A Supported TOLA2C Cesarean Birth Story

by Krystal Cleaver on March 5, 2013

A little background about why I started to seek out a way to birth the way I knew my body was able to.

First we start with my first born, Bridgit, who is currently 4 and half.  She’s a spit fire just like her mom, who knows what she wants and will do what it takes to get it.  I did spontaneously go into labor with her.  My water had broken in the middle of the night.  We of course went straight to the hospital.  There they immediately put me on Pitocin.  After 6 hours of Pitocin I was asking for an epidural.  6 hours after the epidural I still had not progressed passed a 2.  My OB at the time stated, “You can have a C-section now, or you can wait to see what happens in another 12 hours and have a C-section.”  Not knowing what I know now, I opted to have the C-section.  I mean shoot, if it was going to happen anyways might as well beat it to the punch right?  She was brought into the world via C-section on Dec 22, 2007 @ 3:58pm CST.  Recovery wasn’t so bad either.

Next is my second sweet and adorable boy, Brenden.  Currently 20 months.  I continued care with the same OB I saw with Bridgit.  At 38 weeks, he was still high up, cervix thick, and my OB opted that it could be a fit issue, and recommended a repeat C-section as he wasn’t going to let me go past 40 weeks.  Again, not knowing what I know now I agreed and figured my body was broken and just didn’t know what to do.  Brenden was born via repeat C-section Nov 18, 2010 @ 1:09pm CST.  The recovery was much different, and the feeling of him being taken from my body is one I remember and never wanted to experience again.

At the end of Oct 2010 I got the surprise of a lifetime… I’m pregnant again!  And in Colorado (we just moved from Texas to CO) I started to seek out information on VBAC’s and my chances of being able to achieve this.  At first I stuck with OB care, and of course that OB was very against me wanting to VBAC.  She put the fear in my husband at our 20 wk appointment.  But it still didn’t seem right.  I just knew if my body could get pregnant that I could birth this baby to, or even let myself have the chance at labor! I attended an ICAN meeting with my husband and upon listening to the information given there; we were armed with the knowledge that I can do this!

I first got a doula, Lisa, whom we clicked with right away and were very excited to get her onboard.  She was so supportive and it felt great to have someone on my team that knew I could do this.   I was also on the move to find a new care provider.  Upon recommendation from ICAN leader, I sought out care at with a midwife group at the local hopsital.  They too were on board with my plans to TOLAC (trial of labor after caesarean) and to VBAC.  Now it was time to get myself mentally prepared and ready to tackle the biggest challenge I’ve faced head on.

My guess date came and went.  I was okay with this.  I knew my best chances to achieve this was to let him come on his own.  The hospital and midwifery group had a policy to induce by 41 weeks 5 days.  I was able to get that pushed back until 42 weeks.

July 15th was the set date.  I called up at 6am and they said they had room for me!  So we packed up and headed on down to the hospital.   We arrived right on time, only to our surprise that about 7 other momma’s decided it was time to go into labor, and took up all the available rooms.  Already being downtown, we decided to stay and wait.  Finally around 12pm we were told I had a room.  We get up to the room, and continued to wait some more until a nurse came in to get me all settled.  It wasn’t until much later that the IV was placed and a little later that the Pitocin was started.  This is when I like to think that my labor started.  So at 3:50pm my Pitocin was started at a very low dose, and my doula was on her way.  I had already sent my husband home because our two children were done being at the hospital.

When my doula arrived, contractions weren’t much so we decided to get up and walk around to try and help things along.  We did several laps around the labor and delivery floor.  I made sure to include squats, and lunges.  The staff thought it great to see me working at getting labor in a groove.  They slowly increased the dose of Pitocin, and slowly contractions got closer and more regular.  At one point my midwife came in to recommend some sleep options.  As I didn’t want to be groggy, I opted to just rest on my own.  Which I did get some sleep, although it was not enough for what I had ahead of me.

Mel's TOLA2C

The morning of the 16th, I was checked to find that I had made some progress and we could now talk about doing the Foley Bulb.  I knew that I would need some more help in the dilating process as I did have some small amount of cervical scar tissue for a leep several years ago.  Mind you at this time I still had not opted for any pain medication, and was starting to be very vocal (low moans) with my contractions.  I was very internal, I kept to myself and thoughts in my head were just one step closer.  They inserted the Foley catheter and boy oh boy you want to talk about one of the most intense things ever!  It was painful, and had me so wanting to scream our code word for pain help.  (Our code word was Yo Gabba Gabba, my son’s favorite TV show.)   My doula sat on the bed with me and talked me through each contraction and each moment that I just wanted that damn thing out!  After about an hour they came to check, giving the catheter a little tug to see if it would budge.  It wouldn’t budge.  So I had to sit with it for another hour.  It didn’t want to end!  It seemed like forever with that thing in me!

Mel pushing during a TOLA2C

The nurse came to check after another hour passed.  She gave it a little tug, and it was loose!!  Thank the powers that be!  As she pulled it out… I swear that thing was the size of a peach and felt so great to be out of my body.  Upon a cervical check I was confirmed and a 3-4.  I got in the tub again, and we did more walking.  I tried to rest more.  I also sat on the birthing stool since that was one of my favorite places.  At this point I lost more of my mucous plug and started to have a bloody show.   I  called up my husband and he was there.  It was such a relief to have my husband.  It was such a pillar of support that I needed but had no idea how important it was to have him there.  When he walked with me, we danced through contractions, and I even cried on his shoulder.  He just held me and it felt great to be in his arms!  From that point on I knew I didn’t want him to leave my side.

Husband helping

Things continued to get stronger as the Pitocin was slowly increased more and more.  Eventually things got really intense through the night and I felt like I couldn’t do it anymore!  I needed some pain relief as the contractions and lack of sleep were bringing on the tears. I actually screamed our code word!  Instead we opted for the Fentanyl.  It was wonderful relief! Although around this time was when they put in an internal scalp/contraction monitor to make sure all was going ok.  I was able to move around a bit more and feel much better about things.  But my labor had started to stall.  At this point I had been on Pitocin for about 32 hours. Upon discussing with the nurses and midwifes it was time to turn off the Pitocin, get some rest, and see if my body would keep up the labor, or we would have to turn it on. I was at a 5-6, very vocal through each contraction or even cry, and the tub didn’t help manage things.  No matter of talking/coaching seemed to help get me through.  Not to mention I had managed to throw up whatever food I had left in my belly.  Throwing up is a big deal to me and was a point I didn’t like very much.  TRANSITION.

I also spiked with a fever, which also with transition meant no more eating.  When that time was up I was almost scared to start the Pitocin back up.  I knew it meant more labor and more pain was on its way.  I was so done at that point.  The discussion for a C-section started at that time.  It was about 2 or 3 in the morning. If it weren’t for Lisa, my husband, and a wonderful team of nurses and midwives, I would’ve been on the path to another C-section.  But they convinced me to continue to labor on.  The new plan was to get an epidural, rest, and to start back up the pit at a normal pace.  I was able to get some rest.

On July 17th, about 40 hours into labor, getting the epidural was painful.  I managed to jerk upon insertion causing the poor doc to lose the spot.  She had to try another 2 times to get it to go in and work.  Even when it did it worked more on my right side, and had to rest on my left side to help move the medicine.  This helped but only so much.  I was able to rest. I recall thinking to myself I feel like I need to push.  I could feel my body curling around my body.  I was checked and sure enough I was 9cm and baby’s head was half way out of my cervix.  We were so excited!  Who knew I’d get this far!  I was ready to take it on! By this time I had one of my favorite midwife’s on board, Beth.  I was so ready to get the pushing party started and get the VBAC I always wanted.  I can remember being so thrilled and telling myself my body was not broken!

complete!!

I did some practice pushing, and as I did this each contraction intensified!  I was working hard.  I could feel him moving down.  I was getting excited.  Beth was also trying to help by pushing up on my pubic bone to help get Blaine’s head down.  He had gone from LOA to LOT and his head was kind of in a funky position.  We tried different positions to aid in pushing, as well as fingers constantly on that bone to help move that pubic bone out of the way.  At one point I was grabbing on my leg so hard that I left bruises.  By hour 2 of pushing Beth said “we can either keep going for another hour upon which we’ll have to confer with the OB’s to see what they’d like to do”.  The contractions were intense I could feel every one.  I was slowly losing steam.  I wanted to keep going.  Things started to slow again. I was getting exhausted.  Not to mention I had gotten sick again, and with nothing in my stomach I had lost all the water I was drinking.  I even got so sick that bile had come up too.  I was also getting so hot that no matter how they applied a cold cloth or sprayed cold water on me I couldn’t keep cool.  I was still pushing but losing steam and fast!  Hour 3 dawned upon us and it was time for Beth to go confer with the OB’s.

An OB came in, and with my next push continued on with what Beth was doing to my pubic bone.  Only this time it was excruciating.  I couldn’t bare it.  I screamed at her to get her hands out of me, even mixed in a few obscenities as well.  I almost kicked her and had I been able to move my legs better, I may have.  Finally after the contraction calmed, the suggestion was to bring in another OB who could help move the baby’s head and from there use forceps or vacuum to aid in getting him out.  I looked at my husband & Lisa and we both had that look of “NO WAY!!!”  At this time everyone left the room and I spoke with my husband.  I cried and cried because I was out of gas.  Something in my body was telling me that the pushing was done.  This baby needed to come out and he wasn’t coming via subway tunnel (my vagina).  As much as I wanted my VBAC I wanted my baby out just as badly.  My body just knew it was done and there was an unknown reason for it too.  So it was agreed to do C-section.  I was also later told that the OB was actually moving the baby’s head and in doing so also discovered an anomaly of a point in my pubic bone area, the reason why baby wouldn’t move down, and that even if we got baby’s head moved and down, the body may not have been deliverable.  Basically a heart shaped pelvis with some anomaly at the bottom.

At almost exactly 48 hours of the start of my Pitocin it was agreed that we would do C-section.  By this time I was laying on the bed naked as I had soaked myself in my own vomit.  I was hot, and in tears.  Part of me felt like I failed.  Lisa then reminded me of how far I’ve come, that I was able to get to complete and to push.  I wasn’t giving up I was doing what my body needed.  There was so much going on at this point.  Everyone moved fast, while I laid there and cried as another contraction would come and I didn’t want to push any more, which was terribly painful and I think I even gave in to push at some point.  I eventually got more pain medicine, and was able to rest.  I heard mention of Chorio (infection of the uterus), but it didn’t really dawn on me.  I just knew baby had to get out and hopefully it wasn’t that bad.  In the OR I was better explained what Chorio was, but was shaking uncontrollably.  I couldn’t relax. I was tense and continued to shake.  Eventually my husband and midwife came in.  My husband rubbed my neck as they started the surgery.  They did have an issue with scar tissue which took some time.  But I was concentrating on not shaking, breathing, and staying calm.  I was still really hot, and shaky, from the adrenaline.  The OB’s made mention of puss around the baby and in my bag of waters.  I didn’t hear this, but reminded of it later.

CBA2C attempted VBA2C

CBA2C

I soon heard the screams of my son!  I cried and cried.  I did it!  I didn’t care how it happened, I did it!  My midwife looked at me too and said you did it Melena.  All that hard work and you have your baby boy!  My husband was off to take pictures and cut the cord.  I cried and cried!  It wasn’t a failure after all.  My son was safely brought into the world and would soon be in my arms.  He was soon brought to me where I just couldn’t take eyes off of him.  I stroked him with my free hand and told him how much I loved him.  My husband was so happy, and looked at me with such love.  All that hard work he said, and we now have our little boy.

CBA2C

Blaine Carter Cox was born 4:35pm, almost 49 hours from the start of Pitocin.  In recovery he immediately latched.  It wasn’t until the next day that I was properly informed of the puss and that he would have to endure 7 days of antibiotics.  He was a pro at nursing from the start and did wonderfully.  It was a wonder if he was ever really sick from the infection of my uterus, but we stayed on the side of caution.  While in the hospital my blood pressure was high but I think I was just stressed of seeing my wonderful baby boy getting poked to get an IV, and having to endure that.  Not to mention it took me some time to come to terms with the infection of my uterus.

I realized that I had done everything I could do to have him vaginally.  It wasn’t in my cards.  I did everything I could.  I was strong.  I did the best I could ever do by waiting for him to come on his own and to labor as long as possible.  He came just the way he was meant too.  I showed strength I never thought I had.  My husband still calls me his momma bear.

We finally came home on July 25th.

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