Tuesday, August 10, 2010

my glorious hospital VBAC birth story

My daughter's birth story begins two years ago when my son was born. Big brother, Judah, arrived in 8/08 via emergency C-Section after a grueling pitocin induction and three hours of pushing. I struggled for a long time emotionally with what had happened. See Judah's birth story for more details.

So when I first became pregnant with Galilee, I prayed a lot about whether to pursue a VBAC (Vaginal Birth after Cesarean). I knew deep down that I really wanted it, and research shows that in most cases, it is a much safer option for both mom and baby. 60 to 80% of women who attempt VBAC are successful. However, very few women attempt it. Nationally, only 9% of women who have had previous c-sections actually go on to have a VBAC.

I would soon discover why this is the case: I had to fight every step of the way for my chance for a trial of labor! Even my co-workers (who are all neonatal or labor and delivery nurses) were against it. Many people cautioned: "just don't do anything that could harm the baby!" (What a silly thing to say to a mom... of course I wouldn't!). A lot of well-meaning friends were worried about how I would react to another emergency C/S if I did have a trial of labor that didn't end well. When I finally met with an actual physician at my OB practice and discussed the possibility of VBAC, she completely blew me off, using fear tactics and incorrect statistics to steer me toward a "controlled and relaxing" repeat c-section. I was disgusted with how she responded and promptly decided to leave that group in search of more supportive care givers. I was already 28 weeks pregnant, but it wound up being one of the best decisions I ever made!

I spent a lot of time on the internet researching VBACs and the risks and benefits, and while uterine rupture is a serious risk for VBAC moms with potentially deadly consequences, the risk is less than 1%. This is the same percentage of risk for uterine rupture for first time moms undergoing a standard pitocin induction, which happens EVERY DAY. I simply don't understand why there is so much controversy surrounding VBAC. Vaginal delivery is a natural process; if a woman can avoid undergoing unnecessary major surgery, then she should be able to!  [ETA 5/17/2017: risk of UR in unscarred induced uteri is 2.2 in 10,000 vs 64 per 10,000 in scarred induced uteri per VBACfacts.com http://vbacfacts.com/2012/01/16/myth-unscarred-mom-induced-as-likely-as-vbac-mom-to-rupture-2/]

I knew I had to go to a midwife. I contacted several people online who had posted VBAC birth stories from around Buffalo and asked for their care-giver recommendations. Many people suggested I go to the Nurse Midwifery Associates of WNY. This was such a confirmation to me- I had already been thinking of calling them. I saw them for the first half of my first pregnancy, and they were phenomenal.

My first visit with them was fantastic. All three of the midwives saw me and gave me huge hugs and asked how I was doing. It felt like a family reunion. We were off to a great start! I immediately felt at ease and at peace. I completely trusted these women.

Toward the end of my pregnancy, I had to go in for a "VBAC- consult" with a physician, since the midwives were not allowed to go over the consents with me. I think it is ridiculous, by the way, that VBACs need physician-obtained consents, but elective repeat cesareans do not! I was scheduled for an appointment at the Children's Hospital Women's Clinic, but since Sisters Hospital medical records had never faxed over my OR Report from my C/S, they couldn't do the appointment. I had waited for 2 hours in the waiting room while they tried to get Sisters to re-fax the report. Nothing. I went back the following week and waited another hour, before finally getting seen by a resident for 5 minutes. She basically told me everything I already knew and told me that because I was a VBAC, I would be monitored very closely, and that anyone at any point could call a C/S during my labor. This was not a comforting thing to hear! But after all I had been through, I was committed to my VBAC.

My due date came and went. At my next midwife appointment (40 weeks and 2 days), I was told that the hospital had recently had a case of uterine rupture in a VBAC mom who was induced with pitocin. (SCARY!). Because of this, the policy had now changed, and "overdue" moms who had had previous cesareans could not be induced. The midwives, after conferring together and with me, decided that we would wait one more week to see if I would spontaneously go into labor, and if I didn't, I would have a repeat c-section. The surgery was scheduled for Monday, June 14th, at 9am.

I had a 41 week sonogram scheduled for Friday afternoon. The baby looked great, but was measuring very large! They estimated that she was 10 lb 5 oz!!!!!

By Friday night (6/11), I was starting to get very anxious about going into labor. Physically, I felt great. I loved being pregnant and could go another week easily if I had to. But, knowing that I had a "deadline" made me very nervous. I prayed and prayed and prayed that God would start my labor. I called the midwives and left a message, tearfully requesting that they give me more time. I was desperate. I did not want another c-section!

But then- praise the Lord!- I started having regular contractions on Saturday afternoon at 2:45 pm (one week "overdue"). My mom came to pick up Judah at about 5. I still wasn't sure if this was "it" or not, since I had had several periods of regular "pressure waves" lasting several hours all week. They were lasting about a minute and were 2-3 minutes apart. They just continued on in the same pattern, but increasing with intensity over the next few hours. By 8:45 pm, I was positive that this was labor. Isaac was busy cleaning up the house and packing up the car, while I tried to cope with the pressure waves.

See part 2 for the rest!

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