Lightning, Thunder and VBACs

I went into labor on May 14, 2012 with my beloved Baby Maddox.  I went into labor an hour and a half after my home birth midwife dropped the bomb on me that she couldn't attend my birth.  Thankfully I had a backup plan.  I'd had backup care with an OB practice that used midwives and had actually seen them earlier that day.

The midwife I saw told me that I was 2cm dilated (as I had been for 3 weeks), but she felt like I could go at any moment.  She told me that my favorite midwife at that practice, Jessica Ramirez-Trower would be on call that night. 

Let me tell you a little bit about Jessie.  Yes, she works for a hospital midwifery practice, but she's amazing and is 100% supportive of natural, unmedicated birth.  She is funny, quirky and experienced.  I actually told Adam early in my pregnancy that if I could guarantee that I'd get Jessie, I'd be okay giving birth at the hospital.  Well...that ended up being a bit of foreshadowing...

We had just pulled into the parking lot of Stride Rite (around 7:30pm) to look for a pair of shoes for Bettie.  Once Adam parked, I had a contraction.  It was definitely not a Braxton Hicks.  It was the real deal.  It lasted for about a minute.  I instantly dismissed it and we got out of the car to go in the store.  As we walked in the door of the store, I had another contraction.  It was about 5 minutes after the first.  I thought "this is weird" and started looking at shoes.  Five minutes later I had another contraction.  After 3, I was pretty convinced I was in labor. 

We didn't find any shoes we liked, so we left the store and decided to pick up some Mexican food for dinner.  The contractions kept coming every 5 minutes and lasted a minute.  I kept thinking that they'd probably slow down.  No one has their first contractions come regularly.  I read birth stories.  The body just doesn't work that way.

We went home, and the contractions continued...every 5 minutes.  I didn't really feel like eating.  I called my mom and let my sister know that I thought I was in labor.  I texted Nancy, the home birth midwife and begged her to come and deliver my baby.  She was insistent that she couldn't, but offered herself and her assistant as labor support...at a cost of $1200.  I was hurt and angry that I was dumped, had no time to line up a reasonably priced doula and felt like I was getting the shaft.  I have to say, that wasn't really the frame of mind I'd fantasized about being in for this labor.  Both ladies called and tried to offer support over the phone (for free...haha), but I was so angry with them, they weren't helping, so I hung up and called Jessie. 

Jessie told me that she had another woman in labor and was heading to the hospital and that she'd see me there when I was ready.  Adam asked her how I would know that I was in labor.  Jessie calmly told him that if I felt like I was in labor, I probably was (women know these things).  He asked how I'd know how dilated I was.  She told him that I wouldn't, but if my contractions were coming the way I was describing, it sounded to her like I was progressing.  I told her I was going to stay home for as long as I could, and she was fine with that.

I downloaded an app to more appropriately time my contractions.  I told myself that I wasn't going to the hospital unless Maddox was crowning because I was so afraid of "encouraged" interventions.  I got in the tub, and it made me feel a bit better.  I sat in the tub for a long time.  My sweet Bettie was pouring water over my tummy and talking to me.  Adam was nervous and when Bettie started dumping her cup of water over my tummy from over her head, playing and making a bit of a mess, they got in a fight.  She wasn't bothering me, but she was bothering Adam.  All I heard was:  don't make me count!  1-2-3...BETTIE!  Don't make me count!!!  Finally I got fed up and got out of the tub.  It was around 11pm at that point my contractions were about 2 minutes apart and were lasting over a minute, so I wasn't getting much of a break.  I decided I was ready to go.  We packed my bag and my sister came over to take Bettie to her house.  Thelma came in while I was in the middle of a contraction and looked very concerned.  She asked me if it hurt.  I snarled at her like a woman possessed and said:  NO!  IT FEELS F***ING WONDERFUL!  When the contraction ended, I apologized.  Labor is a funny thing sometimes.  I felt like I had multiple personalities.  Between contractions, I was pretty normal.  During contractions I was irrational and insane!

The car ride SUCKED.  It's another reason I wanted a home birth, and I still hadn't gotten over being angry, so I was having a hard time coping.  I teach HypnoBirthing.  I needed to get into a better frame of mind, but I really couldn't, so I just screamed a lot.  To each her own!

At the registration desk, they brought me a wheelchair and took me immediately to a delivery room.  I guess I LOOKED like I was in labor with the crazy hair, crazy screaming...I probably had madness in my eyes.  I left Adam to finish the registration process, and I was okay with that because he'd gotten really chatty and it was annoying me. 

A wicked thunderstorm picked up as I was getting to my room.  There was thunder and lightning and wind howling.  It set an ominous backdrop.

Once in the room, the typical VBAC stuff happened.  The nurse put in a heplock (which I wasn't thrilled about) and put me on the monitors (again...not thrilled).  The nurse informed me that I'd have to lay on the bed, on the monitors for 30 minutes.  She checked my cervix and I was at 5cm.  It was pure torture not being able to move.  The supervising OB for the practice, Dr. G peeked in.  I wasn't thrilled to see her.  She was not my favorite and I had the feeling she'd rather be cutting my baby out than being on standby for a VBAC. 

Every time I'd have a contraction, Maddox would move, they'd lose him on the monitor and the nurse would start messing with me.  This, combined with my anger and my annoyance with Dr. G was a pretty unhealthy labor cocktail.  I desperately wished I'd lined up a doula, but I was expecting that the homebirth midwife's assistant would be my labor support, so that ship had sailed.

Adam came in during the 30 minutes of laying on my back torture (funny how throughout pregnancy you're discouraged from being on your back, but as soon as you hit a hospital, that's how you're "encouraged" to lie.)  He held my hand during contractions and got to the point where he'd squeeze MY hand instead of the other way around.  He was pretty freaked out, but it hurt! 

They finally let me off the bed and Jessie came in.  She set me up on a birthing ball.  I'd always been pretty modest in the hospital setting, but as soon as I got on the ball, I felt hot and restricted, so I ditched the gown. 

Every few contractions, they'd lose Maddox on the monitors and the nurse would start touching me again.  I finally looked at her and said:  You have to stop touching me.  She told me she couldn't.  It honestly made me want to cry.  Contractions were so much worse with her messing with me!

A few minutes of bouncing on the ball and I felt a POP.  I thought I broke the ball, and I freaked out a bit.  Turns out, my water broke.  It was a really weird feeling.  I sat on the ball a little more, still screaming during contractions (and probably scaring people).  Finally I looked at Jessie and calmly said:  I need morphine.  She looked at me like I was nuts and said:  I can't give you morphine!  I can order an epidural.  Adam looked at me and said:  You don't want the epidural!  You want to do this unmedicated!  Think about your birth rage!  He may have said something about cascade of interventions, but it's also possible that I was delusional and heard that in my head.

I told Jessie that I didn't want an epidural that I WANTED MORPHINE!  She smiled at me and said:  No.  I looked at her and Adam, completely calm again and said:  I can't do this anymore.  Then I started giggling (again...feeling a bit possessed).  They both looked at me like I was insane.  I kept giggling and said:  Oh my god...I'm in transition! 

Sure enough, I was dilated to 7...almost 8cm.  Jessie asked me if I'd like to sit in the tub.  I told her that sounded lovely (even though before labor I was a bit skeeved out by hospital tubs, I mean, how do they REALLY clean down in the drain?   Ew...).  The tub made things better, but things got worse.  Jessie came in and said that Maddox's heart rate was decelerating when it shouldn't be and that she'd like to try IV fluids to help him get more stable.  I agreed because Dr. G was peeking over her shoulder and I was worried she'd try to bully me.  Turns out the fluids did help, and they actually made me feel a little better, too.  Contractions still sucked, Adam was still chatty and annoying during contractions. 

Finally Jessie checked me and I was complete.  I was shocked.  She told me I could get out of the water and get ready to push.  I'd never done pushing before.  Despite the sucky contractions, the end was near, I just knew it.  Even though I put on a brave front, I was afraid I'd be a failure to progress...that my body wouldn't work, and here I was!  Complete!

I told her I'd like to try squatting.  The squat bar wasn't awesome.  It just seemed all wrong.  It was hard to hold myself up on it.  Adam wasn't sure how to support me, my nurse was doing her best, but it was one-sided support.  I ended up getting very tired.  I kept pushing and then I was so tired my legs were shaking.  I finally laid back.  I could hear Maddox's heart rate on the monitors dipping and could see how low he was going, which scared me for a variety of reasons. 

They started "encouraging" me to push while on my back.  You guessed it.  Purple pushing.  Something I'm totally against.  I do feel that at this point I was "encouraged" in a not so positive way, but I was tired, getting scared and so ready to meet my Maddox.  Pushing was hurting and when I could see Jessie's hands, they were covered in blood.

Dr. G came in and told me she was going to prep the OR.  She said that if I didn't have him out in the next few pushes, with the way his heartrate was decelerating she'd have to recommend a c-section.  I knew that was BS, and it made me angry.  I pushed and pushed. 

I finally looked up and could see my reflection in the picture at the foot of the bed.  I could see Maddox's head.  He had a head full of black hair.  I could also see what looked like a lot of blood.  Jessie kept telling me to push past the ring of fire.  I told her the ring of fire was nothing, but I knew there was something going on on the right side because it HURT.  I'd push and it would look like progress, then he'd go back in.  Finally Jessie got in my face and said:  if you don't get this baby out in the next three pushes, I'm going to have to cut you.  I started crying.  I told her I didn't want her to cut me, that that scared me.  She told me to PUSH.  On the second push, out he came.  To this day, I'm not sure if that was a scare tactic or what, but it worked.  Within seconds, my squishy FAT, full-term VBAC baby was on my chest.  He latched and started nursing like a pro, and I started crying.  I had to wait 8 weeks before my baby girl latched and nursed, but this little guy was nursing!  I was in awe. 

Jessie did have to give me a shot of pitocin because I began to hemmorhage.  I could hear the blood dripping, but I didn't care.

We waited until the cord stopped pulsating and turned gray, then Adam cut it (something he didn't really want to do).  He did something while he was cutting it and blood managed to land on Maddox's forehead.  Adam took his thumb and tried to wipe it off, which resulted in Maddox looking like something out of a ritual with a nice blood smear in the middle of his forehead.

I delivered the placenta and I told the nurse I wanted to take it home.  I expected a fight, but she brought me a container.  She made Adam transfer it to the "take home bucket" and he put it in the refrigerator in the room for me after pretending to wretch and dry heave.  I never got to see Bettie's placenta.  It was taken to pathology then destroyed.

Maddox kept nursing while Jessie started on repairs.  The reason pushing (and probably contractions) sucked so much was because my dear son wanted to be born with one of his arms across his face with a nuchal hand on the opposite cheek.  That's why I felt more than the ring of fire.  He did 70 stitches worth of damage (which I will lovingly explain when he's a teenager), but it was all TOTALLY worth it. 

When they finally weighed him, about an hour after he was born, he weighed in at 8 pounds 7 ounces.  I got my 8 pound baby and some change!  He was more than twice what Bettie weighed.  He was perfect.  My whole labor with him lasted a little under 8 hours from the first contraction to birth.  Not too shabby. 

I wouldn't let anyone touch him after he was weighed and handed back to me.  I put him in the bassinet when it came time to move to my postpartum room and walked him there with my hand on his little chest.  When we got to my room, Adam handed him to me, and he stayed on me all night, nursing on demand.  I anticipated a fight from the nurses with respect to him sleeping with me, but the fight never happened.  A lot of nurses came to see me...they wanted to see the unmedicated VBACer and her beautiful boy with the head full of hair.  None of them said a word about Maddox sleeping, nestled in my arms.  My boy didn't get a bath until he was 19 hours old because I couldn't bear to be separated from him.  My hospital VBAC experience resulted in an amazing birth of a beautiful boy and was so healing after my traumatic birth with Bettie.  It wasn't easy, but nothing in life worth having is easy.  I wasn't a silent, heroic birthing mother.  I was a crazed, screaming, slightly nuts birthing mother, but you know what?  It worked for me.  :)