birthED VBAC Story - I cannot believe we did that!
THANK YOU to this sweet family for sharing their story We are so thrilled to have this amazing documentation of your VBAC! If you are VBAC hopeful or even VBAC curious please join us for our upcoming VBAC Prep Workshop on September 17th or November 26th.
Deciding to proceed with a VBAC for our second pregnancy was a no-brainer decision, but it helps to understand a little about our fertility and pregnancy journey first. My husband, Jason, and I had been trying to conceive for about a year when we found out we were pregnant with our rainbow baby Mathew in the fall of 2019.
That entire pregnancy was filled with anxiety and stress as we worried about keeping this pregnancy after two early losses and how COVID was changing the world so quickly! Our oldest son Mathew was born via emergency cesarean at 36 weeks. He was breech and we were at the doctors to attempt a version, but our care team noticed Mathew having decelerations while we were just waiting, so a version and vaginal delivery I was hoping for was out of the question. Thankfully everything went smoothly and Mathew is a busy, full-of-life 3-year old!
So, when we found out we were expecting again we were determined to rewrite the story of our second pregnancy and do everything in our power to have the experience we were hoping for the first time around. I had been hoping to work with a doula during our first pregnancy but couldn’t since COVID prevented any extra people from attending births at hospitals. One of the first things we did with our second pregnancy was search for a doula! We were so thankful that we found Michelle at Wellspring Doulas, to be with us throughout this pregnancy. She understood our history and how it impacted our thoughts, feelings and decisions during our second pregnancy.
My OB was fully supportive (and in fact had already planned to suggest it if I hadn’t brought it up) of attempting a VBAC with this pregnancy. While we knew what a VBAC entailed based on conversations with our OB, Michelle suggested we take Liz’s VBAC Prep Class! Even though we had been through delivery before, Liz’s class helped us really understand what would be different about labor and delivery as a VBAC-er so we could put together a birth plan that felt right for us. We knew we wanted to try and labor as long as we could at home, and to wait as long as possible for an epidural so I could still move around to help labor progress.
We joke that we don’t like to do anything the traditional way in our family, so when our due date came and went, our scheduled induction date was slowly creeping closer. I will admit, none of the old wives tales to induce labor worked. We were in touch with Michelle every couple of days talking about positioning to try or other things to do at home, to get labor started so we did not need to be induced. Even my OB was hopeful that just scheduling the induction was enough to convince this baby to come on out on their own!
Unfortunately, baby was happy staying put, so we checked into Methodist Hospital on a Tuesday evening with a slightly modified birth plan now that we were dealing with a scheduled induction. We wanted to avoid Pitocin for as long as possible since it slightly decreases the chances for a successful VBAC, and increases some other risks. Once we were checked into our room, we met with the OB on call that evening (unfortunately my OB was not on call when we went into the hospital, but we knew the entire team was supportive of VBACs) and laid out our plan to induce labor. We would start just trying to dilate my cervix with a Foley catheter balloon and see if that kick-started anything. A Foley balloon would help dilate to about 3-4cm and at that point the hope was my body would naturally take over. Luckily, I was already 1cm so inserting the Foley balloon went pretty smoothly! The difficult part is that you have to keep the balloon inserted until it can be removed on its own…without being deflated. Our nurse encouraged us to get up and walk around, to keep moving, and it definitely helped because within 3 hours I was now at 4cm and they could take out the balloon!
birthEDucator Sidenote
The research says that at approximately 18 hours from the time of AROM (artificial rupture of membranes) the RISK of infection begins to increase. There are many ways providers try to mitigate this risk (ex. fewer or no cervical checks).
At this point, we decided to try and get some sleep (it was around 1am) and see if labor started naturally. We went through a lull in contractions, so we had another discussion with our care team about next steps. We decided to have them break my water because we were still trying to avoid Pitocin. We knew we had a timeline of 18-24 hours after rupturing the membranes, and hoped again this was all my body needed to progress labor on its own.
We got some rest overnight, and Michelle arrived at 7am with some much needed coffee for my husband. We spent the next few hours working through various positioning to try and help labor progress, but around 10am we decided to start Pitocin. I was only about 5cm dilated at this point and our care team was getting concerned about labor not progressing quickly enough.
Oh, did contractions really kick-in after we started Pitocin! Pitocin is administered through an IV, beginning at a very low dose and increased slowly until labor begins to progress well on its own. My plan was to labor naturally as long as I could before requesting an epidural, with the hope that I would be able to get through delivery without needing an epidural. Plus, I wanted the ability to be able to move around or labor in a tub (unfortunately water birth was out of the question with a VBAC) and did not want to be stuck in one position in bed after receiving an epidural. Around noon my contractions picked-up in intensity and frequency and I was feeling really emotional at this point, overwhelmed with so many feelings that we were finally in labor, but also sad that my body needed the Pitocin to get going. By 1pm I was now at 7cm and the contractions were coupling, or stacking on top of each other with little break in between. I didn’t know this at the time, but learned after the fact that Pitocin can cause this to happen, but at that moment the contractions were strong enough that I requested that epidural. At 2pm I was at 8cm and the anesthesiologist finally arrived to place my epidural! (If only he didn’t need to ask so many questions or make small talk…I could barely answer him in between the contractions.) The epidural provided some much needed relief so I could rest a bit more.
birthEDucator Sidenote: While it is true that Pitocin can cause contractions to couple, providers will usually titrate the Pitocin down to bring the pattern that helps labor move along without stressing out the baby or birthing person. There is another clue as to why these contractions could have been coming close together. Laura’s dilation to 7cm suggests she was entering transition - the part of labor where the break between contractions is shorter than the contraction.
At 4pm I was finally fully dilated and ready to start pushing! Michelle and our nurse that day were insistent that I continue to move around, even if it was just hands and knees in the bed. Thankfully the epidural provided pain relief without totally numbing my legs, so I was still able to move fairly well with help from Michelle and our nurse. I was able to labor not only on my back, but hands and knees, on my side, and I was so thankful I could move around still! Not having pushed to deliver a baby before, I did not know what to expect. Michelle had told me this previously but reminded me that my body would know what to do, and that was the absolute truth. Michelle and our nurse helped coach me on when to push and some cues to help. I pushed for what felt like forever, but was 2 ½ hours total! Towards the end I was really getting tired and had been asked previously if I wanted to touch our baby’s head, or see in a mirror as he crowned, to which I had said no, I had no interest whatsoever. So, when the OB told me to look down, I said a pretty firm “no!” thinking they wanted me to try and touch his head again. I think the whole room told me again to look because the OB was holding our baby, Andrew was finally here!
The team placed Andrew on my chest (skin-to-skin right away was part of our birth plan) and the rush of endorphins seeing Andrew for the first time is an experience hard to put into words, but I do remember looking over at my husband and saying, with a huge grin on my face and tears in my eyes, “we did it!” Our care team followed the rest of our birth plan, and I honestly was not paying much attention to what everyone else in the room was doing. It wasn’t until later that they took Andrew to wipe him off and take his measurements. I could not stop smiling thinking about how we managed the entire labor and delivery and had a successful VBAC!
My recovery was so much better compared to my C-section! I was able to get up and out of bed more easily and move around with little effort. When our oldest, Mathew, came to visit us in the hospital and meet Andrew, I was able to play a little catch with him just 24 hours after delivery…I could not imagine doing that so soon after having my C-section. We went home 48 hours later to start our journey as a family of four.
I am so grateful for our entire VBAC experience. We had a chance to process the entire labor and delivery with Michelle a few weeks after Andrew’s birth (highly-recommend doing this!) Even with the disappointment I felt about needing to be induced, and the worry about using Pitocin, I am so happy with how we navigated all the decisions. It felt empowering to control what we could control, and re-write this birth. I’m pretty sure I walked around for days saying “I cannot believe we did that, we had a successful VBAC!” But there is no way I would be able to say that without the understanding of our care team at Methodist Hospital and all the support from our doula Michelle, a simple thank you just doesn’t cut it. And to my husband Jason, thank you for always listening to my crazy ideas and being next to me every step of the way, from Liz’s VBAC class until Andrew was in our arms. Looking back on the entire experience, thinking through Andrew’s birth story, I am so proud and have a new appreciation and admiration not only for what my body did, but what it can do.