A VBA3C: Fused Sacrum, Needed Interventions and Pure Determination

by Birth Without Fear on January 3, 2012

I know Abbey in real life, you know, away from Facebook and blogging. I had the pleasure of meeting her at a Tarrant County Birth Network Meeting. She is funny and says it how she sees it. I also know her Doctor. He is one of those rare gems that support women and their choices. When you have an intervention in birth that you may not have wanted, you know that it is because it was/is needed. I highly recommend pregnant women to him all the time. I love Abbey’s sense of humor and raw honesty as she shares her journey of womanhood, motherhood and birth. ~Mrs. BWF

The birth of Ava Sophia…A VBA3C

You know that definition of insanity? Doing the same thing over and over and expecting different results. Yep, that one. I’ve gone over that saying so many times in my head. Am I crazy? Why do I even want this so badly? Am I willing to go through hours and hours, maybe days, of labor to possibly end up with another c-section? I could, and according to about 99% of Obstetricians, should have scheduled a c-section anyway.

I don’t know if I’m crazy so much as really, really stubborn. I wanted this “natural birth” in 1996, 14 years ago. That plan was foiled when my teeny baby girl stopped moving in utero and had to be cut out of me. It felt more like a tumor removal than a birth. I was terrified there was something wrong with my baby, but the doctor reassured me that I would be able to wear a bikini after the surgery because the incision would be low. Sweet relief. My troubles were over! (Try to keep up, that’s sarcasm!) Yep, that was my welcome to motherhood. Sitting alone in that postpartum room pumping milk like crazy, listening to other babies crying in the rooms next to me, while I had to wheel myself down the hall to visit my little girl.

In 1999, I almost got my “natural birth”, but after contracting for 5 days and reaching 9 cm, my cervix swelled and I was absolutely at my limit. I consented to c-section, firing my doctor in the process. (He acted like a jerk the whole time I was in labor…all 12 hours it took for me to get from 6 to 9 cm. Anyone else would have done the same thing in my situation. The new doc who came to actually do the surgery told me that my pelvis was shaped like a “funnel” and I would never birth vaginally. So I guess my diagnosis was ‘failure to progress’ due to ‘cephalopelvic disproportion or CPD’.

I never paid any attention to that. Doctors do and always will misdiagnose, some more than others. They are human and humans make mistakes. Doctors are no exception. I wish I had a dollar for every time a woman has had a c-section for a “big” baby and then VBACed an even bigger baby.

I didn’t make great choices for my next birth in 2005. I was very distrustful of OBs and hospitals. I decided that I would attempt a homebirth (a HBA2C). I was due Christmas day and hired a couple of midwives that I really didn’t feel 100% comfortable with. I just didn’t know of anyone else who was going to attend a VBA2C. It ended unfavorably. I started contracting on the 19th and kept going and going and going. Just like the last time.

On the 22nd I had reached my limit and was so exhausted, emotional, and devastated. Upon realizing I wasn’t going to get the support I needed from my midwives, I reluctantly headed to the hospital, hoping for some intervention to help me birth. Unfortunately, the on-call OB gave me no choice and told me I had to have a CBA2C. So, I did what I knew I had to do and asked for an AMA (against medical advice) form and went back home. I continued laboring through the night and the next day around noon, surrendered, decided I was done, and went back to the hospital to meet my precious little girl.

In 2009, I find out that I’ve had a fused sacrum my whole life. In other words, my sacrum won’t move. My pelvis is still normal in the front, but birthing for me is a whole other ball game. Labor will probably be longer and more painful. That had already proven to be true.

I felt a little robbed. Whatever. The only thing that information changed was that it gave me validation for what I’d been through. No wonder my labors were so long. No wonder I haven’t been able to get a baby through! I’m not having any more babies anyway.

I’m pregnant. (Bet you didn’t see that coming!)

I’m pregnant and I cannot, no way, no how, can I just schedule a c-section. It’s not in me. No matter how I look at it, no matter how much easier it would be, I just can’t bring myself to be OK with it. I can’t even say it out loud. Just thinking it makes me throw up in my mouth a little.

OK. I probably am a little crazy…or a lot, when it comes to birth.

I’m at a crossroads. I want a homebirth so badly I can taste i.t but knowing what I know, I feel like I’m going to need an intervention beyond the capabilities of a midwife. I met a wonderful OB at an ICAN meeting some months before becoming pregnant. He was warm and kind and very human (not doctor-ish at all) and he said to me, “You’ll have another baby”. At that time, even though I wasn’t planning to, I knew if I ever did, I would go and see him.

I’ve slept through the whole pregnancy. At 29 weeks I had an ultrasound that showed a smallish, golf-ball sized fibroid right in the front of my uterus. I’ve got so much built-up anxiety about this birth.

My “due date” is June 12, and while I’m not afraid to start labor, I’m afraid it will never end. I’ll be in labor forever. I really kind of believe that this baby will not make it out of my vagina. I did start having contractions on the 11th, but ignored them as long as I could.

On the 12th, I went and ate crab legs (contracting about every 3 minutes…probably 60 seconds long), went to the park with the kids, bending over a picnic table every few minutes. They continued to beat me down, well into the night. I’m handling things, but start thinking about the length of time it has taken me to get from point A to point B in my previous labors…oh wait, I never made it to point B, at least not on my own.

Now I’m beginning to feel foolish. Its 2-3am and I can’t sleep. I’d rather someone poke me in the eye with a hot needle than lay down or recline. I’m really beginning to doubt myself. I had to have a good cry…whine to my husband a little. He hugged me and loved me as only he can and I decided to suck it up, wipe my tears and get myself together. No matter how I looked at it, my baby would be here in the next couple of days.

I did some belly lifts and made and intricate arrangement of pillows on my bed so that I could take an Ambien and sleep in as close to the hands-and-knees position as I could get. I used a long thin heated rice sock under my belly and a large square one on my low back. I guess I slept some, because I had really weird dreams…maybe more like hallucinations. I was in Alice in Wonderland. There were bombs planted all around me and when they went off, I had really strong contractions. I got up quickly and practically ran out of my room to get away from the “bombs”.

It was morning and I must have totally relaxed allowing my baby to move into the optimal position, because the contractions were coming hard and fast. I was able to check my cervix and realized that I was dilating and my mucus plug was dislodging. A couple of hours later, I was already at about 3 cm. I was excited, but not too excited because I couldn’t really allow myself to focus on much more than the contractions.

I wanted to go ahead and head towards the hospital, yes, at only 3 cm. It was a 45 minute drive (the doctor made it worth it!) and I didn’t want to be in the car during transition…even though I was still technically in “early labor”. I went by my chiropractor’s house to get a quick adjustment. I know that she thinks I’m crazy for going so early in labor. I had to sit on my nursing pillow, because it was so uncomfortable for me to just sit on the seat.

I waddled up to the nurses station at the hospital, get checked into a room and the nurse tells me that MY doctor is not on call.

Um. The other doctor will give me a c-section. I’ll just wait for him to call me back.

He’s not answering his phone. He was at the hospital 36 hours yesterday with another VBAC.

We will leave if he doesn’t call back. But I know he will call back so I’ll just wait.

The nurse is “OK” with me waiting because after checking my cervix (which seems to be in my throat) she assessed that I am still in “early labor” and at 3 cm. She asked me if I had a birth plan. I said, “My birth plan is to VBAC, that is all.”

She set me up with a heparin lock and put me on the monitors for a 20 minute strip. When she left the room, I ate a protein bar. My doula and birth photographer arrived and I went and walked/squatted in the hallway.

The nurse called me back in the room, my doctor was on the phone. He asked if I wanted to leave the hospital and go labor elsewhere. Ummm, no. I really don’t want to go. I really want to stay. I really don’t think I can handle leaving and coming back. These contractions are really strong and long and on top of one another. He said, “OK” and he’d be up later.

My doula raised the bed into what looked like a throne to me. I started quoting Alice in Wonderland…being the Red Queen. “I need a pig here!” “I like a warm pig belly for my aching feet.” She pushed my knees toward my sacrum during contractions. It felt wonderful!

My contractions started spacing out a bit, and were perfectly manageable. This was the nicest labor ever! I got up a few times to go to the bathroom having a couple of contractions en route and on the toilet. My doula became concerned that I was losing steam and labor was slowing down. She suggested I leave the hospital to labor or take a nap. I was NOT leaving. Not now.

She and my photographer went to get something to eat and my hubby took over the knee presses. I ate a honey stick and kept cracking jokes. This was so easy! I took a trip to the toilet and decided to check my cervix. WHOA! This was different! It was actually opening…a lot! Soft, slimy, at least 5-6 cm and my bag of waters were bulging out. I hurried back to my throne. The nurse came in and checked me and SAID I WAS AT 7cm and gone from -3 station to -1 station!!! I’d been at the hospital for about 3 hours! This was probably the happiest moment I’ve had in a very long time. I was ELATED! I started to tear up and told the nurse, “You have no idea what this means to me!”

About an hour later, my wonderful doctor walks in and says, “You were 7 an hour ago, I thought you might be complete by now.” I’m thinking, ‘How do you know I’m not?’.

At that moment, a contraction came on fast and furious. It only seemed to last a second and then fizzled out really quickly. It felt very different and made me nauseous. I said “Ew, that was weird. That one just made me want to puke.” I was ready to start pushing and my doctor knew it. He said, “Keep it up” and left the room.

I started to feel kind of drunk. Everything was getting hazy. Contractions just shifted gears and made me feel HOT, sweaty, and sick to my stomach. I made lots of references to Alice in Wonderland and continued making jokes even though I was feeling so weird.

I got in all kinds of positions to push. I followed the directions of my doula, but wasn’t really loving pushing. I was on my hands and knees and a contraction started that really hurt. I guess it was the pressure, because all of a sudden my water exploded all over the bed. I laughed because this is probably one of the coolest things that has ever happened to me. It was a huge victory to have my water break all on its own. It felt awesome to have all of it gushing out. Now I could focus my energy into making the water move from my body and know I was pushing in the right place.

Also, just to clarify, these contractions hurt, they sucked, and I only pushed because it felt better than not pushing, but I did NOT like it.

My doula instructed me to get into the ‘dangle’ position. The bed is up as a chair and my husband sat in the chair. I get to wrap my arms around his legs and hang limp, letting my lower body completely relax during contractions. YUCK! This felt AWFUL, so it must be getting the baby down, right? I got suckered into doing that for 5 contractions. There were more Alice in Wonderland references for this one since it looked like I was doing the ‘futterwacken dance’. I told my doula “This is the best birth you’ve ever been to!” Then I though about that for a second and added, “Today, anyway.” I guess the pain made me goofy.

The baby had been having some heart decelerations and my doctor wanted to see where her head was. I was up on the squat bar when he checked me. It HURT! He informed me that my cervix was high and around the baby’s face. She wouldn’t be born if I wasn’t able to move it down around her head. Great. I had to lean over the squat bar, facing the bed, do a pelvic tilt and push to save my life during the next set of contractions. It felt like I was doing this forever, because it hurt so bad that the endorphins must have really kicked in. I felt like I was floating.

I flipped around to face the other way on the bar and kept pushing. All of a sudden there was a mention of oxygen and people started moving fast. I heard “lay on your left side!” “Wait!” (I’m in the middle of a contraction. I can’t move.) I was quickly thrown onto my side anyway and my leg lifted up. Baby’s heart rate came back up, but that really sucked!

At this point, I’m in and out of half-asleep mode. Things are really hurting, I’m working so hard and everyone starts saying, “It’s time to really start working now.” WHAT? I’m working harder than I ever have in my life!! I’ve got my eyes shut and even though my doula told me to open them, I kept them shut. I couldn’t focus on pushing with my eyes open. Everyone starts saying “PUSH!” “I AM pushing!” I honestly don’t know how this could get harder.

It did. A lot. The nurse starts reciting my baby’s heart rate with each contraction. That can’t be good. My doula got a towel for me to pull on while I push…to help the head move under my pubic bone. That took so much concentration, and strength. And it didn’t even work.

My doctor says “Abbey, I might have to use forceps to help the baby come down.” I said, “OK, do what you have to do.”

I really didn’t care, I wanted to be DONE. I asked him if he’d have to cut an episiotomy and he reassured me that he hardly ever does them and just because he was using forceps, didn’t mean he would.

Of course, it wasn’t going to be over until it got even harder. I was instructed to NOT push for 3 contractions. Yes, in other words, eternity. (This was to give the baby oxygen before her descent through and out the birth canal.) After all I’d done to make it to this point; I honestly didn’t know if I could just DO NOTHING for a few minutes.

I started to hyperventilate and was told to slow my breathing…oh yeah…I forgot that I was breathing. OK,that’s done. What’s next?

Somebody says (again), “It’s time to really start working now.” Who said that? If I wasn’t completely incapacitated I would be in a very lively argument with that person right now. But I can’t think straight, can’t see straight, not even sure I’m still in my body.

My doctor put in a quick catheter to drain my bladder before a contraction starts and he positions the forceps. Push through the pain has a whole new meaning to me. I cannot begin to describe the power and force, the inhuman strength it took to do what I was doing. I needed everyone yelling “PUSH!” to keep me going. That contraction ended and the forceps were removed. The baby’s head is under my pubic bone and I feel tons of pressure.

The baby’s head is down and I have another contraction. One of the nurses started counting and I yelled at her, “No counting!”

She says, “Then you have to push.

”I say, “I am!”

Everyone is yelling at me. “Push through the pain!” “Push her out!” “Grab your legs!” “NO!” “Wait!” “NO!”

I think my doula grabbed my hands and put them under my knees even though I needed just a second to catch my breath, there was no time. My doula asked my doctor if I could touch the baby’s head and he replied, “No, I need her to push”. It was OK, I didn’t want to anyway. I really didn’t care. I just wanted it to end.

The nurse is reciting the heart rate, in the 50’s and dropping. My doctor tells my doula, “I’m sorry, I have to do this.” she tells me, “Abbey he’s going to cut an episiotomy.” I say, “OK. That’s fine.” I have never been so ready for anything to be over in my life.

5:13 pm. Suddenly, it was done. It was probably the quietest moment of my life. There was so much energy, so much force and then right at the moment of birth, it seemed so still, so quiet. It was time for me to rest.

I hear my doctor tell the nurses, “Nuchal cord x2 and tight body cord.”

A few minutes pass, I felt like I’d just been hit by a truck. My eyes are still closed and my doctor is working on my vagina. Whatever he is doing is awful. He says, “Here comes your placenta.” I was pretty much ignoring him, at least trying to. He gets my attention, I look up at him and he says, “Abbey, I’m holding onto your fibroid.” Oh, that’s nice. The placenta tore to pieces and his entire arm is inside me. My fibroid is the size of a SOFTBALL!!! The placenta had attached directly to it! NO WONDER I had a hard time pushing her out!!! (As soon as he was able, he drew a picture of what my uterus looked like with the fibroid and where the placenta was. Unbelievable).

I am in disbelief and a bit of shock. I laid there not able to sit up because I would have passed out. I couldn’t believe how light headed I was. I think I had lost quite a bit of blood (because of the fibroid), but my doctor still didn’t require I take the routine pitocin after delivery since I had preferred not to.

Wow, that was hard and painful and certainly not intervention free. But the interventions used, I was grateful for. I still did it without pain medication! I got my “natural birth”!!! It was not at all what it was ‘supposed’ to be like. But I did it. I FINALLY did it!

I have had a combined 250+ hours of contractions adding together my 3 attempts at VBAC. This was a long time coming. I could not be happier. Nothing is going to steal my joy. (Not even the hematoma I developed a week later and 3 weeks postpartum had to have surgically removed. My anesthesia was a spinal. The same kind used for c-sections.)

I decided I’d better call my sister and tell her I’d had the baby. She didn’t answer, but I left her a voicemail. It went something like this:

“I just had a baby. Out of my VAGINA!!!!” I think I made a few more phone calls making that announcement. I took great joy in saying those words!

OK, so that wasn’t the ideal birth, and would probably be way more traumatic for lots of women than a c-section, but it was MY birth and like an ugly child with a face only a mother could love, I am so happy it was what it was. I just had to do it…and according to my “birth plan”, I got everything I wanted. I couldn’t be more thankful.

So maybe my new mantra will be, “If at first you don’t succeed, try, try again”. That’s much better than the definition of “insanity.”

To view a beautiful slideshow of this birth, visit here.

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