birthED VBAC Story - When a Different Choice Leads to a Different Birth
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 one of our upcoming VBAC Prep Workshops
Epidural, Amnio Infusion, Two Malpositioned Babies, but Different Decisions Lead to Different Outcomes
Every VBAC starts with a C-Section. In March 2022, my daughter was born via emergent C-section due to fetal heart decels. I labored unmedicated for about 36 hours all the way to 10 cm but she was not tolerating contractions or pushing. While the midwives did everything they could to help me along, the OB on call ultimately called for the C-section. My daughter was OP, acynclytic, and ended up having a double true knot, a nuchal cord, and a shoulder cord. The pediatrician attending the birth said he’d never seen a knot like hers—it was like a rock climber’s knot! It took me a long time to process her birth, and go through all the what-ifs that could have led to different paths.
I studied up on VBAC immediately. I knew if I got myself back in the ring, back on the field, I’d find myself making different decisions. With an athlete mindset, I knew how I needed to prepare. In March 2024, shortly after my daughter’s second birthday, we found out we were expecting in November.
I had an uncomplicated pregnancy and felt confident in my preparations. I walked daily, continued to exercise, and listened to VBAC podcasts. In the days and weeks leading into November I’d been focusing on Spinning Babies Daily Essentials, walks in our neighborhood, quality time with my daughter, and doing the mental work to prepare myself for birth. I walked myself through my last birth, pausing to let those emotions rush over me, but allowing myself to release them, knowing this birth and this baby would be different.
I’d lost my mucus plug and had some signs of labor right before my due date. November 26th rolled around, my due date, and I was comfortable, outside of pelvic pressure, heartburn, and some mild hip and low back pain. And I’d been experiencing Braxton hicks contractions for the past two weeks. My parents had arrived to watch our older child and our dog so I felt relaxed and prepared for the new baby’s arrival. At 2 pm I felt some mild and trackable contractions but I worked as normal and went on our family walk, made dinner, and played with my daughter before bedtime. She and my dog were all over me and very clingy. Contractions continued in a regular pattern about 8-10 minutes apart through my daughter's bedtime. I had a hard time putting her down and I knew she could sense the shift coming.
After getting myself ready for bed, chatting with my family, and heading upstairs, I tried to get some sleep. Around 11 pm things started ramping up for me and I hopped in the bath. I was struggling to lie down (a characteristic of my previous labor as well), so I switched on my twinkle lights and hopped in the shower. I was in and out of the shower all night and texted my doula Liz Hochman for some assistance around 2 am when it was getting hard. 3 am came and I was still struggling after sitting on the toilet and getting back in the bath. I continued to labor quietly and peacefully through the wee hours of the morning and contractions were close together, about 2-3 minutes apart and lasting 30-45 seconds. Liz later noted this was an early sign of a malpositioned baby and knew we had work to do. I waited to call the midwife until 7 am and she told me to come in. Liz said she’d meet us there. I hugged my daughter between contractions, had 3 as I walked my way through my kitchen and out to the car, and we were on our way. The car ride to the hospital was pretty uncomfortable but I took small comforts in the familiar route and the festive Christmas decorations through the neighborhoods. My husband dropped me at the front doors of Methodist Hospital while he went to park the car and Liz walked with me to triage. A handful of hospital staff offered me a wheelchair but I wanted to walk myself in and out of that hospital on my own. This was one moment where Liz helped me stop to think about how different this birth was than my last. I was walking into the hospital in spontaneous labor, just as I’d imagined and hoped for. I also thought back to my C-section leaving the hospital and refusing to be wheeled out. I needed to have this moment to be centered as I entered the new environment and birth space.
At 8:22 we had all arrived in triage and I went to the bathroom. I came back and let the nurse and Liz know I’d been feeling some butt pressure. A few minutes later the midwife came in to check me and I was at 6/7 centimeters, 80% effaced, -1 station, and had a bulging bag. I had told myself not to think I’d be anything more than 3 centimeters, so this was a relief. They got me admitted and roomed me pretty quickly after that and I was feeling so positive about the progress I had made at home all on my own. At this point, I was thinking I’d have a baby by the afternoon or evening!
By 9:20 am I’d gotten an IV saline lock and was in the birth tub. I labored there peacefully listening to calming music with twinkle lights in the background for a few hours. I was still feeling pretty good mentally, but I was experiencing a lot of pressure from the bulging bag and contractions were coming every 3 minutes. At 12:15, the midwife came in to check me and I decided to have her break my water. I was at 8 centimeters, 90% effaced, and still at -1 station. So after 4 hours, I’d only progressed about a centimeter. It feels discouraging when I think about how long I’d been laboring, but I was so deep into labor land that I don’t even recall reacting to it. What I do recall is so much fluid gushing out of me. Even after I’d moved onto the birth ball I was still gushing fluid. I did feel like I could finally breathe a bit better and the intense pressure from the bag was gone, providing me with some relief.
While on the birth ball, the baby showed the first decelerations of my labor. Liz had me do a side-lying release on the left side where I had been feeling tighter to try to get the baby in a different position. At 2:30 pm I was feeling the most intense contractions and having a difficult time coping. I was feeling physically exhausted and concerned about the decelerations and positioning. It was a pivotal point.
I could feel it. I knew if I wanted a different outcome than my last birth I had to consider a different plan. Everything in me wanted an unmedicated birth.
It wasn’t for bragging rights, for proving anything, or even for the benefits of recovery. It was because I knew I could do it, like millions of women before me. I wanted to feel it all. To be fully present. But having been through this before,
I have learned that birth is unpredictable and that as a parent, part of the beauty is changing course, learning as you go, letting the baby lead the way, and giving up the control of what you thought would be the path.
So I asked Liz if she thought it could change my course. Could an epidural help give me the time to rest so that I could ultimately get my VBAC and be the first person to hold my baby? She empowered me to make the decision by providing all of the evidence-based information and potential outcomes and allowed me to feel confident in my change of plans. Before the epidural, she made sure we tried everything including four lift-and-tucks which were arguably the worst part of my labor experience. Before the final decision, the midwife came to check me and I was still at an 8/9 so we were positive I wasn’t getting the epidural at 10 cm ready to push.
After the epidural was placed by a very loud anesthesiologist who definitely didn’t consider the vibe of the room, around 3:45 pm I was finally able to get some rest. But it was quickly interrupted because at 4:15 pm I threw up and my husband called everyone back into the room. I was still only at 9 cm around 6:00 pm and I continued to rest until 7:15 pm when I tried a test push and the baby experienced some severe decels to 70 bpm. The nurses had me try flipping both sides. Things at this point get a little hazy for me as I was in and out of relaxing and trying to rest as much as possible, but with contractions spacing out and progression stalling, they decided to start me on pitocin around 8:00 pm. An hour later the epidural was starting to not work so well and I was getting more uncomfortable. I was so exhausted but feeling hopeful as we neared 10 cm. Another few hours passed and I had finally hit 10 cm but the baby’s heart rate was dropping again. Some more decels to 60-70 bpm. I wasn’t aware of the severity of the drops, but everything was feeling really similar to my C-section birth. C-section had been brought up by a handful of the people in the room and in my head I kept trying to block it out, stay positive, and listen to my gut and my baby. I had done a lot of work mentally this pregnancy to better prepare for ALL outcomes. In my first birth, I had learned about cesaeraen birth and the method of delivery, but had all but ignored it as an option for me. My pregnancy was uncomplicated and I had naively believed my birth would follow my birth plan. The second time around, I knew, especially as a “TOLAC” patient that I would have to always have it in the back of my mind as a possibility. I had accepted this possibility but did not want it to cloud my determination.
At 10:35 pm after decels during pushing, an OB consult was called in. Dr. Hanson assessed the progression and the monitors and suggested an amnio infusion (wondering what this is? Read up on it HERE). This confidence in my body and the willingness to try every avenue from my birth team gave me such a boost. After the amnio infusion to allow more cushion for the baby to tolerate the contractions, Liz let me know she had called in her backup doula Natalie for a break. It was a long labor and Liz needed to rest and tap out if she wanted to be effective for me. I was feeling a little defeated with another change in plans, but I trusted Liz and knew she would have my best interests in mind. Natalie came in and we started up pitocin to regulate my contractions. Natalie had a calm and easing presence and cycled through some different positions before I tried pushing on my right side around 1:30 am. I was making progress and continuing to push, my husband was pushing the small sips of water after every push, and Natalie was providing support. We had my “Bring It On” birth playlist rolling and even the nurses liked the tunes. Another few hours passed and at 3:00 am Natalie had me do some tug of war in a squat position. It was difficult but effective. At 3:45 am the OB on call came in discussed the risks involved with extended pushing. Everyone continued to ask me how I was doing and if I wanted to continue and I just knew I had to keep going. I was exhausted, but determined. I kept telling myself I wanted to pick up my toddler when I got home and if I had a C-section I wouldn’t be able to do it.
Liz returned at 4:45 am with the energy and vibe I needed to keep going. (Side note from Liz - the vibe was THIS). While Natalie had supported me through many hours of pushing, the change in the energy of the room was electric. Her directions for pushing helped me to really know where to put my energy and I was feeling renewed. As an athlete, I needed her coaching me and telling me to go harder. After 5:00 am, the OB came back for another consult and after I’d asked about a vacuum (only after hearing others mention it), she said that they are only for crowning and didn’t recommend it. I was fine with hearing this and continued to push. Around this time, another laboring person in the hospital had gotten close to delivery so another midwife (Carrie Sauter, who I loved seeing during my pregnancy) was called in. Another person bringing fresh energy to the room. At 5:41 am Carrie could see the head and was confident that the pushes were effective. Throughout the pushing phase, everyone in the room had told me how well I was doing, and how they could see the baby’s head, but no one ever told me how close (or not close) I was. But when Carrie got me on all 4s at 6:00 am, I knew we would be pushing this baby out. They flipped me back on my back and at 6:13 am my baby was born. All I could feel was relief that I had finally done it. That all of the hard work, all of the pain and the decisions I’d made, even the ones I didn’t plan on, had paid off. My husband announced it was a baby boy and he was placed on my chest.
Although I did get to hold my baby first this birth, he was quickly whisked away due to difficulty breathing right away. Those first few moments where I didn’t hear cries were agonizing. My body started shaking, I couldn’t see what was happening because there were people surrounding the warmer. My husband assured me from across the room he was doing ok and then we finally heard a little cry. He had low APGARs, but recovered quickly and we were reunited for a glorious few golden hours. He was 8 lbs, 12 oz, and 22 in and I had a 2nd degree perineal and left labial tear. The tear was so minor compared to recovery from a C-Section. We started nursing shortly after his birth and all I remember from the hospital days are the overwhelming feelings of joy, pride, and gratitude for every single doula, nurse, midwife, and OB who saw me during this labor and delivery. It truly was all about the right people at the right time helping to make this VBAC possible.
After a 39 hour labor that included 5 hours of pushing, I had done it.
There were so many triggering moments where C-section was brought up and unconventional or uncommon practices were attempted. The care team and providers around me (even those I had no control over choosing like the OBs on call) were the exact right people I needed in the room at every twist and turn. Without my doula, my patient midwives, my husband’s support, without the epidural to allow me to rest (it wore off perfectly by the time I pushed baby out!), and without the amnio infusion, I think I would have had a repeat C-section.
I’m here to just tell you a VBAC is possible and it may not look like what you envision, but allowing yourself to make empowered decisions, even if they are not completely what you desired, may bring you closer to a positive birth experience.