Sunday, November 20, 2011

My third VBA2C- another planned homebirth which transferred for a hospital VBA2C

** I wrote this initial birth story last year shortly after the birth. I will be writing another blog with some of the "follow-up" feelings that I have now that I have processed her birth a little bit more.**

October 20th

I had my 39 week appointment this day. I have a history of big babies and problems with blood sugar in the last part of pregnancy so I wanted to be checked for dilation and also to see if she could sweep my membranes. I had been having a lot of prodromal labor and had lost mucous plug for weeks. She checked my cervix and I was 3 cm dilated and 75% effaced. She went ahead and did the membrane sweep and we scheduled my 40 week appointment for Monday.

October 22nd

I had a feeling labor was really close. I didn’t want to really leave the house and I was having a lot of contractions but they were pretty mild and a bit erratic. I also feel like maybe my worry about the other kids getting out of school was keeping the contractions at bay. Not to mention this was my baby Abdul-Qadir’s birth/death date.  Once everyone went to sleep the contractions got a little stronger but they were not close together at all. I finally went to bed between 11:30 pm and 12:00am.

October 23rd

2:30 am—I was awakened by a really strong contraction. I got up and used the bathroom and then I had another one that was just as strong. They felt different so I decided maybe I should time them. I timed them for about an hour and they were about 5-7 minutes apart. I had already gone through this two weekends in a row and the contractions always stopped after a couple of hours. This time though they seemed to be getting more intense. By 4:30 am I was convinced this was real labor and my husband got up and then I called my midwife.  We started setting up the birth tub and filling it with water. I ate some breakfast and waited for my midwife.

6:30 am— My midwife arrived and I was getting more excited realizing this was it! She checked vitals and my cervix to see where we were at. I was 4 cm still 75% effaced but definitely in labor.  I labored for a while the contractions were really intense and ranging from 5-10 minutes apart. They kept fluctuating in the timing. I ate as much as I could and as often as I could stand. I was having a lot of bloody show and I was hopeful this would be a fast labor. Boy was I in for it….

Throughout the day I kept switching between the tub and dry land because progression seemed to be really slow by 5pm or so I was only 6-7 cm. The contractions were really intense though and I was hoping maybe once the sun set and it was darker that would help things move on. My contractions did start coming closer together and I had some hellacious back labor. It was awful.

8:30 pm—I was checked again still no change. Still 7 cm. Ugh I was dying from the back labor so one of my midwives said that she was going to check some of her literature and see if she could get a better vision of baby’s position to see if we could get her on my cervix better. She said she thought maybe the baby was acynclitic or posterior.  So we went to the spinning babies’ site to check some techniques to do while in labor to get baby moved.

Most of what the site suggested I was already doing like changing positions and just constantly moving. One of the tricks though was to get on your hands and knees with your butt in the air and head on the floor. They all suggested I try to get some rest and for at least 3 contractions assume that position. I laid down on my bed and did just that and after the third one I just could not take that anymore and laying down was horrible. I begged to get back in the birth tub because I could relax more in between contractions and I was sooooo tired. I was able to get more rest and the contractions seemed to be laying off of my back a little. The next time her heart rate was checked my Midwife confirmed that she was no longer posterior. YAY!  The incline positioning worked. Since I knew this I continued to lay on my sides in the tub between contractions because I did not want her to go back to posterior. I labored all night long. I can’t recall if I got any more cervical checks that night or not. I was very tired though and my contractions were close enough that I never really could get a decent amount of rest.

October 24th

8:30 am—After laboring all night I thought for sure something would be different. I was checked and still was 7 cm, baby was still high, cervix was only slightly more effaced. I reached one of my first meltdown moments. I was so sad. This was my fifth baby and third vaginal birth. I could not understand what my body was (or was not) doing.  So my birth supporters rallied around of course and reminded me that  I can do this, that I have  done this and to trust my body. That statement for whatever reason brought a wave of emotion over my first VBA2C in which my baby passed away. I started crying and admitted that I was having a hard time getting to that point because I felt like the last time I completely trusted the process I left the experience with a mixture of emotions ranging from triumphant and accomplished to broken hearted and empty handed. I apparently still felt a sense of responsibility for what happened to him. My amazing birth support team though (namely Khadijah) reminded me that things like life and death are out of my control. She reminded me also that my body will do what it is supposed to regardless of what my mind wants.  I was able to pull myself together and labored some more in my husband’s arms. I requested to get back in the tub. I think I labored there for another hour before I came to the conclusion that I was reaching the point of exhaustion and I wasn’t sure if staying home was the best thing at this point. I really needed some rest. I thought to myself that there are two scenarios that could explain my lack of progression, either I was just too tired and my body knew this or there really was something else going on that was keeping me from progressing.  At that moment my midwife came to me and I expressed my feelings to her.  I had been in labor for 33 hours running on about 3 hours or less of sleep. I was exhausted. I made the decision to transfer to the hospital then rather than wait until the situation was emergent. We wrote up a birth plan before we left to make sure that our wishes were granted regarding the baby.

10:30 am—We arrived at the hospital where we had to go to triage and be assessed and fill out paperwork. My midwife transferred with us so she could give them my history and the labor history as well. My contractions were about 5-7 minutes apart still and I was still having a lot of bloody show and tons of pelvic pressure.  I was still 7 cm about 85-90% effaced and baby was -2 station. While sitting in tirage after I had a contraction I felt a trickle down my leg…. Everyone looked at me and asked if my water just broke I said um I dunno it’s never broken on its own lol. I touched what was on my leg and it was oily feeling. They did the ph test and it was positive so my water was broken.

I was asked by the OB what interventions did I want to avoid and she seemed to not have an issue with my desire to VBA2C. I told her no Pitocin. She mentioned that she wanted to do an ultrasound because if the baby was too big they would recommend a c-section. I told her no way no how and my midwife chimed in and said that I am aware of how inaccurate they are for sizing at this stage in pregnancy and I do not need one. I was asked to sign consent for a c-section and I was hesitant to do so and even stated that I don’t mind signing it so long as me signing does not give them the right to wheel me to the OR unnecessarily.  She assured me that was not going to happen that this was only for an emergent c-section.

So we get to our room and I am waiting for the bloodwork to come through and for the first IV bag to go in so that I can get a mild epidural. While in there the same OB comes in again and states that her boss ( she was a resident) is recommending a c-section and goes on and on about the risks etc. I stated that I am well aware of the slight risk of uterine rupture and that I am also aware of the risks associated with a repeat c-section and therefore my decision is still to VBA2C.  She says ok and she will let him know.

I get the epidural and it was definitely mild. To the point that I could easily move my legs and could still feel every contraction and had to breathe through them all. I am glad it was just strong enough to take the edge off but not so strong that I felt zombied out of my birth.

I was ready to get some rest so I slept for a few hours and my contractions spaced out during that time.  I can’t remember if the resident came back again but I know her boss did and he had the same conversation about the recommendation being a c-section and blah blah blah. I told him again I am aware of the risks and have made my decision and I am not changing my mind so long as my baby is happy and I am ok I will ride it out.

I got a few more hours of sleep before the 7 pm shift came on.  My nurse happened to be 38 weeks pregnant and attempting a VBAC herself. This is important because I feel like she may have been one of the reasons my birth went like it did. You know with all of my births I feel that there has always been a reason things went the way they did, even if it went against my ideal scenario or my ideal birth.

My midwife and I felt that it would be best if the nurse was the only one to check my cervix. I liked this for a few reasons. One because there were 3 residents on the floor which meant they are still learning and I wasn’t too trusting of them. Two it was better to stay consistent so that if any change was to occur she would have something to compare. So she went ahead and checked me then. I was still 7 cm but my cervix was almost completely effaced now and baby was -1 station. So there was some progress even if it was slight. As a side note I ate throughout my entire labor. Even in the hospital my birth team brought me food and whenever I got hungry I ate it. I decided to sit upright and labor so baby could be more on my cervix. I labored that way for a few hours and got really tired again.  At that point I just listened to my body and decided I needed to lay back down. After resting for a little while a new resident (jackass) doctor came in the room. He was the senior resident on the floor. As soon as he walked in the room I knew it was going to be some BS. He walked in with a very cocky attitude which immediately turned me off. He has been from that point on referred to as Peter Parker because that is who he looked like.

Ok so the first thing he brings up is that I have had 2 c-sections and there is this risk of uterine rupture. I stated that I am aware of the risks but I have also had 2 successful VBA2Cs with no uterine complications and that alone lowers my personal risk factor. He then went on and on about how there are studies that show that a prolonged labor increases the uterine rupture risk. I stated that was all well and good but my last labor was a 4-day event and my uterus held up just fine thank you. And I also told him that I am also very well aware of the risks of repeat c-sections and so long as me and my baby are ok I will not be consenting to a c-section. Then in the same freaking breath this idiot states that since my labor has stalled out for so long that at this point their recommendation is to begin some Pitocin to increase the strength and intensity of the contractions. My response was um… hello I have two scars on my uterus. Pitocin will most assuredly increase my risk of uterine rupture so I will not consent to that either. I have never had a "textbook" labor and I will not up my risk factor simply because my body is not going fast enough for you.

Needless to say he didn’t exactly like my response so he tried a new tactic. My water was broken so he spoke about the increased risk of infection which I am informed enough to know that it is cervical checks that increase the risk and that I was limiting the number of those. My temperature was normal, the baby was not showing any signs of distress in the least bit. At that point it was a non-issue. He then goes on to suggest that I get an internal fetal monitor so that *he* can better gauge my contractions because he just isn’t sure how strong they are and that this will also give him a better idea if a uterine rupture was to occur. So we just talked about the increased risk of infection from my water being broken and yet you expect me to allow you to put a foreign object in my baby’s head so that there is a direct line from the hospital and its germs straight to my baby?? Um yeah, no thanks. I declined the offer. I stated again I don’t labor according to his textbook and so long as my baby is ok and I feel ok I will continue to labor. ( Not to mention the monitors were showing contractions and heart-rate perfectly. There was absolutely NO need for the internal monitor.)

He again did not like my response. My midwife was not in the room when he first came in so she came back in the middle of the conversation. He again stated that “we like to see you dilate a cm an hour and you have been at 7 cm for several hours now”. I told him for the third time that I am not going to labor according to his rules or his books. I know how my body labors and I have NEVER had a “textbook” labor and refuse to be pushed into interventions based on that alone. His response was well I tell you what if you haven’t made any progress by 5:30 am we will go ahead and do your c-section then. (need to mention here that his shift ended at 7:00 am so that time limit was based solely on that) I said no absolutely not. I am not consenting to a c-section because my body is not following your rules. I am not going to be put on a timeline. And at this point my midwife stepped in and said that I had already had this conversation several times and it is now bordering on harassment. He really took offense to that and said he was not harassing me, but he was in my opinion. He said he just wasn’t clear on when I would consent to a c-section. She and I both said when it’s emergent. I asked to please relay this message to the rest of the staff because I was starting to get really annoyed at having the same conversation over and over again. His boss was the same one on the floor that was there when I got to the hospital. He made one more remark about not knowing what my contractions are doing and my response was every contraction does something. He finally left me alone and I told the nurse (the one trying to VBAC who was there for this entire conversation) that I did not want him anywhere near me when the time of birth came. We never saw him again.

I have to mention here that the manner in which he approached me made me feel like he conversated with the other residents along with his boss (who had already made it clear his recommendation was a c-section) and that he probably made a bet with the other residents that he could convince me to either a-] consent to a c-section or b-] convince me to consent to interventions that are notorious for increasing the need for a c-section, such as Pitocin and internal fetal monitoring. I say this because for each thing he tried to throw at me I threw something back at him and his face resembled that of a chess player who thought they had you and then you took their chess piece.  He came at me with a very car salesmen like approach and I can easily see how a woman not educated or a woman that has any doubts in her ability to birth could fall into the trap which so easily leads to c-sections.

Back to the birth novel though, so I am sure that caused some stalling of labor because I was pretty agitated. My contractions spaced out a bit and I had to take a moment to vent about him being such a jackass.

I labored sitting up for a while again and it was starting to get late I was hoping for some type of change.

October 25th

12:00 am—It was sometime between midnight and 1 am I requested to be checked again to see if there was any change at all. My epidural also seemed to not be very strong as I was feeling a lot of intense pressure. She checked me and I was still 7 cm only now I had a swollen lip of cervix in the front. UGH.  I know that I have this happen because both my last labors I had a cervical lip. I was just so frustrated that no change had been made yet. The baby was perfect on the monitors though and other than being annoyed a little I was fine too so I labored more.

Khadijah and her daughter had to leave so they left and my husband and midwife laid down to get some sleep. The lights were turned down and I was there laboring alone, which honestly I think I needed. I laid on one side for about an hour and a half and the contractions were coming closer together and I was feeling so much pressure in my pelvis and rectal area. I swear it felt like she was coming out of my butt LOL. I switched to the other side and labored there for another hour or so and I had one contraction that made me feel like a mack truck hit my pelvis. I think this may have been when she finally engaged. The pressure was so intense. I woke my husband up around 4 am because I just needed him. I should have known I was in the transitional high stage after I said something really crazy. I remember during one of the contractions I was visualizing people surfing at the beach. Don’t ask I have no idea it was just the picture that was in my head. When the contraction was over though I made the comment “Or maybe we could get her a skateboard”. LMAO I swear I still have no idea and my only explanation was I was delirious from lack of sleep and high on transition hormones LMAO. At this point I remember feeling like being on my side was getting to be too uncomfortable. My husband decided to wake up my midwife and helped me get into an upright position. It was nearing 5:00 am at this point. Sitting up must have made the epidural stop working on one side because I could feel the contractions  more intensely on one half of my uterus. So they got the nurse and she came in and turned the epidural up some and had me lay back down on my side.

At this point my midwife had “the conversation” with me. She really just wanted me to be realistic and asked me how long was I really willing to labor at 7 cm before considering a c-section. I had not been checked yet and really had no intention of being checked at that point. Enter meltdown number two. The thought of another c-section brought me to tears. My midwife apologized profusely and said she didn’t mean to make me cry she just wanted me to think about that as a possibility since we had been at it for so long.  I was really upset and just did not want to go thru another c-section recovery and I knew that if I had a third one I would never have another baby again. And that had me feeling heartbroken because I do want at least one more baby. But it was a real thing that I had to consider.  I had been hoping for a change from 7 cm for 30 hours. I couldn’t get my hopes up that something was different although the pressure was different and I did feel more transitional.

So I made the decision that I would let the nurse check me one more time and that based on her findings I would consider my next step. If there was still no change I would not agree to a c-section before shift change.  I also requested that I not be separated from my baby if I did have one. I also requested that I still get checked once more before wheeling me to the OR.

5:30 am—My husband stepped out of the room for a little while. He was also pretty emotional and did not want me to have a c-section. He actually left the room to go pray that we could do this naturally. While he was gone the nurse checked me. And HOORAY! I was 9 cm with just a slight anterior cervical lip and the baby was at 0 station. She said next contraction she wanted me to push through the lip. I did try and was ok with it because I have done it twice before. My cervix always has a lip. Well let me just that hurt like HELL. That was probably worse than the labor itself. I thought I was going to die and I begged her to just please stop.

So at this point the plan was for me to labor down and see if we could get rid of the rest of that lip of cervix. I had one contraction and my body wanted to push I knew I had the lip though so I changed my breathing to avoid pushing. I allowed myself to bear down a little just enough to ease the feeling. I had two more contractions that were mild. I could tell my body had switched to pushing contractions. I had another contraction in which I felt a strong urge to push but I really did not want my cervix to swell. I mentioned that the urge to push was getting stronger. My midwife told me to bear down a little if it made me feel better.

6:15 am—My husband needed to go make morning prayer and mentioned that he was going to go do that and I told him not to go because I needed to push. The next contraction came and I had to push and did and my midwife was there and said yup baby is coming and the baby begin to crown. My husband went and got the nurse who came in and looked and saw the baby crowning so she called the docs. My next contraction I pushed again and seems like the head must have come out with that one. I am not sure all I remember is the ring of fire and the feeling that I was giving birth out of my butt LOL. I pushed again and She was born at 6:25 am. I had a mild skid mark that didn’t require any stitches. She had passed meconium but was fine all they had to do was suction her out real good. She didn’t need any oxygen or anything. They brought her right over to me and we did skin to skin contact for a good hour and a half before they weighed her. I nursed her for about an hour. She was then weighed and measured.  She was 8 lbs. 11 oz. and 19 in. long.

So a few things I would like to mention about my birth novel.  Every birth that I have had has had some kind of lesson in it along with some type of healing in it. The lesson this time for me was one of patience and also being able to share with other women how powerful we are in birth. Our bodies are amazing things. My body knew that I was tired and this kept my labor stalled out as well and each time I took a nap in the hospital my contractions would space out.  VBAC labors do have a tendency to be a little bit longer as well as be all over the place contraction wise. When we think of our bodies and why this may be it may help to deal better with a stalled out labor. Our body naturally will do what it can to protect an injury. The scar on the uterus is essentially an injury. My body would stall out and dilate slowly as a means to not over extend my uterus, and this is truly what increases the risk of rupture when the uterus gets over extended and is not able to properly recover. I say this for those attempting or who plan to attempt a VBAC in the future. Trust your body. Listen to your body.  Do not let “textbooks” dictate how your labor will go. The only women whose labors are textbook were the ones who inspired the textbook. More often than not your body will do exactly what it needs to do in order to birth your baby. Never be in a rush. Remember slow and steady wins the race.

“Nature does not hurry, yet everything is accomplished.” – Laotzu


  1. mashallah thanks for sharing

  2. masha'allah sis, beautiful birth story. i'm so proud of you and so very happy for you.