HBA4C: Homebirth After Four Cesareans!

by Birth Without Fear on August 21, 2011

*Having a home birth after multiple cesarean sections is not always safe. Please speak with your care providers for more information and support and to see if you are a good candidate for home birth, or vaginal birth in a hospital. VBAC’s are wonderful and can be done, but each woman, pregnancy and birth is different. ~Mrs. BWF

Here’s my story and a photo of our son. The BWF community was instrumental in getting me to feel confident in trusting my body to birth my baby. Thanks for all you do to empower women to make thoughtful choices regarding their births.

All the best,
Rachelle

A Successful HBA4C Birth Story

In order to fully appreciate C’s birth story, I feel like it’s important that I put it in context: I have never before had a vaginal birth. I had labored with my first two, and after hard labors that were made even more difficult with medical interventions, both ended in c-section. My next two babies were born via elective repeat cesarean.

When we learned that I was pregnant with C, I immediately knew that I was going to look into attempting a VBAC again. (Vaginal Birth After Cesarean). Having a 5th c-section carried risks that I was not comfortable with, and though I knew it would be a struggle to find someone willing to attend me, I knew I had to try.

We tried various doctors and birthing centers only to be repeatedly turned down. The risks were “too high” they said. We did a lot of research during those months: reading studies, analyzing data, making sure we were still making the safest choice possible for the baby and I. We tried finding the big “increased risks” that the medical community talked about and simply couldn’t find them.

And then we found midwives who were unable to find those risks either. They confirmed what my husband and I had learned: the risk of a VBAC after 4 c-sections were no more increased than the risks of a 5th repeat c-section. Our VBAC plan was a ‘go’ with only one small detail: we would be giving birth at home.

I have to say that I was really OK with that. After reading VBAC studies and studying my own medical records from the previous deliveries, I really felt that my only chance of having a successful VBAC was away from all the “interventions” of modern technology. No, I did not want to be induced: that would put increased stress on my scarred uterus. No, I did not want pain medication. It would make it impossible for me to alert my birthing team if anything felt “off”, etc. The only way I was going to do this, was if I was left to do it on my own.

And so we did.

Contractions started on Sunday night. Pretty mild in hindsight, but that night, they were strong enough to wake me from sleep every 30 minutes. When I woke up Monday morning, I told my husband, R, to go to work and that I would keep him posted. As I got myself and the kids ready in the morning, they increased to about every 10 minutes apart, but were easy to talk through so I continued to go to work and see what the day brought.

By 2:00 Monday afternoon, some of the contractions were getting pretty uncomfortable. I preffered not to talk through them and they were coming about every 7 minutes. Shortly after that, I told my co-workers I was going to go home and have a baby. I had R pick up the kids from the sitters and we all hung out at home hoping to have a new baby by morning. I put a lasagna together so we would have a meal ready to eat after the birth and the kids and R swam.

After supper we had my mom pick the kids up and R’s sister came over ready to help with the birth. At this point, the contractions were about 5 minutes apart, but weren’t increasing in intensity or pattern. At around 11:00 Monday night, we decided to all lay down and try and get some sleep. The contractions spaced back out to around every 30 minutes throughout the night.

By Tuesday morning, I was so tired from the two previous sleepless nights and was feeling really discouraged. My contractions picked back up to about every 10 minutes and were getting increasingly difficult for me to deal with, but I wasn’t sure if that was because they were indeed getting stronger, or I was just getting less able to handle them because I was so tired. One of the midwives came over around 9:30 to listen to baby’s heartbeat and provide some much needed encouragement. She said that this could last for even a few days and that it was perfectly normal, my body was doing what it needed to do, and that I should take care of myself: rest, eat healthy food and stay hydrated. And so we continued to wait.

Throughout the day, the contractions remained about 5-7 minutes apart. Ingrid went home and we assured her we’d call if anything happened. By 9:45 Tuesday night, I woke R up and told him I needed help getting through the contractions. I thought that things must be picking up and started to feel like I REALLY WAS going to have a baby someday! R started timing the contractions and they were coming every 3 minutes. I was also becoming increasingly uncomfortable during them. We decided to time them for a while to make sure it was the real deal and then we would update the midwives.

At 11:00 there was a change of plans: my water broke all over the living room floor. R actually heard it ‘pop’ from the other side of the room. I immediately felt a welcome relief of pressure. But that nice feeling only last a few minutes because after my water broke, the contractions immediately picked up in intensity and frequency. We called R’s sister and the midwives and by midnight, the whole team was assembled for the job ahead.

As everyone was arriving, I was on the floor on my hands and knees trying to work through the contractions, but my legs were starting to shake and I felt like I needed to get off of them for a while. The midwives helped me lay down in bed on my side and we labored like that while the birth pool was getting filled up. I couldn’t wait to crawl into that pool!! My body was starting to get that pushy feeling and I had even asked for the bucket to throw up in so I was feeling happy, assuming I must be getting close. I got in the pool and my body continued to push and I remember thinking, “Well, the midwives got here just in time! This is happening so fast!”

After I was in the pool for a while, my midwife asked to check and see how dilated I was. I crawled out of the pool and was devastated to learn I was only about 6-7cm! My mood immediately changed. This was exactly what happened with my first two labors: I got the urge to push “too early” and the reminder of my first two “failed” vaginal deliveries just completely devastated me. I started to try and beg R and the midwives to just let me go to the hospital and have a c-section since I was convinced my body was betraying me. But as hard as I tried to tell them that I couldn’t to do this anymore, the more they told me that I WAS doing it — one contraction at a time. And a half hour later, when the midwife checked me again, I was at 9cm.

I was still having the urge to push, but the midwife said that it obviously wasn’t swelling my cervix at all and I was progressing well, so to continue to work with my body rather than fight it. She just kept telling me to give each contraction only the amount of energy it required and nothing more. Wise words!

The next time she checked me, she noticed that I had a stubborn lip on one side of my cervix that wouldn’t thin out. She recommended that I lay on that side of my body and she gave me the option to let it work itself out or she could help push back the lip during contractions. Her pushing back the lip would be “pretty intense” as she said, but it may make baby come faster. I decided I wanted my baby here faster and so she worked on the cervical lip while I clung to R’s hands.

And then it was time to push. The midwives could feel that C was coming down a bit crooked. They recommended that I get in some different positions to help move him down. Moving around during that part of labor was not exactly fun, but it worked. I could literally feel his little body moving and adjusting with each change that I made. I was so proud of my tiny little son doing his part to help with his own birth. So amazing.

Once it got to the point where I could reach up and feel his little head, it was game on. I was so ready to meet this little person and ready to do whatever it took to get to the finish line. We were about half way into the 1 hour it took to push him out when I made a stunning realization: If I got his head pushed out to his ears, I was going to have to sit there like that with him halfway out until the next contraction. I said this to the midwives and they got a good laugh over the fact that I was just now realizing that. So, yes, indeed I got him out about halfway and then had to wait for the next contraction to push the rest of his head out. That was probably the longest minute of my life, but after that, he was out and on my chest and life was perfect.

HBA4C

He came out so calmly and peacefully alert. The midwives joked saying “Does he even know he was born?” He pinked up really quickly and immediately started nursing like a champ. He had a little bit of extra fluid in his lungs that the midwives helped him take care of, but his Apgar scores were both 8s and they declared him A-OK.

I still am not sure that I have fully processed the culmination of a 7 year journey. I am so happy that we finally got to give birth on our terms, just me and my baby doing our thing together that God designed us so perfectly to do. I wasn’t a hero — I didn’t handle it with quiet grace and poise like I had hoped I would. Ha ha ha! I moaned and grunted and even cried my way through it all. But I wouldn’t take it back or change it for the world. Birth is truly transforming… and I can finally say I got to experience that beautiful transformation. I am so very blessed!

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