Birth Story #2: A TOLAC Success Story
In August 2015, we found out we were pregnant again!
I'd known since the day I had my daughter that I'd want to try for a VBAC (vaginal birth after cesarean). I also knew I would need to go with a different provider if that endeavor were to have any chance at success.
So I opted for a group of midwives in Milwaukee (45 minutes away). They came highly recommended by the doulas in my ICAN group.
I could tell at my prenatal appointments that this experience would be totally different. They had a very mom-centered approach to childbirth.
I hired an amazing doula, Amanda.
I did everything a woman should do if she is trying for a VBAC.
And then the day arrived!
Here's how it all went down. It's a long story, because it was a long labor.
Saturday, May 7, 2016
6:00 pm (hour 0): Contractions became regular and increasingly stronger while we celebrated an early Mother's Day with Eric's parents.
9:00 pm (hour 3): JM was in bed for the night after I dawdled putting her to bed because I knew this was the last time I would with her being my only baby. I tried to sleep as best I could despite increasing contractions.
Sunday, May 8, 2016 (Mother's Day)
4:00am (hour 10): I could no longer sleep through contractions. They were 4 minutes apart and a minute long, which is typically indicative of active labor. So we called my in-laws and our doula and headed to the hospital (a 45-min drive). Amanda met us there.
6:30am (hour 12.5): It was determined that, though completely effaced, I was only 1/2 cm dilated. How discouraging! But, I was trusting God—and my providers—to help me persevere. We walked around the hospital for a bit to try and move things along. We also grabbed some breakfast.
8:00am (hour 14): I was still only 1 cm, so we went ahead with a membrane sweep, and they told me to leave the hospital until things progressed further (How will I know if things have progressed further if I'm already having contractions 4 minutes apart?!?!). Amanda went home to rest up for when we needed her most.
9:30am-2:00pm (hours 15.5-20): Eric and I took a nap in the car, then walked around Milwaukee for a while (didn't want to drive all the way home just to have to drive all the way back). We walked around the Marquette campus (Eric gave me a tour of his alma mater), while I did some exercises that my doula sent me.
It was a beautiful day and laboring in the sunshine on that beautiful campus was therapeutic for me. The tulips were in full bloom, and the way the sun hit them had them shining golden, violet, and red like jewels.
I would close my eyes and lift my face to the sun during contractions, and I could feel God's tender care for me through the warmth and light. These moments were glimpses of the "ideal birth" I'd always pictured: intensely painful, to the point that it brought me into some other realm of being where I could commune with God and fall completely dependent into His arms.
Eric and I held hands and talked about anything and everything. It was like your typical perfect date... um, except for the being in labor part. That part was not typical date material.
By the time we finished our sweet onion chicken teriyaki sub from Subway, my head was swirling with the pain, contractions were closer, and it all felt unbearable.
2:30pm (hour 20.5): We went back to the hospital, where they found I was at 1.5 cm (womp womp). They brought me to a labor and delivery room (even though I was still technically not admitted) because triage was full. They wondered if baby was nudged in wrong, hindering dilation—possibly posterior. So I labored on a birthing ball, continued doing the Miles circuit as best I could, and also tried to get some rest.
6:30pm (hour 24.5): I was sent home for the night. Things were simply not progressing very quickly. Despite it feeling otherwise, I was still in early labor. But going home only produced a ton of anxiety for me. I felt like I was going backwards.
7:30pm (hour 25.5): When we got home, the neighbors were having a huge, loud party (seriously—there was even a bouncy house). Some kids were coming into our yard, and I yelled at them as if I was a grumpy old man. Our landlord (who lives upstairs) saw us arrive and was concerned there was no baby yet. All of our parents were there because they were switching who was watching our daughter. It was good to see them and to see my little lady, but the commotion was more than I could handle being in labor. Soon enough everyone left and the party next-door died down. I ate some lasagna from the freezer.
9:00pm (hour 27): I called my angel chiropractor and met her at her office way after hours for a middle-of-labor adjustment to try and get my little guy in the right position to descend. I then tried to get some sleep—and failed miserably.
11:00pm (hour 29): Around midnight things got super-intense. I couldn't handle the contractions. They were super-long, and I wasn't getting any breaks in between them. I could no longer breathe through them well on my own. Life was basically one big contraction at this point. So we went back to the hospital. I called my doula, who joined us there—again.
Monday, May 9, 2016
12:00am-3:00am (hour 30-33): I was 1.5 cm and stayed in triage for a while with Nancy, the midwife who was on shift at that point.
4:00am (hour 34): I was finally admitted to the hospital at 2 cm after baby descended a bit more.
5:00-6:30am (hours 35-36.5): I got to labor in the whirlpool. I finally got to relax for a while. It was so desperately needed. I'm so grateful I had an opportunity to labor there. My exhausted mind melted into the twinkle lights on the ceiling. I think I may have even gotten some sleep.
6:30-8:30am (hours 36.5-38.5): I rested in bed, as my contractions had become much more spaced out after the whirlpool (good for resting, bad for progressing). Nicole (one of the midwives I hadn't met and hands-down the best midwife I had the whole time, which is saying a lot because they were all great) came on shift. God was gracious to place her there for this part of my labor. She was amazing. She even let me order oatmeal (which was a big accomplishment, believe me)!
9:30am (hour 39.5): Nicole took about an hour to thoroughly discuss with me my options for either getting some more rest or speeding things along. I could do some walking (which hadn't accomplished much of anything up to this point), go home (we all saw how poorly that went last time), do therapeutic rest (morphine so you can sleep, essentially), or induce with Pitocin. I opted for induction, as I have had adverse reactions to narcotics in the past and had a relatively high Bishop score that indicated conditions for induction were favorable (basically every factor was cooperating except dilation, which was still only at 4 cm).
11:00am-9:00pm (hour 41-51): I labored this way all day, for about 10 hours. I spent some time in the shower, and tried many positions in the bed. Labor definitely intensified during this time since they were now Pitocin contractions. I had a lot of back labor, and during every contraction Nicole, Eric, or Amanda would push on my back for counterpressure, which felt so good (relatively speaking, anyway). I could hardly bear contractions without that each time. I really, really wanted to have my Bible verses for labor read to me during this time, but we couldn't find them in our bag. I was disheartened and frustrated about it, but didn't have the wherewithal to communicate how much I needed them. By 8:00pm I was at 4 cm, fully effaced, and at -1 station.
9:00pm (hour 51): At this point I opted for an epidural. Fatigue was a bigger enemy than any potential results of an epidural. I had the best epidural EVER. The doctor who did my epidural was a total sweetheart—complete night and day from the snarky anesthesiologist who had done the epidural for my first birth. I could barely feel the contractions but was still able to use my legs well enough to change positions pretty easily on my own! I slept well that night, and woke every hour or two to switch sides since gravity was causing the epi to lose effectiveness on either side after a while.
Tuesday, May 10, 2016
2:30am (hour 56.5): We decided to have them break my water and put in an internal monitor to better regulate the Pitocin.
5:30am (hour 59.5): My IV came out so they put in a new one. They also topped off my epidural since I started to feel too much. Rockstar Amanda went home for a while to care for her kids and get some rest. My backup doula, Eleanor, arrived (she has a British accent, which is essentially always a calming thing).
7:00am (hour 61): I measured 6 cm. Baby was at -1 station and had some caput (scalp) swelling. Midwife Paul came on shift. I continued to labor in various positions. There were a couple times that baby's heart rate decelerated, which brought in crews of OBs and nurses to help me change position and monitor him until things improved. Those moments were a little scary. We started to wonder what might be causing that and trying different positions to get him off his cord.
8:00am (hour 62): I reached 7 cm—the point at which labor had stalled with my first labor.
12:00pm (hour 66): I was 9.5cm and 100% effaced! It seemed like it'd be happening soon! Things were getting so close. Eleanor left and Amanda returned.
1:30pm (hour 67.5): Things were not looking good. Baby had more swelling on his head, and things had regressed to 9cm and 70%. Something was causing the little guy to move back up instead of descending properly. Paul recommended a c-section. We agreed and opted for the cesarean. We knew something wasn't going right for our baby and just knew it was the right decision. I asked for some time alone with Eric and Amanda.
When all staff had gone, Eric came over and held me in his arms. I cried and cried and cried. I had peace about the decision, but was still grieving the loss of the VBAC I'd wanted. I asked Eric to tell me true things, and he preached the Gospel to me, reminding me who (and Whose) I am. The OB stopped in, asking if I was ready, and I said that I needed a little more time. It was so very good to have the time I needed to cry and grieve in the moment. I'm grateful to have had the realization to know I needed it, and the strength—even after 68 hours of labor—to ask for it. Besides that little "intrusion" from the OB, I did not feel rushed to finish the grieving I needed to do.
3:00pm (hour 69): They prepped me for the cesarean. I was able to feel too much when they tested the epidural strength so I had to be too drugged to remember the actual operation.
3:53pm (hour 70): Little Man was born at 3:53pm!
I'd hoped for a family-centered c-section where I'd be awake, have immediate skin-to-skin, etc. That didn't happen because I was essentially on another planet during the surgery. But the first thing I remember upon "coming to" was having my baby placed on my chest to nurse—a welcome change from last time.
While doing the surgery, they found two things that could have been catastrophic had we continued to labor much longer: Baby's cord had a knot in it. (He was a little blue, needed oxygen, and his 1-minute APGAR was only 5.)
AND, my uterine scar had a 7cm window in it that could have become a rupture! So, all in all, it's obvious that God was protecting us, and I'm thankful that He very clearly showed us WHY, which He didn't have to do.
Yes, it was still really disappointing to have another cesarean. And, given the circumstances, all my providers agreed that in the future I should only have cesarean birth(s), which was also disappointing news, as I know that only increases potential risks and complications... and major surgery is no walk in the park.
But, I'm grateful for God's protection and His clarity in showing me the "why" and in clearly closing that door. In some ways, it'a a relief to at least know the door is closed, so I can fully grieve and move on. I will always wonder what would have happened had I had a different experience with birth #1 (what if I'd been able to wait for labor to begin naturally, what if I'd waited to agree to the c-section to see if things progressed more, etc.), but I simply must take this as an opportunity to trust that God knows what he's doing and allowed all of it to happen that way for a reason. He could have given me more knowledge about my options back then, but He didn't for a reason. And I know my God, and I know He's trustworthy and perfect. I know He's faithful. So, despite the questions, in the end, that's all I need to know.
THE LEARNING POINTS
So, as I mentioned, it was clear that God was protecting baby #2 and me in our crazy labor and delivery!
There are many things I've been learning as a result.
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I am still sad my deliveries had to happen this way.
My doula told me about a website called Surrender Birth, where people share their birth testimonies. She encouraged me to write my own (hence these posts).
Anyway, as I read these testimonies, I sensed some bitterness when I read the stories that were along these lines: "I've never felt as close to God as I was during my delivery! It was magical and went exactly the way I wanted—home birth in the birth pool and everything! What an answer to my fervent prayers!"
Or this mom who accidentally had a natural birth. (How is THAT fair?!)
I've spent a bit of time fighting that bitterness and the "why couldn't I just be one of those women who can birth naturally?" question. I've visited Scriptures that remind me who I am and who God is... like the end of Job. He gives and takes away.
Why does God say "no" to anyone about anything?
Why are there some who can't have kids at all?
Why are there some whose loved ones die too young?
I get that, in the grand scheme, my problem is small compared to some others. But that doesn't mean I don't still have to process through the Big Question: Why pain?
I've spent some time reading The Problem of Pain by C.S. Lewis to grapple with this question more. This Big Question is something I've been wrestling with for the past few years, as many friends and family have passed away in the past few years as well.
I still don't have all the answers. But God's been humbling my heart to come under His sovereign authority over all things—life, death, and birth stories.
Job 42:1-3 - Then Job answered the Lord and said: “I know that you can do all things, and that no purpose of yours can be thwarted. ‘Who is this that hides counsel without knowledge?’ Therefore I have uttered what I did not understand, things too wonderful for me, which I did not know.
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For a while at first I felt embarrassed that this VBAC I talked about wanting so badly was not something I ended up accomplishing. People kept asking about it, and I sometimes I felt a little silly having to tell everyone it didn't work out how I'd hoped.
I've had to wrestle with that a bit, too. There's simply nothing to be embarrassed about.
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As I mentioned in Part 2, they (not just the OB's, but the midwives, too) told me no more VBAC attempts—only c-sections from now on. That was sad news to hear.
But it also helped to provide closure for me. No more wondering or open-endedness. Just a closed door that I can fully grieve now, which is a blessing in a sense.
And the planner in me intends to fully enjoy the benefits of a scheduled cesarean next time, like lining up all my babysitters and getting a good night's sleep beforehand!
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There are so many Small Kindnesses from God that I'm thankful for and don't want to overlook. Some of the many (besides the main one—that God obviously protected our lives—and my ability to continue having more children) include:
The entire staff at Mt. Sinai (besides the OB's I had to deal with afterward for an infected incision) was AMAZING. The whole time during labor and delivery I felt heard and respected. With each step the midwives took they explained my options and allowed me to make the decision that I wanted. They were not in a hurry to get the baby out. I knew I could trust them completely. Even the anesthesiologist was wonderful. And every nurse. They just have amazing staff there.
They gave me time to process and grieve even during the labor, when things didn't go how I wanted. When we decided to have the c-section, I knew better this time. I knew I needed to process. Last time I was whisked away too quickly (and for no good reason, since it was not an emergency) and sobbed the whole way to the OR. This time, I asked to be left alone with Eric and Amanda for a while. I had Eric come sit on the bed and hold me and tell me true things while I cried and let out all the things I was feeling. It was SO GOOD to have that time beforehand to process the surgery before it happened.
That awesome epidural that allowed me to still move around easily.
I had the opportunity to TRY. I know I did everything within my power to make a VBAC happen. The only "what-if" I'm left with is "what if there was no knot in his cord?" There are no other questions like the many I had last time (such as "What if I'd known to choose a different provider or tell this one no?"). I have no regrets and wouldn't do much differently if I could.
I didn't feel laughed at. I didn't feel like they thought I was silly for trying, or like they were looking down on me or questioning my decisions.
I got to labor outside in the sunshine on a perfectly beautiful day (something I didn't even know I wanted till it was happening).
Despite the One Big Request being answered with a "no," there are many specific prayers that God graciously answered with a "yes," just to remind me that He hears me. These "yes" requests—these Small Kindnesses—included:
being able to labor in the whirlpool
making it past 7cm (where things stopped the last time)
being able to experience natural/non-induced contractions
not having my water break before contractions began
having Eric with me the whole time
having Amanda AND Eric in the OR (not typical)
having Eric present for everything they did to the baby
Recovery has been a thousand times better this time—even with the infected incision and much resulting antibiotic ridiculousness. I'm much more able to do things and feel already at three months the way I felt at a year or more after my oldest was born. I think this is because I'm sure I had mild PPD (postpartum depression) after my first delivery, which is not the case this time. Now, I'm like "What?! You mean I can feel mostly like my normal self and not living in a dark cloud after having a baby?! I had NO IDEA!"
My doula was able to be present for the actual birth. This was a concern because she had to leave a few times since my labor was so long. But when the actual birth happened, she was there for it.
My little guy has been a super nurser! He had latching figured out from the very beginning and is efficient, too. He's also been a good sleeper overall (despite his recent sleep regression). He's such a happy, low-key, straightforward kid.
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One thing that's been hard/fun/interesting/sad/happy has been the switch to a family of four. Big sister loves him but is also having a rough adjustment period. It's hard to watch her experience grief. It's hard not to give her the time I'd like. But it's fun to see her bond with Daddy in a new way, and to see her love on her brother and learn about babies and how they grow, etc.
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One other thing I've thought about is the fact that, at its root (though perhaps I held it too highly as an idol), the desire for a natural birth is a good thing! After all, vaginal delivery is God's good design and the healthiest route if possible. And the fact that I'm disappointed it didn't happen makes a lot of sense.
We were created for heaven, so life under the sun is bound to be less than what our hearts long for (recent Ecclesiastes sermon series influence there).
When God cursed Eve after the Fall, He said she would bear children in pain. It never says that pain is limited only to the pain of contractions and pushing. It very well can be the pain of births not going as planned, of surgery and resulting complications, etc. it also never says anything about my being exempt from the effects of the Fall.
It is my hope that, as I process through these ideas, my "mad at God" attitude will continue to dissipate and become instead humility and a longing for That Day.
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Well, there it is, guys. My whole birth testimony. I hope you can see how I can call it a TOLAC Success Story despite a repeat cesarean, and I hope you enjoyed reading these posts! It helped me so much to write them.
If you had a disappointing delivery or a difficult recovery, can I encourage you to write out your story? Grab a journal or a computer... and just write away. It can be so therapeutic. I'd be happy to read it if you want to share ♥