told me that they were not legally allowed to accept VBAC clients. They did though, provide the names of a couple midwives who worked with couples in their home, I couldn’t believe it; I was seeking out a homebirth. I thought to myself that I must have been crazy; then came the research. I read TONS of articles online and watched ‘Pregnant in America’ and was appalled at the OB world; I HAD to learn more! Then I came across ‘The Business of Being Born’, a truly phenomenal work of art! I realized that I wasn’t crazy, I was validated! I would do what was necessary, I was not going to ‘feed’ the hospitals quotas; I wanted to become a statistic in my own right! I quickly got used to the ignorance and fear associated with not only midwives and homebirth but also with VBA2C. I was getting reamed from every angle. I had nowhere I could turn where I knew I could be understood. When I had decided to attempt it the first time, I caught some grief, but honestly not much. This time it was EVERYWHERE. I had to make a decision. I was going to do this, not because I wanted it, but because it was the safest thing for both of us. I had to battle virtually everyone around me. My best friend and husband finally just decided to go with it. They knew how upsetting it was for me to be at attention at every turn. I needed them, I needed their support and I needed them to believe in me too; so while they would support me to my face, they would agree on my blatant stubbornness and insanity as soon as I was gone. I continued to be plagued with negativity; some I was able to brush off, some wasn’t so easy. The hardest thing at that point was dealing with my own mother. Being a nurse her entire adult life, she has seen the worst of the worst. This only fueled her inner fire, setting mine ablaze. One of the most influential people in my life and I couldn’t simply talk to her, and I definitely didn't feel supported by her. She was frustrated at my ignorance, as I was of hers. We each were passionate and educated, whether formally or informally, in our own areas, there was no stopping it. I finally had to tell her that as much as I wanted her involved in my baby’s birth; I refused to deal with this. She reluctantly stopped trying to convince me that this was not safe and I reluctantly stopped openly discussing the topic with her.

Appointment after appointment we met with the midwife, we were truly heading in the right direction. Then smack! We hit a wall. At my 18 week checkup, we attempted to listen to my baby’s heartbeat as we had done before and found nothing. My heart sank. My three older children were bustling about excited about the baby and at that moment I feared I would have to give them catastrophic news. My midwife sent me to a local hospital ER for an emergency ultrasound, and hallelujah, there was my little one sleeping peacefully, little heart beating away. We soon learned that it was because of a placenta previa that the little heartbeats could not be heard, so back in square one we stood. Weeks continued to pass, we learned that we were had been blessed with another daughter and continued to pray that the placenta would move. Finally at around 28 weeks, my midwife and I decided that it may be best for me to find a doctor who would be willing to let me attempt another VBAC. My search…again…was on.

Already knowing that Ocala and its surrounding area are extremely anti-VBAC, I called every office in the Gainesville area, but mainly due to insurance issues, no such luck, until I called specifically Shands. Bingo! At 32 weeks, I visited my new provider, an OB intern who was barely understood in his broken English and despite his intricate training, was not capable of listening to my plights for treatment of my raging sinus infection. He scheduled me, on the same day, for an ultrasound to look at my placenta, this was first and foremost. But before even scheduling my scan, he first attempted to schedule my cesarean. This was NOT going to work. I had the ultrasound, my prayers had been answered, and the placenta had shifted up and away from my cervix. Even some of what was believed to be 'vernix' was seen, on the ultrasound, freely floating in the fluid; I was increasingly convinced that my time was nearer than earlier anticipated. Now my only barrier to my VBAC was this incompetent man who called himself a doctor. I knew at that moment, I would not go back. I could not trust a person who can’t listen to me about a simple sinus infection, much less pain, pressure, dilation, VBAC or cesarean. After giving myself some time to relax and really think about the situation, I started making some calls.

Enlisting the help of the wonderful ladies associated with ICAN of Gainesville, I was given the name of Amy Reynolds. A simply amazing midwife whom all seemed to sing her praises. It was a shot in the dark. Mine was a case she rarely accepted. Being a VBAC mom herself, she enjoys assisting moms achieve their own VBAC but since I’d had two cesareans, she was reluctant. The only reason she ever considered me was because 11 years prior, at 19 years old, I vaginally delivered my firstborn. I had a ‘proven pelvis’. The next stipulation was honestly a humorous one, humorous only because it was a stipulation from each of us of the other, my baby would be born in close proximity of a hospital…in a hotel. It sounded crazy, it really did. The mechanics of it ran laps around my head. All I could envision was police banging on my door in an attempt to rescue the woman who was being murdered within. She assured me that it really sounds most like vigorous sex. We both laughed and it was decided.

If I thought that I caught negative feedback before, I surely would now. It was because of the lack of a need to know that most people did not know what was planned. I began gathering various items that would be required; towels, adult diapers, shower curtains, peroxide amongst other odd items, and I was to call the overseeing physician whom I needed clearance from. Being aware of the tension between my mom and myself, Amy made a wonderful suggestion; I should go to the doctor’s with her! We did exactly that. We sat down together while the doctor explained the risks and benefits and reviewed the actual statistics involved, my mom asked lots of questions and it was reaffirmed that, for me, this was truly the safest option. It was also agreed that deciding on a location so close to the hospital made it even safer, should something go awry, help would be virtually immediately available. We thanked her and began our two and a half hour drive home.

Yet again 40 weeks came and went and I was again antsy. At 40 weeks and 4 days, I asked about a home induction, I knew that my babies are stubborn and are no midgets; I also knew that they gain SO fast at the end; I feared I was going to deliver a toddler. I needed to wait a little longer to allow my body the opportunity to go into labor itself. Nothing. Oh…wait…never mind, just a false start. Nothing. Nothing. Finally at 41 weeks and 3 days, Amy came for my last prenatal exam. I had dropped, was dilated to 2 cm and was 75% effaced. It was a little progress. Then came the fun part! She stripped my membranes and gave me in depth direction on Castor Oil in conjunction with a homeopathic cohosh and a breast pump…Oh yay! Around 2:30 pm, I ate my lunch, and drank a full glass of water, then drank my ‘milkshake’ I then lay down with my two year old in an attempt at some last minute rest before everything started kicking in. 45 minutes later, I got up in fear of vomiting. I was contracting, light, across the back and around the front! Within the next 15 minutes I started feeling the lovely effects of the Castor Oil. I took a shower and got on my ball. I rocked and rocked with each contraction. I contacted my cousin who was going to watch my two year old and informed her that we would likely be dropping her off around 6. I started timing them and they quickly began coming closer together. By 5 pm, they were roughly 2 minutes apart lasting about 45 seconds. We started getting ready to leave. Around 6 pm I took my first cohosh pill allowing it to dissolve under my tongue. The contractions immediately picked up.

After dropping off the little one, we finally arrived at the hotel around 7 and took another pill. My contractions were about 90 seconds apart and lasting 45-60 seconds. I was stopping and breathing through them, rocking, I found my ball very uncomfortable from this point forward so I rarely used it. Amy and her assistants arrived around 8 pm. When she checked me I was 3-4 cm and 100% effaced, I was so relieved that I was making progress. The contractions continued to increase in intensity. I would close my eyes with each one and breath through it while telling myself to allow my body to work, and to relax to allow myself open up for my baby. I would tone everyone out who was around me. I remember hearing them speaking, sometimes to me, other times in general conversation. I couldn’t stop and answer, I had to maintain my composure, I had to maintain control rather than letting my contractions control me. As painful as it was, it didn’t even compare to my firstborn’s Pitocin driven labor. Around 7 cm seemed really difficult for me; the contractions seemed to go on forever. They would peak, and then start to subside but would come to a peak again. I would get three or four ‘contractions’ all wrapped up in one long one, then I was able to relax for a slightly longer period in between. She checked me again and I was finally 8 cm and had a bulging bag of waters. She asked me if I wanted her to break it, I told her yes. A little pressure and the familiar ‘pop’ sound then a warm GUSH! I instantly went to 9 cm. I asked if the fluid was clear as I have always had a fear of meconium, and it was in fact stained. It wasn’t fresh she assured me, not enough and thick enough to put the baby at risk, but definitely there. The nausea and hot flashes hit me, I was transitioning. At this point I was able to get into the Jacuzzi tub, oh my goodness; it was like heaven…in a bathroom! I worked through quite a few in the tub then got out to use the bathroom as I was still feeling some of the effects of my ‘milkshake’ added to the pressure from my baby's head, then I found myself instinctually bearing down. I asked the assistants to refill the tub, I knew I was about to give birth. The water was still hot but I asked if I could get in, I did. I worked through a couple contractions and then all of a sudden, as if I was possessed, my body began to push. I could feel the baby moving downward. My husband was not immediately in the room which threw me in a mental panic, I did not want to have my baby without him by my side. I told Amy that I was pushing and she quickly turned on only the cold water, she kept saying I couldn’t have the baby yet; the water was too hot for her. So I focused my energy on breathing through and over the contraction in order to overpower my body’s drive to push. I called out for my husband, he quickly came and the next moment the water temperature came within safe limits so I allowed myself to go with it. Amy massaged my perineum while I held my husband’s hand and I pushed out our daughter, I felt every millimeter of her journey, it was expanding, it was burning, and it was amazing! It was everything I have ever wanted. By the end of the first push, her head had moved all the way down until it was lodged between my bones, then with the next push, I again forced myself to get on top of the contraction and my instincts and I breathed her out. I had to stop, the cord was wrapped around her neck, ok, I pushed a third time and I felt her body slither out of mine. I was beside myself! I had done it! My dream of having an unmedicated birth, a VBAC, was now a reality, and I was the proud mother of an 8 pound 12 ounce, beautiful, baby girl. She was unwrapped from her cord like a present and lay on my chest. It was so incredibly peaceful, she just lay there looking around, taking it all in while I cried at the entire miracle of it. Finally the cord stopped pulsing and it was clamped and cut. She let out a little cry; welcome sweet little one, welcome! It has been a long road but we did it!