Attack of the 11 Pound Baby: VBAC Edition

A conversation on Twitter inspired me to write Henry’s VBAC (vaginal birth after cesarean) birth story. Reading positive VBAC stories was really helpful for me, so I hope I can help someone, or at least entertain those of you “birth nerds” who are into this sort of thing! For the “AC” in “VBAC”, see Benjamin’s birth story

Short Version:

Feb 14

  • 4:30 am – Wake up for the day. Irregular contractions
  • 8:00 pm – Contractions nearing 5 min apart. Leave for hospital
  • 9:00 pm – 4 cm, admitted

Feb 15

  • 4:00 am – 6 cm, epidural
  • 8:00 am – Water broken, 8cm
  • 3:15 pm – Start pushing
  • 6:42 pm – Henry Keith Frey born, 10 lbs 14 oz 23.5 inches

My due date was February 9th, and on February 14 I was one day away from my next OB appointment. I knew that the “the talk” regarding induction was coming. I was eager to go into labour on my own. Feb 14 seemed like an auspicious date to go into labour. It was our third wedding anniversary, and essentially our third anniversary of being parents, as Benjamin was conceived just after we were married.

I woke up for the day at 4:30 am. I’d been having Braxton-Hicks contractions for months, but I immediately knew something was different. The pain was different, the intensity was different, and I “just knew” these were the real deal. The pain was too much while lying down, so I alternated between a rocking chair and the bathtub for the morning. Jason was home, and his mother was set to come over in the early afternoon to look after Benjamin. The mood was calm but excited. I was just SO happy that my water didn’t break before going into labour, which would have vastly increased my chances of needed an induction.

Things didn’t get really intense till around 6:00 pm. I wanted to wait until I was sure we wouldn’t be sent home. By 8:00 pm, contractions were nearly five minutes apart, so off we went. Jason and I were still calm; we went through the Tim Horton’s drive through on our way there. I knew that I wouldn’t be allowed to eat or drink once I got to the hospital. A vanilla dip doughnut was my last meal.

Our doula, Mitzi Gerber, met us at the front doors of the Lois Hole Hospital for Women. We signed in then waited… and waited…. finally got in to be assessed after about an hour.  I was relieved to hear that I was dilated to 4cm and was in active labour! Then I waited and waited and waited some more to get into a room. I think they were pretty busy that night. My room was ready around 10:00 pm.

As I dealt with various medical staff, I kept my “birth plan” (but we weren’t calling it a birth plan) in mind. Mitzi and I discussed everything from what I wanted to wear to delayed cord clamping and wrote everything down (Jason listened politely.) My OB recommended we write down my top three preferences on my chart. They were:

  • Don’t offer pain medication
  • Hep Lock rather than IV
  • Remote monitoring

Another of my preferences was to wear my own clothes. I have bad associations with hospital gowns, as the one I wore when I had my c-section gave me a bad rash. When I politely turned down the hospital gown during assessment, the nurse made a snarky comment about how it isn’t “a fashion show”. Nice. I asked the OB if I’d be able to eat and drink. I knew the answer would be no, but figured it wouldn’t hurt to ask. Denied.

I walked from the assessment area to my room. By this time, I was in active labour, and it was a slow, loud walk. I didn’t think I’d be loud, but I found making the “low” noises really helpful! I was coping well at this point, and contractions were close together and building in intensity.

Once we were in our own room, the reality of having a VBAC set in. I needed to be continuously monitored – awkward straps around the belly. Remote monitoring wasn’t available. No food, no drinks. No labouring in the tub. IV is standard, but I requested a hep lock – no problem there, though the nurse did a hack job and it was really bloody! Mitzi and Jason helped me try all sorts of positions to cope with contractions, even though it often meant untangling the monitoring cords again and again. Anything other than sitting up was just excruciating.

By 3:00 am, I was not coping very well. My contractions were on top of each other and very intense. I had been awake for a long time, and not eating or drinking, and was getting tired. When I was checked and only 6cm, it was a low moment. I’d been in active labour for six hours, and only dilated 2 cm from when I arrived.

I decided to go with some pain relief. I tried the laughing gas, but it did nothing. So frustrating! Then I was faced with a tough decision – whether to get an epidural. I had a lot of issues with the epidural in my last labour. I felt bullied into getting it too early. It made me shaky and nervous. I think it led to other interventions, and ultimately the c-section. Mitzi was supportive but neutral. Jason was supportive and leaning a little towards the epi – I’m sure it was difficult for him to see me like that! Around 4:00 am I made the call. I shed a few tears – I knew this could change everything. But I didn’t feel I could take that level of pain much longer.

The anesthesiologist arrived pretty quickly. I had to change into a gown, which was super awkward while having intense contractions and with all the monitoring cables and what not – I guess the snarky nurse was right. The needle was no problem, but the darn thing didn’t take. By the time I realized it wasn’t really working, the anesthesiologist was gone, and I was flat on my back, i.e. the WORST possible position in terms of pain. I was in way worse agony than I had been before, with no idea when anyone could come help, and not able to try different positions. It took a top up and some adjusting, but I was finally MOSTLY pain-free around 6:30am. Thus ended my 12 hours of non-medicated active labour. I’m telling you, it ain’t for sissies!

I was checked again around 8am and was still around 6 or 7 cm. I was starting to worry about the lack of progress. The doctor suggested that they break my water, and I was just fine with that. The resident who did it was not experienced at all; in fact, I think it was her first time! I could tell it was a “learning experience” for her. A little disconcerting, but she got the job done. I was checked a few minutes later and was at 8cm. Result!

The next part of my labour was long and boring, but probably made a huge difference in terms of achieving my VBAC. I wasn’t checked again until 3pm. Yes, I was left alone by all the doctors for SEVEN HOURS with water broken and 8cm dilated. My main activities during this time where rolling over from one side to the other (a major undertaking) and sneaking bites of my smuggled Lara bars. I also convinced one of the nurses to let me have ice chips – this privilege was revoked as soon as a doctor caught wind, but my goodness was it lovely while it lasted! Jason and Mitzi got a chance to sleep and eat. But mostly, we just waited. I was feeling pressure as the baby moved down, and focused on that – I was making progress. Slow progress, but progress!

I was left so long because there were a large number of emergency c-sections happening. “Code Pink” was called out over the intercom again and again. Mitzi let me know what it meant. It’s a sad footnote to my story that so many other moms weren’t having the kind of birth they may have wanted.

I think I needed all that time to get to 10cm and for the baby to move down into position. I have the distinct feeling that had I been checked sooner, and had I perhaps been only 9cm, or the baby not been  well positioned, I would have been assessed as “failure to progress.” But, when the doctor finally came, I was 10cm, and it was time to start pushing. I remember a nurse said “you’ll have your baby soon.” Like with the epidural earlier that morning, I felt a sense of “oh thank goodness it’ll be over soon” but ended up waiting much longer than I thought I would!

I started pushing lying on my side, and this position was pretty much useless. I couldn’t feel anything happening, and I was just getting tired and frustrated. Thinking back, I’m not sure why it went on as long as it did. I feel like someone should have said, hey, let’s try something else.

After more than an hour, Mitzi brought out the birth sling. We set up the birthing bar (just as it sounds, a bar across the bed that you can sort of hang onto in a squat position) and tied the sling so there were two long pieces of fabric hanging down. I was half sitting up, half lying down, and grabbed one piece of fabric in each hand, and just pulled on them for dear life. The pushing part comes naturally when you do so, without having to think so much, if that makes sense. Sadly, there are no pictures of me doing this! Anyway, this made a HUGE difference. I could feel the baby moving down, could visualize the path he was taking, and my frustration level was down.

The doctor on call during this time was my least favourite. She was really negative and kept mentioning that I would need a section if this happened, or that happened. She explained why it was risky for me to push for so long. As I got closer to three hours, she told me I could choose to have a c-section now if I was too tired. I understand why she said what she said. She wanted me to be informed. But as someone who actually was informed – very well-informed – I just wanted to tell her to shut up about c-sections!! And as for being tired? No kidding I was tired. For me, that wasn’t a reason to give up, it was a reason to keep going. NO WAY was I going to get this close and throw in the towel. I knew that as each minute passed, it was more and more likely that I would not have a VBAC, but I had to use every last minute.

At about 3:20, the doctor’s shift changed. This was a turning point. I’m fairly certain that had the previous doc stayed around, I would have been in the operating room by 3:30. Dr. Tankel saved the day. That doesn’t mean I like him, though. He walked in the room, sat down and proceeded to do a vaginal exam, without saying one word or looking at me (well, my face.) NOT COOL. He was very casual, cracking jokes and basically struck me as a typical cocky, egotistical doctor.

Dr. Tankel had one thing going for him. He believed in me – or at least gave me that impression. When he came in, I’d been pushing close to 3.5 hours. He said, “You know how when the speed limit’s 60, but everyone really goes almost 70? That’s what we’re going to do. We’re going to keep going because you’ve come so far.” That was really motivating for me! He did go on about the risk or shoulder displacement (?), but other than that, he was focused on getting the baby out – proper thing! We decided to change positions again, and go for the traditional flat on the back. Mitzi said sometimes the thing you’re avoiding is exactly what you need.

Describing the last couple minutes is difficult. I was so close. The baby was RIGHT THERE. The nurses in the room where telling me they could see that he had dark hair. I was making progress, but still slow. We were getting to the point where a c-section was imminent. Things began to change – my nice dim lighting gave way to bright fluorescent. The room started to fill with people. My brain went into tunnel vision mode – I was barely aware of anything happening around me. I was 100% focused on what I was doing. I had my embarrassing, “scary lady in labour screams at people” moment when the doctor asked if he could do an episiotomy, and started talking about the pros and cons – I cut him off and screamed, “JUST DO IT.”

I was overwhelmed at this point. Then, Mitzi leaned in and whispered, “Get angry.” I just gave it all I had, and then some. I remember a nurse saying the head was out, and to look. I didn’t really look. I was still in hyper-focused mode. I wasn’t finished! He was born with the next push, and in that moment I felt such a rush of accomplishment, relief and joy! I said, “I did it!” and then “His name is Henry,” in case there was any doubt. He weighed in at 10 lbs 14 oz – pretty close to my guess of ten and a half pounds.

Unfortunately, it wasn’t long before things started to go wrong. The cord broke before the placenta was delivered. That meant the doctor had to remove the placenta manually. This was one of the most horrific experiences of my life. The epidural had been turned off at this point, so I could feel everything. It’s pretty much what you would think – the doctor scrapes your whole uterus with his hand. I was screaming and begging him to stop. It seemed to take forever. Mitzi stayed with me, and I’m so grateful that she was there.

Once that ordeal was over, well, it still wasn’t over. First, I needed stitches. A LOT of stitches. I tore in addition to the episiotomy. I asked the resident how many she was planning to do and she couldn’t tell me! This was also without epidural so I felt it all. After all that, I was bleeding a little more than they liked to see, so I had to wait around to see if I would need a D&C to remove any retained placenta, which would mean general anesthetic… which means I STILL couldn’t eat or drink. I was desperate. I was allowed a few little sips of water, but that was almost worse than having none at all.

I held Henry in my arms during this time, but I was feeling too weak to breastfeed. He was taken to the nursery to be checked out while I was still waiting. Finally, much later, maybe 10 or 11 pm, I was deemed okay and sent to the maternity ward. On my way there, I was given a huge glass of apple juice and crushed ice. I have never tasted anything better, ever!!

At the time, I didn’t even think to ask why the cord broke, but Mitzi later told me that the doctor was pulling on it way too aggressively. She said he seemed impatient, and was trying to speed up delivery, and went too far. I thought it just broke spontaneously. Mitzi said with midwives you would typically get an hour to deliver the placenta before anyone would intervene. I was given just a few minutes. I wonder if the doctor would have a different version of this story, but I find this pretty disturbing.

The rest of my hospital stay was uneventful. Being able to hold and breastfeed Henry almost right off the bat was incredible. My recovery was a thousand times easier (but by no means easy) than with Benjamin.

I credit my VBAC to a bunch of factors; supportive husband, supportive doula and supportive OB being the most important. I am now one of “those people” who will tell complete strangers to hire a doula. When things seemed impossible, I had my husband and Mitzi right there, and I could hear my OB saying “It doesn’t matter how big the baby is, you can have a VBAC!” Delaying the epidural, luck and timing were the other factors for me. I’m so glad things turned out the way they did.

Henry

Brand New Baby

Henry
First days at home

Family
Our family is complete. Probably.

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One comment

  1. Pingback: How I Spent My Summer Vacation | Reading in Bed

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