Nov 2012

A Restorative Birth

A mom who wants a VBAC (Vaginal Birth After Cesarean) usually has a different perspective. She usually feels either the first time was unnecessary, or she wants to try to have a safer healthier birth with more control the second time (even if it was due to circumstances beyond her control). Even if the first time c-section was the first option for the baby, it doesn’t have to be with the second. The VBAC moms I have worked with have done a lot of their own research and have concluded they want a natural birth. The reasons for the natural birth are many, but mostly I have heard, they know a natural birth is their best option at a VBAC, they want to feel more in control of their body, they want to feel everything and be a part of their baby’s birth. This is exactly how Jane felt when deciding to have a VBAC. She created everything around her to have the best opportunity possible for a VBAC.

Setting everything up to give you the best possibility for a VBAC doesn’t mean you will have one and it doesn’t mean that things will go your way. Jane had to accept this when she was a week past due, was having mild contractions every night, but not full labor. She was due, Sunday, September 30
th and had a doctor appointment on October 7th where she had to schedule a c-section for October 11th, almost 2 weeks post due. She knew that in the end she would still have her healthy baby and she would accept it, but she really wanted to go into labor.

Sunday, a week post due, Jane and Kevin decided to take their little boy to Disneyland to walk all day. I had mentioned to them, if you have a baby at Disneyland, they will have a lifetime pass for free. That wasn’t the goal, but they had free passes and thought the day might help get labor going. They had a fun, tiring day. Early Monday morning, October 8
th, their little boy threw up, so Jane had to wake up She felt the usual rushes and thought it was the normal night time contractions. After taking care of her little one, she went back to bed. Around 6 am, she woke her husband up telling him she couldn’t get out of bed. He just thought he could get her out of bed, but she was having pretty strong contractions at this point. She went to sit on the toilet and hung onto the shower door while Kevin called me. I told her to take a bath because the contractions were pretty intense and about 5 minutes apart.

I arrived at their house at 6:30 and she was in the bath with the water running past the overflow spout. I sat with Jane so Kevin could eat some breakfast. During a contraction, I would turn the water off for her and turn it back on to get the level high enough. During this time, Jane still felt pretty comfortable and wanted to stay home. I think it had been about a half hour and Jane wanted to try to go to the bathroom so she labored on the toilet for another ½ hour. By this time, their little boy woke up so Kevin got him settled with grandma so she could take him to her house. As soon as Jane got off the toilet, she started to have the urge to push. I got her on her hands and it helped somewhat, but didn’t take the urge away. She had some signs of transition, but just some. So, I was thinking, “We need to get this baby turned.” I was afraid he was face up. At this point, Jane decided to go to the hospital, it was somewhere between 7 and 8am. Her contractions were coming strong and fast.

In the car, she had the urge to push through all of her contractions; we hit traffic, so Kevin took side streets to UCI. We got there a little after 8:30 am. They had someone pick up Jane in a wheelchair. Kevin wanted me to go with her while he parked the car. The wheelchair guy, (I don’t know what they call them) wanted to take her to admitting first. I told him, “We don’t have time for that, she wants to push.” But, he insisted, they have to go there first to fill out paper work. I told Jane not to worry we would get her up there soon. So, we arrived at the desk for the paperwork and the girl sitting there stapled a bunch of stuff together and starts to tell her about it and I just blurted out, “She’s pushing!” That worked! The girl says, “Oh! Go on, take her upstairs.”

As we are walking through the halls, I’m trying to coach Jane how to breathe through the pushes but the halls were so narrow, I would walk next to her for a second, then stop while we passed something, then run to catch up beside her then stop again. Finally we got to triage and they wanted her to pee in a cup. Kevin was still parking the car so I took her to the bathroom. As soon as she got in, I hear, “Kristen!” So, I put out my arms and she just fell into them. While I’m standing in a squatting position holding up another adult, I’m thinking, “Only a minute, I can do this, it’s only a minute.” It was perfect though. Jane had this amazing ability to let everything go limp while she was having a contraction. She would let her body relax while her uterus did all the work. Jane said, any time she felt pain; it was a good feeling because it was what was bringing her closer to her baby. See, that’s VBAC perspective. As the rushes intensified, the better she felt.

I kept asking someone to check Jane because she wanted to push so bad and couldn’t control the urge, so finally the 1
st year resident came in a checked her. She was about 3 months into her residency. She said, “Well, I think she is about 7 cm, but she could possibly be complete, but probably 7. Does someone want to follow this exam?” to the other nurses in the room. I don’t know if this doctor has kids or not, but 7 and 10 are a big difference! Finally they take us to a regular room and this resident is trying to do an ultra sound to make sure the baby is head down, but she can’t find the baby. So, she brings another doctor in the room to do it. Baby was fine and was head down. At this point, we are still waiting for Kevin to get back and I am trying to create as much of a bubble as I can around Jane. There were so many people coming in and out of the room and the nurse said Kevin couldn’t come back until the IV was done. Jane didn’t want me to leave to switch though.

With the lights finally out and whispers to Jane we worked on concentrating with each rush. The goal was to not push. Kevin finally was allowed in before the IV. Jane was doing wonderful, she managed tiny pushes while one of us held one leg up and put pressure on it, while the other talked her through the contractions and breathed with her. We worked like this for some time and by 9:15 she was 9 cm. Once the room was empty and dark Jane sat on her ball. She hung on the rebozo while Kevin squeezed her hips. Concentrating and breathing with each rush (Well, once she threw Kevin’s red hat aside) Those pushes came stronger and stronger.
Jane wanted to push so bad, she started to get disappointed in herself that she couldn’t control the urge and then the resident came in again to check her. Jane was 9 cm but thick and swollen. The chief resident didn’t think she could reduce it and they along with a nurse that was not who Jane’s started talking her into an epidural. Jane responded with, “Well, yeah, I guess so.” Kevin just looked at her and said, “But Honey, you didn’t want one.” So, I asked for some time alone for them. Everybody cleared the room immediately. I suggested that Jane get on her hands and knees with her head down and if that works, no need for an epidural. If it didn’t work, then we would know for sure that she needed one. Jane agreed and with her head down, the room dark again and her face buried in the pillow, she was able to concentrate. Rush after rush, she fought the urge to push. It helped, some of that pressure was gone and she could breathe better; but she still wanted to push so bad.

With her first baby, it was a very long induction a few weeks early because her water had broken after an exam. She always thought the water broke because of that exam and her baby wasn’t quite ready. After 36 hours of labor, they had her pushing at 9 cm and her cervix swelled so they took her to a c-section. With a VBAC, the hardest part is getting past that point the mom got to before. So, during this time it required a lot of concentration for Jane to relax, let go and do what her body needed her to do to get some pressure off her cervix.

By 11:15 the attendee doctor, Dr. V came to check on Jane. We asked him to check to see if the swelling had gone down and if she could push past it. Dr. V was so positive along with Jane’s regular nurse. There were some dips in the baby’s heart rate and the nurse explained to her that it was good that the baby was responding to the contractions. When Dr. V checked Jane, right away, he said, “Oh good! This is good.” He said there was a bit of swelling, but not much. Yay! I was so happy the swelling went down; I asked if he could reduce it and she could push past it. He said, “Oh yeah, I think so. Let’s try.” He got in position and had Jane push with the next rush. She did and it worked the first time! She was so happy and the nurse was so happy for her, we all were. She could finally push. She passed that point!

After about an hour of pushing a very determined Jane birthed her healthy baby boy face up! He was a tired little boy and was so happy to rest right there on his mommy’s skin and sleep. He stayed there for over an hour while his mommy cried with joy. Jane and Kevin got to touch and hold him as long as they wanted this time. Jane was so happy she did it this way and her words; she didn’t even have to have an epidural. I am so happy we tried something other then the epidural. Kevin and I knew she did not want it and I knew she could do without it. This was one strong and determined momma.

The best thing I heard from her was, this birth made up for everything that happened before, she felt like she did what her body was meant to do. The experience for a mom to get past those obsticlas is so powerful and healing. I am so blessed to be a part of it and experience a little bit of it. The joy in Jane's face and her words are something I will never forget.