Monday, April 10, 2017

Graham's VBAC Birth Story

Graham Robert Bruce arrived healthy and happy via unplanned c-section on April 6th, 2017 at 4:04am.  Seven pounds, eight ounces, 20.5 inches long.  


Carter's birth via planned c-section was nothing short of traumatic for this first-time mom.  It was my first major surgery and first baby.  My goal with pregnancy number 2 was to do whatever I could to avoid a repeat c-section.

Pregnancy #2 happened effortlessly and the pregnancy itself was uneventful.  I may have caught every cold and flu bug humanly possible through the winter months, but was otherwise blessed to avoid any other complications.

At the urging of some new friends, I hired a doula to help me achieve my goal of a vaginal childbirth. My doctor was incredibly supportive of my desire for a VBAC as well.  Armed with my team of professionals we anxiously awaited my due date.

Which came...and went!

At my final checks, my cervix went from not dilated, to a "tight 1cm", to a "1cm"...At 41 weeks, making little progress on my own I was checked into labor and delivery to try a balloon catheter (no pitocin) to see if we could get things moving. The timing was important because that day/night my doctor was the one on call, which was incredible.  The next day was another VBAC friendly doctor in the group on call, the following day was a doctor who is not VBAC friendly.  So it made sense to do the induction ASAP vs. wait it out a few more days.

Prior to my appointment, I'd decided with my doula that if I was making progress (dilating) I would ask for a few more days time (turns out this probably would not have made a difference).  But, if I was not progressing on my own after my 41-week check then we'd talk induction methods.  I also did 2 acupuncture sessions to encourage labor to start.

Fortunately, my mom had come into town to watch Carter so when I called to say I wasn't coming home that morning from my doctor appointment I had peace knowing that things at home were just fine.

I knew once I was admitted, that meant no turning back.  The baby was coming!   It was incredibly exciting and terrifying all at the same time.  I settled into my hospital room with Corey, still in disbelief that it was time!  I changed into a gown and Corey went to get lunch.  While he was gone my doctor came in and inserted the catheter and filled it to 40cc's on either side of my cervix.  It was slightly uncomfortable but not a bad procedure at all.

Corey came back with sandwiches (which I got to barf up later on, haha) and we nervously chatted and ate.  My contractions started almost immediately after the insertion which is apparently not normal (normally it takes several hours and often pitocin to start labor).  By 5pm the contractions were coming hard and fast.  I called my doula to please come and I was in active labor by the time she arrived an hour later.

Around 7pm my doctor came in to check progress and remove the balloon.  I was dilated to 4cm and quickly reached 7cm not long after.

But, that's when progress stalled out.  Baby was still "floating" in my abdomen, possibly tipped in front of my pelvis, and not descending into the birth canal.  We were trying various positions and methods to get baby in position, but none seemed to be working. Unmedicated for hours,   I labored on a ball, the toilet, standing up, laying down, on all fours...you name it.  My doubla used a riboso scarf around my abdomen to try and shimmy baby into position as well.

Because of being a VBAC I had to be hooked up and laying down for monitoring every hour or so.  When I would go on the monitor it started to show baby's heart rate dropping during my contractions.  I was put in bed and baby kept showing signs of distress unless I was laboring on my right side laying down, even then we saw dips.  I would watch my doctor and nurse and doula check the monitors and their faces scrunching up as they watched the screen.   I knew I was on borrowed time to labor naturally with this child.

My water was broken and revealed that I had an unusually large amount of of amniotic fluid...hence baby floating in my upper abdomen vs. engaging into my pelvis.  The fluid also contained meconium poop, meaning baby had pooped inside me and was now at a possible risk for infection

A side note on mother's intuition...the last few weeks of my pregnancy I felt baby pushing something (a head? a shoulder?  an arm?) into my left pelvis.  I felt the pressure often and strong.  I'd asked my doctor to check to see what was going on and she poked around on me at my second to last visit, unconcerned about my pain or baby's position.  I thought baby was not in the right position...I think I was probably right and should have advocated for another ultrasound to see the exact position in my pelvis...but that's neither here nor there...maybe it would have changed the outcome?

Or maybe, the eventual outcome was indeed perfect for us...I think it was...

I finally asked for an epidural as the contractions were so strong, and definitely too much to deal with on my side laying down.  The anesthesiologist was there in a flash and performed the procedure quickly with very little pain.  Relieved I laid back and we tried to find positions where baby could be comfortable but there was just no other way I could labor that didn't upset the baby.

My contractions slowed and baby continued to show patterns of decel on the monitor.  I could hear it and would feel so bummed out.  I rested and meditated and talked to baby and tried to tell him or her it was OK, but he was just not happy.

Finally at 3am with labor slowed, my doctor and doula agreed that it was time to do a c-section.  I looked at my doctor on my left side and asked if we'd done everything we could do, she said yes.  I turned to my doula on my right side and asked the same question, she said yes.  Corey stood a few feet away with a furrowed brow, understandably scared and frustrated that here we were again, facing major surgery.

I felt at peace knowing we'd done all we could but baby was in distress - not an emergency situation, thankfully - but not progressing.  Since he was floating and not engaged, my cervix no longer had pressure on it so it stopped dilating.  I was given a dose of medication to stop my contractions.  In this moment I felt like I'd completely and utterly failed.  My labor was being forcibly stopped.

In a funny twist this medication actually got my contractions to get closer together almost as if I *might* be able to pull this VBAC off...alas baby was still not engaged and my cervix was not opening any further...

The anesthesiologist came back in to administer a dose of spinal block to fully numb me and we headed to the OR.  Note, at this point, my doctor had been working for almost 24 hours and had done 3 other c-sections that night alone...apparently, there were some uncooperative babies that evening!  It was an operating room full of women and it was kind of awesome.  I knew what to expect and was excited to finally meet my little one.  I made everyone cast their vote - boy or girl - before we got started...it was a fairly even split.

This surgery felt different.  In Carter's I felt NOTHING.  I couldn't feel my lower body at all.  This surgery I felt lots of pushing, pressure, discomfort and nausea at times.  My arms were not tied down and shook uncontrollably which was awful.  There was no pain, but  I just wanted them to get this baby out of my body.  Luckily, the baby came out fast.  My doctor confirmed as she extracted the baby that he was not only NOT in my pelvis at all, he had also turned completely sunny-side (face) up. The pediatrician brought the baby over so Corey and I could look at him at the same time to see IT'S A BOY!  So much fun, definitely worth the wait to find out the gender.

Baby Graham was healthy, happy and barely cried as they wiped him and suctioned him.  He and Corey were whisked into recovery and I was closed up.  I met the boys and my doula in recovery where baby Graham latched like a champ.  We all got a laugh at how hungry he was and how he knew exactly where the food came from!  We spent an hour in recovery and I relished the moments of not being able to feel the pain of my incision or surgery.  I had a flush of happy hormones from laboring and felt great.

The moments and hours after Carter's birth were a complete blur of fear, pain and fuss.  This birth was dramatically different as I felt love, peace and connection with my new baby and so much support from my husband, doctor, doula and nurses.

Having a doula was worth every, single, penny.  We had to welcome baby into the world a different way than we planned but her support and knowledge was invaluable.  Her partnership with Corey and I during labor was incredible.  Everyone had their role in that room.  She pushed me, comforted me, knew what to do and say at every juncture, had energy to spare, shared a peaceful vibe and love with everyone that participated in the process of bringing Graham into this world.  She was my labor "person".  I appreciated her and needed her more than I knew I would.  Even more so as we faced the decision to do a c-section.

Having a "She-Wolf" pack with Dr. St. Pierre, Nurse Tess, Doula Sheri and the other women who supported my labor and delivery was empowering!  There's just something about a group of strong, passionate women working together, intensely, in the wee hours of the morning, exhasted, towards a goal that was a life-giving experience, literally and figuratively!

We entered the hospital around 1 pm on Wednesday the 5th and left around 11 am on Saturday the 8th!  Quick stay!  Fortunately, the recovery from this surgery was night and day different from the previous one.  I strongly advocated for my pain meds and lots of them.  Those, coupled with an incredible nursing staff helped me to recover at a rate that surprised everyone, myself included.  The care at the hospital made all the difference in the world.  My favorite post partum nurse Bethany got me up and moving shortly after my surgery, encouraged me to get my catheter out at 12 hours post surgery vs. 24 and stayed on top of my meds.

Yes, I wanted a VBAC...no, that wasn't what happened in the end.  But, I would do it all over again exactly the same if I had to.  Getting to feel labor and see my body respond in amazing ways to the process was incredible.  There are no hard feelings that hours of intense contractions ended in surgery.  Honestly, with how quickly I recovered from this surgery I'm not sure I'm too upset that I have a quickly healing belly incision vs. a wrecked vajayjay!  Ha!  Everything happens for a reason.

I'm sure I will add to and update this story, but for now I just wanted to get the details down before the newborn fog gets any more intense....

We're so thankful for you, Graham Robert Bruce.  You fit right in our family (and are nestled close to me in your Solly wrap sleeping soundly as I type this) and in our hearts perfectly.  We love you so.