It’s hard to believe it was nearly a year ago when my neighbor and friend Beckie mentioned that they would be trying for baby number two and asked what I knew about VBAC. I shared what information I had, but little did I know that it was just the very beginning of an epic journey, many parts of which we would share.
Since her first cesarean wasn’t due to a pre-existing condition and all had gone very well, her OB was very open to a trial of labor, and supported her choice to attempt a VBAC. She asked if I would consider being her doula, and I was, of course, thrilled to accept!
After an uneventful and active pregnancy, we rolled into the final weeks, fully expecting baby G to arrive slightly early or close to her EDD, even though his big sister arrived 10 days post dates. However, baby G had his own agenda (as all babies do) and decided to enjoy as much time as possible in mama’s belly!
On Tuesday, at 40+6 weeks, Beckie texted me to let me know she’d been having regular contractions 45 minutes apart, then 20, and then 10, so things might be happening. I encouraged her to alternate rest and activity, and to be sure to stay hydrated and nourished, but basically try to ignore the rushes as much as possible. That night things died down enough for her to sleep then were back at around every 10 minutes once morning rolled around. We decided to check in on the baby’s heart rate using my fetoscope and it was strong and steady at 130-140 beats per minute and VERY low down. We also palpated to determine his position and he was resting happily with his back on her left side (LOA), which is optimal for labor. That afternoon, she went in for an acupuncture treatment to stimulate some lovely labor points, and things really intensified for awhile, but by that evening contractions went back to their steady 10 minutes apart, so we decided to try a little aromatherapy and homeopathy to see if we might encourage her body to let things roll ahead. The contractions picked up briefly to 8 minutes apart, but then sleep took over, and back to their favorite pattern in the morning.
Because mama was a VBAC, they had scheduled a c-section for 10 days post dates if she hadn’t gone into labor yet, so Thursday was spent walking and waiting to see if this might be the day. We talked again about relaxing during contractions, positions to open up the hips, and also beginning to give them some attention to see if they might prefer that! The day passed without much change, though she began to lose her mucous plug, which was a good indication that all of these contractions were indeed doing something. Alas, things were still not rolling by 6am when she and her husband headed to the hospital. She requested that they check her before going in for the c-section, and when they did, she was 1-2cm dilated, so after some deliberation, they encouraged her to go home, and see if the weekend might bring-on active labor. That afternoon included another acupuncture treatment, walking, eating, sleeping… Still 10 minutes apart.
The weekend started in much the same way, and still, those contractions held steady. At this point we wanted to see if we could encourage her body to “reboot” and get into a more efficient pattern, so she took some Calcium/Magnesium and went to bed. The rushes didn’t stop completely, but she was able to get a decent night’s sleep, which is never a bad thing, especially so late in pregnancy! Alas, the contractions just continued steadily through the rest of the weekend.
I’ll pause here to say that this is one of the most patient mamas I’ve ever met! It is no easy feat to remain so calm and optimistic at the end of pregnancy, let alone after days and days of prodromal labor, and her ability to do so was inspirational.
At her Monday appointment she was still 1-2cm dilated and her OB encouraged her to try a low dose of pitocin if things weren’t moving by Tuesday to see if that might not do the trick. We chatted about it and since it seemed like this might be the best option based on the events up to this point, we prepared to meet at the hospital the following morning. That evening, we chatted again, and it was as though a well of emotions came bubbling to the surface. As emotions can play a huge role in labor, this was a beautiful release. The next morning, we chatted on the phone and when the resident checked her she was 3-4cm dilated and we were thrilled that things had moved ahead more on their own.
At 10am, they started a Pitocin drip at a very low level (it was agreed that it would be kept very low to avoid increasing the risk of uterine rupture) and I headed over to meet her and her husband and dad who was also there keeping them company. After 2 hours she was at 5cm and at this point they broke her water and things began to pick up, and another two hours later was at 6 cm. Unfortunately, it was at this juncture that baby decided to flip OP (Occiput Posterior – his back to mama’s back) and we rolled right into some extreme back labor. They turned off the Pitocin at this point and this strong mama did such amazing work! After 4 hours of increasingly intense back labor, and since we had reached a point where she could no longer work with her contractions or get into positions to help baby flip back around, she opted for an epidural to allow for some much needed rest. After a good sleep, the OB checked her and she was still at 6cm and baby was still OP. He recommended a cesarean at this point, but after some discussion, and since baby and mama were both doing well, Beckie decided to try some positioning to see if we might get things moving again, and the doctor turned the Pitocin back on at the lowest dose to increase the strength of the contractions. We used several techniques over the next two hours – a modified side lying release (she was not allowed to have her leg over the side of the bed, so we gently but firmly used a rocking motion of the hips to compensate for the lost gravity), belly lifts and tucks while sitting on the bed in the “buddha position,” and then hands and knees on the bed. We were going to try the rebozo technique of “sifting” at this point, but the nurse came in and scolded us for moving too much and messing up the monitors and wires so we promised to allow her to be still for a bit. When the doc returned, baby had shifted to ROA (which we surmised by the big bump his butt suddenly created on her belly!) and she was at 7 cm. Then 8cm. Then 9cm. It was getting late, so we all decided to get some rest and hoped that when we woke up it would be time to push. 4 hours later, still 9+cm. The OB was getting anxious by this point, so we decided to try one push to see if it would get rid of that final lip around the cervix – and it did! Hello 10cm! Baby was so close! So Beckie pushed for 20 minutes, and at that point, baby G let us know he didn’t like that part based on his heart rate, so it was decided that the safe course of action was to perform a cesarean. As soon as she stopped pushing, he was happy as a clam again, so thankfully there was no emergency. He clearly just didn’t want to come out that way! It is safe to assume that his mama must have the most comfy uterus ever. 🙂
George IV joined us earth side happy and healthy, sweet and mellow, at 5:24am on the final day of week 42.
While it was a bittersweet end, we were all so thankful that everyone was safe, and what a joy it was to be a part of this process. When I returned to the hospital to visit the following day, it was sheer bliss to witness this radiant mama, snuggled up with her beautiful boy!
Congratulations Beckie, George III, big sister Lily and welcome little one! It was an honor and a privilege to work with you during this special time. Much love!