Thursday, May 6, 2010

A's VBAC story

I had been having surges for the past week off and on. By Saturday night I had called my doula to let her know that we were getting close. On Sunday, I had bloody show so I was wearing a cloth pad and we went to trader joes and while there I felt my legs sorta wet and so we headed home. I definitely had lost some fluid.

I called my doula and so Sunday night she slept the night since I was having contractions every 7 or so minutes and was 80 percent. We tried moving my placenta since it was a bit anterior, but it didn't do a lot of help. I wasn't dilating. Monday I did a lot of walking and the contractions were staying at around 6-7 minutes apart. I again called my doula, she came up around midnight or so from another birth. SHe told me she'd have to head to the other for around 6 am. At around 4:30 I was still having contractions and went to the bathroom and I had a very thick discharge and saw some meconium. We decided that I should probably head into the hospital. She had another doula accompany me. This new doula was very awesome! She was very calming and in spite of not knowing her she was super supportive and helpful. At the hospital they checked me and I had a leak in my fluid so they kept me rather than turning me home. I was 100 percent.

I was having surges every 5-6 minutes at this point. With some walking and rest I wasn't progressing. I was around 2.5 cm around 10 am. I was doing some laps and using the birth ball to get through surges. I swear I was the only one walkin, so I had no idea where all the other birthing moms were. Shortly after that the nurse came in and said that I had to stay on the bed now since she had read the policy and VBAC patients had to be under constant monitoring. At this point, I started crying. I asked to see my midwife. While we waited, the new doula let me know that each thing was my choice and with policies there are ways around it. In my mind I kept thinking that there was just no way I could progress from less than 3 cm to 10 without any movement. The midwife came in and let me know what my options were - stay there and listen or request an AMA form (against medical advice) to allow me to walk. Apparently this policy isn't always enforced, and it is up for review in May. Anyway, while waiting and talking (and plenty of tears) my progression definitely changed. I had been having contractions/surges every 5-6 minutes and after the situation, I had barely 2 contractions over a 45 minute period) and definitely affected how I was feeling about the whole situation. After I signed the form I laid in bed for quite a while and did some thinking. I had received some beads from a birth circle meeting and another set from my friends at a blessingway. I asked for those and thought about all the well wishers I had through this birth. I got up and we tried to do some nipple stimulation and a shower to try to get things going, and I just didn't feel it happening so we requested a breast pump, which I also didn't feel helped the contractions get closer. By this time my doula had come back but was exhausted so shortly after she went home. It was around 6 pm and I spoke with the midwife and we decided that we'd try a small amount of pitocin to try to get my body moving again. I knew that once this happened I'd have to stay on my back so we did some walking again. Ravi and I had a few disagreements - I posted via my blackberry that I needed some "eggplant parmesan" (there's a recipe on the web that "guarantees" labor), and Ravi wanted me to remained focused, I was beginning to waver in my belief that I could get through this. I tried some stadol to get some rest because I had been up for basically 3 days and hopefully it would allow me to relax some. While I was able to get some rest, I wasn’t sure if I had progressed. I asked to be checked (we were minimizing this due to the water being broke) and I was at 4.5. My "agreement" to myself was to do the pit if I wasn't at a 5.

We started the pit and the contractions were within 2 minutes of each other within a few hours but I was in horrible pain. They had been slowly upping the pit and I didn’t feel I was able to handle the pain since I had barely any down time between contractions. I had asked that no order be put for an epidural because I wanted to be sure that I spoke with my midwife again before asking for it. The hospital staff had been mostly awesome to this point because I know they wanted to ask me for an epidural for quite a while but in my birth plan I had asked to not be asked. I called for the nurse and let her know that I wanted the pit turned down. This helped the contractions subside but I knew that wasn’t going to get me closer to having the baby! I was without a doula at this point and was confused and definitely losing focus again. I asked for the midwife, and I swore she was just never coming because every contractions felt like an eternity! While waiting for her to come back, I requested the pit be turned off. The nurse basically told me that if I asked for it, she could, but she couldn’t keep changing it. She turned it off, and I let her know I’d like an epidural. She had to call the midwife who was on her way to get the order. I felt so sad and deserted at this point. No doula, midwife was taking forever, I wasn’t progressing!
Finally just as nurse came in and turned off the pit, the midwife came in and we had a short talk and we agreed that the best bet would be to do the epidural. The anesthesiologist came in and explained the procedure to me. I still think it is a bit funny that they didn’t tell me the side effects of this, but I got the whole “fetal death” talk when I asked for intermittent monitoring. Anyway, we started the pit again along with some antibiotics (this may have happened earlier?) since I had been ruptured for a while and was having cervical checks. The epidural didn’t fully take effect but I was able to get a few hours of sleep. I woke and was feeling the contractions and was able to use breathing to hopefully make them more positive. I had feeling on my left side and most of my vaginal area. Around an hour later I was still awakeand felt the rest of my water break. I asked for the nurse and she came and said I was a 9. I never felt so good in my life! I was getting the urge to “bear down” and she said that it wasn’t time yet. I didn’t really stop myself , but she told me it’d be at least 90 minutes before I’d probably be complete. I looked at the clock- it was 6 am and he was almost all the way in position. Shift change was in an hour. Couldn’t help but think of this! Anyway, the new midwife came in around 6:40 and checked me and said I was definitely at a 10 at this point and baby was fully ready! I could feel that she was trying to help me stretch. She had me do a few test pushes so I’d know what to do. I swear I thought I was pooping (earlier on I had called the nurse to change the bed pad because I swore I pooped, apparently I had farted and there was some show). We worked on where I should be pushing and adjusted the bed (I had wanted to birth squatting but only had use of half a leg so without an additional support person this wasn’t possible. I began pushing with the surges and could feel him progressing again and again. At one point he was crowning and she asked me to feel his head and I said I can’t. Apparently both she and Ravi thought that meant I was giving up, but when I showed them, my arm was too short! Anyway, around 7 am, more people began coming in and I kept saying WHO ARE THESE PEOPLE! It definitely was distracting. A midwife from the UK was in to catch the baby, and I was fine with this, the previous midwife had asked if I was okay with this, which I was. We continued pushing and I felt him begin to come through and was getting tired but knew I had more in me. I was being cheered on by the nurse and two midwives and Ravi. Finally at 7:17, less than 30 minutes of pushing, Rohan Jakob entered the world. I am glad the epidural didn’t fully take effect, without it, I’m sure pushing would have been more difficult. I also am thankful for the entire process of getting this baby here. I now have confidence in my body that I didn’t know I had. I had wavered many times but we made it through.

In the end, he was a vbac and I'm so happy that we were home within 12 hours of his birth. He never left our side :) Official stats (after nursing and pooping and all that jazz)
Born 4/28/10 at 7:17 am19.5 inches long7 lbs, 4 oz13.5'' head

Tons of thanks to my friends who’ve helped me get to this point and especially to Sarah for coming to our house before 5 am to pick up Viveka. I’m so thankful that I knew Viveka was in good hands while we were in the hospital!

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