February 12, 2006 — Jarod DeMar Hunt
It took me a long time to really process my second c-section. At first, I was totally okay with it, because when the call was made I was at the end of my rope and there was no other option. But when I broached the subject of another baby with my OB, and he said it would be an automatic c-section, I started thinking hard. I realized all the ways that my second birth could have gone differently, and I was determined to make it happen this time.
First step when I got pregnant was to find a provider. Obviously, my regular doctor was out. I never even told him I was pregnant, he had no clue until I showed up for my regular pap at 6 weeks postpartum (that was fun!). I started calling around to doctors, because I just assumed that no midwife would take me on as a VBA2C. I never did find a doctor to even talk to. Either they didn’t do VBACs at all and were willing to say so over the phone, or they wouldn’t tell me anything until I’d come in for a complete prenatal check and physical. I am not about to let somebody examine me before I have the chance to interview them! I was even willing to pay the full exam fee just for the privilege of having the interview, so the doctor wouldn’t be wasting time, but still no dice.
I tried calling a group of homebirth midwives that my best friend used for her births. They were located in Ann Arbor, but were willing to drive to Lansing for the birth as long as I was willing to drive to Ann Arbor for the prenatals. But after interviewing each other, they refused to take me on. At this point, I had more than done my share of research, and I was willing to have an unassisted birth no matter how much my husband disliked the idea. But I made one last-ditch effort and visited the local Greenhouse Birth Center. I went for their weekly tour for expecting moms. After the tour, I spent a couple of hours just sitting on the floor and talking with the head midwife. We talked about my last births, what went wrong, and what I planned to do this time. They took me on.
My birth plan was pretty simple: “Leave me alone.” They made me flesh it out a bit, made me write this long two-page story about my ideal birth. But honestly, I didn’t much care if I got my ideal, as long as they left me alone until I requested assistance. No suggestions, no advice, no coaching, no exams. All I allowed was intermittent (about once an hour) monitoring with the handheld Doppler. I also spent the pregnancy educating my husband. We read several Bradley books together, I read him a new birth story almost every week, I shared with him all the pertinent emails from my UBAC group. We discussed my second birth in detail, and I explained to him very clearly what I needed from him. I needed him to be my defense, to run interference. If the midwives had a question, they needed to ask him, then he would ask me and relay the answer. If I needed something, I would tell him and he would ask the midwife. I wanted total isolation.
I went way overdue. It was very stressful, because my mother had come to stay when I was 38 weeks, but her vacation was going to be up soon and she’d have to go home, no matter what. I had contractions constantly starting at 17 weeks, same as before, and by term they were full strength and would frequently stop me in my tracks to breathe through. Every time, my mother would panic, wondering if I was in labor YET. Then the midwives, despite our previous discussions and my clearly stated intent to do absolutely nothing unless there was a medical indication, had to start giving me my options, covering their own asses sort of thing. They knew I didn’t want to hear it, that I knew it all already, but they had to repeat it anyway. I had to schedule ultrasounds and NSTs to start at 42 weeks. I was completely fed up!
When I was 41w4d, I went with my husband to spend a night at the local Sheraton. They had an indoor 24-hour heated pool, and I wanted to go swimming and be weightless for a while. So we left the kids with my mom, went out for dinner, relaxed in the room, went swimming, hung out in the bar, went swimming some more. It was wonderfully relaxing and pressure free. Sure enough, at 3:30am that night, I woke up with full-blown labor contractions coming every 7 minutes or so. I waited about an hour before waking up Brian, to make sure I wasn’t imagining it. We left by 6:30am. I wanted to get out of there and get home before I was incapable of driving. Driving was easier than I expected it to be, but I’m glad I didn’t put it off. We got home, and my mom helped cook me some breakfast and finish packing while we waited for our friend Dave to take us to the birth center (we wanted Mom to have the van so she could bring the kids up later, and because the midwives didn’t want me to drive myself home after).
I finally got to the birth center about 9:30am. Contractions had backed off a little bit, with all the fuss and commotion of checking out of the hotel and checking into the birth center. Brian went back to sleep once we were settled, and I went into the meeting room and stuck Charlie and the Chocolate Factory into the DVD player and sat knitting. The contractions were still regular, or I would have gone home, but not too bad yet. I had already discussed with the midwives that I would probably come in very early labor, and they knew I’d been in labor for 4 days the last time, so they didn’t say a word, I could stay as long as I wanted. I putzed around all day with contractions about the same. Brian fetched lunch from Steak ‘n Shake for us, we walked around the parking lot and up the street several times, we sat in the room and read Good Omens (birth is the only time we ever read that book!). About 4:00pm, the contractions backed off even further, and I was actually able to lay down and nap for an hour.
When I woke up from the nap, the contractions were still almost gone. 10-15 minutes apart and not very strong. I went for another walk, a longer one, and it didn’t change anything. So we started reading again and I started doing some nipple stimulation. After about an hour of that, labor suddenly shifted into the active phase. I asked Brian to get the tub filled and got in. I tried to keep reading, but I very quickly lost all interest in doing so. Brian turned on my music, and the timeless work began. It was about 5:30pm when I went into active labor.
(I am glad I was not in the hospital at this point. I would have been told that my labor had stalled, and either sent for a repeat c-section or given pitocin. In fact, I probably would have gotten that sooner, because I’m positive I had not dilated much at this point. I probably would have been labeled failure to progress way before 4 o’clock. But in fact, my body was simply tired. I had not gotten a full night’s sleep, and so I was getting a chance to rest before labor went into high gear.)
I spent active labor moving around. I was in the tub for some of it, but I could not stand any pressure on my genitals, so I couldn’t sit on the floor. But the tub wasn’t deep enough to completely support my body floating, so I would either be on my knees (ouch, unpadded tub) or squatting, which also wore my knees out a lot. Walking around was good, but then I’d get tired. I tried lying down, but just like my second labor I just couldn’t, it hurt too much. I tried making a nest out of one of the superpillows, but even lying on my tummy hurt too much during a contraction. The birthing stool worked better this time, but it would make my sit bones ache after a while. So it was just a matter of keeping moving, all the time.
My water broke while I was in the tub. That was weird. I felt the pop, almost heard it internally, like you can hear yourself swallow, and I felt the water come out and saw it swirl in the tub. It was clear, no meconium staining, but you could see the rush of fluid from the little bits of vernix that were in it. I told Brian to let the midwives know, since they’d want to write down the time, but I don’t know what time it was. I was probably around 7 or 8 cm; that would fit with the timing, and that’s about when it broke the last time.
At 8:00pm, I went through transition. I was exhausted from having to be moving all the time, I still felt sleep deprived from getting woken up so early and I wanted to rest. At one point, I whined to Brian that maybe I should give up and transport, just to have something to whine about. Bless him, he completely ignored me, just like I told him to! About 8:15 or so, everything stopped. I was sitting on the birth stool, leaning on some pillows stacked at the foot of the bed, listening to Chumbawamba. I started singing along a little bit, not because I felt good but to try and make myself feel good; it was a miserable attempt. The contractions slowed back down to about 15 minutes apart, and they were very mild again.
(Once again, I am glad I was not in a hospital and was not being monitored. I was probably fully dilated at this point, but my contractions had stopped almost completely. I would definitely have been given pitocin and/or sectioned at this point. Or, I would have been told to start pushing NOW, regardless of how I felt, and worn myself out way too fast again.)
This break lasted for about an hour. Halfway through it, I got back in the tub. I was able to sit on my bottom for a little while, and the rest was lovely. While I was in the tub, the contractions started up again. They started slowly, building very gradually in intensity and frequency. For the first time, automatically, I began vocalizing with them. I would let out a long, loud “Ohhhhhh!” as each contraction peaked and faded. I was very self-conscious, because I knew anybody in the entire building could probably hear me (and probably the parking lot!), and I knew Dave had brought dinner for Brian a while back and for some bizarre reason I thought he was still out there (because Brian was still with me), but I couldn’t help myself. This went on for about half an hour, with my vocalizations gradually getting louder and deeper as the contractions built.
Suddenly, right at the end of a contraction, my entire body just gathered and pushed down, hard. I felt his head move down with it, noticeably so, and the pain of the contraction completely went away while I pushed. It absolutely took my breath away. I thought, so THIS is how it’s supposed to be, and it worked beautifully! I noted the time on the clock (about 11:15pm) because I wanted to know how long I pushed. Then I forgot about the clock. Pushing built gradually, just as these second-stage contractions had. At first, I didn’t push with every contraction, and when I did, it was only at the end. But soon, I was pushing with every contraction, all the way through. The contractions became a little shorter and farther apart, but not much, and the pain was still completely gone when I was actually pushing. After a few pushes, I reached inside myself and felt this huge glob of mucous, which was probably my mucous plug. I cleared it away with my fingers, it seemed huge, tons of bloody snot, gross. But then, there was his head, I could totally feel it, just a single knuckle away. I told Brian that I could feel his head, and I think he told the midwives, because they started fussing around, getting the cameras out (I had requested pictures of the birth) and getting all the emergency stuff ready in case it was needed. The head midwife tried to check the heartrate between every contraction, and I finally snapped at her, probably practically bit her head off but I just couldn’t handle the distraction; she left me alone after that. I had to be completely down between contractions, resting and enjoying the endorphins and preparing for the next push. I did constantly remind myself to breathe deeply, so that baby would have plenty of oxygen. I gradually came up onto my knees, leaning on the side of the tub for support, and this was how I ended up birthing, in a modified hands-and-knees position. When he crowned, I remembered that I needed to push through the pain, although it didn’t really feel like the “Ring of Fire” everybody talks about. He crowned, and then he actually ended up being stuck for minute, only out to his eyeballs, because the contraction stopped and I just could not push in between contractions because that actually hurt! So he was a little swollen. Also, when the head was out, it didn’t feel as much like the total relief I’d heard described, either. His shoulders were pretty big, and I didn’t feel any lessening of the stretching and fullness until his shoulders were out.
Although I didn’t get the crowning and birthing pictures I really really wanted, because my butt was facing the corner of the room, somebody reached over my head and shot one picture just as he was caught by Brian, with the midwife directing his hands a little bit since he couldn’t see what he was doing.
As soon as he was out, I straightened up and looked over my shoulder. He was limp and splotchy, all purple and white, nestled in Brian’s arms. I turned and reached through my legs, and they passed him through. Then they helped me sit back and recline in the tub. He started crying very quickly, and pinked up quite fast after that. I tried to nurse him, but he wasn’t having any, he was just plain pissed about the whole thing and cried for almost two hours (bonus APGAR points for that!) The umbilical cord was so cool, gray and very rubbery. I’d never seen one before. About 15 minutes after he was born, I was feeling lots of painful cramps, and I actually had to be reminded that it was probably time for the placenta to come out, I was so busy checking out Jarod and trying to soothe him. It came out in one push, and they placed it in a bowl next to the tub for the time being. After a while longer, Brian cut the cord. At my request, they clamped it about 4 inches away from his skin; I wanted to wait until it didn’t need clamping to cut it short, because Liam’s cord had been permanently flattened by the clamp and constantly poked his skin. We stayed in the tub for about an hour, then got into bed to rest. The midwife checked me out (first vaginal exam they ever gave me), and told me I had two skid marks and one first-degree tear. Honestly, those skid marks hurt more than the tear did. I declined any repairs, and that was it. We got back into the tub for an herbal bath after they’d rinsed and cleaned it out, and sat there again for about an hour. I have pictures of that time, Jarod was BRIGHT RED, comically so. It was because of the extra blood he got by delaying the cord clamping, and it was normal. Then back into bed, and mom brought the kids up to visit, even though it was past 1 in the morning. They climbed into bed with me, held the baby, it was wonderful to have everything be so normal so soon, just a couple of hours after the birth. Mom went to fetch some IHOP pancakes for me to eat, and the midwife cut up some of my placenta and stir-fried it for me with some garlic and soy sauce. We went to sleep, and didn’t leave until about 11:30 the next morning, 12 hours later.
I’ve said since then that comparing VBAC and c-section is like comparing running a marathon to knee replacement surgery. This is so totally correct. I was tired for several days, but just to where I would feel a little light-headed if I did too much. I could still walk around, get up and sit up, go to the bathroom, roll over in bed (!!!!), climb the stairs. I even went shopping about 3 or 4 days out, no problem! The difference was just night and day, and I will never, ever willingly be cut again for anything less than a life-threatening emergency.