Articles


Getting My V Back


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I was in my 37th week of pregnancy with my second child, and my obstetrician was examining my bulging abdomen.

“That kid has a gigantic head. Who has the big heads in your family?”

“Probably my side,” I answered, laughing. Then I thought, “Maybe having a baby with a huge head isn’t such a great thing when you’re hoping for a vaginal delivery.”

My first child, Finn, was delivered by emergency cesarean section in February 2006. For this pregnancy, I wanted things to be different. I wanted a healthy baby, but I also wanted to be able to pick up my older child, all 30 pounds of him, after I gave birth.

On my first visit to my obstetrician, who had delivered Finn, I told him I wanted a VBAC, vaginal birth after cesarean.

Dr. M., who is reassuringly calm and optimistic under almost any circumstances, said I could have a VBAC if that’s what I wanted (although he was also willing to schedule me for a cesarean).

So I read books about childbirth, I went to a movie (The Business of Being Born), I attended meetings of the local chapter of ICAN (International Cesarean Awareness Network). I talked to my husband and convinced him we should hire a doula because I thought her assistance at my birth would help me avoid a repeat cesarean.

My first C-section had saved my child’s life, but it was not the way I would have chosen to go. A cesarean is major abdominal surgery. In the first three weeks of my recovery, I was not allowed to drive, go up and down stairs more than once a day, or lift anything heavier than my baby.

I reminded Dr. M. about my wish for a VBAC at almost every prenatal appointment. At one, I quizzed him on placenta position, birth plans, and at what point in labor I should head to the hospital. I wanted to gauge his commitment to helping me deliver vaginally. I always left my appointments confident he would support my decision.

The real test of that confidence came after an early-morning bathroom visit in my 39th week. It was 3 a.m. and I was very wet. Had I peed in my sleep? I didn’t think so, and the intermittent twinges I felt for the next several hours suggested I might be in labor.

My husband and I headed to Dr. M.’s office later that day. A pelvic exam confirmed my suspicion.

“You’re scheduled for a C-section?” Dr. M. said to me.

“You’re kidding, right,” I replied. He wasn’t. With dozens of pregnant women due in August, he’d forgotten which one I was.

“I want a VBAC,” I said emphatically.

“So go home and rest. Labor typically begins within 24 hours of water breaking,” he said. But just in case it didn’t, he wanted me to call him no later than 6:30 a.m. the next day, ready to go to the hospital.

My contractions never grew more frequent or more intense, and by 7 the next morning I, my husband and my extra-large birth ball were waiting on the 10th floor of Crouse Hospital to get a room assignment. Shortly after, my doula arrived.

My fantasy had been a natural birth, where I labored almost entirely at home, my husband and doula with me, and only the actual pushing part and birth happening in the hospital. But with my membranes ruptured and labor not really happening, it didn’t look like my dream would come true. Instead, I got the trappings of a full-bore hospital birth. I got an IV to pump in antibiotics. My nurse wrapped the belts of a fetal monitor around me.

And then Dr. M., who had met John and me when we arrived, came into the room and recommended I be induced with Pitocin. Pitocin is an artificial form of oxytocin, a hormone that helps start labor. I’d read that Pitocin contractions come on so fast and so hard that an epidural was practically inevitable. But I really did not want an epidural, which I remembered from my C-section: a needle inserted in my spine, followed by numbness and immobility from the chest down.

Dr. M. insisted the Pitocin drip would start with a very small amount, increasing very gradually.

So Pitocin it was. And just as he said, the drip started out slowly. For an hour, I didn’t feel much of anything. I lay in bed, chatting with John, my doula and my nurse. Eventually I felt some discomfort, which became intense enough that I had to get out of bed and bounce on the birth ball or lean on the bed while the contraction rumbled through.

Before long discomfort became pain. From there, as my nurse continued to turn up the Pitocin, the pain moved into the unbearable, living-hell, make-it-stop territory.

I had already told my nurse I didn’t want to have my progress checked. I didn’t want to know how large the cervical opening was or how far the baby had descended because I didn’t want to feel like I was making progress only to discover I was hours from the pushing stage.

So I spent what felt like an endless amount of time leaning on my husband, swaying my hips to move the baby down while my doula rubbed my back. As the contractions grew closer together, I had about a minute to rest between each one. Just as I began to think the agony wasn’t going to end, I felt the urge to push. My doula fetched my nurse, Dr. M., a medical resident and maybe a few dozen other people—at that point I didn’t know or care.

Reluctantly, with a lot of people urging me on, I pushed and was rewarded with more excruciating, mind-blowing pain. More pushing. Faster than seemed possible, my baby boy flew out and began to cry. I had been pushing for only 17 minutes.

Someone put my son on my chest for a few minutes and then he was taken to the NICU for a quick check. During the birth I had suffered severe tearing and was bleeding heavily. Rather than wheel me down to the hall to the operating room and put me under general anesthesia, Dr. M. injected lidocaine and stitched me up in my room. Finally, I was able to lower my legs and cover up.

And it was over. After everyone except my husband had left the room, I bawled.

I got my wish—a VBAC. But as they say, “Be careful what you wish for.” Now I know: Vaginal birth is no picnic either. And it took several months before I was back to my pre-birth self.

In the end, though, I got to do birth, instead of having it done to me. And I got to pick up my big boy, just like I wanted. For me, it was a happy ending.


Reid Sullivan, editor in chief of Family Times, is the mother 3-year-old Finn and Niall, 9 months. Niall, 7 ½ pounds at birth, now weighs 21 pounds.


Tips for a VBAC

Know your goals. Why do you want a VBAC? Having personal, meaningful reasons for pursuing a physiological birth will help you succeed in the face of resistance you may encounter.

Do plenty of research.
Visit Web sites, talk to other women who have had VBACs, read books about birth. Know how you want to give birth and the pros and cons of each of your decisions.

Talk to your caregiver. Make sure your obstetrician supports your decision to VBAC and is prepared to follow your lead. Ask lots of questions and offer different hypothetical scenarios to determine how your caregiver would respond. Ask him or her: “What if I am not in labor at 41 weeks?” “What if my baby is in the breech (feet-down) position?”

Find support. Have several conversations with your spouse or partner to see how much help he will be during labor and birth. Decide if a doula (trained birth assistant) might be useful. Attend meetings of the local chapter of ICAN (International Cesarean Awareness Network) to hear about other women’s experiences.

Be flexible.
No matter how much you read and whom you talk to, something unexpected is bound to happen. Do your homework, surround yourself with people you trust, and be prepared to change your plans. Understand that sometimes a cesarean is necessary to save your life or health, or the life or health of your baby.

Resources:

Books:

Ina May’s Guide to Childbirth, by Ina May Gaskin (Bantam; $18)
Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First, Marsden Wagner (University of California Press; $16.95)
Birth: The Surprising History of How We Are Born, Tina Cassidy (Grove Press; $14)
Pushed: The Painful Truth About Childbirth and Modern Maternity Care, Jennifer Block (Da Capo Press; $16)
The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, And All Other Labor Companions, Penny Simkin (Harvard Common Press, $16.95)

DVD:

The Business of Being Born; directed by Abby Epstein (DISTRIBUTOR??2007; $27.98)

Web sites

ICAN of Syracuse: www.freewebs.com/icanofsyracuse/
ICAN (International Cesarean Awareness Network): http://ican-online.org
Childbirth Connection: www.childbirthconnection.org
Doulas of Central New York: www.doulasofcny.com
www.vbac.com




© Family Times: The Parenting Guide of Central New York