My first child was born via cesarean section due to his breech presentation. 19 months later, I had a VBAC (vaginal birth after cesarean), and it was as wonderful as I hoped. We knew we wanted more children but having two back to back was challenging to say the least, so we delayed trying for a while. Once we decided we were ready, we experienced several devastating losses. Then our miracle was conceived, the baby we prayed for. We were cautiously excited for this baby, keeping the news close to our hearts.
Once we allowed ourselves to celebrate, I started planning for the birth of my third baby. I knew I wanted to keep my OB/GYN in New Orleans so we would have to contend with some travel. I also knew I wanted to attempt an unmedicated birth. I was determined to and followed through on my goal of remaining active and healthy during pregnancy. My rationale was that if I ate as much sugary and processed foods as I did during my other pregnancies, my baby might be larger and get stuck again. My first weighed 8lbs when he was born at 39 weeks, and my second weighed 8lbs, 15oz when he was born at 39weeks, 6 days.
When 39 weeks approached, we asked my mother in law to come to town to watch our older boys for when labor began. I was convinced that since I went into labor for my second at 39 weeks and 4 days, I would do the same (if not earlier) for baby #3. I had completed Lamaze classes, felt confident in my ability to have a natural birth, and was ready. So we waited. And waited. For weeks, I experienced mild cramping. In fact, at 36 weeks I had regular Braxton hicks contractions for over 2 hours.
At my appointment the next day, they had done nothing to change my cervix. In the afternoon of 39w4d, I had regular non-painful contractions for approximately 3 hours and we were convinced this was the start of labor. They abruptly stopped. I went to the doctor the next day and was 2cm dilated and 50% effaced. I was elated. My body was gearing up, and I just knew it wouldn’t be much longer. That evening, they kicked up a notch in intensity and were regular for approximately 5 hours. Again, they abruptly stopped.
So we waited and waited.
Which I know is incredibly normal. And all babies come differently. But that didn’t make it easy. I was confident he would come when he was ready, but my husband had to miss several days of work which I hated because I would rather he be able to use that time after the baby arrived. When we got to 40 weeks and 1 day, my doctor ordered an NST (non-stress test) and BPP (biophysical profile). The BPP went great but after showing regular contractions and baby having decelerations 3 times during fetal monitoring, my doctor told me she could not send me home and we would have to induce. I had not dilated or effaced anymore than I was 3 days prior. I had to fight back the tears. I told myself that it did not matter how he got here, just that he was healthy. This baby that we prayed for shifted my perspective. Of course, I wanted a natural, non-medicated birth, but I was coming to terms with any birth that brought him to me.
Although there was acceptance, I did advocate for myself. I asked how my baby would be able to tolerate Pitocin if he couldn’t handle my non-painful contractions? She acknowledged it was an appropriate question, and the honest answer was he may not. She admitted I may need a C-section, but they wanted to let me try. Unfortunately, he was still too high to rupture my membranes so Pitocin was where we would start. In my mind, this was going to result in a C-section. I headed to labor and delivery trying so very hard to be brave. I told my husband that my plan was to labor with the Pitocin as long as possible but that there was no way I could go all the way without an epidural. I was also told my doctor was heading out of town that afternoon so I would be attended by a male doctor whom I had never met. After arriving in L&D, my contractions got more regular but not super painful. After 3 hours of contractions going from regular to irregular, they started Pitocin.
They started the Pitocin around 4:45 pm.
I was 3cm and 50% effaced when they started the Pitocin, and within 10 minutes my contractions quickly became regular and more intense. Baby was still too high to break my water (risk of cord prolapse). I should mention that after we got to L&D, baby never had any more decelerations. I don’t know whether that had anything to do with positioning (I mostly labored on my feet). Regardless, this made us really hopeful that maybe a C-section would not happen. They rechecked me a couple hours later, and I was 4cm and 75% effaced and baby had come down, so they popped my water. This is when things got super intense, but I managed the pain with everything I learned in Lamaze and it was peaceful. My husband applied counter pressure to my back and I used other comfort measures. The room was dimly lit with meditative music playing. I can’t recall exactly when things got bad but I was shaking, feeling like I would vomit and nothing was helping me stay on top of the pain. They kept increasing the Pitocin every hour or so. I asked for an anesthesia consult and I was 7cm dilated. At this point, I said I would try nitrous, but I was probably going to be begging for the epidural soon.
I used the nitrous and it helped a bit.
Truly. But it is hard to describe the level it helped because the pain is still very real. Eventually, I felt I couldn’t tolerate the pain and was telling my mom and husband that I needed an epidural. However, I was in transition and there was no turning back. There was some concern of how baby tolerated the contractions when I laid on my left side, but truthfully I was so distracted by the contractions that I just rolled over when they told me to. Eventually, I felt the urge to push and my doctors asked me what position I wanted to push in. Even in that state, I knew it was amazing that I was being given options. After one try on my side, I decided to lean over the back of the bed to push. I still am not sure how I got myself up there. I was able to push without time constraints. It felt like I was in a room filled with cheerleaders, urging me on and encouraging me. After 30 minutes of pushing, at 10:55 pm, he was here! Just under 6 hours of labor, far less than for my first VBAC.
A few things my labor and delivery taught me:
I incorrectly thought I wouldn’t have an optimal birth without my doctor present. I had two male OB/GYNS (one was an intern – which I said I didn’t want on my original birth plan), and had you asked me a month ago if that was okay, my reply would have been an emphatic “NO.” But I am eating my words because these two physicians were phenomenal and supportive. They were kind and encouraging. They were calm, a feature admirable and appreciated in labor and delivery. They asked me how I wanted to push. They let me push without time constraints, all the while telling me how great I was doing and how close I was. My point is this: have a plan but be flexible. Things can change in a moment. That morning, I thought I would be having a C-section or at the very least be getting an epidural because I did not believe I would be able to handle contractions on Pitocin.
As for the pain, I cannot lie, it was brutal at the end. The last couple of hours were so intense I almost felt delirious from the pain. The nitrous probably contributed to that feeling. Prior to transition, I really did see the contractions as productive. I imagined my cervix opening and making room for baby. It was impossible for me to see the pain that way for transition and pushing.
That leads me to my next point: the pushing. I did not start pushing until I felt I needed to and in total, I only pushed for 30 minutes (It was 2.5 hours for my first VBAC). But when they say “it feels like you’re having a bowel movement” and “it actually feels good to push”… I’m going to have to say those statements do not tell the whole story for me. Yes, it is a similar sensation but the contractions are occurring simultaneously and there was a lot of pain. Pushing did not feel good to me. Good news? The “ring of fire” does happen, but it is shortlived and not as painful as I feared. I truly was not prepared for the pain. I think after he came out I was in a state of shock that it had happened and that it had hurt so badly.
Full disclosure: I do know that the Pitocin affected my body’s response to the pain. Also, I had a 8lb baby who was over 21 inches long. Then my placenta did not come right out; they stitched me (ouch!) as I contracted while my body tried to get rid of the placenta. I actually had to push to deliver it and they remarked at how large it was. Lovely. I wanted the pain to be over but the new protocol at my hospital was to receive 3.5 hours of Pitocin after delivery to help with bleeding. After 3 hours, I was begging for them to turn it off. I wish I had thought to refuse it. All I wanted to do was snuggle with my new baby, but it was hard to enjoy on a Pitocin drip.
Would I change anything?
Not a chance. I firmly believe that going naturally, staying upright until transition, and laboring over the back of the bed all placed baby in an optimal position for birth. Pushing on my own, I believe, also helped me have minimal tears (two 2nd degree tears for an 8lb baby). I believe that a natural birth helped me birth a big baby with no complications. For that, I am eternally grateful for the opportunity to do so with a supportive nursing and medical staff.
I am also quite confident that I wouldn’t have been able to have a 2 VBAC without the love, support, and encouragement from my labor support team: my husband and my mom. I’m surprised I didn’t break my husband’s hand squeezing it so hard. I don’t know how my mom watched me in so much pain. But they never waivered. They were incredible.
It was the birth I said I wanted. I just had no idea how much pain it would be. But in the end, I was walking to the bathroom on my own within an hour, and my baby was safely in my arms nursing within minutes.