Postpartum · Pregnancy

Holy Shit, I got my VBAC

Note: This post is the continuation of my VBAC story started in two other posts, whether to try a VBAC and yes, I was induced for a VBAC. The induction story was getting too long for one post. Anyhow, continued below or if you’re just joining us, I’m in labor below!

The idea of a baby coming out of your vagina is a strange one. Yes, it’s the way it’s supposed to happen, but that didn’t mean wrapping my mind around it was easy. There were moments in labor when I wondered why I hadn’t just scheduled another c-section, shown up at the appointed time and place, been sliced open and handed my baby. In the hard moments that seemed like the more civilized option.

I guess that’s labor

The Pitocin drip began at 6am and started out manageable enough. The early labor felt like low cramps, consistent, but nothing I couldn’t handle. I could move around the room while tethered to the monitor, unhook myself and go to the bathroom which I did frequently with all of the fluids being pumped into me, and was even working a little off my phone because I didn’t have much else to do. I was a bit cocky, thinking “oh, this isn’t that bad.” I bounced on a ball, swayed a bit and was generally able to function.

The issue of laboring on Pitocin is that the medicine takes your body into labor and ramps the contractions way up, but in my case, my cervix wasn’t matching that intensity. By the middle of the morning I was already having contractions two to three minutes apart lasting for nearly a minute, but I hadn’t dilated any further than when I had started. I decided that I would wait to get an epidural as long as I could since I didn’t want my movements restricted further until I couldn’t stand the pain anymore. That turned out to be eight hours in to the labor.

My nurse had told me to call for anesthesia before I couldn’t take it anymore but when I could see that point of no return coming, as I would have to be still for the needle. I made the call; the anesthesia team came and placed the needle in my back and turned on the drip. I started to get relief, but it turned out to be fleeting.

I had to pee right after I got the epidural. I told the nurse that I was going to the bathroom and she told me I would fall over, that I couldn’t feel my legs. I told her that I could feel them, and I was going. We argued like this for a few minutes but she was so earnest in her desire for me to not hurt myself falling that I agreed to pee in a bed pan. She told me that the medicine would be working and she would place a catheter. She went to do it; I could feel her touching my urethra. I told her “the fuck you are! I can feel that.” This was the start of a terrible two hours.

The resident who placed the epidural came back in multiple times trying to adjust the medicine. They did this test on my legs where they move something cold on my skin to see if I can feel it, which I could. The contractions had continued to be two minutes apart and had gotten more intense to the point where I couldn’t talk through them. Since I “had an epidural” I wasn’t permitted out of bed to move through them as I could have fallen and hurt myself. I cried nearly nonstop for two hours while they did a series of evaluations and adjustments which ended in the determination that I was getting a little bit of the medicine – just enough where I was a fall risk – but the catheter section of the epidural wasn’t properly placed deep enough and would have to be redone.

When they came to fix the epidural the chief OB came and held my hands, helping me to breathe through it while the Anesthesiologist – and not the resident – placed it. I could tell when it was done right. I stopped crying and though my right leg was totally numb, I could talk again, settle in and watch Netflix.

During the crying my husband texted my best friend and told her to get over to the hospital if possible; I could use a little emotional support. She rolled up with a giant Starbucks iced tea, lots of gossip and shit talking to get my mind off of the labor, and like the amazing bestie that she is, snuck me a cookie while no one was paying attention. It was also her birthday, and she would be mad if I didn’t publicly acknowledge that/give her extra credit for coming to the hospital to hang out with me instead of doing something more fun. She is amazing and just for the cookie-sneaking alone deserves her title as my son’s Godmother.

She was there when the next cervical check happened about 11 hours into labor. I had only progressed to 4 cm and I promptly burst into tears. My doctor was on duty at that point and a new plan was formulated.

At just over the 12-hour mark I was taken off of the drip for a “Pitocin Rest,” basically giving the body a couple hours break to reset any tolerance developed before the medicine is restarted. They also broke my water. A few hours later the drip was restarted and an internal, intrauterine pressure catheter (monitor) was placed to measure the strength of the contractions. They had to reach a certain strength and stay that way for two hours. I asked what would happen after that and Dr. K and Patti, the resident who checked and praised my cervix Monday night and who was back Tuesday night as well, told me we would reassess after that point. While Patti was hanging out elbow deep in my vagina to place the monitor I cried about my non-complying cervix. She earnestly looked around my knees and said, “your cervix is awesome. I really think you’ll be able to do this.”

The timeline gets a little hazy here. I know that by 9pm-ish, about 15 hours in, I was started back on the Pitocin. At some point between when the epidural was working (hour 10) and about 11pm I had to have the pain medicine upped as I was having back labor that was ripping through the epidural, and it felt like it would break me. Around 11pm after the second epidural adjustment I dozed off for roughly two hours, waking up in pain around 1am. The contractions were so intense that they cut through the epidural again. My husband woke up with the Nintendo-like “beep beep beep” of me hitting the morphine push button in time with my contractions which were closer than two minutes apart. I paged the nurse, who paged anesthesia.

The Anesthesiologist came in and asked me about what I was feeling. I told him what I had told the nurse who called him. I could feel painful contractions in my lower back as well as my lower abdomen. He asked about pressure and I said I felt it in my general vagina region, as with the meds affecting that area it was hard to pinpoint where. He advised against increasing the epidural. He said that if I was close to having a baby it would be better to have some feeling. It sounded logical enough and the morphine took the edge off the worst of it so I agreed on waiting until I knew what was happening. I was due for my next cervical check at 1:30am.

When Patti came in around 1:35am I told her that I felt like there was something in my vagina. I did have lots of things going on/hanging out down in the regions I could neither see over the bump or feel clearly through the epidural. I had the catheter from the epidural in my urethra and the internal monitor for the contractions snaked up my vagina, but it felt like there was something there. She was like, well, let’s see where your cervix is…

“Oh, you’re 10 centimeters and what you’re feeling is a head! Let’s text Dr. K and get set up for a practice push to see how close you are.”

The pit crew began rushing in to get everything set up in the delivery room. It was like a clown car full of people showed up with all kinds of supplies. At the hospital they will do all care short of NICU in the room, so everyone had to be in position just in case they were needed. I didn’t know what to do with this new crowd so I started introducing myself to everyone. Thanks, drugs, no sleep and anxiety.

I had my practice push around 1:45am. Patti told me to stop and paged Dr. K. My baby was nearly immediately crowning from the practice push.

“Dad, he’s crowning. Would you like to see the head?” Awkward “ummmm….” from my husband, but I yelled, “I do!” and they brought over this giant mirror.

The mirror is not for everyone.

It wasn’t my plan to watch the delivery. When they offered the mirror I though it would be like a little sneak peak of the head. Nope. Full, giant mirror where I could see my unkempt though quite well attended at the moment vagina staring back at me. It was bizarre and a bit disconcerting to have it so readily on display at multiple angles in the room, but I liked seeing what was happening, even though it was a surreal experience. It made a lot more sense to me with how I felt later when I could remember witnessing what weird, wondrous and insanely stretchy things happened to my vagina. As my husband liked to tell people for the first month, “her vagina got SO BIG!” Thanks, honey. Excellent dinner conversation.

Dr. K arrived and I got the information on how to push. That sounds weird if you’ve never had a baby, but as this was my first vaginal delivery I didn’t know the deal. They probably teach it in a childbirth class but we didn’t take one this time, and instead got a helpful crash course in laboring strategies and push positions from a friend who had a home birth. You don’t push with your vagina per se, you push like you’re trying to take a huge poop. This is helpful to remember if or when you’re still dealing with hemorrhoids down the road following your vaginal birth.

My husband thought he would be supportive and hold my hand or something in the safe zone by my head. Patti told him to grab my right leg, as he would have to brace me by pushing my leg back for me when I had to push and a nurse grabbed my left leg. With the epidural the nurse looks at the monitor to see the contractions and says when to push as you do it in time with the contraction. But since I could mostly feel the contractions I just said “now!” and she confirmed the first few and then let me go on my own.

I watched in the mirror as I pushed, which I think was helpful as I was able to see how the pushing was effective and control my effort without bearing down blindly. I could see a dark mess of wet hair stretching out my lady parts to an unholy degree. I pushed a few more times and I could see his head coming out and then he was here and placed on my chest. It went very quickly. He was out at 2:04am and I had pushed maybe ten times.

That I successfully had a VBAC wasn’t my first thought.

I think the first thing I said was “oh my god” or “holy shit!” or something along those lines, as I held a wet baby with his umbilical cord still attached against my chest. He cried a little bit and settled in very quickly against my breast before he began to nurse. My husband got to cut the cord.

After the cord was cut was when I was like, “holy shit, I did it. We did it. We HAVE A BABY and he came out of my vagina! MY VAGINA!” My doctor was happy for me and told me that now I could eat, at which point I fessed up about the cookie. Patti, the cheerleader every cervix would be honored to have, was stitching up my 2nd degree tear ever so gently. When I remarked on her focus she said “I treat every one [vagina] like it’s my own.”

Twenty hours later, I had my VBAC baby. Look at that sweet hand and ignore the surprise, awe and exhaustion on my face.

I declined to have my baby washed and we were left in the dimmed lights of our delivery room in the darkness of the night, in the quiet of the hospital with the monitors turned down low. The experience was very different from my first delivery.

In the aftermath of having a successful VBAC I’ve learned more about the risks I faced, and how some of the things along the way were to try and assess if it was working. The internal contractions monitor also could have told us that my cervix wasn’t dilating and that would have led to a repeat section. I could have had a hard time pushing and ended up with a vacuum assist or a c-section. If I had reacted poorly to the Pitocin, or if the baby had reacted badly at any point, I would have had another c-section.

I don’t know if knowing more of the risks would have changed my mind. I went into the experience open to what would happen and hoping for the best, and I’m fortunate that it all worked out in my favor.

There were differences in how I felt about having a baby the second time around, and I don’t know if that’s due to him being the second child or the hormonal difference of having labored. I felt immediately bonded to him, but that could also be because I knew what he would become and how much I would love him every moment of his existence, as I learned would be true from his brother. Nursing wasn’t as hard as I knew what to expect and when I had issues I knew they were surmountable, and I also knew enough to advocate for myself.

The experience was incredible because it was successful. I still don’t regret my c-section as it gave me my first son. I will say that seeing my vagina turn into something like an overextended Georgia O’Keeffe painting affirmed my belief in my own strength as a woman that I had already gained from carrying my babies and being their mother.

 

 

 

 

 

 

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