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Leslie's 4th VBAC Hospital Birth of Baby Rose

When we had our first baby 10 years ago, my husband Joe and I took all the classes and read all the books – but we were both completely inexperienced with actual labor and birth. It is the classic story of interventions causing complications: after several hours in the hospital, I allowed a midwife to break my water to hurry things along. And as it turned out, the baby was in a bad position (posterior, or “sunny-side up”) and no one realized it until several hours later, long after my waters were gone and now with much less room to turn. I was then given Pitocin to keep labor moving, but spent 10 hours at 8cm and never dilated further. It ended with a cesarean section.

I learned a lot from that experience. The next pregnancy, I switched providers to a small midwifery practice and hired a doula, and the next 3 births were all successful hospital VBACs. By my fourth pregnancy, the small midwifery practice had joined up with a hospital practice, with four midwives doing prenatal visits and a few more who only attend births – all very kind and competent, but a little less personal since it is hard to get to know everyone.

As my due date approached this fifth time around, there were two major fears weighing on my mind. The heaviest was the memory of my last birth. Baby #4, our largest at 10 pounds, had been a somewhat traumatic birth that included a shoulder dystocia and a fractured collarbone. All of my babies have been on the larger side (my smallest was 8lb 8oz) and up until baby #4 I felt pretty confident in my ability to birth those big babies. But that last birth had been humbling, and had left me feeling like there was a limit to what my body could do. I really feared I was not physically capable of birthing a baby larger than 10 pounds.

The next fear I dealt with was at around 36 weeks when the midwife insisted that I needed to schedule a cesarean for my 41st week. She told me that the doctors like to get people on the schedule “just in case.” This was never something that had been done during my previous pregnancies, and no one had mentioned it to me earlier in this pregnancy, so I was caught completely off guard. They penciled it in for August 1, which would be 41+5, if it went that long. I never had gone that long before, so it shouldn’t have been a worry… but now there was a supposed deadline, so of course that brought fear.

For several weeks, I had been feeling contractions in the evenings. Every morning I’d hope to wake up in labor, and every morning was disappointed. All of my babies have come between 40 and 41 weeks, so although disappointed, I wasn’t surprised when my due date of July 20 came and went. I tried to keep reminding myself over and over that the baby would come when she was ready, and that the c-section “deadline” of August 1 didn’t actually mean anything.

A 41-week post-dates ultrasound on 7/27 showed that baby, fluid levels, and placenta were fine, and estimated baby’s weight at 10lb. 11oz. I was pretty sure the weight estimate was too high. Still, baby #4 had been 10 pounds right at 41 weeks. The midwife I saw that day was anxiously pushing me in the direction of an induction, telling me I could go in the very next day if I wanted to. Her anxiety didn’t help mine. I think I stared at her like a deer in the headlights, until she finally just told me to call on Monday to schedule an induction if I didn’t have the baby over the weekend. She stripped my membranes to try to encourage labor to start, but it didn’t work.

I did lots of reading that weekend about naturally birthing larger babies, while trying to decide what the best course of action would be. Everything I read seemed to indicate that the baby’s position is more important than the size when it comes to the ability to push her out. My own experience had also played this out. After thinking and praying and talking about it for the weekend, Joe and I decided not to schedule an induction. I feared that the baby probably wasn’t in a good position to trigger labor to start, or it would have started already. If she was in a bad position and she was bigger, then inducing labor was more likely to fail, and I would need a c-section. Why put my body through a difficult artificial labor just to end in a c-section anyway? That was more worrisome to me than the surgery by itself. So we decided that if we got to August 1, I would go through with the scheduled c-section and be at peace that she wasn’t meant to come naturally.

I put a temporary tattoo on my forearm that read “Be not afraid!” in St. John Paul II’s handwriting. This was a total copycat of Mary Haseltine (thank you, Mary!). Her baby had arrived a couple of weeks earlier and she had just posted his birth story on her blog, including a picture of her own arm tattooed with “Be not afraid!” It was providential that I happened to have the same tattoo laying around, and it did bring me comfort.

I woke up disappointed yet again on Monday morning 7/30. I called the midwives’ office and talked to the midwife on duty that day. I told her about my decision not to induce, and my reasons for it, and she was understanding. She did want me to come in to check on the baby. Joe and I brought the kids over to their grandparents’ to stay until after the birth, and then headed to the hospital for the NST, which was perfectly fine. Afterward Joe and I had a rare night to ourselves. We walked the mall, bought a gift for the baby, and then spent a strangely quiet evening at home. I didn’t sleep terribly well that night, woke up around 4:30am, and never quite went back to sleep.

On Tuesday 7/31 (41+4 and the day before my scheduled cesarean), as usual I did not wake up in labor. After Joe went to work, I started reading up on c-sections, to refresh myself on the procedure and what the recovery was going to look like. I was resigned to it, reminded myself that I’d been through it before, but the reading was a bit disheartening. I got into the shower in the later morning and had a good, long cry about it all. But I had that reminder on my arm, “Be not afraid!” so I tried to let go of that fear and let the water wash it away. After that release, I felt a bit better, and as I was getting dressed, I happened to catch a glimpse of myself in the mirror. My belly was HUGE. I stared at it for a few minutes, and made a mental note to have Joe take one last photo of it later.

I was reading some more at 11 a.m. when I felt something strange. I went to the bathroom and discovered a lot of bloody show – normally one of the first signs I notice when labor really starts. Could it be? I tried not to get too excited, headed back to the couch and plopped in front of the TV to time contractions. They were coming steadily at 6 minutes apart for an hour, and I started to feel pretty confident that we were finally in the early stages of the real thing!

Joe called around 12:30 when his classes had ended for the day. I let him know that it looked like we were in early, active labor. That was not the update he expected! He said he would finish up some work and pick up subs for lunch. After we hung up, I called our doula Nancy and told her what was going on. She was happy to hear it and suggested that I try the Miles Circuit positions as I labored, to encourage the baby to get in the best position. When I got off the phone with her, I got into the open knee/chest position (head/torso resting on couch, backside in the air) and stayed that way for a full half-hour while watching some more tv, laboring, and waiting for Joe to get home with lunch.

Joe had said he thought he’d be home about 1:00, so I was surprised when he didn’t get back with the food until closer to 2:00. He had been taking his time, figuring there was no rush, as our normal pattern with our previous VBACs had been about 24 hours from bloody show until birth. I didn’t mind much, except that he had promised the food and I was ravenous! I remember thinking I couldn’t be too far along in the labor because I was so hungry, and usually I don’t feel like eating when I’m in later stages. At this point the contractions were about 4 minutes apart and I was stopping to work through them, but could still mostly talk through.

After lunch, Nancy called back to see how things were going. She was supposed to pick up her daughter at 5:00 and wondered if she should make other arrangements. I doubted things would move that quickly, but I let her know what was happening. She decided to have someone else get her daughter, just in case. Then I headed upstairs to lie down. I figured this was a two-fold solution: first, since I’d been more or less awake since 4:30am and we were probably looking at a long night ahead, it wouldn’t hurt to try and get some rest now while I could. Second, the next position in Miles Circuit was side-lying, and I wanted to do that for half an hour. I lay down to rest and the contractions spaced back out to 6 minutes or so. Joe was torn as to whether I should be resting or trying to speed things up.

Just a short while later, at 3:19, I had another contraction and felt (and Joe heard) a pop and a gush – my water had broken! My first thought was, “Oh no, I’m going to ruin our bed!” Joe saw the greenish-brown color and knew the bed was not our highest priority. He called the doula and told her that my water had broken and there was meconium in it, so we were deciding to head to the hospital. He put down some towels to sop up the mess and packed up the car, while I continued to labor in our room, now needing to vocalize through the contractions as they had gotten a lot stronger. He helped me out of my wet clothes and into dry ones, and carefully led me to the waiting car. The contractions were very strong now, I was loudly moaning through them, and I think Joe might have been starting to worry that we would birth in the car. (He knows I only sound like that when we’re getting close to the end!)

We made it to the hospital around 4 p.m. and I’m sure I was making a noisy scene as they wheeled me inside and up to the fourth floor. We were greeted by the midwives on call: Jennifer (who had attended #4) and our friend and neighbor Tiffany, who was in training. They got us into a room and had me get changed and hooked up to the monitor. My moaning was high and loud and maybe a little hysterical, but they got me calmed down, taking deep breaths, and making low sounds. I think at some point Joe was trying to be encouraging and I may have told him to shut up… oops. Our doula hadn’t arrived yet.

Jennifer checked me (8cm) and then had me turn to my side. A minute or two later she had me change positions again because “baby wasn’t happy”; this time I was kneeling and leaning over the back of the bed. I liked this position and felt like I was really working with the contractions and laboring the baby down. Nancy arrived at this point and took her place rubbing my back and giving me sips of water between contractions. I remember a lot of soft, soothing voices and feeling like I must be making good progress.

After a bit Jennifer asked me to change positions again, this time to my left side. Baby still wasn’t happy and she wanted to check me again. I was still about 8cm dilated, and she said there was a swelling anterior lip of cervix. Jennifer explained to us that the baby’s heartrate was dropping with each contraction more than she liked, and since I was only at 8cm and not ready to push yet, she wanted to have an OB consult. She feared we might be looking at a c-section. Okay, I thought to myself, I was already prepared for a c-section, so maybe that is just what it’s meant to be this time. We can do this.

The OB on call, Dr. Cromwell (whom I had never met before), came in and checked me and assessed the situation. To everyone’s surprise, he recommended that, since this was baby #5 and I had birthing experience, it would be faster to push the baby out than have surgery. (I still look back at this moment and am so grateful to that doctor. This was probably the first time in weeks that I actually felt like someone believed in me, that I was empowered instead of helpless!) Dr. Cromwell explained that he would need to stretch the cervix over baby’s head in order for her to descend. I listened and moaned my way through a contraction. As soon as the contraction ended, he reached in to stretch my cervix with one hand, while with the other hand he pressed on my belly, externally manipulating the baby to make sure she couldn’t slide back up. Joe said that from the way I reacted, this might be the most painful thing he’s ever seen me deal with! Next moment, the doctor was telling me to push. Now, with no contraction and no urge? “I can’t!” I cried. I couldn’t figure out which muscles to use or how to make them work.

Everyone encouraged me that I could, and to try. They helped me pull my legs back, Tiffany on one side and Nancy on the other. Joe was by my head and supported me with my chin to my chest. Now his voice was the one I heard, as he firmly coached me to push and not give up. I like soft, gentle voices when I’m laboring, but I need firm instruction at transition and pushing. Joe had observed this enough times to be able to step in with that part I needed. After a minute I got my bearings and pushed. There wasn’t time to rest between pushes, but I could feel the baby moving so I kept going.

As the baby crowned, the doctor stepped aside to let Jennifer take over catching. (So I am told; I had my eyes firmly closed the entire time!) Baby had a nuchal cord and Jennifer couldn’t pull it over her head, but was able to work it loose enough to pass her body through it. I felt immense relief as soon as she was out, and when she cried, I cried too.

Rose was born at 4:47 p.m. on July 31 after less than 6 hours of labor and only 7 minutes of pushing – and somehow I did it with no tearing. They did unfortunately bring her to the warmer right away due to the meconium instead of checking her while on me. After she pinked up, they put her on my chest skin-to-skin and bundled us with warm blankets. She was perfectly healthy, loudly voicing her displeasure a few times. She was interested in nursing and latched on right away. After an hour the nursery nurse came to weigh and measure her. We took guesses at her weight – I was still thinking she must be 10 pounds like our last baby after all the concerns about weight, but Joe said no way, he could tell she was smaller. And he was right: she weighed in at 9 pounds 7.1 ounces, 21.5 inches long!

Everyone left us alone soon after, and Joe and I looked at each other in a daze. What just happened? That morning we’d woken up prepared to spend one last day at home together before a cesarean. Now here we were, having dinner at the hospital with our newborn. Joe’s total involvement with the labor amounted to less than 3 hours, and our doula had barely made it to the hospital 20 minutes before the baby arrived! After making us wait 11 days past our due date, Rose had made her grand entrance before we even had time to process what was happening. I never even got that final photo of my giant pregnant belly!

There was a lot of fear attacking me at the end of this pregnancy. Fear of shoulder dystocia, fear of induction, fear of the c-section, fear of my own limitations. But “be not afraid!” became the theme. It was only AFTER I gave it over, after I accepted that I didn’t have the control, after I made my peace with what was happening and let go of the fear… THAT was when labor started. I don’t remember any fear during the labor, even with the meconium and concerns about the heartrate. God was with me, and I could accept whatever was coming. But what an amazing blessing that the doctor had faith in me and my body, and I was able to do it in the end. I can do all things through Christ, who strengthens me. Be not afraid.

This birth story is shared with us from Leslie. Leslie is a convert to Catholicism who has been married to Joe for nearly 15 years, and they have 5 children. In another life, she used to work as a computer programmer, but she much prefers her current job as full-time homeschooling Mom. In her free moments, Leslie enjoys ice cream, reading, sewing, genealogy, creating annual photobooks for her family, and allowing her kids to beat her at Mario Kart.


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