Rebekah's birth

For comparison, you may want to re-read Rachel's birth story. With Rachel, we had a very detailed birth plan. We wanted skin-to-skin right away, no episiotomy, intermittent fetal monitoring, and a host of other things. Instead we got a c-section. More than one nurse laughed and said that everyone with a birth plan winds up with a c-section. That was their running joke. So, this time I was determined not to have a birth plan--even though we were living on the edge by going for a VBAC. My unwritten birth plan was this: "no med students please except my hubby. And if we get a healthy baby with a vaginal birth, I don't care what else you do to me." So here goes our story:

I have no idea where to begin...do I begin 3 weeks before the birth when I started having semi-regular contractions? And multiple false alarms, calls to my doula, calls to my mom? Perhaps. I seriously thought Rebekah would never come. Rachel arrived at 37 weeks 5 days. Rebekah arrived at 41 weeks 2 days. I was going insane waiting around.

At my 40 week + 2 days appointment (July 30), I was presented with three options. 1) Schedule a repeat c-section at 41 weeks 2) Induce or 3) wait till 42 weeks. She had me come in for an appointment (with a different doctor) at 41 weeks to choose one of the 3 options. At that time, I didn't think inducing would be an option--as pitocin is dangerous business for a VBAC.

At my 41 week appointment (monday the 4th), I was 2.5 cm dilated already, 70% effaced, -1 station... this different doc thought I was a really good candidate for vbac. She was sure that a gentle "induction" via AROM (artificial rupture of membranes) would do the trick without the need for pitocin. She had to find a doctor who was willing to do the "induction" (she didn't have any hospital time this week, or else she'd do it herself). Thankfully a doctor was found, and I was scheduled to show up Wednesday at 6am. She also stripped my membranes in hopes that I'd go into labor on my own.

I started having some stronger contractions--but nothing signaling that I should go to the hospital. We called Dan's mom anyway and she came out to our house. That way we wouldn't have to worry about Rachel being taken care of. Tuesday I hung out with my MIL and Rachel, and made sure they were both situated. I had semi-regular contractions, but nothing to write home about. That evening we took a long walk, and then I started experiencing painful contractions. I was certain the time had come. The contractions stuck around even when I was resting. I called my doula, Brenda, and she came over around 11pm. As soon as she showed up, the contractions slowed down again. So frustrating!

Brenda thought we should do everything possible to encourage labor and make progress before the scheduled induction. So she and I went walking around the condo complex--at midnight--for a couple hours. She also had me bounce on the birth ball for awhile. By then it was 2am and I was tired. So we both went to sleep, and woke up early for the 6am appointment.

Dan, Brenda and I showed up at the hospital promptly at 6am...and waited around quite awhile. Dr. C showed up at some point and said point blank, "I was post-call when I agreed to do this and I'm not really comfortable with it. We should consider a c-section right now, but I'll let you think about it." I replied..."I'd really just like to have my water broken and see if I can make progress before we go for a c-section". So ahead we went.

The actual AROM happened at 10:30am. At that point I thought I'd have 2 hours to make progress and then we'd know whether I was still in the game or not. I was 3.5 cm dilated at that point.

Other details: I had an IV put in, and continuous fetal monitoring (external monitor on the baby, internal monitor for my contractions). I was not allowed to leave the bed, not even to use the restroom. But I could try different positions on the bed, as long as they got strong continuous monitoring. If ever the monitoring got a little iffy, they'd come back and tell me to go back to my previous position. I was NPO (nothing by mouth), allowed only a couple ice chips here and there. (But I disobeyed this one. Though the course of the day I had a total of 3 bites of granola bar, and many sips of water. Shame on me!)

I started having 5-10 minute apart contractions, reasonably strong. I breathed through them, and was handling things okay. By 1pm, they were very strong (as strong as I'd ever experienced at the very end of Rachel's labor) and focused in my back. Dan and Brenda were awesome about helping me through each one. I did a lot of vocalizing. But my spirits were high: my thoughts were "I was made to do this. I am fearfully and wonderfully made. I am fulfilling my calling." Between these contractions I was pretty much normal.

Then came our first shock: around 1pm the nurse came in, checked me (4 cm) and announced "Dr. C will be back to check you at 4pm". WOW!!!! :) I couldn't believe she was going to give me so much time!! I was so hopeful :). (With Rachel, they checked me every hour on the hour, and expected 1cm dilation per hour or else...)

A little later, things started changing in my labor. It got really bad. To me, even though the contractions were coming 2-3 minutes apart, there was no "break". That is, I was in the intense unhappy mode constantly. The peaks of the contractions were the most painful thing I've ever experienced in my life. Dan and Brenda were both massaging me, then using counterpressure on my back during the height of each contraction. They used lots of verbal encouragement as well. I was pretty out-of-it. I was definitely not myself...a little bit like an out-of-body experience. At some point I lost it--saying "I can't do this anymore." I remember Dan and Brenda whispering to each other that I was probably in transition.

At 4pm, I got checked again. It was so very painful--and I hadn't progressed at all! Still only 4cm. I'll never forget the look of shock that came over both Dan and Brenda simultaneously. We all expected a 9 or 10. At that point, I was like, okay this is over. Let's just do the c-section and put me out of my misery. But again, shock of the century, Dr. C said "OK, you're at 4 cm now, so hopefully things will speed up. I'll be back to check you again in 3 to 4 hours." Again, normally the doctors expect 1 cm per hour and check every hour. She was so different. But... could I seriously take this for 3 more hours? Deep down I just wanted the c-section and was convinced it would happen anyway--so why not sooner rather than later?

Instead, I went hysterical, screaming and begging for an epidural. Brenda kept saying, "this is a change in what we'd planned...you can do just one more contraction. Just one more." I got more adamant...I just wanted to sleep! I'd only gotten 3 hours the night before, and every ounce of me wanted to crash. But I couldn't, because the horrible contractions kept waking me up. Finally Dan said we should just get the epidural. The nurse checked me again before calling the anesthesiologist... 4 to 5cm dilated - not speeding up much yet!

While we were waiting for the anesthesiologist, Brenda said that the baby was probably posterior, since I have was having so much terrible back labor with no progress in dilation. At this point, she wanted me to try some different positions in hopes to get the baby turned around. First I knelt on the bed and draped my arms over the back of the bed. During every contraction, they squeezed my hips as hard as they could. Next, they had me sit on the edge of the bed and lean over the birth ball. I also did some lunges. I was in agony...

Then, the angel of mercy appeared (aka anesthesiology resident). He tried to give me the schpeal about all the risks, but I was like "I just want an epidural, where do I sign?" Brenda had to leave for the procedure. I was shaking uncontrollably. Two nurses and Dan were doing all they could to keep me calm for each contraction so that they could insert the epidural properly. I felt a little stronger knowing that relief would come soon. "Please hurry!!!!" was my cry.

Finally everything was in place around 6pm. I was a very happy camper. When they asked "how are you?" my answer was "FABULOUS!!!" I tried to get some rest. I had never been so thankful in my life.

The next time they came to check me--around 8pm, we had our next shock. "9 cm!!" Dr. C announced. Then, while she was still checking me, I dilated all the way to 10!!! And +2 station! Wahoo! She said she'd be back shortly and I'd start pushing. I guess the baby really was posterior and Brenda's doula magic turned her around. I also think I really needed that epidural so I could relax and let my body do it's thing. I never thought I'd be saying that about an epidural, but there you go! Birth experiences have a way of changing your preconceived opinions :).

Next came a big flurry of activity. Dr. C and a bunch of nurses and who knows who else came in with equipment. Dr. C looked like she was dressed in a HazMat suit. Soon they were all gathered around me (Dan and Brenda were there too--each one holding one of my legs), watching the contraction monitor. With each contraction, they coached me to push. It was so fun!! They were like my cheerleaders and I felt like a star athlete. It was a little surreal, since I couldn't feel much. But I could push as hard as I could and imagine all that energy being focused towards the baby. After 45 minutes, she was out!! 9 pounds 3 ounces!!! Again, I was shocked. I was certain I was carrying a 7 pounder, as I weighed 20 pounds less than I did with Rachel. (Rachel was 8 lbs 11 oz--and they thought she was too big to fit through my pelvis. WRONG!!!)

They took Rebekah to the warming table right away, and then to the NICU observation as her breathing was grunty. I got to hold her for a minute before they took her down the hall. Dan went back and forth between me and Rebekah. Brenda stayed with me while they sewed me up (I had a second degree tear) and delivered the placenta. I was pretty much oblivious to what the doctor was doing (I couldn't feel it after all!!), and was just relieved and happy. I wasn't worried about Rebekah at all. The pediatrician reassured me that this was common and everything would be okay shortly. Rachel had had some grunty breathing as well when she was born.

An awesome nurse made me a juice/soda concoction to drink. It was so delightful. After 2 hours, Rebekah was released, and we were moved to the postpartum unit. By that point some of my feeling was back, so I could get out of bed, use the restroom and then sit in a wheelchair. (With Rachel I was still flat on my back at this point).

Once in the postpartum unit--Rebekah nursed and latched on right away!! I was so thrilled. Rachel refused to latch for several days, and instead screamed and arched her back.

We were scheduled to leave on Friday, but ended up having to stay because Rebekah was jaundiced. They wanted us to supplement her with either pumped milk or formula (in order to dilute the bilirubin out). Sadly, my pumping efforts produced very little. So, here we were again giving (gasp!) formula to our newborn. However, since we'd done it with Rachel, and Rachel went on to successfully nurse for 19 months, I wasn't really traumatized about it.

So, Friday night, Dan and I slept in the waiting room (my hospital time had expired), and every 3 hours I woke up, went to the newborn nursery to take Rebekah out of her bili-light, nurse her, and then finger-feed as much formula as she would take. By the morning, the doctor said her bilirubin level looked great, and we didn't even need to do home phototherapy (which we did do with Rachel). Hooray! We were on our way home. And no more formula for Rebekah! :)

At her follow up appointment, Rebekah had already re-gained her birth weight.

All in all, I feel so wonderful and victorious about the whole birth experience. In the world of birth, there is this constant tension between the "medical viewpoint" and the "natural/crunchy viewpoint". Through the whole pregnancy, I felt that I was labeled and discouraged by both parties. NOT by any of my friends, who have been wonderful and encouraging no matter which camp they fall in. Just labeled by books I've read or websites or even certain doctors. Many medical people would say that VBAC's are dangerous, with a risk of uterine rupture, and you should really just play it "safe" and have a c-section (never mind the other serious risks of having multiple repeat c-sections). The crunchy people would say that having so many interventions in the hospital is the slippery slope to another c-section, and if you really want a successful VBAC you'd better have none of that.

However, in order to be allowed to VBAC at my hospital, I've always known I'd have IV (no hep lock!!) and continuous fetal monitoring. And I wound up with true continuous fetal monitoring--no trips to the bathroom, only be in positions where they get a strong signal. So in order to successfully VBAC, I'd have to beat the odds of the naysayers on both sides. And I did!!
Not that I can really claim any credit. It was seriously just God's grace. He found me an awesome doula (friend of a friend) who helped me labor effectively despite being way more confined than I was for Rachel's labor. He sent me nurses and a doctor who allowed me space and time to labor on my timeline, not theirs. He even allowed for an epidural--which though not in my original plans turned out to be for the best in every way.

And all those lingering thoughts that I didn't write in Rachel's birth story--about something being wrong with me because I couldn't birth her properly--have completely vanished. I am fearfully and wonderfully made. For the future, every birth from now on will also be an attempted VBAC. I may have another c-section in the future...but I'm confident now that if I do ever have a c-section it will be because I need one (i.e. fetal distress or something like that), not because I didn't dilate fast enough to match some arbitrary average. :)

Now, to go enjoy my beautiful little girls :)