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Jessica's Second Birth Story

5/12/2011

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Editor's Note: This birth story is very special to me. As a woman who had a disastrous first birth experience that ended with a C Section, I know how much it meant to Jessica to have her VBAC. I am so proud of her and happy for her accomplishment. 

I was due December 31, 2008 with my second son. I had made it clear
that I intended to do a trial of labor and hoped for a VBAC (vaginal
birth after cesarean), but by early December, I was having problems
with high blood pressure. On December 16, a Tuesday, not only was my
blood pressure once again stubbornly high, but there was +1 protein in
my urine. Figurative alarm bells went off. I was sent to have labs
drawn and go down to the hospital to be monitored. The hospital was
about 45 minutes away, and I had been there about a week and a half
before for the same reason and had been sent home within 90 minutes of
arriving. I figured surely everything would be fine again this time. I
called my neighbor to see if she could watch my older son while I made
my way down to the hospital to be checked out, assuming that I'd be
back in a few hours. I called my husband and told him not to bother
coming with me this time, since there wasn't any point in his missing
more work to watch me lie in the L&D triage room for 90 minutes again.

I went home and packed a few things to take with me in case I was
there a little longer than anticipated, then made my way to the
hospital. Once there, the four L&D triage rooms were all in use, so I
got to wait in an office with a couple of nurses while we waited for a
triage room to open up. There was no sense of urgency in my case,
really, and I kind of enjoyed the behind-the-scenes peek at what the
nurses were doing when they weren't in the patient rooms. This was a
little after 3:00 P.M. on Tuesday.

When one of the other women was sent home (as I hoped to be in a few
hours), I was put into a triage room and hooked up to a blood pressure
cuff and fetal monitors again. I was having regular contractions,
though I couldn't feel them, really, and my blood pressure Would Not
Come Down. A nurse-midwife came in and did an internal check to see if
my cervix was dilated at all. Upon finding that I was about 4cm
dilated already, she declared "this baby is coming tonight! Let's get
him out."

Er... What?!

First of all, my husband was 45 minutes away, my son had only very
temporary childcare, we were not expecting to have a baby just yet,
and, wait, I was only 38 weeks! I still had two weeks to prepare! My
mom would be there in a week. She was supposed to stay with my son.
What were we to do?!

Well, I called my husband, of course, and told him of the change of
plans. They intended to induce with Pitocin and were still quite
willing to allow me my trial of labor and VBAC attempt. But, I knew
that a Pitocin induction would increase my risk of c-section. I
decided to delay any other interventions as long as I possibly could,
hoping that would help me avoid the dreaded repeat c-section.

We decided the only possible course of action was for my husband to
bring our son with him to the hospital. As difficult as it would be
for me to have him there with me while I labored, and as problematic
it would be that my husband would have to mind our son instead of
being totally there with me in the labor and delivery, we couldn't
think of anyone else we could call upon who would be able to take our
son overnight. My mom was supposed to have been there!

They got me set up in an L&D room while my husband picked up our son
from daycare and drove down to the hospital. I was hooked up to an IV
for fluids and Pitocin, and they also said I'd need to be on magnesium
to help prevent seizures due to my blood pressure. The problem with
magnesium is that is is a muscle relaxant, also used to stop preterm
labor! So they would have to balance the magnesium and the Pitocin
carefully to make sure labor didn't stop while still ensuring I had
adequate protection from the risks of preeclampsia.

Another problem with magnesium is that it can cause you to retain
fluids dangerously, so they would have to very carefully monitor my
fluid intake and output while I was on it. This sounded inconvenient.

The biggest problem with magnesium, though, is that, as a relaxant, I
would be unsteady on my feet, and weak, and possibly unable to control
my muscles, and unable to properly care for a baby as long as I was on
it. This meant I would not be allowed to be alone in the room with the
new baby until I was able to come off the medication, which was the
absolute biggest concern I had. I had not successfully nursed my first
son, and this time, come hell or high-water, whether I needed a
c-section in the end or not, I had every intention of making
breastfeeding work. And if I couldn't room-in with the baby, how was I
to start a successful breastfeeding relationship? I was quite upset by
this news, but still determined to make it work somehow.

My husband arrived with our son. He had the foresight to bring PJs,
books, blankie, pacifier, and snacks for the little guy, who was very
well-behaved and charmed everyone with his sweet nature, general
cuteness, and amazing red curls. The nurses started taking bets on
whether the new baby would have such gorgeous hair, too.

My son's being there meant that I was a little distracted from this
whole labor business. I tried to remember to change positions, did not
request pain relief, and got up to pee when I had to. I was quite
surprised to find, however, that I was feeling almost no pain at all,
despite the use of Pitocin. I was contracting nicely, and my cervix
was opening, and everything that was supposed to happen was happening,
but where was the pain? It was nice, but surprising.

I was very concerned about frightening my son if I were to need to
yell, so I tried only to hum quietly when the contractions became
stronger. My husband took him out of the room when the doctor came in
to break my waters. She had trouble getting slack in the amniotic sac
because the baby's head was pressed right up against the cervix. He
was excited to come, unlike his reluctant brother! She eventually
popped the bag, and my waters came gushing out.

Then the pain started. I felt those contractions like a vise clamping
down on my abdomen. It was crazy. When I had to yell, we had my son
and husband yell along with me. He thought it was a great game (ah,
two-year-olds).

I had made some calls to friends and relatives to give them the news
before things got really intense. One of these calls was to my rabbi
and his wife. My rabbi's wife called back wondering where my son was
during all of this. I told her he was with us. She said she'd arrange
for someone to come and get him and bring him to her house for the
night. I was so relieved. I couldn't imagine what we were going to do
with him when things got really heated. I wasn't sure I wanted him to
witness the birth, but I also wanted my husband to be there with me!

A friend came to the hospital, and my husband met him outside,
switched the car seat to the friend's car, and sent our wonderful
child off to a bewildering night's stay with the rabbi.

My husband came back, and the relief of not having to worry about our
son meant that I was experiencing fully the insanity of
Pitocin-induced contractions. I remember one of the nurses saying that
they needed to increase my Pitocin, and the other one saying she
didn't want to do it because she had seen a uterine rupture. How
reassuring! But they did increase the Pitocin, and I couldn't bear it
anymore. I was 6cm dilated, which I thought was a pretty good
accomplishment right there. I asked for the epidural, and they sent
for the nurse anesthetist.

They had me get up to go pee one last time before the epidural. I have
my timeline a bit mixed up here (oddly enough), but I think my husband
had taken our son outside right about the time I asked for the
epidural, so that our son wouldn't be able to watch them do that. I'm
not exactly sure when he got picked up and taken back to the rabbi's
house, but it was not long after.

While in the bathroom, the contractions starting coming one after
another. It felt like one didn't even end before the next one began. I
couldn't believe the torture. I could barely walk back to the bed, and
when I got there, I started throwing up. The nurse said not to worry,
that I was just in transition and it would pass.

What?!

In the five minutes I had taken to pee, I had gone from 6cm to transition! Wow!

The nurse anesthetist was there, and he was able to do the epidural
despite my shaking, nausea, and general incoherence. The epidural was
perfect. It took away the pain but not all of the sensation. I could
still move my legs, and I could still feel that I was having
contractions, but it didn't hurt anymore. It was amazing.

Though I was fully dilated, they said I didn't have to start pushing
right away. The baby was fine, and he could labor down on his own for
a while so I didn't exhaust myself pushing when I didn't need to. This
was new to me, since the minute I had reached 10cm with our first
son's birth, they immediately had me start pushing. I liked this new
way better! I was able to rest a bit, kind of drowsy and groggy. It
was a little after midnight by then, I think, on Wednesday the 17th. I
had been in labor for a little over 6 hours. Right there, I was
already amazed by the contrast with my first labor, which took over a
day to get to this point!

Finally, they said I really did have to start pushing. He had come
down to +2 all on his own (what a guy!), but he needed help to come
the rest of the way. (This also is in contrast to my first labor,
where the little boy wouldn't even come out of the cervix - he was
stuck at -1 station the entire time I pushed!) I protested, enjoying
my relaxation, but they set up the table for delivery and called for
the doctor. He wasn't going to come out if I didn't do a little work!

The epidural was such that I was able to feel the need to push on my
own. So I pushed, and he came down a little. I pushed, and he came
down a little more. I pushed and pushed, and he kept coming almost
out, then sliding back in. After about half an hour of this (during
which there was a fair amount of "I can't do this!" and "I don't want
to push anymore!" whining out of me, as is apparently how I react to
the pain of labor), the doctor said he really was just about there,
but my perineum wasn't stretching quite enough, and he kept sliding
back in. She said probably just a little cut would let him come right
out. Now, an episiotomy was my second worst fear in childbirth, but if
it meant all of this would be over, and I would have my baby in my
arms, I was willing to do it. It was far less traumatic than a
c-section!

A little cut, a few more pushes, and out he slid, a gorgeous, little,
bald baby boy, at 1:19 A.M., after only about 7 hours of labor and 39
minutes of pushing. I had done it! He was here! I could not believe
it. I couldn't! The placenta slid out a few minutes later, to my
surprise. In fact, I distinctly remember saying, "What was that?!" and
my husband reporting that it had been the placenta. For some reason, I
had thought I'd have to work harder to get that out. They took the
baby to be cleaned, diapered, Apgar-ed, weighed and measured - he was
only 7lbs., 6oz., almost two pounds lighter than his older brother had
been! - then brought him to me quite quickly and put him on my chest
for his first breastfeeding. I had no idea how to hold him, and the
doctor was still down below doing... something. I put him to the
breast. He latched on and sucked. I held him and held him and held him
and he nursed and nursed and nursed, and I knew this was how it was
supposed to be.

First of all, tending to him took my mind off my other end, where the
doctor was working busily stitching me up. Apparently, I was bleeding
quite heavily, and she was trying to get the bleeding stopped along
with sewing up the episiotomy and so on. It was not particularly
pleasant, but I had a very pleasant distraction!

I ended up staying in the L&D room for about four hours, and the new
baby lay on my chest, nursing, the whole time. They were looking for a
room on the maternity floor for me, and they were also still
monitoring my blood pressure. It started to come down, and stayed
down, and they decided they could take me off the magnesium and
instead give me oral phenobarbitol, an anti-hypertensive, instead.
Hooray!! No fluids monitoring! No fall hazard! I could keep baby with
me.

Everything went very well the second time around, in great contrast to
my first birth experience, and I look back on my second birth very
fondly.


Shai
7 lbs, 6 oz
Picture

On Jessica

Jessica is a lovely mother of two boys expecting her third (boy!) in a few months. She is a wealth of knowledge regarding VBACs and car seat safety. I am grateful for Jessica's contribution to this blog and would like to direct you to her blog if you would like to read more of her work: http://jessicaonbabies.blogspot.com/ 

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