Thalea’s Birth Story (My Perfect VBAC):

Fourth pregnancy, due June 10, 2007

If you are not familiar with our history we had a few obstacles to overcome before this birth became possible.  1993 - My first baby was born via induced vaginal delivery at 9 days past my “due date”.  A week of prodomal labor, 12 hours active/hard labor and 30 minutes of pushing.  She was posterior, but born vaginally.  1997 - Second baby was born via c-section for posterior brow presentation after induced labor (18 hours of hard labor, at least of an hour of pushing and the sOB trying to turn her head during contractions) at 6 days past my “due date”.  I had not gone into labor on my own, but had been leaking amnio fluid for 2-3 days and had a low-grade fever.  2000 - Third baby was born via scheduled repeat c-section (4 days before my “due date”) for breech position that turned transverse upon the opening of my uterus which required an Inverted T incision by the doctor because the baby got stuck.  I had a panic attack (I believe the first of many) while they were closing me up and thought I was going to die and never get to know my baby.  That was one of the worst experiences of my life.

I researched my last surgery and discovered that the surgeon did use a double layer of sutures when closing my uterus. Some will argue that there isn’t much of a difference but it made me feel a little more confident.  However, the vertical part of that incision “extended into the fundus”.  There was no measurement of how far into the fundus the incision extended so I have no way of knowing specifically how far.  The OB who performed that surgery told me afterward that if she were to care for me again through another pregnancy that she would insist on a c-section at 38 weeks for fear of uterine rupture.  I've heard other OBs say they prefer 36 weeks, fearing any prodomal labor.

When I first discovered I was pregnant with this baby I started seeing CNM midwives attached to the local hospital and overseen by an OB group.  I was told at my first appointment that the midwives would see me for my prenatal care until 34 weeks upon which time they would transfer me to one of the high risk OBs due to my c-section history.  They never verbalized it, but I had a strong feeling that this meant I would have a c-section before 38 weeks.  During one of my ultrasounds it was discovered that my placenta was anterior, adding the concern that it may attach to my scar.  Oh yeah, and let’s not forget my advanced maternal age of 35.  *rolls eyes*

Shortly after that, I found and joined the ICAN list and read the research on the ICAN site.  I spoke through e-mail to two women who had also had either vertical (classical) or inverted T incisions.  I read Natural Birth After Cesarean by Karis Crawford, PhD and Johanne C. Walters, BSN, RN.  Karis herself had an inverted T incision and went on to have 2 VBACs.  In the midst of this research I decided to find a homebirth midwife or at least a midwife that was not working for a hospital/OB group.  There was only one in my immediate area that I could locate and she would not assist me.  I did a search for home birth midwives on the internet for my area, very few, they either turned me down or didn't return my call.  Ohio is apparently fairly unfriendly to lay midwives or Direct Entry Midwives (DEMs) and all Certified Nurse Midwives (CNMs) seemed to be under the thumbs of the OBs and hospitals.  So, I expanded my search into Michigan, which luckily is a bit more midwife friendly.  I was still turned down by every midwife within 30-45 minutes of my home. I finally found a DEM owned birth center nearly 50 miles from my home.  We discussed my history and current situation with the anterior placenta, and she said they would be happy to assist me, that they had assisted with other VBACs after incisions like mine!!  At 22 weeks, I transferred care to the Michigan midwives and began the 45 minute drives to my prenatal appointments.  (My home was too far for them to drive giving that they have other women in their area that could go into labor at the same time.)

My pregnancy went along fine, no complications.  I was fully planning on giving birth to my daughter at their birth center but I was prepared for the possibility that I might end up with another c-section due to whatever unforeseen emergent circumstances might arise.

One evening in my 36th week I began having fairly regular contractions, during these contractions the baby started to flip.  I immediately stopped her believing that she was already vertex, I put my hand against whichever part it was and pushed it back to the top of my belly.  At 37 weeks the midwives both felt that the baby was breech upon palpation.  They explained that as long as she was in a frank breech position they would still assist me with a VBAC. I, however, was in shock, this was the same road that led me to my last c-section with the inverted T incision and laying on the table thinking I was going to die.  I did NOT want to repeat that experience.  I was angry with myself for stopping her from turning the week before and angry with her for being in that position.  I spent that weekend doing everything known to man in an attempt to turn the baby, ice on the top of my belly, pulsatilla, music at the bottom of my belly, hands & knees position with my shoulders down, chiropractic, tried to find an acupuncturist with no luck, manual manipulation, and I can’t remember what else.  I did get her to a transverse position which was a start but I explained to the baby that she couldn’t stay their either because that was worse!  I did get her back to a vertical position but wasn’t sure if she was breech or vertex.  I stopped my turning attempts just in case if she was vertex.  I located a local office that does “reassurance” ultrasounds and made an appointment for the following Saturday.  During the ultrasound she was frank breech oblique, with her butt sitting on my left hip and one of her hands was near my cervix.  This position was not optimal either.  I began the turning techniques again, but not as vigorously.  I came to a place of peace with either position being ok as long as there were no limbs or umbilical cord in the way.  My fiancé and I talked to the baby a lot, explaining that it would be much easier for both of us if she were to turn head down.  She did a lot of turning back and forth in the last few weeks and I had a lot of prodomal labor (several weeks) to show for it.

At my last prenatal appointment (Thurs. 6/21), I was 41w4d, dilated to 1 cm and 20% effaced.  Hadn’t really had too many contractions the last few days.  One of the midwives felt that the baby was vertex again, but I was still trying to be prepared for any eventuality.  We went to a relaxing Summer Solstice celebration that evening, everyone wished us good labor energy.

Friday morning around 3:30 am (the same time I’d been waking up nightly for the last 4-5 weeks), I woke up having some good, strong contractions lasting about a minute or longer, about 5-7 minutes apart.  They kept me up for an hour or two and then I was able to sleep for a few hours.  I was a little disappointed when I woke up that I’d slept so long, I thought for sure it was another false alarm.  I stayed in bed most of the day resting and contracting, they gradually got stronger, but after dinner slowed down to about 10 minutes apart.  I had already talked to one of the midwives a few times, she suggested that maybe they were giving me a break so I could get some rest and they would pick up again tomorrow.  I did sleep pretty well that night and they did pick back up around 3:30 am Saturday again.  A little stronger than before.  By 10 am they were requiring some attention and were starting to hurt.  Around 10:30 am I had a very strong one that reminded me how badly labor hurts.  :-)  A friend of mine who is a massage therapist came over after noon and gave me a wonderful back and shoulder massage.  By 2 pm, my contractions progressed, they were 5ish minutes apart, about 1 minute to 1.5 minutes long and getting continuously stronger.  I had been eating small snacks here and there, nothing major, I knew the puking was coming and food wasn’t too appetizing anyways.  At some point the contractions started hurting in my butt cheeks, which was new to me.  My labors with DDs #1 & #2 involved back labor, but low back, not butt cheeks.  lol  By 6 pm, I was having difficulty carrying on a conversation during the contractions and they were beginning to require a bit of concentration to get through.  I called the midwives and explained my progress as best I could.  I was still feeling pretty good, but felt like I should be closer to the birth center.  She told us to come up and she’d at least check me.  That was the most painful car ride of my life – having strong/painful contractions while on bumpy I-75 and sitting up right!  Sheesh!  I think I should have sat in the back so I could sit however I wanted.  One of the midwives met us at the birth center, my fiancé wanted to start bringing our stuff in, I told him to wait just in case if we weren’t staying.  When she checked me I was already 100% effaced and a stretchy 4 cm!!  Holy crap!  I didn’t think I was that far along but thrilled that I was!

Labor continued, my friend, the massage therapist, had come with us.  Thank the Lady and the Lord!  The pain in my butt cheeks quickly became unbearable.  At this point I started to go inside myself during contractions, which is what I did during my induced labors.  Somehow I decided I didn’t want to do that this time, I wanted to be more connected to the people in the room.  During my inductions I was not able to connect to anyone else in the room or communicate very well at all.  This time I tried to keep my eyes open during contractions and to focus on something, anything in the room.  It was extremely difficult, but it did help.  Also my friend massaged my hips/butt cheeks during each contraction, that helped make it much more bearable.  I’m pretty sure she wasn’t counting on having to play with my butt all night.  :-)  At some point my water broke and the contractions got even stronger.  I think within an hour of my water breaking my body started to push a bit with the contractions.  I tried really hard not to, I knew I wasn’t dilated enough and didn’t want to make my cervix swell.  It was very hard not to push, my body was pushing on it’s own.  A few hours after that (I think) I got in the tub.  I labored in the tub for a while (not sure how long) before I couldn’t fight pushing anymore.  Luckily, just as we were all getting very exhausted our High Priestess and High Priest from our coven showed up.  Our High Priestess helped me focus and not push.  Around 3 am I couldn’t not push anymore, it was uncontrollable.  Someone went to wake up the midwife, who’d laid down for a quick nap.  She came back to check me at 3:30 am and I was at 10 cm!!  And the baby was LOA!  What luck!  With the next contraction I pushed as hard as I could, I think it took me 2 or 3 pushes to get Thalea’s head past my public bone.  Then the ring of fire…  Ahh!!!  When I got to that point the midwife asked me to stop pushing so hard, to just do slow gentle pushes, she wanted me to let my body slowly stretch to let the baby through without tearing.  That wasn’t fun at all.  I did what I could to not push too hard.  Finally, her head appeared, for the first time in 4 births I was able to reach down and feel my baby as she was coming out.  A minute later I tried to reach down to pull her out, but there wasn’t enough of her out.  LOL  Everyone knew what I was trying to do and stopped me.  Thalea wiggled a few times while she was in the birth canal – that is the MOST bizarre feeling on the planet.  A few more gentle pushes and she was completely out!  The midwife had lifted Thalea out of the water and slipped one loop of her umbilical cord off her neck and I reached over instinctively and slipped the second loop off.  (Seemed completely natural to me at the time, but a little odd that it seemed so natural later.)  I took her from the midwife and laid her on my chest.  We were all laughing and talking to her, I checked to make sure that she was in fact a girl.  LOL  After a few minutes she opened her eyes and started looking around – several camera flashes went off 2-3 times each.  :-)  I birthed the placenta within about 10 minutes or so without any problems.  Daddy was trapped behind me and a little startled that we were sitting in a tub full of blood, amnio fluid and who knows what else.  LOL  Finally, it was time to get out of the tub and since I was laying on Tony and the baby was laying on me, Tony decided to let his dad hold her first after me, so we could get out of the tub.  Getting out of the tub was quite the chore, but we both had plenty of help.  I made my way to the bathroom and then to the bed, the midwife checked me out – no tears!!  I was quite impressed with this as my first baby was a pound and a half smaller but I did get the obligatory episiotomy at the hospital.  Eventually after everyone got to hold the baby, I got her back and we made our first attempt at breastfeeding.  She wasn’t terribly interested but she did make a good effort.  From the time she was born until this point she’d been wide awake and very alert, but had not cried at all.  Our family and friends left around 5 am, we all laid down for some sleep.  I didn’t sleep much at all, I was too enamored with my new baby girl, I just laid there next to her watching her sleep.  :-)  Finally around 10 am, Tony got up, got the midwife up.  He got our stuff together while I got myself together.  It was incredible to be able to stand up and walk to the bathroom unassisted 6 hours after giving birth and NOT feeling like I had to hold my guts in!  We were home shortly after noon.  She had a cone head for a few hours, but it was gone before we even got up to leave from the birth center.

I truly feel like I could not have had this birth without my midwives, Tony, our friend – the massage therapist, and my High Priestess.  Had I not had their strength to draw from and lean on during my pregnancy and during my labor, it might have had quite a different outcome.

Thalea Sage, 8 lbs., 3 ozs., 24 inches long with a 14 inch head.

It is so amazing what your body will do, when it’s left to it’s own devices and not interfered with by doctors who have nothing better to do than to tinker with things they ought not tinker with.

 

Thalea at 7 months

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