Preface: If you remember from Peter's birth story I came into this pregnancy having already had 2 c-sections. This time I was bound and determined to find a doctor that would be more friendly to a VBAC. So I made appointments and talked to doctors and midwives and then I got discouraged. Everyone I talked to considered me too "high risk" to even let me attempt labor, they all wanted to schedule another c-section. Well the midwives didn't but they couldn't accept me as a patient because the doctors that back them up have a 1 c-section limit to allow a VBAC. So I took a small break from looking for a doctor and when I started my search again I started at the University Medical Center (UMC). I made yet another appointment and was really impressed with the office staff that I talked to on the phone, then when the actual appointment came along I was equally impressed with the doctor, the only problem was the doctor was a resident and could be overruled and also she was scheduled to be in oncology in November and couldn't guarantee she'd be with me for the rest of the pregnancy. So she went to find an attending doctor that would agree to a VBAC and when she came back she gave me the name of my doctor. Sometime in the middle of this this article, which is the ACOG's updated guidelines for VBACs, came out. Needless to say I was excited because I was a perfect candidate for VBAC. I printed the article and took it with me to my next appointment and actually had an intelligent conversation with my doctor about it and how it applies to me, which was a breath of fresh air considering all the previously condescending conversations with the other doctors. I was still considered "high risk" but with the ACOG behind me I actually had a chance at getting what I wanted.
Sidebar: I don't have anything against medically necessary c-sections, but a woman who is otherwise having a completely healthy pregnancy shouldn't be forced into major surgery just because she's had one or two before.
My primary reason for wanting a VBAC was and still is: I don't know how many children we want to have but I'm pretty sure the number is more than 2. The more c-sections you have the more likely you are to experience the actual risks associated with VBACs.
So now we get closer to the actual story. :)
There had been a miscommunication between the doctor and me about the due date. Conception and the 1st ultrasound put me at November 8th, which I had been telling everyone, but the 2nd ultrasound and my last period put me at November 2nd which was what was in my chart and my doctor had been going by. So at my last scheduled appointment we scheduled an induction for the 9th (which was 41 weeks) and she wanted me to have a couple of non-stress tests done before then because I was "high risk" and would be past due. My doctor was very optimistic that Josie would come on her own and we were just going to wait and let her.
Thursday morning I woke up around 5:30am with a contraction, it wasn't anything special just enough to wake me up. I got up and used the bathroom and went back to bed and had another contraction about a half an hour later and did the same thing and saw part of my mucus plug. I warned Andrew when he got up that today might be the day and that he should be prepared for a page to come get me to go to the hospital. Since I had never gone into labor before I had no idea what to expect but I figured he was safe to go to work and he was. I had mild contractions all morning and went to the hospital for my 9am non-stress test, which was uneventful. I took my new Robert Jordan book with me and just read during the whole thing. I mentioned to the nurses and my doctor (who was scheduled to be at the hospital all day and all night) that I had seen part of my plug so they checked my and found that I was 1.5cm dilated and 80% effaced and her head was in a -2 station, which meant as long as the ultrasound showed that the fluid levels around Josie were good I could go home. They were fine and I went home.
Peter and I had a nice quiet day at home watching movies and resting. My contractions were slowly getting stronger and more frequent but still nothing to make me rush to the hospital and when Andrew got home from work I told him this. So we went about our evening and the contractions slowly got stronger so Andrew suggested that we go for a short walk around our neighborhood which made the contractions increase in frequency and intensity and also made me need to use the bathroom.
I was concerned that we might have to go to the hospital in the middle of the night so we called up our friends and asked if we could bring Peter by all ready for bed to their house just in case so we wouldn't have to worry. We dropped Peter off around 7:30pm and stayed and chatted for a while. At that point my contractions were about 6 minutes apart but I could still walk and talk through them. We discussed going to the hospital and since my doctor didn't want me contracting too much at home (the whole high risk thing again), we decided that the worst that could happen is they could send us home. So off to the hospital we went. It was about 8:30pm when we got to the hospital so it was closed off to the public and the guy at the desk asks us who we're visiting I tell him, "I'm thinking about having a baby" and show him my belly. He smiled and let us pass. :) The contractions stayed pretty consistently at 6 minutes apart on the drive to the hospital.
We go up to labor and delivery and we're told that the triage is full and that it's about an hour wait until a bed would be ready for us. They had just gotten 2 ambulance patients and I heard a nurse comment that it must be the new moon causing so many women to be there that night. At least 4 of the laboring women already admitted were my doctor's patients. So we waited. My doctor walked by and stopped to talk to us. She told us that she was going to admit me but we still had to wait for a bed in triage. Thankfully that meant the minimum time was going to be spent there. Our wait was more like an hour and a half during which we considered going to Wendy's to get a frosty or something, we didn't but we talked about it. The chairs in the waiting room were actually quite comfortable so it wasn't too bad, plus I had my crocheting and my book so we were both able to keep occupied. During this time the contractions got to a point where I couldn't keep walking but I could still talk through them. The nurse that discharged me earlier that day was the one who admitted me that night, she was also the same nurse that did my previous non-stress test on Monday. So they hook me up and I'm in there for a relatively short time and they check me and I'm only at 2cm. So they move us to a Labor & Delivery room and we're prepared to hunker down for the night. My doctor anticipated me delivering around noon the next day. I estimate that we got to the room around 10:30, 11 o'clock, something like that. The contractions are now to a point where I stop talking and close my eyes and breathe through them and relax.
I just have to say that I'm SO thankful that my nurse, Mary Jo, got called in to work that night because she was absolutely the BEST ever! So she's going through her list of things that she has to do and is very considerate of me and the contractions.
Then the anesthesiologist comes in to consult with me about getting an epidural and I don't really feel it necessary so he goes away and we go on with contracting. Then I feel like I'm going to throw up, I don't yet but a little later I do. While I'm throwing up the main anesthesiologist guy comes in and tries to talk to me, I thought that was quite rude. I think he was trying to get me to get the epidural again. When I'm done I inform him that that's the first time this pregnancy that I've thrown up. Either way he leaves and I'm given something for the nausea and I'm started on the very bare minimum dose of Pitocin. The first anesthesiologist comes back in and we discuss the epidural again. I'm still on the fence leaning towards no but the point is brought up that we can put it in check that it's working and not do anything else with it just in case I have to be taken in for a c-section. That sounded good to me so that's what we did. After a little while we discover that the epidural has only taken effect on my right side, Mary Jo has me lay on my left side because gravity can typically help move things around and we want to try that before we call the anesthesiologist back. So I'm laying on my left side and we're finally left alone to labor when in rushes the doctor on duty and my nurse because he was concerned about a dip in Josie's heart beat.
I get checked and I'm at 5cm and the doctor breaks my water and puts an internal monitor in to check the true intensity of my contractions, I could have told him they were pretty intense and they got more intense after breaking my water and with the minuscule drip of Pitocin. I have no idea about how long this all took, there was a clock in my room but I wasn't paying any attention to it. So the doctor leaves and Mary Jo stays and talks to us about something. She mentioned that if I felt the need to poop that is ususally a sign that it's time to push. Not too long after that I have that feeling but she misunderstood me and thought that I said that I was going to be sick again and she rushed out of the room to get me another sick bag. When she got back I shook my head and pointed to my bum, she got the hint and checked me again and I was a 9. At which point she suggests we discuss pushing. I agree with her and we do a few practice pushes and then she makes the call to wake my doctor up so we can do some real pushing to get this baby out of me.
I expected just my doctor to show up but I get a total of 3 doctors, 2 nurses and a nurse technician all there to cheer me on and catch Josie. My doctor was there for obvious reasons, then there was the doctor on call and the 3rd doctor was a new doctor there for training or something like that. The 2nd nurse was there because she was new to the hospital and needed to learn processes and procedures, etc. So everyone was nervous and excited for me because of the whole VBAC thing. Anyway everyone is there and encouraging me and they tell me I'm at 10 and I can start pushing. I have Mary Jo holding my leg on the left and Andrew holding my leg on the right and I push and they count and we get 3 good pushes in with each contraction and near the end my doctor says, while I'm waiting for the next contraction, that Josie is so close I don't have to wait for a contraction to push and so I do. I don't know how many more pushes after that it takes, not many, and out she came. From the time I'm declared a 10 to the time Josie comes out is only 14 minutes. I can't imagine having to do that for longer and hopefully I never have to.
It was so awesome to hold her without assistance right away for as long as I wanted. Since she came out so fast she had a bit of fluid still in her lungs that they needed to suction out but when they finished I was able to nurse her. Her APGAR score was 8 and then 5 minutes later she was a 9. She was perfectly healthy and beautiful and still is.
I did need a bit of stitching up after that though. I was told that I had a 2nd degree tear that the on call doctor and newbie doctor took care of. Andrew says that she was an extremely slow stitcher; I agree that she was because I had to request a 2nd dose of lidocaine since I started to feel the poking midway through being stitched up. I had to request the 1st dose of lidocaine because the epidural was only working on my right side and it was starting to wear off.
Both my doctor and my nurse were really impressed with how I handled labor and delivery. I think it was because I was able to breathe through most of the contractions so well and I only yelled out a couple of times while pushing. They said that the shoulders are easier than the head, that may be true but they don't feel that much better, in fact I think the only reason they are considered better is they take a lot less time to come out.
Even though I carried her in my body for 9 months it's hard to believe, albeit I've done this before, she ever fit in my belly.
Random Facts:
- Josie was both early and late.
- My favorite part of pregnancy is the fact that my nails grow so much faster and my hair doesn't shed.
- I weighed the same on the day I had Peter and the day I had Josie but with Peter I only gained 15 lbs the whole pregnancy and with Josie I gained 40 lbs.
- I've lost 30 of those pounds already. Thank you nursing!
- I went to the chiropractor and got my back adjusted the day before I went into labor.
- Josie shares my brother Wyatt's birthday and Andrew's brother Jared's legal birthday (he was really born on the 6th but his driver's license says the 5th). A few days before I jokingly predicted that Josie was waiting to share her birthday with them.
- 21 hours of labor isn't as bad as it sounds. The worst was the transition contractions and Josie's head crowning and coming out.
- If you've ever had an abnormal pap-smear and you've had to have a colposcopy and you've undergone cryotherapy to freeze the abnormal cells off of your cervix then you have scar tissue on your cervix, like I have, then you're more likely to be slow to dilate at first and then when it's time to fully dilate it'll happen all at once. I was told this by 3 different nurses on Thursday and I wondered why my doctor with Peter never mentioned it or thought of it and perhaps that was the reason I wasn't dilating. C'est la vie.
- I had an excellent experience and wouldn't change a thing about how it all happened. That's not true, if I could control it I wouldn't have torn, but that's the only thing I would have changed.
