Thursday, March 28, 2013

My Journey to VBAC

I DID IT!!! I GOT MY VBAC. It still seems surreal...and although a lot went wrong, I think it did for a reason. Without all the puzzle pieces falling where they did, I think I could have very easily wound up with a repeat cesarean.

From the outset, excuse me if this post jumps alot. I am writing this as my 2 day old beautiful baby boy is cuddled in my arms. I am inhaling the delicious newborn scent and that can be very distracting. I want to write down my story while it is fresh in my mind. It started on Sunday, March 17th....

....George is on call so it is just Mark and myself and I although I am ENORMOUS at 39 weeks and 4 days pregnant, I am trying to do as much with Mark as I can. We started out the day normally with breakfast, followed quickly by watching "The Lorax" (the favorite at the moment). Since the weather was so gorgeous, I was feeling a bit guilty about not being able to take Mark out to the St. Patrick's Day Parade. But being that pregnant, it just wasn't possible. Instead, I pulled out the hose, a bucket and some beach toys and you would have thought Mark was in heaven. I left the hose on for as long as he wanted and just let him play. Boy did he. I remember having this feeling (Which I have had many times before), telling myself to take a picture of him in my mind having a blast. I felt like we wouldn't have that moment again...well we would, but it wouldn't be with just Mark. I almost went inside to get the camera (which was packed in my hospital bag), but since he was having so much fun, I didn't want to make him stop. Instead I just sat there and drank in the sight of my beautiful baby boy having a blast on a gorgeous spring day. So proud of himself for filling up the tub on his own and for watering the grass. It was a moment I hope I never forget. Once George was home we had some family time and before I knew it, it was time to put Mark to bed. I put him to bed that night which at this point in the pregnancy, was pretty uncomfortable. I think I knew what was coming on some level. George and I snuggled on the couch and watched some DVR. After some time I thought to myself, I am having alot of contractions tonight. Just for the fun of it, I decided to start timing them around 9:45. For over 2 hours they came at 11 minutes apart exactly. I told George (and myself) there was no way this was labor...I was convinced I would be going past 40 weeks at a minimum. They weren't really increasing in intensity either so we decided to turn the clock around and attempt to sleep. I continued to have them and at some point I had a couple that did increase in intensity and were slightly uncomfortable. But I fell asleep somehow. Throughout the night, I was woken up by similar contractions but I was still able to sleep in between. When I woke at 6:45 am, I had menstrual like cramping but no contractions. I was exhausted so I decided that even if I wasn't in labor, it might be sooner than I thought so I needed to start my maternity leave then.

I dropped Mark off at daycare and headed to my 8:30 am OBGYN appointment. On the way there I had more contractions that I would describe as more intense than Braxton Hicks but not painful, just uncomfortable. They were irregular. My OBGYN checked me and I was completely closed but my cervix had softened since my appointment the week before. I was so excited. This was progress! I went to work to checkout to my boss and complete some paperwork then I got a quick mani/pedi. At this point, the contractions continued, although irregular, and I became more and more convinced that this was early labor. I went home to clean the house in hopes that all that walking would encourage my contractions to become regular and consistent. I had several contractions while cleaning but I didn't time them. George came home from work because we both thought, this was the beginning of labor. I finished around 2:00 pm and decided that I should take a nap. I laid down in bed and my contractions were getting stronger. I decided to start timing them and they were 5 minutes apart. They were very manageable at this point. Needless to say, we did not take a nap. George went to pick up Mark from daycare around 5. At that point, my contractions were 5 minutes apart for over 2 hours and lasting about a minute each. They were still manageable but increasing in intensity. I decided to call my amazing doula. She got her affairs in order and told me she would be to me around 6. I also called my mom and said it was time to head down to Nola. George took care of Mark and I labored on my own. The contractions at this point were intense enough that I had to change positions and could not really talk through them. I think it was around this time that I stopped texting my friends to update them. My doula arrived at 6 and helped me with comfort measures during my contractions. My mom arrived at 7. I remember crying to my mom when George put Mark to bed that I wanted to put him to bed one last time. She assured me I would have plenty more nights to put him to bed. From that point on, the contractions got more intense. I know I keep saying that but it is the only way to describe them. I did a lot of breathing exercises and focal point techniques. Mark's photograph got me through a lot of contractions. The reminder that I wanted a VBAC partly for him. So that I could be a more present mommy when I returned home from the hospital.

I labored at home and by 9 p.m. when my contractions were 3-5 minutes apart, I started to panic. I did not know how much more pain I could tolerate and felt the need to be near access to an epidural. I vascilated but by about 9:30, decided I wanted to leave for the hospital. We arrived to Ochsner at 10pm. I know most people describe the carride as unbearable but it wasnt for me. In the 15 minutes it took to get there, I had 3 contractions. Once we parked, I had several back to back contractions. However, I got anxious that I had come to the hospital too soon and they would check me only to find out I had very little cervical progress. So I mustered the strength to labor in the atrium at Ochsner. Several people walked by and asked if I was ok. I found walking to be the best pain management technique during contractions. I labored in the atrium for 2 hours and again got exhausted and decided it was time to head to labor and delivery. My contractions at that point had been 3 minutes apart except for the occasional one that was 4 or 5 minutes apart. When we called to the unit to be checked in we were told that they were full and would get back with us. So here I was with excruciating contractions 3 minutes apart, with my mind made up that I wanted the epidural, and I was told to wait. So we waited, and meanwhile I labored in the waiting room. Thank God it wasn't packed. I labored for an hour before they called me back. Even then, I was placed in triage for monitoring, as the labor unit was full and no LDRs were available. I wanted the epidural so badly at this point. Laboring in a bed is without a doubt the worst position to labor in. It is hard to distract yourself and manage the pain. They checked me and I was 5 cm dilated and 80% effaced. To say I was elated is an understatement. My personal goal was to get to a 5 or 6 before asking for the epidural. Well I asked for the epidural but I did not recieve it for another hour. At that point, I was 6cm dilated. Although I was happy for the progress, I did not want to feel another contraction. Sadly, my epidural only took on the right side of my body. For an hour we tried techniques to get the epidural to take on my left side but to no avail. Finally, they manipulated the epidural and it provided relief from the contractions. At this point it was 3am and we had not slept. I tried to doze but could not. Sometime later I was given an LDR room. Although I was beyond frustrated with how slow things seemed to move in getting me into a room, it was a blessing in disguise. By the time I got the room, my OB was coming in for the day and she would be delivering my baby. I was elated.

In the LDR, I was sitting up and talking and only feeling a dull pressure when the machine showed contractions. I continued to progress, albeit at a slower pace. My contractions would be regular and then they would space out. When I got around 9cm, I was checked by several OBs, and it was determined that I had a cervical lip that was not dilating. My doctor decided to put me on the lowest dose of pitocin to speed things up. It was around this time that my epidural started wearing off. At first it was manageable, and then the pain became excruciating. Anesthesia did not offer any assistance. Instead, they kept adding medication to my line but I was getting no relief. I was numb from the thighs down but could feel everything upwards. It was as if they did not believe me. And then the baby rotated and I had back labor. It is very true that there is nothing like back labor. The best way to describe it is that it felt like the baby's head was going to burst through my spine with every contraction. It was brutal and there were many tears. I had surrendered to the pain hours before and decided I didn't want to feel it anymore. Well, my body had other plans. Again, maybe this was a blessing in disguise because I was able to push more effectively.

And let me say this, pitocin is no joke. The contractions were crazy on pitocin. Some were less than two minutes apart, lasting 2-3 minutes each. They did not peak, they plateaued. Part of what got me through the earlier contractions was telling myself that I could get through anything that lasted one minute. These 2-3 minute contractions were a whole different story. I stayed at this in between 9& 10 cm for quite some time. I have no doubt that many OBs would have begun talking about a c-section at this point. However, my amazing doctor is really supportive of VBACs and the baby was showing no signs of distress.

So at some point they stretched out the remainder of my cervix manually. Remember, I could feel everything at this point. Not fun at all. My doctor, realizing that I would not be getting any relief from the contractions suggested we start to push and use the contractions to my advantage. The baby was still at -1 station so I would have to do more work but it would be better than breathing through every contraction (and crying). So with my amazing team positioned, I began to push with every contraction at noon. I pushed for two very long tiring hours. After the first hour I would fall asleep between contractions, waking and begging for a break. But my team coached me on, I was so close. I never let the words "I cannot do this" leave my lips but believe me, they were floating around in my head. I still cannot believe that noone, at any point suggested a c-section... I was so  exhausted, I'd like to believe I would have turned it down but who knows. After 1.5 hours into pushing, my doctor said that the baby seemed big so we may have an issue with the shoulders but that if everyone listened to her, we would do some techniques to get the baby out. It all happened very fast. Once I felt the head pop out, I was lifted up and the McRoberts maneuver was performed. I lost all control at this point and my husband had to hold me down. I was never scared of what shoulder dystocia could mean. But when I looked at the tears in my mother's eyes and the fear on my husband's face, I understood that things could have gone very bad. I cannot say enough about my OB who predicted the problem long before, and had him out in seconds with the technique. The team of medical personnel listened to my doctor and everything went smoothly. I will leave alot of the gory details out. Suffice it to say that I labored and birthed my 8lb 15 oz perfect baby boy at 2:06 p.m. When they placed his little body on my chest the tears came and they did not stop. He healed me. I had the birth I dreamed of (well sort of, minus the failed epidural and the shoulder dystocia)...but I had my natural birth and a lot of it was unmedicated. The rest is history, I held my baby and the world stopped around me.

I have to admit that the pain of labor was much worse than my recovery for the c-section. However, I would do the natural birth 1000 times again. Because even though I had a 2nd degree tear, I could walk over to my baby in his bassinet, pick him up and change his diaper within hours of his birth. I could do none of that for days with Mark. I only needed low dose pain medication for 24 hours so I remember everything and was not constantly falling asleep (other than the fact that I was awake for over 30 hours). For Mark, those first days are hazy. Looking back, I can say it was all worth it. It was a traumatic birth of sorts but I wouldn't trade it for a second. And the added bonus, my OB said I can go natural next time as well. Although that is in the future, that knowledge is a relief.

I have to thank several people. My doula, Maggie Schneider. Without her, I do not think I could have labored on my own for as long as I did. Her pain management techniques and positive reinforcement were invaluable. I would recommend her to anyone. It was hard for me to believe I was her first birth she attended as a doula. Maggie, George and I cannot thank you enough. We give you so much credit for my VBAC. My mom, who came down to New Orleans to help her daughter labor. She never panicked (visibly) although I know there were lots of moments that were very hard for her to watch and experience. Mom I am so glad you were there and a part of this with me, I know it was not easy for you. Last but not least, my wonderful husband. I know it had to be hard to watch someone you love in so much physical pain and not be able to help. But you stayed by me, even trying to make me laugh (although during a contraction, NOTHING is funny :) I love you more than you know and appreciate your support of me during this journey even if you didn't understand why it was so important to me. I am blessed to have found my partner in life in you.

Sorry this is post is so long. It was a long labor.