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Marci's Home VBAC

8/23/2013

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This is the story of the HBAC of Cayla.  In many ways, it begins with the
birth of her older sister, Annalise, so I’ll start there. Forty-nine hours into
labor, I was transferred to the hospital, and after fifty-six hours of pain-med
free labor, Annalise was surgically delivered via caesarean section. I had the
classic occiput posterior labor with Annalise: back labor, painful contractions
that inhibited rest, very little dilation for all the laboring done. I was
fortunate that labor started soon after PROM with a gentle nudge from homeopathy
and acupuncture, but since her amniotic sac was gone, once she turned from ROT
to OP position she had a really difficult time turning into either the OA or LOA
positions that are ideal for vaginal birth. Although I only had maybe three
vaginal exams during my labor with her, my temperature started to creep up at
home, at which point we abandoned our plans for a homebirth and heeded our
midwives’ advice to transfer to the hospital. By the time I got to the hospital,
I had a full-blown fever, and both my heartrate and Annalise’s were
tachychardic. They managed to get my heartrate down after administering
antibiotics and fluids, but her heartrate remained high.  The OB on call
recommended pitocin to expedite delivery, because there was only so long I could
go on laboring now that Annalise’s heartrate was tachycardic. She also wondered
if the tachycardia might be due to Annalise being in a sleep cycle, but as labor
progressed, it became clear that this wasn’t the case.

I did all the things that generally increase the chances of successful,
non-traumatic vaginal birth: I remained pain med free until they wheeled me into
the OR and gave me a spinal for the c-section; I was active during my whole
labor, trying to use various positions to help Annalise move out of her
malposition into optimal birthing position, and I only accepted interventions as
they became truly medically indicated. Despite this, Annalise was born with an
APGAR of 2, was a “Code pink” baby and had to be resuscitated for a long time
after birth. I’ll never forget what it was like to hear the terror in the
pediatrician’s voice.  He hadn’t intubated Annalise, thinking she’d be okay. 
(The OB was going to go ahead to surgery without the pediatrician present; my
midwife intervened and insisted that the pediatrician be there specifically
because Annalise’s heartrate was so high and she thought he might well need to
intubate her at birth. [sigh])  Turned out she had thick meconium and mucous
blocking her airways and the suction device got clogged and stopped working. A
back up suction device wasn’t handy, and he started to shout to the staff “I
need suction! I need stimulation! Code Pink! Within seconds, people were pouring
into the room from all doors, and working on Annalise.  After all that, her
breathing still wasn’t okay, and she was in the NICU for 48 hours.

I figure I did my best, and in life, there really are no guarantees. Most
times, what you accomplish will reflect your efforts. But sometimes, what you
accomplish won’t be what you envisioned.  I tried to give Annalise a good birth
and that didn’t really happen, but I really did try my best….so I leave it at
that.  Despite the fact that the birth didn’t go as planned, I am so thankful
for those in my immediate and church family who prayed for me during the birth.
I truly do still feel that God protected Annalise and helped her to be born just
in time.

When I returned home five days after my c-section, the waterbirth tub we’d
rented was still full of toasty warm water….and I’d never gotten in because of
the hospital transfer. Ouch.

When I got pregnant with Cayla, I knew I was going to try for a VBAC. I had
done research into the risks and benefits of VBAC versus RCS, and knew I wanted
to at least try.

What I didn’t know was whether or not I was going to attempt VBAC at home or
in the hospital.

 [Well, I knew what I wanted....]

 I live in Ontario, Canada, and here, we have one of the best midwifery
systems in the world. So I could choose to have my birth at home or in hospital,
and because midwives here must attend both hospital and homebirths, I knew that
if there were signs I needed to be transferred, the midwives would recommend
transfer because – unlike some other places in the world – transferring to the
hospital setting would not prevent them from continuing all my care and would
allow them access to any necessary interventions. Still, the question of birth
location is one I discussed at length with my husband Orett, my doula Jo-Ann,
and my midwives, Kara and Edie.

 There isn’t a lot of research on HBAC, but my main question was whether or
not, in event of emergency such as uterine rupture, I would actually get access
to lifesaving surgery any faster by being in a hospital. Because of how close I
lived to the hospital, and the hospital’s “decision to incision” time of 20
minutes according to my midwives (the OB I consulted with at the local hospital
was reluctant to guarantee a “decision to incision” time of sooner than 30
minutes, but the midwives use 20 minutes to err on the side of caution when
advising a client about whether or not HBAC is generally a safe option in her
specific case), I actually wouldn’t receive lifesaving surgery any faster by
being in hospital. Of course, people have become accustomed to believing in the
inherent safety of all things hospital and most folks actually think that,
should there be an emergency, lifesaving surgery is performed immediately. Even
when the call for surgery is made and given priority status, real life just
isn’t like it is on many medical TV shows: rescue efforts still take time. My
distance from the hospital meant that should my uterus rupture, the midwives
would make the call in immediately so the hospital could get everything ready
for surgery and they would run all my IV lines and prep me for surgery in the
ambulance: I would arrive at the hospital BEFORE the hospital was even ready to
make an incision. Once the hospital was ready, they’d give me general anesthesia
and surgery would commence. If I lived further away, or lived close to one of
those rare but awesome hospitals that had a “decision to incision” time of five
or ten minutes, the hospital would’ve been a safer place for my birth; however,
my proximity to the hospital and its “decision to incision” time opened up HBAC
as a safe option for me.

 I hoped, though, to avoid needing surgery and interventions in general. So
from July 2011 till I gave birth, I faithfully went to chiropractic care to get
my spine and pelvis in optimal condition for birthing (I was in a car accident
just before I got pregnant with Annalise, and – despite four months of
physiotherapy – still had problems with my pelvis and spine).  I ate healthy,
tried to remain active, took lots of vitamin D (to lower chances of c-section
birth), and vitamin C (to prevent repeat PROM scenario and increase my body’s
natural oxytocin levels). I took Gentle Birth Formula, a tincture to promote
uterine tone and prepare the body for labor. I prayed and asked others to pray
for me when I felt overwhelmed by the idea that achieving a vaginal birth after
caesarean is often harder than getting a vaginal birth as a first-time mom. (My
immediate family and church family were AWESOME about praying whenever I
asked!).  I connected with VBAC support boards that could help me navigate the
emotional and physical politics of achieving VBAC. I hired a doula who
specialized in birth trauma and had worked with VBAC moms before to help me do
the necessary emotional work before and during labor to have a successful
outcome. And I had three sessions of craniosacral therapy, since
spinningbabies.com suggested that body work like this could increase the chances
of malpositioned babies turning to optimal positions either prior to or before
labor. In my case, every time the craniosacral therapist did a session, my baby
would shift from ROT to LOT/LOA, which are better birthing positions. So even
though Cayla did shift back to ROT at the beginning of labor, she did finally
shift to LOA partway through labor, and I do credit this to all the extensive
chiropractic care and craniosacral therapy I received helping to balance my body
for birth.

I had hoped for a shorter birth.  It was shorter – 44 hours instead of 56 –
but not as short as I’d hoped for. We don’t always get what we want, yet, as my
story demonstrates, sometimes it’s still all for the best.

 At my 37 week appointment, I asked my midwife for a vaginal exam, and I was
not effaced or dilated at all. I wasn’t surprised, but because there are things
in my medical history that make me more likely to need an induction, I did want
my cervix to be at least ripe. Part way through the 37th week, I started using three
capsules of Borage Oil and one capsule of zinc orally at night to ripen the cervix.

Around 5pm December 30th, 2012, I felt really nauseous. I didn’t throw up, but just wasn’t
feeling very good. An hour later, I went to the toilet and had a serious bout of the runs. TMI, I know, but I was wondering at the time what on earth I’d eaten to have my system so upset:
I was only 38 weeks pregnant, so I just didn’t quite connect it all to labor quite yet.  In any case, I felt pooped and decided I would go to bed really early. I woke up at 12:30 am on December 31st
to use the bathroom and noticed bloody show.  Within 30 minutes, contractions 8-10 minutes apart commenced. They were long and strong right away, so that put an end to my attempts to fall asleep. Three hours later, the contractions were still strong, so I got out of bed and decided it was time to wash up the dishes I’d left in the sink the night before and do light cleaning. I made eggs and bacon, ate some, and then decided I would return to bed to try to sleep. After 20 minutes, my contractions finally stopped altogether, and I slept for about two hours, only to again wake to strong contractions, 8-10 minutes apart.

By this time, Annalise was stirring, so I got up and set about getting her
fed and ready, etc. I sent my doula, Jo-Ann, an email letting her know that I
had bloody show and had contractions 8-10 minutes apart. She wasn’t supposed to
be “on call” for my birth for another 3 days, but she emailed me right back and
said to consider her on call for my birth now. Contractions continued, and I
closed my eyes and breathed through them. My husband Orett got home from working
a night shift in the ER (he’s a Registered Nurse) and played with Annalise for
awhile. I told him I was having strong contractions and that he needed to get
the proper connector to attach the hose to the faucet, as I would never let him
hear the end of it if I didn’t get a waterbirth this time round because he
hadn’t got the connector in time!  Realizing I was serious, he hustled out to
purchase the right connecting piece. Contractions continued 8-10 minutes apart.
I was tired because I hadn’t had much sleep, and was a bit concerned that this
labor pattern might just indicate that baby was again ROT or some other
malposition. The contractions stopped at 12 noon and I immediately went to lay
down and sleep, only to awake to more too-strong-to-sleep-through contractions
at 1:30pm.

I got up and got more things ready for the baby’s arrival. Contractions were
still 8-10 minutes apart and I continued most of the afternoon the same way. At
around 6:30pm I spoke to my doula about the labor pattern and the fact that I
was a bit concerned about how this was playing out. She suggested taking a warm
bath and then taking homeopathic pullsatilla to see what effect this would have
on my labor. I did this, and an hour after taking the bath and homeopathic, my
contractions stopped. So at 8pm, I dashed into bed….only to – you guessed it! –
awake at 10 pm to contractions 8-10 minutes apart.

I had told Orett it was okay to go to work before I went to sleep because, at
this point, the homeopathic and bath had seemed to stop my labor, so I actually
thought I was going to be the very lucky lady who got a whole night of sleep
before labor resumed: I thought this would be just the ticket to waking up with
contractions 5-1-1.  Orett promised to notify his work as soon as I was clear
about the birth being imminent and return home. So I was really concerned when I
awoke at 10pm with strong contractions 8-10 minutes apart. I was hoping for a
whole night of sleep, not just a couple hours!

Finally, at midnight, I sent a text message to my doula and told her I was
really concerned about the lack of sleep, yet I couldn’t sleep because the
contractions were just too strong and I had to breath through them. She
recommended Gravol, and then asked me if I’d contacted my midwives to let them
know I was in labor. I said no – I’d kept waiting for labor to get to 5-1-1, and
it hadn’t. She said that while she would recommend Gravol, I should really call
the midwives and let them know what was happening and find out their
recommendation. So I did, and my midwife, Edie, was concerned about the lack of
sleep and how that might impede labor. She supported using Gravol…but we had
none. Which isn’t surprising, because I rarely ever take so much as an Advil or
Tylenol; I’m more of a ‘natural remedies’ type of gal.  So I dug around in our
First Aid kit, found and took Tylenol (which did nothing to make me sleep) and
then called Orett to come home at 3:31 am, asking him to bring Gravol. Orett got
home and gave me Gravol. No change – contractions still 8-10 minutes apart and
incredibly intense.

So despite taking the Tylenol and Gravol that were supposed to make me sleep,
I actually didn’t get a wink more.

 I called Edie around 8am in the morning explaining that I still couldn’t
sleep – contractions were just too strong. She offered to come do a home visit
and assess me, to which I agreed. She also mentioned that if this situation
continued, she might have to take me to the hospital to get morphine, as that
would knock me right out and then I could sleep. But she explained that that was
sticky, because an OB would need to prescribe the morphine and depending on what
happened with my cervix, this could create a “transfer of care” situation. Even
though she’d be able to stay on in a supportive role during my birth if a
transfer of care took place, we both agreed that this option should be a last
resort.

 By 9am, both Edie and Jo-Ann arrived to see what we could do about my labor.
Edie watched me during a few contractions and confirmed that I was, indeed,
having really strong contractions.  Edie did a vaginal exam, and confirmed that
I was now 5 cms dilated and very soft, so there was no doubt I was laboring. She
did a stretch and sweep to see if this would launch my contractions into 5-1-1
pattern sooner rather than later. She then checked the baby’s position, and baby
was just as I’d suspected: ROT.  ROT fetal positioning tends to result in
protracted labor, and until the baby’s head is more firmly applied to the cervix
and the baby rotates to a position like LOA or OA, labor and progress are slow.
But I took comfort in the fact that my cervix had dilated to 5cms, because with
Annalise, after all that labor, I’d only dilated to 2cms: she just got wedged
into a bad position early in labor and couldn’t get out.

Edie had me pee on a stick to check for keytones, which I had, so I then ate
some more and she and Orett ran an IV line into my arm with fluids because the
dehydration was so severe. She also gave me more Gravol, hoping it would knock
me out and I’d sleep. No luck – the contractions were just too strong and I
couldn’t even sleep between them.  She brought in some things for the homebirth
and I stayed in bed laying on my left side for hours, trying to ride out the
contractions and wishing I could sleep. Because we didn’t want baby to descend
before rotating to an ideal birthing position, lying down was a good option at
this point in my labor. Edie would come in at intervals to monitor the baby’s
heartrate. I kept hoping and praying that things were going to progress.


Edie didn’t want me to feel like a watched pot, so she and the doula left for
a bit.  Before Edie arrived in the morning I’d called Kitty, my naturopathic
doctor who does acupuncture, to find out if she could use acupuncture to change
the course of my labor. It was New Years Day and I KNEW she might not come, as
it was a holiday. But she knew my story and that I really wanted a VBAC, and I
called, hoping that she just might help me out. She called me back and said she
would come to my home, but was concerned about using acupuncture for labor
augmentation if I was already running on such little sleep. She suggested
instead giving me herbs to reduce the contractions so I could sleep, and then –
after a good sleep – seeing about bringing things on more strongly using
acupuncture.


Now, by this point I was becoming skeptical of the notion that my labor could
be quelled enough for me to sleep – after all, I had ardently been trying to
sleep through contractions to no avail. But I recognized that if sleep could be
had, it would be fantastic. So I agreed. While I waited for her to come, I got
out of bed and labored on the toilet. It felt really good to do that and I
started to feel rectal pressure. I labored there for an hour and then switched
to the birth ball beside my bed to labor more. Kitty arrived after 2pm and did a
full history on my current situation. She gave me a homeopathic remedy and then
gave me some Crampbark tincture to help labor subside. She said that if the
tincture were going to work, it would work within an hour, and said that I
should take a ½ tsp dose every 10 minutes for an hour then wait a bit. She also
mentioned that getting in the tub might also help to dissipate contractions. She
asked my permission to speak to my midwife, and I granted it. She relayed her
recommendations but asked what my midwife felt and left it up to her. My midwife
agreed that if I could sleep, that would be best. But if I couldn’t, it was what
it was. Kitty stayed with me for about half an hour, softly helping me breathe
through contractions, then left.

 I waited over an hour for the tincture to do its work.

 And then I came to my senses.

 
Now faith is the substance of things hoped for, the
evidence of things not seen


~ Hebrews 11:1 KJV~

Contractions were just getting stronger. I realized that our baby had decided
to be born today, and it was time to get about the business of birthing my baby
before severe maternal exhaustion set in and I would be unable to have a vaginal
delivery without some variety of hospital drugs to assist me. I spoke to Orett
about my feelings and he agreed 100%. I called my doula Jo-Ann around 4pm and
told her that I felt sure that the baby wanted to come tonight, and that I was
sure that if I could just birth my baby in the next four to eight hours, I would
get my HBAC and all would be well. And I accepted the fact that if I couldn’t do
it in that timeframe, I was probably looking at having to transfer to the
hospital for drugs so I could sleep and then deliver vaginally. This was hard to
say, as I really believe in not using drugs during childbirth unless truly
medically indicated. But I know all interventions under the sun have their time
and place, and if it was truly needed because I was exhausted, I would accept
interventions.  I also acknowledged that there was the chance of a repeat
c-section if some complication cropped up if I transferred, but for right now I
just had to focus on birthing Cayla.  Jo-Ann mentioned that she loved the
determination she heard in my voice and that I should continue to focus on
welcoming labor now.

 I called Edie and told her that the tincture didn’t work and I was still in
labor. I asked if she would come to my house and check my cervix to see if I had
progressed since the 5cms I was at 9am that morning.  I knew that she had
recommended me calling her when contractions were five minutes apart, and even
though they weren’t, I was completely going on my gut instinct now and asking
her to trust my sense that this was going to happen. Most careproviders ask
women to follow the 5-1-1 rule for their first planned vaginal delivery, as a
woman is usually consider in “active labor” if her contractions are 5-1-1 and
her dilation seems to confirm this diagnosis.   It was ultimately because I was
not experiencing contractions five minutes apart when Edie checked me in the
morning that we were all still waiting for this signal of “active labor.” But by
this point in my labor, I knew that although my labor was not conforming to
standard medical definitions of active labor, there was no doubt that I was
laboring hard.

I also told Edie I wanted to know if the baby had shifted positions, because
I’d been feeling a lot of flailing around in there. And I told her that after
she checked, I intended to get into the birthing pool for at least an hour to
see if the natural oxytocin increase that water labor creates would send us full
steam ahead; or alternately, if this wasn’t “it”, stop labor. I was not going to
transport to the hospital until I’d at least gotten into the water this time
round!

 [By this point, I really doubted that anything would stop labor....but I
wanted to sound rational, because I knew my labor was not fitting textbook
parameters and definitions]

 I suggested that after doing all these things, we could all decide on the
best course of action. Edie agreed.

I walked up and down our house, trying to focus as I listened to my birthing
tracks, and feeling the labor intensity soar.

 I had Orett call my parents and ask them to pick up Annalise, as I was in my
birthing time and felt I needed less distractions now. They came, combed
Annalise’s hair and got her ready, said a prayer for me that that Cayla would
get into the right position for birthing, that my labor would progress, and that
she would be born vaginally. They also prayed for wisdom in all our decision
making as we went through labor. They asked us to keep them posted and then they
left.

I continued to walk around our house, stopping for focused breathing when
contractions would hit, and felt renewed faith that the Lord would hear the
prayers of myself, Orett, our families, and the community of faith (huge shout
out to The Campus Church – our home church in Aurora, Ontario!) we knew had been
praying about this birth for so long.

At 6pm, Edie and Jo-Ann arrived. Contractions were still 8 minutes apart.
Edie checked my cervix – I was 7cms dilated and Cayla had now shifted from ROT
to LOA: the optimal position for vaginal birth. The energy in the room was just
amazing and Orett still talks about how my countenance registered complete
relief when I heard that Cayla was FINALLY in the optimal position for birthing.
We all knew that her newly-altered position dramatically increased the odds that
I was going to have a vaginal delivery, and I was so excited.

 Jo-Ann gave me some homeopathic remedies to gently encourage labor on. I
hopped into the birth pool. For an hour, my contractions didn’t get any closer
together. Edie thought I should stay in the pool longer and felt things were
going well. She even suggested she could break my waters. Since I had PROM with
Annalise, I really didn’t want to get rid of my waters just yet, because AROM
can cause a baby to get into a bad position and be unable to maneuver enough to
get out….but decided I would do it before transport to the hospital if it came
to that. For now, I would just labor with my amniotic sac intact.

 Around 7pm, my contractions suddenly dropped to 2 minutes apart. I
instinctively shifted to hands and knees during each contraction in the water.
Jo-Ann and Orett talked me through visualizations with each contraction. Before
I knew it, I was in transition, and contractions were double-peaking. I felt my
body bear down and water from my amniotic sac shooting out of me like a rocket. 
Finally, Edie said she wanted to check me. I asked her if she could just check
me in the water. She chuckled and said she could, but it would be more accurate
if I got out of the tub.

So feeling quite grumpy about having to leave the birth pool, I got out and
lay on the couch. A contraction hit and I sat up to ride it. When it was done, I
lay back down. She assessed me and said, “Well Marci, you are 9 ¾ dilated with
an anterior lip.” I was so excited and asked if I could just get back in the
pool. Everyone laughed and said that I could.

The urge to bear down just took over. When Edie realized that I wasn’t trying
to push, my body was just ejecting the baby, she walked over to the phone. I
heard her say “client has the uncontrollable urge to push, come right now.” With
this, midwife #2, Amanda, was on her way.

 (She didn’t make it before Cayla came out)

Once my body started pushing on its own, I remember trying to scheme in my
head how I could get this baby out of me in no more than 10 minutes. A mom in
one of my VBAC support groups had recently pushed for only eight minutes and
that sounded like a pretty sweet deal to me…except I really had no control over
the pushing; my body was just chugging her out and the pressure was incredible.
Orett sat by the pool and held my hands and told me I was doing it, that our
baby was coming to us just like we’d prayed for, that the pressure meant she was
almost here, that my uterus was strong, that he knew I could do it. Almost
thirty minutes after I started pushing, I felt the ring of fire. I gasped “I’m
splitting!” as I felt her head crown. Edie asked me to flip from hands and knees
to my bum after Cayla’d crowned and push through the burning.

And at 8:07 pm on New Year’s Day, Cayla Ariel Brown was born, a mere two
hours and seven minutes after Edie had returned to check me at home and found me
to be 7 cms dilated with contractions still eight minutes apart; an expeditious
one hour and seven minutes after my contractions had finally dropped from every
eight minutes to every two minutes.  Her APGAR’s were 8 and 9, and she was seven
pounds, six ounces – six ounces heavier than Annalise had been at birth. It was
so surreal when Edie lifted her out of the pool and placed Cayla on my chest,
and Orett cut Cayla’s cord. I couldn’t believe I’d done it; I’d pushed a baby
out the old fashioned way! I was so overwhelmed with emotion and felt so
incredibly happy and lucky to have helped her have a gentle entry into this
world through waterbirth, with the hormones of birth the Lord designed
uninterrupted by labor drugs, and with lots of hugs and cuddles and
skin-to-skin.  Birthing Cayla in a pool of warm water – in my living room,
beside my fireplace and the twinkling lights from my Christmas tree – was such a
blissful, peaceful experience, and I am truly thankful for this blessing.

 Once Cayla was born, we figured out why – besides her pesky ROT positioning –
it’d taken so long for her to come: she had a long cord, and somehow managed to
get the cord not only around her neck, but knotted at the base. My midwives are
sure that the cord was a significant part of why the labor took so long: with
the cord knotted at her neck, she needed time to rotate and descend through my
pelvis.  We’d planned for delayed cord clamping, but at this point, removing the
knotted cord from around her neck was the priority. Her cord was clamped and
then cut off her neck, and she took her first breath. In a lot of ways, I am
fortunate that I had an amazing birth team at home. Were I admitted to the
hospital at 7 cms dilation with contractions 8 minutes apart, it would’ve been
typical for the on-call OB to recommend pitocin augmentation to “establish
contractions and labor.”   But with the cord so tightly knotted at her neck, the
oxygen deprivation that pitocin regularly causes could’ve easily produced
another distressed baby, caesarean birth, and NICU stay. I am thankful for all
the people who prayed for our VBAC birth, as I know the Lord protected us,
guiding our decision making, so that we would chose the path most likely to
result in the healthy birth of Cayla.

 I hemorrhaged and was hypotensive after the birth, and my midwives were
recommending that I be transported to the hospital. Despite the shot of pitocin
and running pitocin through my IV line after birth, I was still bleeding. There
are other PPH drugs they carry to births, but my uterus had already clamped
down, so some of them were no longer medically indicated. But Orett asked if
they could run one more bag of IV fluids, administer more meds, and monitor my
bleeding and blood pressure for a further 30-60 minutes.  Once the bleeding
stopped, they agreed to let me stay home because Orett had the nursing skills to
continue to monitor me through the night.  (When Edie came for her home visit
the day after Cayla’s birth, she told me that had Orett not been a Registered
Nurse who worked in an ER, she would’ve insisted on transport. I’m such a lucky
gal!!!).  Once it was under control, they applied some anesthesia and sewed up
my second degree tear. (No, I wasn’t even TRYIN’ to get stitched up sans
anesthesia lol!) It was so nice to have Cayla on my chest while they worked on
me, as after my c-section with Annalise, they whisked her off to the NICU
because of her breathing and I never got to see her till 6pm the next day.  It’s
so wonderful to be able to bask in skin-to-skin bonding time after birth.

Even though my first day and a half were challenging because I was a bit
lightheaded from blood loss, baby Cayla and I have both been doing well since
delivery. Orett and I are so thrilled with Cayla’s HBAC birth and hope to do
this again for any other children with which we are blessed.

 MY BODY IS NOT BROKEN!!!!

I will praise thee; for I am fearfully and wonderfully
made: marvellous are thy works; and that my soul knoweth right well 


~Psalms 139:14 KJV~

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Melek's Home VBA2C

8/23/2013

 
This is the story of the home birth after two cesareans of our third son,
Evren Abel, whose birth was the culmination of five years of hoping, planning,
wishing for the peaceful, gentle birth I wanted so badly to give to all of my
children.  I’m sitting beside him, having just nursed him to sleep in our bed,
the bed he was born in, and all I can hear are the lyrics from that song
“Breathe” by Anna Nalick.  “I feel like I’m naked in front of the crowd/Cause
these words are my diary, screaming out loud/And I know that you’ll use them
however you want to.”  I’ve already shared his birth pictures on Facebook and in
a lot of ways, that is much easier than sharing this will be.  This feels a
little bit like baring my entire soul in front of goodness knows who, because
once I release this on to the Internet, I know anyone can read it.  There are
people who just don’t “get it,” this longing some women have to deliver their
children naturally and not surgically.  There are those out there who judge
women who make choices like I did, and I know I am opening myself up to
criticism for it.  And then there are women out there who desperately need to
hear that what they feel is normal and natural, and that their bodies are strong
and capable of giving birth to their babies without the assistance of a surgeon
or a scalpel.  I know because I was that woman.  I am sharing this now for these
women.


When we got home from the hospital after my HBAC turned CBAC in 2010, I sat
down at the computer and I wrote and wrote and wrote and cried and cried and
cried.  That is where the birth of Evren starts, with the processing of the
birth of my second child, Emre, which by the way, I think I just finished two
days ago when I gave birth to Evren.  I started a blog soon after, with the
intention of blogging my way through the prep I would do before we conceived our
third and during our pregnancy and birth.  It kind of quickly turned in to a
huge part of my process, as I realize now that a big part of what I was doing
was trying to understand what went wrong with that birth.  Don’t get me wrong,
Emre’s birth was beautiful, but I wanted to understand why it hadn’t
ended the way I planned and intended.  I had worked so hard for that birth and
the vast majority of VBACs are successful, so why wasn’t mine?  I wrote a lot in
the early months and then as time went on, and life got busy with the boys, I
wrote less and less…such is life.  But the prep continued—Maya abdominal
massages to break up adhesions and scar tissue from my cesareans, reading books
about natural childbirth (more on this later), consultations with a local
perinatologist about our options for a third delivery after my second son’s
delivering OB said something to me about what he discovered internally that I
wanted to get more information on.  I was going to fix whatever it was that went
wrong and we were going to have a VBAC next time, dammit.


At some point during my reading, I stumbled upon a passage in an Ina May book
about how she loves nothing more than to see a mama who is a lawyer shut her
brain off, let her monkey do it and give birth to her baby.  Well, HELLO!  This
really clicked with me, and I realized that my biggest challenge during our next
pregnancy and birth would be to get out of my head, as I tend to live there and
play the “well, what if this, then this and this and then this” game and on and
on.  I could spit VBAC facts at you all day long, but obviously that hadn’t
gotten me the birth I wanted, so I needed to do something to change that.  Don’t
get me wrong, this wasn’t like a one day turn around—I struggled to stay out of
my head, both before and during pregnancy, and in fact, had to enlist outside
help on many occasions (thank you, Catherine!) to keep myself from going down
never ending rabbit holes.


When we discovered we were pregnant with Evren, I was both happy and really
nervous.  I had just decided that we would stop playing fast and loose with
birth control since Emre had recently weaned and get serious about preventing
another pregnancy for awhile.  Little did I know, I was already pregnant.  I
only knew a few things: I wanted a VBAC, no matter how or where, I wanted him to
come before or very soon after his due date so his head wouldn’t be a 15”
unmoldable mass, I did not want the ambulance to come to my house again, and I
wanted him to be smaller than my 10.8 pound CBAC babe.


We decided to keep this pregnancy a lot more private than we did with Emre’s,
because I felt like I let a lot of outside pressure and influence come in to
play in that birth, and I wanted to preserve my peace about this one by keeping
it a little more personal.  To that end, there were no Facebook announcements,
my twitter, Instagram and blog were made private, and we just went about life
with as little fuss about it as we could manage, only telling a few people who
we knew would be unconditionally supportive.  Something about the way I’m built
or the way I carry my babies, I don’t necessarily look unmistakably pregnant
until I’m fairly far along, so it wasn’t much of an issue.


The pregnancy itself was pretty blessedly uneventful.  An early dating
ultrasound put his guess date around 12/2 or 12/3, which was close to my
charting of when he was conceived, which gave a date of 11/30.  We found out we
were expecting our third little boy at the anatomy scan, I confirmed my
suspicions of an anterior placenta that was thankfully up and away from my scar,
everything looked good for a VBAC.  Throughout my pregnancy, I was so blessed to
be supported, encouraged, uplifted, and sustained by friends who had much more
faith in me than I had in myself.  It’s a lot easier to believe other people are
capable of something than you are, especially when you’ve tried before and not
been successful.  I depended on these affirmations from them, they carried me
through.  I hung out with my midwives and they’d talk about how big my pelvis
was and how my body was built perfectly to birth my babies.


I had some grand plans for all the books I was going to read about coping
techniques for natural labor and delivery, but I only ended up reading The Sears
Birth Book (which was really good!!) before I felt myself slipping back in to
that head space that I wanted to stay out of.  So I decided I was going to focus
on reading women’s firsthand birth stories and watching their videos, which is a
nice, no pressure, not at all like studying kind of activity that really worked
for me.  I did have moments where I had to be talked off ledges, and at some
points, I considered making a political statement by showing up to the hospital
and declining a cesarean (that didn’t sound that fun), or renting a hotel room
or birthing at my midwife’s house, which would be slightly closer to a hospital
than I was, but at some point, I realized making all these contingency upon
contingency plans was setting myself up to open the door to allow myself an out
when things got intense.  Obviously I was not opposed to a hospital transport if
it was necessary for my or baby’s safety (and I am thankful that I live close to
one in which I would be treated kindly and with respect should we need to go
in), but I wanted a home birth, and I wanted a home birth in MY home, so I kind
of let those options quietly go.


I saw a chiropractor pretty regularly throughout pregnancy because I wanted
to be on top of positioning.  Dr. Ron was great, and I didn’t deal with a lot of
pain during the pregnancy, except towards the end when my pelvis started to
spread.  I started taking Gentle Birth tincture around 35 weeks based on
testimonials I heard about it.  It couldn’t hurt, I figured and hey, if it
helped, all the better.  As soon as I started taking it, I started having
frequent Braxton Hicks contractions.  I planned for acupuncture at the end of my
pregnancy, just the last four weeks, though, because you know, I wasn’t going
past my due date.  I also took 1000 mg of Vitamin C a day because I wanted my
water bag to remain intact as long as possible.  Which it did.  I mean, that
thing might still be intact somewhere.  What I’m saying here is, I had a really
strong bag.


Around 36 weeks, I had a small Mother's Blessing, which surprise!!! one of my
internet best friends, who I had bonded with over our VBAC attempts with our
second babes, flew in from Florida to surprise me for.  I may or may not have
closed the door in her face when I opened it and saw her on my doorstep.  Sorry,
Christine, I blame shock!! It was an intimate and really beautiful ceremony and
Christine and I had a wonderful weekend of fun together.  I was so blessed
during that time.


At some point, I realized I needed to take a social media break.  There was
getting to be too much distraction and it was taking away from the peace I was
working for, so I deactivated my Facebook account and told my twitter friends
I’d see them in a few weeks.


Also during my third trimester, I started getting these flags with
affirmations on them in the mail from the wonderful women I had met in my due
date club on Mothering when pregnant with Emre.  I thought it was so incredibly
sweet, and was only slightly embarrassed that it took me about 7 or 8 flags
before I realized this was a beautifully orchestrated plan to show their support
and belief in me and my body’s ability to birth my baby.  I can’t say enough
about this group of women.  They lifted me up and believed for me when I had a
hard time believing myself.  Another friend I met on twitter sent me a beautiful
heart shaped rock that said “strength” on it, which I ended up holding on to the
entire time I was in labor until the moment baby was on my chest.  I think every
birthing mother should have one of those rocks.


I had halfway convinced myself that I would be going in to labor on 11/28,
which was a full moon and I also was going to an acupuncturist that day known
for getting babies out.  I mean, this wasn’t my first go round, I’d dilated
before, I’m black, I mean come on!! This baby was totally coming before 40
weeks.  Obviously.  I waited patiently for the full moon to do its thing, and
when it didn’t, I figured it had probably just started the ball rolling.  Surely
I would be in labor by the weekend.  The acupuncturist, Alighta, who is
basically one of the most awesome people I have ever met, suggested I come back
in on Friday and we would try again.  I had used our entire acupuncture budget
in the weeks leading up to the birth at another acupuncture clinic, but this
wonderful woman offered to see me through this pregnancy for no charge.  I go in
Friday and…..nothing.  Well, forget this!!! I had been careful with my diet, but
I could feel babe packing on the pounds in there.  Could totally feel his little
skull bones starting to become less and less moldable.  I wanted him O-U-T.  So,
that Saturday, 12/1/12 (cover your eyes, hardcore natural
childbirthers!!!!!!!!!!!), I tried to “naturally” (insert caveat about how
there’s nothing natural about interfering with any part of birth) evict him. 
Let’s not go in to specifics here, but let’s just say it didn’t work.  My
midwives, who I feel I should say here are very non-interventionist and only
supported me in decisions I made myself regarding this delivery, gave me the
option to keep trying or just wait.  I felt like it was clear that he wasn’t
ready and I decided not to push it.  All of a sudden, I had a zen attitude out
of who knows where, and I just felt like he would be here by the next weekend. 
I could make it one more week, right?  No big deal.


Then Wednesday came.  That freaking hump day will get you every time!!! All
of a sudden, I’m in despair.  Baby is going to 42 weeks, he’ll be huge, I can’t
birth a big baby, we had invested so much in this birth—emotionally, mentally
and financially, and I was going to wind up on the operating table a third time.
  Even though she had offered, I felt so guilty taking Alighta up on the gift of
her services.  Brielle was like “shut your face and call her,” but in the nice
way a midwife does (not really, she said it like that to me, but only because we
are super close).  So, I call Alighta and she tells me we will do it once a day
until baby comes.  I start back up seeing her Wednesday and I am also getting
sweeps, which I had actually started before this 40th week, again, only at my request.  And by request, I mean desperate begging and pleading.  Seriously.


Wednesday.  No baby.  Thursday.  No baby.  Friday.  No baby.  Saturday. 
WHERE IS MY BABY???


Saturday 12/8/12.


I had a second Facebook account which I kept active so that I could keep in
touch with the ladies from Emre’s due date club.  One of them posted to check up
on me.  I mention that as each day goes by, I feel my HBAC, or even a VBAC, slip
away.  I just could.not.birth.a.big.baby.  The girls encourage me to do things
to keep my mind off it before my scheduled midwife appointment that morning, so
I go to the post office and then head to see the midwives.


11:30 See the midwives, beg for a sweep.  4-5 and 70%.  Started contracting. 
Don’t get excited, I had been contracting nightly since I started seeing
Alighta.  Never went anywhere.


1:00 See Alighta. More contractions.  Not getting excited.


3:00 Second strip.  More contractions.  Tons of bloody show.  Not getting
excited.  Been losing plug for weeks.  Contractions not letting up, though.


5:00 Contractions getting painful.  Different than they’ve ever been. 
Confused because I don’t feel them in my abdomen at all.  I only ever experience
them as waves of rectal pressure.  This remained true for the duration of my
labor.


5:30 Go to Sam’s and to get gas in the car just in case.  Start timing and
they are about 4-5 minutes apart, lasting 30-45 seconds.  Thought about walking
around neighborhood looking at lights as I labor.  Quickly dismissed.  Not
leaving house.  Kids starting to annoy me with being loud.  My big kid asks me
“Are you saying ‘oh God,’ because it’s <my uterus> hugging?”


7:10 Text Brielle.  This really hurts.  My bottom hurts.  She’s asking me
questions about the contractions.  I don’t know.  They hurt.  She says take a
bath and try to sleep.


8:00 Laboring away around the house.  Brielle wants to know if she should
come.  Don’t want them to come too early and have labor stall or be really early
on.


8:50 Out of the bath.  Only had a couple more mild contractions in there, but
things pick right back up after I get out.


9:15 Brielle wants to know if she should come.  I’m still not convinced it’s
time.  I’m texting to her and giving updates to my girlfriends.  I can’t be in
that hard of labor.


10:30 I text Brielle that ok, I might finally believe it’s labor.  She
suggests wine.  Choke wine down.  Nothing.  Still contracting.


10:50 I don’t want to do this anymore.  Crying through contractions.  I feel
fine in between, but so much pressure during.   Tell Brielle I can’t do it
anymore.  I want an epidural.  She says they are on their way.  They call me to
listen through a couple contractions.  I’m crying and asking them to hurry.


11:00 Tons of bloody show.  My friend Emily says she guesses I am in
transition.  No way.  With Emre, in transition, no way I could text or update
anyone.


11:55 Last update for my girlfriends.  8 cm.  Midwives here.  Think they got
here at 11:30.  Don’t know.


Time melts away now.  I have no idea what time anything happened from here on
out except the time baby was born.  I’m probably going to get a lot of details
or order of events wrong, but hey…that’s what happens when you’re trying to
remember what happens in labor.  When they get here, I’m laboring in the bedroom
and bathroom by myself.  I have a towel rod that I’m hanging on to.  It reminds
me of my friend Jamie’s birth story and, since I now know how exactly it feels
to want to rip a towel rod off a wall, I almost smile to myself.  Almost.  I
tell Kari I want to punch someone in the face and then go ask her to get my
“strength” rock.  They ask if I want to labor in the water in my tub or the
giant, glorious birth tub.  Giant, glorious birth tub please.  Brielle started
to fill it and I’m working through contractions with Kari as Brielle handles
that.


Brielle’s daughter Kaya is coming to the birth with the other midwife who is
coming just in case, Christy.  So glad Kaya is coming.  She is the best girl
ever, and very calm around birth.  Also, she’s 10.  I can’t freak out and
embarrass myself in front of a 10 year old.  Laura, my dear doula friend, comes
to care for my older boys in case they wake during the labor, which they
did.


I get in the tub and it’s ten times better than laboring in my little tub. 
Don’t get me wrong, it still hurts, but like I’m prone to do, I find the easiest
position to labor in and try to stay there.  By easiest, I mean, my contractions
kind of start to space out and I can get a good break going.  Surprise, my
midwives want me in positions that actually bring baby down and encourage my
labor to keep progressing.  Darn it.  So, ever a lawyer, even if inactive, I
bring my master negotiation skills to the table.  I will do some contractions in
the tougher positions (on my knees, leaning over the edge of the tub), and then
I get to get back in the easy position (sitting on my bottom in the pool with my
back against the tub).  I sometimes negotiate for 30 seconds, sometimes for a
number of contractions.  During contractions, I have Kari count—the contractions
peak at 30 seconds, so I focus on her voice and getting to 30.  Wish she would
count faster sometimes.  During one contraction, I feel myself start to lose
control.  I remember my friend Jordan’s amazing birth with her second babe, when
she talked about how important it was for her to stay present in her body and
not allow herself to slip out of it.  I had started to say “I can’t, it hurts so
bad,” thought of Jordan and started singing “Hurts So Good” by John Mellencamp. 
We all laugh, and I remain present in my body and in the moment.  During a
couple contractions, I chant “epidural, epidural, epidural,” which I remembered
reading in a woman’s birth story.  She said she knew if she could say it, she
didn’t need one.


Kari and Brielle encourage me to reach in and feel—I can feel the bulging
water bag and baby’s head behind it.  I want the water bag to break because it’s
holding me up, I think.  Started to bear down through some contractions.  They
ask if I am pushing because I have the urge or if it just feels better.  It just
feels better and I do little, tiny bear downs during contractions.  Makes it SO
much better!  Decide to break the water—takes what feels like forever, but then
I can reach in and really feel baby’s head.  I tell Kari and Brielle there’s a
baby in my vagina, in case they didn’t know.  I tell them, “I’m going to have a
VBAC!!!” Soon after, I have the urge to go to the bathroom.  You know, the URGE.
  Kari and Brielle get me out of the tub—I thought I was going to have a water
birth, but very thankful for midwives’ intuition.  This baby did not need to be
born in water.  Go to the bathroom because I think I have to go.  Oops, no, time
to push!!!


On to the bed.  Kari and Brielle are down below for the catch and Christy is
by my head encouraging me.  Kaya is taking the pictures I’ve been wanting to
have for so long and Jason is taking some that could be posted publicly.  I
start to push because I want to be done.  Christy reminds me to wait for a
contraction.  Oops, just wanted to be done.  Kari helps me get my pushing
focused properly and she, Brielle and I all provide counter pressure while I
push.  My friend Catherine had told me that during her birth, she pictured
baby’s head as a boulder that she had to use her body to push out.  This
visualization was so helpful, and at 3:31 AM, after less than a half hour of
pushing, my first vaginally born baby flew out in to the world and was
immediately placed on my chest.  Kari and Brielle later tell me that I yell out
“I HAD A VBAC!!!!” before he was even all the way out.  When he was on my chest,
I am crying and saying “I’m the only one touching my baby!!! Am I dreaming?
Please don’t wake me up.”


Post birth rush, posting announcements to Facebook and my VBAC Support
groups, etc.  My husband, Jason, got to cut his son’s cord for the first time
and stay in the room with both of us after the birth, not decide which one of us
to go with (the baby, of course).  My midwives gave us time to bond with baby
alone and then we weighed and measured him.


I couldn’t birth a big baby, but then I pushed a 9.13 pound baby out.


I couldn’t birth my baby if his head was big and hard, but then I birthed a
baby with a 14.75” head that did not mold.


I couldn’t go past my due date and Evren was born right about 41 weeks.


I am happy to report, though, that there were no ambulances called.




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