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Joanna's VBAC

10/20/2013

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Joanna blogs here.  
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Our baby girl was born on 6/13/13.  After almost 48 hours of induced labor, I was blessed to have a successful VBAC!  Here is my birth story and why I decided to attempt a VBAC birth (vaginal birth after c-section).

On 4/1/11, I had an emergency c-section with our first daughter, Elyssa.  I was induced at 37 weeks because the fluid around Elyssa was too low, my BP (blood pressure) was high and I had protein in my urine.  After being in the hospital for almost 48 hours, pumped with different medications, being subject to different interventions attempting to jump start labor, being forced to stay in bed on one side because of my BP, the already challenging and disappointing experience ended in an emergency 
c-section.  In surgery it was discovered that the umbilical cord was wrapped around Elyssa’s neck which was causing her heart rate to drop.  Though I was sad and disappointed about having to have the c-section, I believed that we made the right decision.  Our health was at risk and I was grateful that we both were ok and able to leave the hospital together without any complications.

While I had to seek God’s peace and determine to be happy despite not having the birth that I desired, I did determine that I wanted to attempt a VBAC the next time. When we found out that we were pregnant on Elyssa’s first birthday, we were both so surprised and overjoyed.  Sadly, that pregnancy ended in a miscarriage the next month.  I was heartbroken and we sought couples grief counseling immediately.  I wanted to build myself back up emotionally, spiritually and physically so that we could get pregnant again.  God showed himself faithful and on our last day of counseling, we reported to our therapist that I was one month pregnant.  While I was super excited to be able to conceive again, I knew I had a journey ahead of me. I wanted a complication free, worry free, peaceful pregnancy and a successful VBAC birth.  I truly believe that NOTHING is too big for my God so I took my fears, anxiety and concerns to the cross and asked God to guide me and protect my baby and help my body to do all that he created it to do.

I messaged Keva Zeigler Williams, who is also a doula and an associate of mine on Facebook and asked her if she knew of any doulas in the Southfield, MI area who were knowledgeable about VBACs that would work with me for a reduced fee.  The associate messaged me back within a few hours and gave me the information to a lady name Cate Stolz.  She said that she reached out to her doula network and asked if anyone would be able to help me and Cate replied and said that she’d love to meet me. I contacted Cate that day, set up and interview and the rest is history!  We immediately clicked and we hired her as our doula.

Cate met with my husband, mom and me three times to develop my birth plan and to educate us about VBACs, medication options, tips for natural labor, positions and massages to assist with labor and so much more.  Cate was always respectful of our desires and beliefs and remained patient and compassionate as she answered my questions and eased my mind about certain concerns.

I educated myself about VBACs and talked to my friend Erica Andrews who had been blessed to have a successful VBAC.  My network of mommy friends were encouraging me, praying for me and cheering me on every step of the way.  Erica, Stephanie and Shereena had all had awesome experience with doulas and midwives and were helpful in educating me about why a doula would be an added blessing during my birth.  My husband was on board with me birth plan and was hopeful that I would get the birth that I desired.  He remained encouraging and supportive
from the beginning to the end.

My BP remained stable and the end of my pregnancy arrived and Elaina appeared to be very comfortable in my womb.  I was not dilating or showing any signs that labor was approaching.  My OB told me that she would induce me at 41 weeks if I had not gone into labor on my own.  At 39 weeks I became concerned and desperate to go into labor on my own.  I tried many recommended methods to induce labor naturally. I read a book by my friends Pastors Rich and Karla Walker entitled "How To Give Birth In The Presence Of The Lord."  I contacted Pastor Karla on Facebook and told her about my desire to go into labor naturally and to have a VBAC.  Pastor Karla sent me encouraging words about the remaining days of my pregnancy as well as my labor and delivery. After asking me a series of questions, she also developed a Customized Natural-Induction Guide just for me.  The tools given to me inside my CNIG helped me to remain at peace and the interventions used helped to prepare my body for labor.

I was induced on Tuesday night, 6/11/13.  I was concerned that being induced would cause me to end up with a repeat c-section but I continued to pray and ask God to be with me and our baby. My doula Cate came to that hospital every day that I was there, sometimes twice a day.  My husband and mother also remained by my side.  Unlike with my first pregnancy, I was educated about the different interventions and medications and was able to advocate for myself.  I was confident and bold enough to say no when the doctors on call attempted to rush and intimidate me into breaking my water too early.  I was bold enough to fire one doctor who was clearly not in support of my VBAC and was cocky and even rude.  I continued to get out of bed and walk the halls and get on the exercise ball until I received the epidural later in the day on 6/12/13.  The nurses were frustrated because they had to continue adjusting the baby monitor on my belly because I wouldn’t stay in bed and just lay on back like a good patient.  My husband told me not to worry about the monitor, just to remain active and let them come in and fix it.

I received an epidural after being in labor for 24 hours with no pain medications and no labor progression.  I had been at 5 centimeters all day and was in a lot of pain.  I tried one dosage of pain meds in my IV but that was a huge disappointment.  The IV meds may have worked for 20 minutes and then the intense pain was back and for some reason felt even worse than before.  I was afraid to get the epidural because when attempting a VBAC, you should avoid as many interventions as you can so that you decrease your chances of complications.  Also when I received the epidural with Elyssa, her heart rate immediately went down and I was wheeled into the OR.  After receiving the epidural I was able to get a good night's sleep and prepare for the big day. 

The next morning is when I fired the doctor on call because of his negative attitude and him telling me that the chances of me receiving a c-section that day was high.  I knew that I had not been making progress, that my water had been broken the previous afternoon and that I had a c-section once and might end up with another.  I DID NOT need a cocky doctor with poor bedside manner to wake me up at 6am to tell me those facts.  My internal monitors to monitor my contractions and the baby’s heart rate continued to come out (I had them both inserted three times a piece already) and the doctor was insisting on going inside of me and putting them back on and my husband said no.  He told him that my cervix is shaped awkward and it’s hard to get to, therefore it hurts like high heaven everytime I'm checked.  Also, since my water has been broken, to reduce the risk of infection, we should reduce the number of checks and internal interventions. The doctor continued to insist that I had to get the monitors inserted again anyway.  I said ok thank you and when he left the room and informed my nurse that I wanted another doctor assigned to my case and I wanted to speak to my OB immediately. 

It turned out that my OB was on her way to the hospital to see me.  It was 7:30am by this time. She checked me and I was at 8 centimeters!  I was overjoyed after being at 5 for a day, to move up to 8 was such a victory!  My OB agreed that I did not have to have any more internal monitors and she ordered me to get more pain medication when I was ready.  When my OB checked me at 12pm or 1 pm I was at 9 centimeters.  I was making slow progress but hey, at least I was progressing.  My OB went back to her office and I had to continue to labor.  All that day my pain was intense.  The epidural did provide me some relief in certain areas but did nothing for the pain and pressure in my back and butt.  My husband, mom and doula continued massaging the different parts of my body throughout the day.  Often times they were massaging different body parts at the same time while worship and praise music played on low in the background.  The three of them were rock stars, they were my dream team!  Both of our fathers were in the lobby, praying and being supportive from a distance.  Most of the afternoon I was quiet and focused on my goal.  My eyes remained closed and I rarely spoke.  Sometimes I practiced my breathing when the pain or pressure felt too intense.  Sometimes I hymned or moaned but I kept praying in my head, Lord help me, give me strength.  Words can’t describe how my body felt or the state of mind I was in.  All I can say was I was determined and focused and I kept my eyes on Christ.  I was picturing my baby girl’s arrival.

Around 2-230pm Rolisia, one of my closest sistafriends, surprised me and came to visit.  She came to pray in the hall outside my room but my father encouraged her to go into my room to see me and encourage me.  I don’t believe I opened my eyes much during her visit because I was in so much discomfort but I was super glad that she was there.  My parents, my husband, Rolisia and Cate and I took hands and had prayer.  Rolisia prayed a POWERFUL on time prayer with such authority and boldness and my faith was completely stirred up!!  I was coming down the home stretch of my journey and her bringing the presence of God into my room was just what I needed to finish my race!  Now that I think about it, the only time I cried the entire time I was in the hospital was when she came to visit.  Rolisia and I have been friends since we met at college in 1999 and she is the sister I never had.  To have her obey the Holy Ghost and come to pray for me meant so much because I was tired and casting down fear and I needed all the support that I could get!

The on call doctor checked me at 4:00pm and said I was at 10 centimeters and needed to start pushing even though my OB had not arrived back to the hospital yet.  Hearing the phrase, “it’s time to start pushing,” was bittersweet because I was so excited that my body and baby had worked together and I was going to get a chance to have my vaginal birth BUT I was so nervous at the same time!  I handed my camera to Cate and asked her to take pictures during the birth since my husband and mother were going to hold my legs.  I did a few pushes and the baby started coming down faster than they expected and my OB still wasn’t there so they asked me to try to wait for her.  My OB ran through the doors, told me exactly what to do and Elaina was born 20 mins later!!

It’s an indescribable feeling when your legs are in the air and you’re pushing with all your might and there are lots of people in the room all looking at your vagina and cheering you on.  Everyone kept saying, "she’s almost here keep pushing, push harder push harder."  I never cried or yelled throughout my 40 minutes of pushing.  I remained focused and wanted to save my energy for the battle.  I would push while my doula counted to ten then I would rest for a few seconds and start pushing again.  It was intense to say the least but once I felt her shoulders slide out and then the rest of her body, I was in awe and felt pure joy.  My OB lifted Elaina up so I could see her and we saw how big she was and my and my husband's eyes got so big!  She was almost 9lbs! They laid her on my chest so we could meet and Eddie got to cut the cord.  They cleaned her up and examined her all in our room.  I had to birth the placenta which was a little painful and messy but I didn’t care because I had done it, I had given birth vaginally and my baby girl was finally here and doing well.  I did get two stitches as my take home prize but again I wasn’t complaining.

Elaina wanted to nurse as soon as they gave her back to me.  Everyone but my mom and Cate left the room to get us food and to call the family and share the good news so I was able to nurse my precious newborn in peace.  Elaina latched on perfectly and nursed like a pro.  I truly enjoyed nursing my first daughter and was excited that my nursing journey with Elaina was starting out so well.

Our first night in the hospital with Elaina was perfect.  Elaina and I were both healthy and happy and were able to go home from the hospital that next day at my request.  I couldn’t wait to see Elyssa and have her meet her new baby sister.  Elyssa was excited and curious about her new sister and it was cute to see her stand next to her rocker and watch her sister sleep. It felt so good to have my family back under the same roof together with our new addition sleeping soundly next to our bed.  Once again God had shown himself mighty and faithful and I went to sleep with a smile of happiness and gratitude on my face!

If you are a woman who hopes to have a VBAC, I encourage you to get educated, locate an OB who supports VBACs and to build a support system.  Never lose hope, no matter what it looks like. Remember that your body was created to birth babies and Lord willing, you will get the birth that you desire.  While VBACs are important, we must remember that our health and safety as well as our babies always come first.  For different health reasons, VBACs are not an option for some women and that is ok.  We do not receive medals based on how our children come into the world. I’m really encouraging the women that are healthy and completely able to have VBACs to know their rights and take control of their births.  The medical professionals sometimes have their own agenda so the more educated you are and support you have around you, the less likely that you will be bullied into having a repeat c-section.

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2 Comments

Hawa's VBAC

9/6/2013

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I live in London, UK and birthed in an NHS hospital. My first baby was a planned all natural water birth at a birthing center that ended up in an emergency cesarean for failure to progress. I had spontaneous labour, followed by nearly 3 days of exhausting prodromal labour which resulted in me requesting an epidural as soon as I was 4cm and 'officially' in labour. Things went down hill from there.


Looking at my 10.5 week old baby girl Aisha sound asleep, I am struck by a sense of familiarity. It is like she has always been here, always been mine and we were merely introduced again through the process of birth.  It's hard to believe I carried her for one day shy of 43 weeks.  She almost didn't want to come out.

When I fell pregnant 8 months after my son's emergency cesarean, there was no doubt in my head that I wouldn't or couldn't have her vaginally.  I plunged myself into research, I read birth stories and scientific publications.  Most of all, I supplicated to the Almighty to guide me towards what was best for both of us.

My pregnancy was uneventful.  By that, I mean I was besieged with the typical pregnancy niggles but nothing so bad as to make me never to want to become pregnant ever again.  Nevertheless, I was put under consultant care because of my previous cesarean - I was considered high risk.

At my 24 week appointment, my consultant was understanding of my intention for a VBAC.  She explained the pros and cons of a VBAC vs repeat cesarean all the same. However, when I saw her again at 36 weeks, she mentioned that a VBAC was too risky and that she attended one recently where a rupture occurred and the baby died.

I was too shaken by her revelation and left the hospital deflated.  It was not at all what I expected to hear 4 weeks to my due date.  I chucked it down to her being still shaken by the awful experience of witnessing a baby dying.  In hindsight, I realise if it had been a mother who had died from a cesarean under her watch, she would not have used it as justification for encouraging me to have a VBAC!

I know ruptures are rare. Statistically they occur in roughly 1 out of every 200 spontaneous, unaugmented VBAC births.  So I was not under any illusion that I was 100% safe.  It was around this time when I was researching the rights of birthing mothers under the NHS that I came across the statistic stating black women were less likely to be successful at a VBAC than white women.  I thought to myself, hell no, this baby is coming out of my vagina and that was that!

I saw my consultant again at 38 weeks.  She checked my cervix and declared I was just 1cm, barely effaced and labour was, to use her words, "not imminent."  Again she tried to coax me into a RCS but I reiterated that the only time I will consider a cesarean is if it was an emergency.  I then whipped out a giant notepad with questions and it shut her down immediately.

Well, by 40 weeks my due date came and went with nothing significant happening.  My midwife gave me a membrane  sweep and signed me off her care.  Besides Braxton Hicks which were irregular and unpredictable, I was just your garden variety pregnant woman waddling from point A to B, thoroughly fed up with being pregnant and eager to meet her baby.

I checked into hospital around noon at 40+12 weeks for an induction.  My plan was to wait for spontaneous labour, but hubby and I decided the anxiety of waiting and possible stress of daily fetal monitoring with a 17 month old toddler in tow would be too much to handle.

In triage I was strapped unto the monitor which showed baby was moving but not as much as it was expected to.  By 8pm I was taken to the delivery suite.  I went through my Birth Plan with the midwife which was to be minimal interventions, delayed cord clamping, skin to skin, no offer of pain relief unless requested and most importantly we did not want to be told the gender; we wanted to find out ourselves.

Around 9.30pm my membranes were ruptured, baby had passed meconium but they weren't too concerned.  I was about 2cm, my cervix had thinned out but baby's head was still a bit high.  I was allowed to walk around for 1 hour to get things moving.  Hubby and I went to pray and afterwards headed downstairs to grab something to eat.  We had to hurry back to my room because I underestimated how much fluid leaks post waters breaking.

At 11.30pm, syntocinon (pitocin) was administered starting from the lowest dose and an increments every half hour.  I was contracting every 10 minutes on my own prior to this and still strapped to the monitor but was sat on the exercise ball.  I was able to bounce up and down and wiggle around to help baby descend.

I remained mobile and upright for most of my labour, either rocking gently on the ball or leaning against the edge of the bed.  Every 30 minutes the dose was increased and my contractions got more intense.  I was coping well with gas and air.  It made me so high I was giggling in between contractions yet it did absolutely nothing for the pain itself.  Contractions were coming hard and fast, I was having one every 3 to 4 minutes.

5 hours later I had had enough, cue screaming for an epidural.  Nothing helped with the pain, plus I had a weird pushy feeling at the end of each contraction.  I would scream at the beginning and then grunt against my will towards the end.  I can't remember telling the midwife I had an urge to push, but if I did, nobody took me seriously.

The anaesthetist took forever to arrive and forever to insert the epidural, all the while threatening me with paralysis if I didn't keep very still.  As soon as it was in, I heaved violently and nearly passed out from low blood pressure.  When the epidural kicked in, hubby and the nurse piled my numb legs unto the bed.  Just at that moment, the Dr was doing her rounds. She wanted to check my progress only to see a head of hair peeking out.

She says to the midwife, "deliver her." Those were the most beautiful words I had heard all day. I was ecstatic.  I couldn't believe it was finally happening.

I tried to push but felt nothing.  Darn epidural!  I was completely numb waist down.  I KNEW I was bearing down but the Dr said I wasn't.  Then baby's heart rate began to drop.  She told me baby was stuck and needed to come out ASAP and to push really hard.  I pushed and pushed but baby wouldn't budge.  So she said she was going to do an episiotomy and then use a ventouse to help baby out.  Two assisted pushes later with a lot of coaching and and encouragement from hubby, our precious baby slid out.  A screaming 3.589kg (7lb9oz) wriggling red lump of a baby.

She was immediately placed on my tummy, with her back to me,  while they waited for her cord to stop pulsating.  I was too giddy with emotions to check if it was a boy or a girl.  Then hubby told me and it was as if I had always known.

While stitching me up the Dr said she was born with a nuchal hand and I received a second degree tear.  If you ask me, it was all worth it.  I felt and still feel incredibly blessed.  It was my ideal birth, despite the pain from induction, despite it not being as intervention free as I has envisaged, despite getting an epidural 10 minutes before she was born, despite repeated warnings that I will be wheeled away for a cesarean if I didn't progress, I would do it over again in a heartbeat.  I thank Allah for His Mercy and Compassion and for the wonderful blessing He bestowed on us.

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