We are sharing birth stories from super mamas. Make sure you read part 1 of Nadia’s Birth Stories if you missed it.
2. Natural Hospital VBAC: The Marathon Labor
By Nadia Mudder
I should start by saying that this birth for me was equal parts healing and learning. Healing because my first birth ended in an emergency C-section, and learning because this second time around really felt like I was giving birth for the first time. I had to trust my body to do what God made it to do, and I was terrified because for a long time after my first child was born I felt like my body failed me and could not finish bringing a baby into the world on its own.
When we found out I was pregnant with #2 (A GIRL!), I did my homework and chose a hospital with a certified midwifery team that was VBAC (Vaginal Birth After Cesarean) friendly. I hired a wonderful doula, Marilyn, who took me on despite my unusual circumstances and supported my birth plan, encouraging me via email throughout my pregnancy. The birth option I felt most comfortable with was having a natural hospital VBAC. I could labor and give birth naturally, with the comfort of knowing that should anything go wrong, there was a NICU and a team of OBs who were readily available. I tried to eat healthy foods and get some exercise (chasing after a busy toddler on the playground was a fun way to do it). This time around I craved green apples and yogurt, so by the time I gave birth, I had only gained a respectable 28 lbs.
To complicate things, my husband, son and I were moving from our rented apartment in Kazakhstan to a rented apartment in the south of China, with a stopover in the USA to have our baby and visit with our families. I had to take that long, LONG series of flights at 35 weeks pregnant, dressed in dowdy compression stockings and with a toddler who was not old enough for his own seat. That is a story all on its own. Thankfully, our long 10-hour flight was not full and the flight attendants took pity on us: we were given a row of four seats to ourselves for the three of us so I could lay down when Jeremiah napped.
Most of my prenatal care was done overseas again, but initially and at the end of my last trimester the midwifery team oversaw my care. The midwives were so friendly and knowledgeable. They made me feel like a mom, not a patient. They noticed when I cut my hair, remembered more about me than just the details of the chart, and were very honest about their work with VBAC patients and birthing experiences. All three women had given birth themselves, which was helpful for me because they really knew what I was talking about.
From 36 weeks on and until I gave birth, I had weekly non-stress tests done to make sure baby was doing alright. Because of my prior section and my international prenatal care, I had to work with a maternal/fetal medicine team who were nervous about the VBAC and asked me if I wanted to just schedule a C-section. I politely and firmly said no. The OB who performed my C-section two years prior signed off on my “VBAC labor attempt” form and encouraged me with her confidence in my ability to give birth to this little girl. My doula, Marilyn, partnered with another doula, Suzanna, who agreed to meet me at the hospital when I was sure things were underway. They would stay afterwards and make sure our baby girl was latching and nursing before they left. They were so sweet and encouraging, and I don’t think they knew what they were in for when my labor finally got started.
This time around, I read one important book, Natural Hospital Birth: The Best of Both Worlds. I felt better educated about hospital procedure and better equipped to handle the different interruptions and interventions that hospitals tend to impose on laboring women. Continual fetal monitoring was one of them. Being tethered to my bed with the contraction monitor would prevent me from being able to move, so I asked for a wireless monitor so I could walk around. I asked ahead of time, and put it in my birth plan. I tried to get as much information to my midwives as possible about my physical and emotional needs for birth, which calmed some of my fears.
I did have an irrational moment at about 37 weeks, when I knew I couldn’t fly, and I wanted to be with my mother. Both she and my father were flying out to see me in about a week and a half, but suddenly I desperately wanted to be with her and have her walk me through these fears about labor. My husband found me on the computer at 4am looking up routes for the Greyhound bus and Amtrak. Of course I didn’t go across the country that night (but only because there were no direct routes from our state to hers). I realized that although I had mentally prepared for the labor, I wasn’t emotionally ready to let go of the control I wanted over this birth. Praying about it and talking at my husband helped me to get past the fear that I had of “failing” again. I say “talking at” because I just kept talking and sobbing and didn’t really let him get a word in. Jan finally just pulled me onto his lap and hugged me and we eventually sat on our couch in silence together. He was going to be my strength in this and help me through it, even if I needed to have another C-section. I felt relieved.
Fast forward to 39 weeks: I had been having contractions that started to pattern at about 5 minutes apart for several hours together for 2 weeks straight and I was tired and a little frustrated with them. With my son, I was blissfully unaware that I had made it to 3.5 cm, 50% effaced before I got to the hospital. Now, a week before baby girl’s due date, I was having steady contractions that I had to stop and breathe through every 5-7 minutes from 7pm-10:30pm. The hospital was an hour and a half away so we got our things, left our almost 2-year-old Jeremiah with Grandma and Grandpa, and made our way.
We arrived at the hospital just before midnight on Sunday. I made sure we packed my birth plan and called our doulas. The room was already ready for me. My labor room was dark and quiet, and the midwives had secured my nurse, Julia. She was chosen by the midwives because she was “natural birth friendly,” and had a wonderful, kind sense of humor which helped during my long, slow labor. When they checked my progress I was a disappointing 2cm dilated, so I got up and walked (waddled) around the labor and delivery unit for two hours. Julia kept track of my laps and pointed me towards the ice cream at the nurse’s station after every 8 trips around the unit. My midwife checked me again: 4cm! I could stay at the hospital and the other midwives were on alert. My doulas walked beside me and talked me through each contraction: holding my hands and hips, reminding me to breathe, affirming me and my labor process, and giving me spoonfuls of ice cream, water, and honey sticks for energy.
Just like my last labor, all of the pain of the contractions rose and fell in my lower back. Walking and rocking my hips helped me move through the pain, and I know I would not have made it very far without asking for pain medication if my doula had not squeezed my hips together during each contraction. Everyone took turns, Marilyn, Suzanna, and my husband. Hours later, the contractions were getting more intense, and I thought I might go to the whirlpool tub in my labor room and lay in the warm water for a while. I was tired. The water felt amazing. My husband stayed with me, and then took a small nap on the couch after he realized I was comfortable. I dozed on and off too. Then, my nurse came in. My contractions had completely stopped. At first they thought the monitor was wet, but I confirmed that I didn’t feel anything. I stood up and told the nurse that I had to use the bathroom. She got all excited and brought the delivery cart into the room. I told her that it wasn’t the baby, that I really just had to go, and I did. It was after 2pm on Monday, I had no contractions, and after a check they found that I was 6cm along, and about 75% effaced.
My midwife came in to make sure baby girl was doing well. She was! We worked with the doulas for about an hour to get the contractions started naturally. Bouncing and hip rotations on a birth ball, different positions, walking, going back in the shower—you name it, we tried it. Nothing was happening, but baby’s heart rate was perfect and we had no complications so far, so my midwife talked me through my options. We could try a Pitocin drip, but she knew I wanted a natural birth and was worried about the complications that artificial contractions might cause in my VBAC attempt. She could break my waters, but then I would be “on the clock” at the hospital, and she knew what had happened with the intensity of my contractions during my last labor. So, she told me she would send me home to rest, hoping some sleep in a non-hospital environment would help me. Marilyn and Suzanna wisely guessed that I was stopping my own labor because of the fear I had about having a C-section. Psychologically and emotionally, I needed to relax and give up trying to control my body to let labor happen, but I couldn’t do it yet.
My husband and I decided we would see if some sleep and peace outside the hospital would help. After getting officially discharged around 4:30pm, we checked into a hotel across the street from the hospital where they house the families of patients who need long-term treatments. My doulas went home to rest and refresh themselves as well. Then my husband and I went out and had that last lunch (dinner?) that we missed when Jeremiah was born. I had a grilled ham and cheese sandwich and a salad with blue cheese dressing. It tasted delicious!
Back at the hotel, my husband closed all the curtains and made it as dark as possible. We got under the covers and he just held me while I slept. I woke up with a start at around 9:30pm when a massive contraction hit. “OwOwOwOwOw! It’s happening!” I yelled. My husband got his phone and I got into the tub in the bathroom. The contractions were coming 5 minutes apart and I was groaning through them. Jan called our doulas and they got ready to drive to the hospital when we called again. I didn’t want to go back to the hospital until I thought things were really underway, because who wants to get sent home twice in one day? Two hours went by; with my husband coming in to squeeze my hips together through the contractions and then leaving the bathroom to give me some space…and watch some baseball game that was on TV! (I don’t know that I’ve quite gotten over that yet) I was annoyed. I just wanted to sit in the tub with the hot water and have this be over and done with. Then I remembered that I was already 6cm dilated and I did not want to have the baby in a hotel room! Jan grabbed our things and we tried to decide whether to walk or drive. Another contraction hit and I yelled for him to get the car. I think I was in the car for 7 minutes total and had two painful contractions. I thought, this has to be it, or I am going to go crazy.
We walked into the hospital through the emergency entrance just before midnight. Marilyn and Suzanna arrived and I had another contraction in the waiting room. I was not quiet. The night shift nurse was surprised to see a woman so far along in labor, she ran and got the security guard and called up to the labor and delivery floor. Two L&D nurses came down with a wheelchair before my husband finished signing me back into the hospital.
This is where my prep work from the Natural Birthing book came in handy: I had made multiple copies of my essential medical information, (full name, blood type, baby’s gestational age, prior pregnancies, results of the strep B test, etc.) and a simple list of birthing wishes, so instead of having to restate or remember all of my information for each nurse or aid who asked, Jan gave them a sheet with all the answers and I could focus on the labor. Any additional questions were answered by my husband. I got behind the wheelchair and pushed it to the L&D floor. I absolutely did not want to sit down!
Back in a birthing room I was checked again (between contractions) and was between 7 and 8 cm dilated. I was in transition, and my hips and lower back hurt so badly as the contractions came and went. Marilyn suggested that I go through 4 or so contractions with my face on the bed and my bottom in the air. These were really uncomfortable contractions, and then…there was some kind of clicking noise from my lower back and the labor pains were in my lower abdomen, and much less intense! Unfortunately when I stood up and began rocking my hips things went back to where they were before, but it was just enough to help me get through transition. I could feel our baby girl moving down, and my midwife came and checked me around 1:30am. I was 9.5 cm with a cervical lip, almost complete! She asked if I wanted her to break my bag of waters to see if things might move faster, and I agreed. My waters were clear and baby’s heart beat was mellow and steady. Within minutes I felt ready to push.
I had never pushed a baby out before, so initially I didn’t know that you were supposed to wait and push with the contractions. Whoops! That was an embarrassing and futile false start! My doulas talked me through it, and I pushed with each contraction, but I was getting frustrated. After an hour or so of pushing I was ready to give up. I could feel her head come out a little as I pushed and then she would slip back. My lower back felt like it was being pushed out of my skin. I begged for drugs at that point, and they told me it was too late. “Fine!” I remember saying out loud, “I can’t do this anymore, I’m leaving.” I stood up and tried to climb up the raised head of the bed to leave the room. Marilyn put both arms around me and hugged me tight. “Where are you going to go?” she whispered in my ear. “You can do this, you can finish this.” I needed to hear that. I lay back on the bed and focused on pushing effectively. Jan held my hand. Suzanna put praise and worship music on her iPad and showed the midwife a picture of a different pushing position. I saw the midwife nod and they moved me over to the edge of the bed with a sheet wrapped around the birthing bar overhead. I was in a supported squat, holding both ends of the sheet with Marilyn and my husband on one side and a nurse on the other. My midwife was in front. We all waited for the next contraction together, silent except for the music playing quietly in the background.
When I pushed, I tended to make a high-pitched yell, and Marilyn told me to breathe low and bring my voice down so it was more powerful. She was right, my pushing was much more effective. I gave a several big pushes in a row, and baby’s head was half way out. I didn’t know it at the time, but she was possibly asynclitic: her head was not completely aligned with my pelvis. She was leaning to the right. This may have caused the longer labor, as the contractions were not pushing her head down fully on my cervix to help it dilate. Just then, a song I knew came up on the iPad. It was so calming, and the words, “Strength will rise as we wait upon the Lord” floated softly in the air as the song continued. I felt another contraction and pushed with everything I had left in me. Her head was out, and they told me that with the next contraction I would meet my baby. Her shoulders and body were so easy to push out after her head, and when I did gently push, my midwife put my beautiful Audrey on my chest and I was overcome with joy. She was born at 4:35 am on Tuesday morning.
I held her as they rubbed her, wrapped her and cut the cord. They took her to the cart, and it took only minutes for the nurses to complete all the medical procedures to make sure we were both healthy and alert. She looked at me with her huge blue eyes and cried. Then she wanted to nurse. She was 7lbs 12 ounces and 20 inches long. She had dark hair. I had to have a few stitches where I tore a bit, but I don’t even remember feeling much pain because having my little girl in my arms made me euphoric. My husband didn’t get to hold her for the first hour because I wouldn’t let her go.
I was so alert and capable after this birth. Audrey was alert too. I didn’t even need drugs afterwards, except for a little Ibuprofen for the first week orso. Because of my long pushing stage (over 2.5 hours!), I needed to rest my pelvic floor and take it easy for a few weeks. And I took home 2 bottles of Dermoplast because of my tear. I used up both bottles. But my energy levels were up, and I was walking around almost immediately. I knew what I was doing with the breastfeeding this time around, so nursing was a breeze. I could lift my toddler and my baby. I could enjoy and participate fully in the first days of my little girl’s life, and it was a wonderful surprise compared to how I felt after the previous birth. I felt like a mother, not an invalid.
Now my baby is almost 10 months old and is crawling and pulling herself up on everything she can reach! We are still nursing, and plan to until she is at least her first birthday. We have a new normal in our house with a baby and an almost 3-year-old. I feel more like myself than ever before. I had an easier time losing the baby weight, although I still have a little pooch where my C-section scar pulls my skin together. It has faded almost to the color of my skin, but it’s still noticeable. However, I have made my peace with having both births, and have accepted both births as blessings because they were both necessary: the first to bring my sweet Jeremiah to our family and the second to bring my dear Audrey here to us. In having the C-section, I learned that I am not always in control, and that life can still return to a new normal. In having the VBAC, I met my fears at their threshold and stared into my utmost limits as a woman. And I pressed on. I finished and gave birth. I couldn’t have done it without the support of my strong and patient husband, my midwife, and my doulas who believed in me and stood by me through a long and tiring labor. And who knows? Maybe there will be a 3rd baby in our future and I will have to figure this out all over again, but I was blessed with the people and the circumstances that made my births happen the way they did, and for that I am grateful.