It is a JOY to share Sam's birth of sweet baby Millie. Sam hired me as her doula for her beautiful, redemptive pursuit of a VBAC. It wasn't an easy journey. Rather, perhaps like walking into a current. A current of fears, opposition, insecurity, unknowns, judgment, and the list goes on.
Although the true win was witnessing Sam overcoming fear and choosing hope (and evidence based truths) - You will see soon how cheesy-joyful I was when her VBAC came to fruition!
We hope this story deepens these truths no matter the story line of your birth - you are strong, capable, and supported. Sam's words are GOLD! At the end, she will share words of wisdom for those pursing a VBAC. We are rooting for you!
Thank you, Sam, for sharing your story.
Millie's Birth Story
Spoiler: Successful VBAC! Woohoo!
It may seem painfully obvious, but every VBAC story first starts with a cesarean story. In June of 2018, I birthed my son via cesarean section. My experience with his birth was overall very positive - I had a textbook pregnancy, went into labor spontaneously at exactly 40 weeks, dilated as expected, but failed to make any progress while pushing. I pushed for several hours in all kinds of positions, but he simply would not budge! After my cesarean, I learned that my son was face up (rather than the preferred position of face down) and had his umbilical cord wrapped around his body in such a way that prevented him from turning.
While I had a positive experience with his labor and birth, I cannot say the same of my time postpartum. My son inhaled fluid and needed resuscitation, so he was whisked away for ‘observation’ soon after being born. The hospital pediatrician insisted on monitoring him for 4 hours before allowing me to see him. My husband and doula tell me that he spent most of this time screaming, and he was not actually hooked up to monitors. We experienced hurtle after hurtle with our breastfeeding relationship during his first 3 months of life before we were able to sort those issues out. The hospital stay kept getting extended due to issues with adequate weight gain (and a very inconsiderate pediatrician). I was attempting to heal from major abdominal surgery, running on 45 minute fragments of sleep, juggling brand new motherhood, and trying to allow friends and family to come meet our son. While I don’t completely blame my postpartum depression and anxiety on this experience, I do think that it heavily contributed.
My husband and I knew that we wanted our children to be close in age, and God granted that wish! Fast-forward to December of 2019, I am nearing the end of pregnancy with a healthy baby girl. During my 38 week appointment, my OB/GYN discovered that my blood pressure was elevated. After a 24 hour urine test, I received a pre-eclampsia diagnosis. Knowing that I wished to have a TOLAC (trial of labor after cesarean), my Dr. checked my cervix for dilation in order to see if it would be possible to insert a foley bulb. I was measuring at 1cm, and a foley bulb dilation was approved!
After several hours of waiting, I was given a saline lock and hooked up to contraction/fetal heart rate monitors. A hospital midwife inserted the foley bulb in order to manually stretch my cervix from 1cm to 3cms. It worked very quickly - the foley bulb fell out almost immediately. A couple of hours later, another provider came in to my room and hooked me up to an IV drip of pitocin. I was nervous about the pitocin, but I decided to try to nap so that I could store up some strength in anticipation of my labor progressing. A nurse would come in and increase the pitocin drip every hour or so. Eventually I was maxed out in the allowed dosage of pitocin, but my labor was not intense and I was not experiencing much progression.
I had been texting with my doula, Samantha, throughout the morning. After updating her on my lack of progression, Samantha came in to help us get things going! At 11:30a, after 7 hours on pitocin with little progress, Samantha arrived and worked some magic with her knowledge of Spinning Babies positions. My sister arrived around the same time with her camera in hand. I wanted this VBAC documented with photos, and my sister was more than happy to make that happen!
I knew that I needed more mobility, so I requested a wireless set of monitors. The hospital had only recently begun working with wireless monitors and were reluctant to use them on me. However, my sweet nurse was willing to give it a try and came in with a set! The wireless monitor made a world of difference in my ability to move freely. Cords are for the birds! Samantha lead us in some positional changes such as using the birth ball, butterfly legs on the bed, side-lying release position, table top, squatting, and hanging out on the toilet (which is just as glamorous as you can imagine). We started to see some progress, but my Dr. suggested that we break my water in order to keep the progress going. I requested more time to labor with my water intact, but ultimately agreed to breaking my water a few hours later.
Labor gradually intensified - yay! Samantha and my husband helped me to cope with contractions through the use of positional changes, counter pressure, and the rebozo. Around 8cm, I hesitantly requested an epidural. I knew that limiting my ability to move and reducing labor sensations increased my likelihood of needing a repeat cesarean, but I was no longer handling the contractions well. I felt like I could not get ahead of the pain, and contractions were coming every 2 minutes without reprieve.
My anesthesiologist was wonderful and allowed my husband to stay in the room during the procedure. Once the epidural was in place, and the dosage was adjusted to accommodate for some persistent pain levels, I dozed off for a couple of hours. Samantha helped my labor to continue to progress by rotating me every 30-45 minutes and using the peanut ball to keep my pelvis in open positions.
My nurse returned to our room, concerned about some heart rate decels that she was seeing on the monitor. She checked my cervix and found that I had progressed to 10cm, 100% effaced, and +1 station! She suggested that we do some ‘practice pushes’. Friends, I am not a fan of ‘practice pushes’. During my labor with my son, those practice pushes completely exhausted me and my pushes became ineffective.
I have to admit that I had a moment of internal panic. I tend to be very stoic, putting on a brave face despite what I am feeling internally. That is exactly what I did during this moment. In retrospect, I wish that I had let my husband and doula know how I was feeling and given them the chance to encourage me! Instead, I internalized some flash backs to my son’s birth. I vividly recalled the hours of pushing with no progress and the moment that my provider said, “Sam, I think we have to call it. You need a cesarean.”
So, I decided that I was not going to ‘practice’ pushing. If I was going to push, I would PUSH. After pushing with 3-4 contractions, my nurse called my Dr. to come in to the room because my daughter was on her way out! Even after my nurse assured me that I was making great progress, I didn’t believe that I was actually pushing my baby out of my vagina. My Dr. calmly came in to the room and encouraged my pushing efforts. After 2 more pushes, my daughter’s head was born! Dr. P released my daughter’s nuchal cord and coached me through another push as he maneuvered her shoulders through my pelvis, later telling me that he narrowly helped me avoid a shoulder dystocia.
The reality that my baby came out of my vagina did not actually hit me until several minutes after the fact. Unfortunately, my daughter was not given delayed cord clamping or immediate skin to skin because she was not born immediately breathing. My Dr. allowed my husband to quickly cut our daughter’s cord (an experience that he was not given with our son), and brought our daughter over to the warming lamp to have the fluid suctioned out of her lungs. After a few minutes of her nurse working on her, my daughter was given back to me for some GLORIOUS skin to skin and nursing.
At that moment, I realized that I had just had a successful VBAC! My baby had just come out of my vagina - the way that God intended! Despite a diagnosis of pre-eclampsia, an induction, max dose pitocin, an epidural, and coached pushing WITH the use of stirrups, (all factors that reduce the likelihood of a successful VBAC) my 8lb 11oz baby made her way earth-side via vagina. All I know to say is, “Praise God!”
I’d like to highlight some of the ways that I advocated for myself during this process. During prenatal care, I never entertained the idea of a scheduled cesarean. While my providers requested that I have a repeat cesarean scheduled ‘just in case’, I simply said, “No thank you. I would rather wait.” My providers always honored that decision! Additionally, I was the person who requested each cervical check prior to my baby’s heart decels, I declined my nurse’s request to abstain from eating and drinking during labor, I decided on the right time to break my bag of water, and I insisted on the wireless fetal monitoring. I was not always happy about having to say, “No thank you,” but I was willing to do so and my providers were willing to listen!
My hospital stay and recovery was completely different from my experience with my son. As soon as the epidural wore off, I was able to get up, take myself to the bathroom, and pick up/ nurse my daughter with relative ease. There was no urine catheter, no abdominal incision requiring help every time I got out of bed, and no need for strong pain medication contributing to a drowsy daze during my first moments with my baby. After a short hospital stay, I got to go home and greet my son by PICKING HIM UP. Hallelujah.
SAM'S ADVICE FOR YOU
If you are reading this birth story and hoping for a VBAC of your own, please know that it is possible. Your VBAC is never guaranteed, but it is absolutely possible. I highly recommend regular chiropractic care to help the alignment of your pelvis, allowing your baby to rest in the optimal birth position. I also cannot overly stress the importance of hiring a quality doula to help you before/during/and after labor - ESPECIALLY if that doula is knowledgeable of the extra stresses that VBAC mamas experience. If you are not sure whether you would prefer a VBAC or a repeat cesarean, that is okay! A VBAC is not the best option for everyone. Only you can know what is best for you.
Finally, please know the power of your own voice. Your medical provider cannot possibly make the best decisions for you. He/she can (and will and SHOULD) make medical recommendations, but you are the ultimate decision maker. Your provider should encourage your active roll in the decision-making process of labor. Your preferences matter. It is true that you do not get to ‘plan’ every detail of your child’s birth story. But you DO get to insist that your preferences be honored whenever possible.