Thursday, October 04, 2012

The Story of Our Successful VBAC


Simon James Hendler-Voss was born early Tuesday morning, September 25th via an unmedicated VBAC water-birth, attended by our doula, midwife, and a nurse.  This is the story of how it unfolded, and the resources that enabled us to have a successful VBAC in Asheville. 

Perhaps unlike many mamas hoping for a VBAC, the cesarian birth of my first child had nothing to do with lack of support or knowledge.  New Dawn Midwifery provided care throughout my pregnancy and I planned on a natural birth at our local, baby-friendly hospital.  I attended prenatal yoga and a birthing class with Seth.  We chose not to have any ultrasounds and did not know if the baby would be a boy or a girl.  I read Ina May's books and birth stories and it never even occurred to me that I might have a cesarian birth.  Growing up athletic, my body knew hard work and always seemed to rise to the occasion of any challenge.  I wanted to have a doula for the birth, but felt we didn't have the money in our budget.  Instead I recruited a friend who was training to be a doula, and she would provide her services for free as part of her training.  When it turned out that she needed to move out of Asheville a few months before the birth, we decided not to hire a doula to replace her, but invited another friend to attend the birth as a support person. 

As labor got underway and we went to the hospital, it became apparent the baby was positioned posterior, and I experienced painful back labor.  My friend Cindy applied pressure to my back with almost every contraction for hours, but the contractions were so painful that I couldn't lean into them and allow them to do their work; instead, I found myself resisting them.  12 hours into labor, with no rest through the night, my labor began to show signs of stalling.  The midwife suggested I have a whiff of pitocin.  I was willing to do this only if I could have an epidural, since I had been working at my edge for so long.  Thus began the cascade of medical interventions...

I received an epidural (a great one, which allowed me to still feel the contractions a tiny bit and to push on all fours) followed by pitocin, and promptly dilated to 10cm.  Then I began to push.  A few hours into the pushing, I could see and feel Myles' head, but I could not get him under my pubic bone.  Between contractions, his head would recede.  The midwife called the back-up doctor.  When he arrived, he determined Myles' head was not crowning, but rather presenting at an angle that would be impossible for me to deliver him vaginally.  He could not be turned; he could not be vacuumed out, I had to have a c-section.  Seth and I were exhausted and bewildered by this unexpected news.  His head was right there, I could touch it!  I continued to push while they prepped me for surgery.  Luckily Myles' heart beat never wavered, and so there was no sense of the surgery being an emergency.  Myles was delivered by c-section, I saw him briefly afterward, put my hand on his head and whispered his name to him.  He was given back to me after I was stitched up, which seemed like an eternity. 

The aftermath of the cesarian birth was painful in every way.  I had never had major surgery before, except to have my wisdom teeth removed.  I could not go to the bathroom without assistance.  I could not stand and hold my baby.  I could not change his diaper.  I was overwhelmed, rocked, and toppled.  My milk took forever to come in.  I shuffled off to the breastfeeding center in slippers since my feet were swollen for weeks after the birth.  I was instructed to nurse and pump every two hours, and with the support of my husband and my mom, I did it.  It was painful and hard, I was totally sleep deprived.  Eventually, my milk came in and I went on to successfully breast-feed Myles for 14 months, until he self-weaned. 

My midwife said that every birth teaches us exactly what we need to know.  My first child with his shock of red hair has taught me so much about letting go of my need to control things.  He has been one of the best teachers in my life, and the over-achiever in me is still learning that I cannot accomplish everything by sheer will.  Myles' birth was humbling and it began to teach me a very valuable lesson about parenting...it's not all about me. 

When we discovered I was finally pregnant again (we waited a while for many reasons), I knew my hopes for this birth included a VBAC.  My sister had two VBACs, and that encouraged me.  Again, I went through New Dawn Midwifery and attended pre-natal yoga.  This time, however, I invested in chiropractic care through Awakening Heart Chiropractic, figuring if it could save me from the cost of a cesarian by helping the baby get into optimal fetal positioning, the cost would be well worth it.  We also invested in a doula team.  I visited the spinning babies website and practiced the exercises and stretches they recommended almost daily.  I also opened my mind to the possibility of another cesarian birth if things did not go according to plan.  

My pregnancy was very pronounced with Simon...I seemed to get big much earlier, and as a short person, my belly just continued to grow straight outward.  I felt very cramped and crunched inside, and the third trimester was uncomfortable to say the least.  Simon kicked me so hard sometimes that I thought he might do damage.  The Thursday before he was born, I had contractions all day long; first 10 minutes apart and then 5 minutes apart.  They never intensified, but my body seemed to be ready to birth this baby. 

On Monday morning, I lost my mucus plug, and I knew he would come soon.  That night, I began to have braxton-hicks contractions again, and they intensified.  By 11:00pm, I believed I was in labor.  I came down to the kitchen where Seth was working at the computer and told him this was it!  Simon was 37 weeks and 1 day; early, but full-term.  The contractions started at 10 minutes apart.  Seth called Tom, Myles' Godfather, to come over and be with him.  Myles was asleep, but we had told him that he might wake up to Tom if the baby came.  Tom arrived, and Seth began packing things up.  The contractions moved to 7 minutes apart.  We called our doula, who said to call her when we were closer to 4-5 minutes apart.  I labored in the shower until the hot water ran out. 

As we called the midwife, the contractions moved to 5 minutes apart.  She asked Seth to put the phone near me so she could hear what I sounded like during a contraction.  When she heard my low groaning, she said it was time to go to the hospital.  First, I had to make it down two flights of steps and into the car.  The contractions now seemed to be coming faster.  Our doula arrived just as I was getting to the car, and she squeezed my hips together during a contraction as I leaned against the car door.  The pressure took the edge off and helped me focus on something other than the pain.  I got in the car, and instructed Seth not to speed (speeding intensified the contractions).  I had my most intense contraction yet in the car and need to scream a little, which scared Seth a bit.   

When we got to the hospital around 2:15am, Seth left the car where it was and helped me in.  The contractions were coming like waves, one on top of the other.  Our doula Jordan helped me through them, and our midwife Angie wanted to check to see how dilated I was.  First, she encouraged me to pee.  As I got into the bathroom, my water broke all over the floor.  I got into a bed in the labor and delivery room as they began to fill up the birthing tub.  The contractions were now so close I couldn't get any relief between them.  I had to pound on the bed frame a little and sometimes would do some screaming, though Jordan and Angie always reminded me to try to bring my tone lower, as this would help me progress.  Angie checked and I was 9 cm dilated...I had started to transition in the car (transition is moving from 8-10cm).  I could feel Simon's head moving around as he tried to position himself to come out.  It hurt like crazy, but I was glad he was moving into position.  By the time I got into the tub I quickly dilated to 10 and the contractions, mercifully, spaced themselves out. 

I felt the urge to push, but did not really like the pushing.  Laboring through transition and throughout the pushing was an experience of extreme vulnerability.  I had to get the baby out, but wasn't sure if I could do it.  I kept asking for help.  Jordan rubbed my back and Angie encouraged me.  Seth held my foot and leg every time I pushed.  Because I pushed so long with Myles and still had to have a c-section, I kept worrying that I was not making progress with the pushing.  Angie and Jordan insisted I was making progress, that everything was just fine and I would meet my baby soon.  When I asked if it was taking too long, they said my body was so smart; it was slowing things down a little so I wouldn't tear. 

After about an hour of pushing, the baby's head began to crown.  I thought it would never come out!  But when he got to the place where his head didn't recede between contractions, I knew I had to get him out because it hurt too much to just leave him there.  Everyone cheered me on to give my biggest push ever, and I did.  Out came his head under the water, and I paused so Angie could check for the cord around his neck.  I didn't think I could push any more, but I had to and so I did, and out came his body.  Angie told me to grab my baby and pull him onto my chest.  I couldn't believe he was out...the relief was incredible.  I pulled him onto my chest and welcomed him into the world with a prayer of thanksgiving, tears of joy, and incredible wonder at this little being.  I told him his name.  I looked him over and comforted him as he cried.

They never took him from me.  I was able to have him on my chest while I delivered the placenta and got stitched up.  Only when we requested that he be weighed did they weigh him (6lbs 10oz) in the room and later they gave me the option of having him cleaned up (the vernix was still on him) and I said yes.  And then he was back in my arms.  It was a hard birth, a little less than 6 hours, but it was exactly what I had hoped for.  He was alert and began to nurse almost immediately.  Amazingly, I didn't feel tired and just wanted to spend time with him.  The rush of natural hormones left me feeling exhilirated and full of gratitude.

The difference in my recovery has been amazing.  I was able to walk right away, to stand and hold Simon to comfort him when he cried.  The swelling left my hands and feet immediately, and my body felt so roomy and good.  At one point I thought it might all be a dream, and I'd wake up to find myself still pregnant.

While Simon's birth was empowering, each birth is truly a miracle.  I could not have done it without the amazing support of my husband, doula, and midwife.  The experience of his birth was one of incredible vulnerability and after it happened I couldn't believe we did it.  I am so thankful for a healthy birth, a beautiful baby, and a strong recovery.

If there are any mamas out there reading this who are hoping and praying for a VBAC themselves, I would highly recommend the following:
Good chiropractic care to ensure optimal fetal positioning.
Visit the spinning babies website and practice the poses and exercises they recommend.
Hire a doula.  It's the best investment you can make and it will affect your outcome.
Enjoy the fact that a second labor is usually shorter...
Make sure your partner/spouse is on board for whatever kind of birth you want, because you will need their support.
Remember that we cannot control our births, we can just do our best to open ourselves to their power, lean forward into labor, and let our bodies do their work.

I am thankful that my body was so smart this time around.  From the many contractions I had before real labor (which got me to 2cm dilated before I went into active labor) to the way I progressed in labor and then the slowing down that happened in pushing, my body knew what it was doing.  My milk came in right on time.  I'm out taking my baby for walks in the October sun every day now; amazed at the miracle of this birth.  Simon, so far, is a peaceful, calm, and content baby.  Perhaps he senses my own contentedness and joy.

What a gift.  God is good.     

2 Comments:

Blogger p-fitz said...

You are a total badass Voss. Much respect and congrats!

7:08 AM  
Blogger Kara Melissa said...

Oh Mandy! So beautiful. I was in tears. Thank you for writing so candidly. It brought back memories of my own birth stories and I know we were both able to experience some of the same things. I wish I could hug you and your sweet Simon. God is good indeed.

4:58 PM  

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