The Birth Story of My VBAC Baby: Gianna Lucia 11/20/2007
Subtitled: How I learned to Stop Worrying and Love My Pelvis
My second daughter, Gianna Lucia was born on Tuesday November, 20, 2007 by VBAC. She was 7 lbs 9oz and 20.5 inches long with a 13 inch head. I had 6 days of prodromal labor, including 41 hours of continuous contractions (10 minutes apart or less) before she arrived. With the help of my awesome support team (Midwife Pam from Midwifery Care Associates , Student Midwife Heather, Doula Sarah, and DH Anthony), I did the whole thing without drugs, in a hospital. For the record, I have a single layer vicryl suture.
Before I tell her story, let me back up and just briefly explain the birth of my first daughter, Elizabeth on September 9, 2004. Elizabeth came 10 days late and the midwives I was using at the time kept threatening an induction by 14 days past edd. I showed up at the hospital with contractions 3 minutes apart but only 2.5cm dilated at 4am. Over the next 10 hours, I had every intervention in the book to help things along – manual dilation of my cervix (ouch!), AROM, stadol, an epidural, and, finally, a c-section at 2pm. The ob who did my c-section told me I had a "5% chance of a vaginal delivery." The next day, my midwife explained that my pelvis was an oval shape and I had a thick sacrum so there was no way I'd ever vaginally birth a baby over 6 or 6.5lbs (my dd was nearly 8.5 lbs).
For Gianna's birth, I found a new practice of 2 midwives that primarily do homebirths but also have hospital privileges. There is a law in NJ which prohibits licensed individuals from attending HBACs. I knew I needed my energy to focus on a successful vbac rather than fighting the system and going underground for a midwife. They were completely on board with vbac and very supportive the whole time. I had to make 2 concessions though to keep their back up doctor happy: CFM through the use of wireless telemetry and a hep-lock.
The birth of Gianna really starts on Tuesday November 13th. I began losing my mucous plug and then having pink show. I went to bed only to wake up feeling contractions about 10 minutes apart around 2am. I was so surprised since my due date wasn't until November 25th. Could this baby possible be coming early? After about 5 hours, the contractions petered out. They started up again during the day and eventually petered out again. This pattern kept up for the next 6 days. Several weeks earlier, I had taken a Hypnobirthing Class and then ordered the Hypnobabies Home Study Course so I did a lot of hypnosis to keep me calm and get me through the on and off again labor.
On Monday morning November 19, I began having contractions again at 2am. They were getting more frequent and painful, coupled with the fact that I hadn't been sleeping well for days. Around 7am that morning, I finally lost it sobbing hysterically that this baby was not coming. I was also worried about how much my uterus could handle, especially being a vbac. Even though I was downstairs on the sofa, my sobbing woke up my husband who came down to comfort me.
Contractions kept up all day. I took a benedryl at one point to sleep which helped although I don't think I really fell asleep. Around 6pm the contractions seemed to be coming at a more steady pattern of every 4-6 minutes. My mom called at 9pm and I told her what was going on. She decided she better come up to watch my dd and suggested that I call my doula. Since I had been in this on and off again pattern for days, I really hesitated to call Sarah in case it was a false alarm but I did. I guess I sounded like I was really in labor because she came over within an hour. At that point, the contractions were stopping me in my tracks and I would have to hold on to something or drop to the floor to deal with them.
I called the midwife to give her a heads up but I wasn't ready to leave for the hospital yet. I labored at home for a couple more hours until midnight when Sarah suggested that I might want to think about getting to the hospital. I called Pam back and we headed down. The hospital was an hour away so I put on hypnosis CDs so that I would live through the ride. Luckily, at that time of night, it was a smooth ride. We got there, parked and went into the emergency room entrance. I walked up to the L&D floor where it was pretty quiet. Surprisingly, no one tried to force me into a wheel chair which pleased me. Our nurse, Tasha, showed us to the L&D room. I got settled in and Pam showed up. Tasha gave me a little tube top thingy to put around my waist so that they could insert the telemetry monitors in there. They bugged me a little bit since it poked on my abdomen a little but overall, not a big deal. Then she inserted a hep-lock into my wrist which bugged the crap out of me. The place where she put it (just below my thumb) made it darn near impossible to move my hand much so holding onto anything caused me pain. Pam did an internal and declared me 4cm but she could easily stretch me to about 5-6cm. I felt pretty good about that since my last labor had stopped around 4-5cm. This time, I was starting out there. I figured it couldn't be too long!
I decided to do a bunch of laps around the L&D floor to get things moving. Anthony and I walked and walked and walked. I was a little disturbed to see 2 cytotec inductions along with a cervadil induction and 1 other natural labor (but I digress….). Contractions were intense for hours but it didn't seem like it was going anywhere. Pam told me that I was being too nice and too calm. When I got near the end, she assured me things would change. She didn't want me getting into the laboring tub until things had picked up a little more. So it was back to doing laps, yoga, OFP and anything else I could think of to make labor progress.
Around 7am, Pam asked to check me again. I was only 5-6cm at that point. Pam also finally called in her student midwife, Heather, who had been at a birth the night before with her. Pam wanted to allow her some time to sleep before getting her in.
We decided to try some nipple stimulation in the shower at that point. Anthony was given that task. It worked and my contractions got closer together making it tougher to get through them. After the shower, I began laboring in the room again. Anthony put on the Bare Naked Ladies Holiday Album to lighten the mood as a I labored. Sarah entertained me during the Hanukkah Song by dancing the Horah (as the lyrics went). For some reason, I found that hilarious and couldn't stop laughing. I began dealing with the contractions by collapsing in Anthony's arms and allowing him to hold me. After each contraction, he would sing to me in his best Barry White voice. I honestly thought I could have laughed the baby right out at that point.
I tried doing a hypnobabies script which got me deeply relaxed on the bed. Unfortunately, it made my contractions spread out again. A couple hours later, I got into the tub. Although I liked being the tub, the room was a bit cold and the tub was a little big to allow me to get into a comfortable position for more than about an hour. My contractions again spread apart to 5-6 minutes by just being the tub so I knew I wouldn't be doing that again.
We did nipple stimulation again and my contractions got closer together. However, around 2pm, my cervix still hadn't made much change. We had to talk about what else to do. Pam was worried about how tired I was getting at that point. I couldn't find a comfortable position to deal with contractions in. Every time one would come on, I would kneel on pillows and lean on the bed or on the birthing ball. I tried eating and sipping Powerade to keep me energized but it was really getting tough at that point. I'd been up all night and most of the night before.
Pam decided that we needed to talk about our options. At that point, she felt that breaking my water was the best and least invasive thing to do to make my contractions stronger and closer. As much as I didn't want an AROM, I knew we needed to do something because I wasn't going to be able to go on forever.
Breaking my water definitely made the contractions harder and closer. I started going more inward trying to deal with the contractions. I tried listening to hypnosis again just to rest. I started off well but things were getting more and more intense. Sarah would stand behind me rubbing my back reminding me to go to my special place (a hypnosis technique) and to remember that each contraction was "just a wave…. just a wave." Heather massaged my back while I rock on the birthing ball and leaned against the bed. I kept telling myself "Relax..... peace...." which are also hypnosis cues. Several times I asked Sarah if I was in transition. She always told me that she didn't know and maybe I was. I had always heard that transition was the worst time and I just needed to get through that. The not-knowing was killing me but I went on.
Around 3, Pam suggested putting the squatting bar on the bed so that I could get into a squat during each contraction and allow the baby to move down further. When I got tired out from the squat bar (which got uncomfortable after a while since I needed to use my arms to support my whole body), I got on all fours and used the back of the bed. In between contractions, I leaned with my head on the top of the bed (which was moved into a chair conformation). When the wave of contractions came on, I held on to the top of the bed and allowed by body to grow heavy. I did this for a good hour or hour and a half. I did feel some muscles in my abdomen began pushing somewhat but I didn't have a strong urge to push. Finally, Pam checked me again. I was only 8cm and about 75% effaced. I still had quite a cervical lip that I needed to get rid of. So I kept trying to push with the squats (Heather and Anthony braced me in squats by holding onto my hands and pulling me up) and then by holding on to rings on either side of the bed. While I did this, Pam and Heather began pushing my cervix out of the way and around my baby's head. I was getting really loud at that point to deal with everything but no one seemed to mind. I remember Pam's back up doctor wandering into the room smiling broadly as if he didn't notice the moaning woman on the bed.
Finally, at 5:30, Pam told me that I was going to be pushing for real. It took a couple tries for me to get the hang of what to do but my body really took over. It was funny because as soon as I engaged certain muscles in my abdomen, they would all cheer and tell me to push like that. I started imaging that those muscles were on tracks and I just needed to engage them and get them going. I also remembering getting a little scared because I felt like I was pushing so hard and after all this time, I was worried about how much my uterus could handle. I know that I was getting really loud but Anthony coached my "vocals." Instead of getting loud and shrill, they wanted me to keep it low and guttural. I've never felt so primal in my entire life. My body honestly did know how to push. I pushed through each contraction as many times as I needed too. Pam and Heather and Debbie followed my birth plan by allowing me to push as my body told me to rather than trying to coach me with the "Push, 2, 3, 4, 5, 6…"
I wound up doing most of my pushing in the reclined position. This allowed me to hold on to the rings on the side of the bed while pushing and allowing Pam and Heather to get in there and stretch my cervix and perineum. They propped a mirror up so that I could see. They kept telling me that the baby had a lot of hair. I still had that little fear in the back of my mind that maybe I got this far but wouldn't be able to push her out. However, Heather smiled at one point and told me that I had a pelvis made for birthing. I was so surprised. She and Pam went on about how roomy my pelvis was and how they could move their hands all the way around. For a split second, I wasn't in labor anymore. I was digesting this new information that was in direct conflict with what my old midwife told me. Unfortunately, my contractions started spacing out again. Pam finally told me that it might be time to discuss some options. I momentarily feared the dreaded "c" word but she quickly said she might have to suggest the "p" word. With everything going on, I couldn't figure out what the "p" word was. Pitocin. If my contractions didn't get closer together, she wanted to try a little pitocin to get the baby out. Sarah and Heather knew how much I didn't want pitocin so Anthony went back to doing nipple stimulation. I'm surprised he didn't have a hand cramp at that point!
Gianna's head finally began appearing in the mirror. I finally realized that this was for real and it was going to happen. They told me to reach down and feel how she was right there. I would keep pushing though and she'd start to move out but then she would sink back in after each contraction. Finally, her head began popping out. I remember thinking, "Okay, this is that ring of fire. If I can just push past this, it will be all over." A couple intense pushes later and I felt her head coming out. It stayed there and I began to get her whole head pushed out. Heather and Pam guided my pushing to prevent me from pushing too hard against my perineum. My body seemed to follow right along with their guidance and then her whole body come out. Then they started yelling, "Reach down! Grab your baby! Grab your baby!" So I did. I pulled her up to my chest and they immediately covered her with a blanket.
I was in such shock after that. I practically shouted, "I did it!!! I did it! I'm not broken." I finally realized that I needed to announce the sex. I reached down, lifted up the blanket and screamed, "We have a girl!" I had to check 2 more times since it was such a thrill to actually be able to check (and because the entire world thought I was having a boy!) After that, I professed my undying love to Pam, Heather, Sarah, my nurse Debbie (who was still there beyond her shift) and, of course, my husband. At that point, the whole room was on a huge high. Later, we laughed about my love fest and how great it was that we didn't resort to pit so that my natural hormones soared right after the birth.
Gianna cried on her own just enough to let us know that she was perfect and healthy. They never took her away from me. I gently scooted her over to my breast and she latched right on in a perfect latch. Sarah, a LLL leader, was completely amazed. You hear about babies moving toward the breast and latching right on without help but it was really something to see. Heather and Pam told me to give a little push to get the placenta out. "It feels like pushing a marshmallow out. " said Pam. She was right - it was an odd feeling though! A little later on, Heather brought the placenta over so that we could do a placenta appreciation. Since I never saw my first daughter's placenta, I thought this was really cool. Heather actually lifted up the placenta by the bag and showed me how tough it was (which probably explains why it didn't want to break easily).
The post partum wing was filled that night so we stayed in the LDR room. They moved us the next morning and one of the best sights to see was that bag of pitocin, still hanging from an IV pole… untouched.
I spent 3 years being angry that my first ob told me I had a 5% chance of a vaginal delivery and making me feel broken. I realize, though, that he was right. I probably had a 5% chance of a vaginal delivery with this baby also. But that 5% didn't have anything to do with my body's ability to birth. Rather, it was a 5% chance of having birth attendants that were patient enough, skilled enough and experienced enough to work through my labor and allow my baby to be born in a beautiful and gentle manner.