VBAC Plan Turns into a Healing Repeat C-Section

I had a very traumatic cesarean section birth with my first son. He was induced at 39 weeks because of my rising blood pressure and labor progressed uneventfully. I had an epidural and got to the pushing stage, but he got stuck in my pelvis after pushing for 3 hours. I was terrified of the surgery but the doctors assured me I wouldn’t feel a thing. They were wrong. After my son was out and my uterus was being repaired and closed, the epidural began to fail and I could feel everything that was being done. I felt such intense pain and began to curl up on the operating table with my hands and legs tied down, screaming that it hurt and for them to stop. It took what seemed like forever for the OB to realize I really was feeling everything before she stopped and they ordered more drugs. They drugged me heavily, and though the pain was gone I too doped to stay awake very long to enjoy meeting my newborn son Gabriel. We were unable to breastfeed that night and I had troubles feeding him for the next several weeks, so eventually I had to switch to formula.

At 4 months post partum I was diagnosed with Post Partum Depression and PTSD after my traumatic experience. I re-lived the birth every night and couldn’t stop obsessing over what happened. It took two years for me to come to terms with it and how abandoned I felt by the doctors. It was a rough road, and when I got pregnant again two years later I was so very scared of having the same experience all over again. I began having flashbacks when seeing C-sections on TV and movies.

But I was determined to make this second experience a positive one, despite my fears. I worked with a midwife group to plan a VBAC, and even though my second baby was measuring large at 37 weeks they still were willing to give me time to go into labor on my own. My goal was a medication-free birth, so I read up on Hypnobabies and crafted a detailed birthing plan that would help me in case of any eventuality. I also hired a doula-in-training to assist me in making the decisions I wanted in the thick of things. I was open to the possibility of drugs, but after doing extensive research I was sure that in case I needed a repeat C-section, I wanted to get spinal anesthesia and not another epidural.

I woke up at 7:30am two days before my dute date on October 29^th, the day Hurricane Sandy came to town, expecting a quiet hurricane-day off of work. My husband Mike was already up with Gabe and they were watching TV. I got up to use the bathroom and tried to climb back into bed, but the second I put my leg up I felt the POP of my water breaking. I ran back to the bathroom and yelled to Mike that it was time! He immediately got into gear and started running around getting all of Gabe’s stuff ready to go to daycare and then my parents’ house. We finally got ready, and I sat on my trash bag and towel in the car while we drove Gabe to daycare. I began having mild contractions just as we dropped him off. We got to the hospital around 8:30am and got triaged in. The nurse checked my pad to make sure it was actually amniotic fluid and there was already meconium in it, so they began admitting me.

Contractions had picked up by that point, but they were still pretty mild. My doula Rene arrived while we were being admitted and we got everything straightened away and went off to a delivery room. I felt so confident and ecstatic that I had gone into labor on my own and it seemed like everything was falling into place for this VBAC to happen. My birthing room was gigantic, and included a shower, a rocking chair, a birth ball, and a peanut-shaped ball. I immediately changed into a hospital gown because my clothes were very wet, which was nice.

I met my midwife Julie who I had seen a few times before at the midwifery and we talked casually a bit about the weather and how busy it was getting already at the ward. Everyone’s water was breaking because of the storm front coming in! At this point contractions picked up a bit, but I worked through them with deep breathing and some moaning. I labored pretty well in various positions, mostly sitting on the birth ball leaning over the bed. Occasionally I would get up and try to walk but sitting with my butt out was my favorite way to be.

At 12:30pm I was checked and was 4cm and fully effaced. We were all hoping it would continue to progress quickly. Over the next few hours the contractions seriously intensified. The pain began to be less of a pressure wave and more of a sharp, crushing pain that felt like my entire abdomen was being torn into. The nurse tucked hot packs into my underwear to help with the pain, and it felt great but couldn’t dull the sharp stabs of the contractions.

I began trying every position the midwives and doula suggested: on the ball, on the bed on my knees with my arms up on the headboard, standing and swaying with Mike, leaning over the bed while it was raised, and leaning on the windowsill. I liked leaning over with my butt out and swaying my hips. My back was killing me, every contraction radiated back too, so Mike provided counter pressure and he and Rene were awesome at reminding me to breathe through each wave. The contractions came regularly but sometimes there would be two right after the other, then I’d have a few minutes break, then one, then maybe another two. So it was erratic and tough to find a rhythm.

I got checked again at 4:30pm and I was at 6cm. Baby Evan was also still very high up. I was both amazed that 4 hours had gone by and discouraged that it was so painful and yet I was only 6cm and he hadn’t dropped. I started asking for some drugs at this point.

To keep with my birth plan Rene suggested trying the Nubian in my IV. It seemed to take forever to get ordered and injected, but it did help cut the edge off. I progressed for another hour, but at that point I was lying down on the bed on my side, clutching Mike’s hand and the bedrail and shaking and moaning with each contraction. I was out of my mind with how much it hurt. After each one passed I broke down crying and sobbing at Mike and Rene and I remember feeling like I couldn’t do 4 more centimeters of that kind of pain.

The midwife offered to check me again and was at 7cm. At this point I let a few more contractions go by, each one just more painful than I could handle. When my head cleared at one point I looked at Mike and Rene and said I had made up my mind and wanted the epidural. I needed a break and I was no longer able to relax my hips and body. I was clenching everything in my body and shaking with each wave, completely unable to control my breathing at that point. They both agreed that I was serious about my decision and the epidural order went in.

That also seemed to take forever to arrive. I tried to remind myself that relief was on the way but the contractions were just too painful and I couldn’t manage it anymore. I had also vomited a couple times by that point. My body felt entirely out of my control. Finally anesthesia arrived and the epidural was placed. I was checked again once it went in and was at 8cm or so, Evan was still high up and hadn’t descended at all. At that point it was around 6pm.

I labored on lying each side for a while, getting checked intermittently and resting for the pushing stage. I made it to 9cm and was hoping the end was in sight.  He was still high, and I said I was worried and the midwife agreed that it was not a good sign. We had me laying almost on my stomach with my leg over a small ball on each side for the next few hours. This was pretty uneventful, and I was feeling a lot of low pressure, but another cervix check at 11pm showed that I was still 9cm and he was still high up.

The midwife started talking C-section. I had a moment of panic watching her use those words, but I had started feeling that this discussion was bound to happen, and so it wasn’t too much of a shock. We had gone 5 hours of no more progress or descent of the baby. He was way too high and I wasn’t able to get completely dilated. The midwife called in the OB on duty and she agreed with the decision to go for a cesarean section. I started crying, and admitted that I was terrified of another section. I explained again to them what happened with Gabe and they assured me that the epidural should be sufficient pain management for the surgery. But I just didn’t trust it. I wanted a spinal. I had them call in the anesthesiologist on duty to talk over my decision.

The anesthesiologist came in and I laid out my fears. He just shrugged, grinned at me, and said “Sure I’m cool putting in a spinal.” I almost hugged him! He said “I just want you to be comfortable.” I was still nervous but his attitude was so refreshing and reassuring. I really felt like the team listened to me and let me make the right decisions for me. So I signed the consents for surgery and we shut off the epidural to give it time to dissipate before putting in the spinal.

Once I got into the OR it went very quickly. I unfortunately vomited again on the table just before they put in the spinal. But Julie held my hands and reassured me that it was going to be fine. The anesthesiologist placed the spinal and I started going numb very quickly. By the time they had the drapes up and Mike was allowed in, I was numb up to my chest and felt it in my fingertips!

I felt absolutely NOTHING for the whole surgery! Roger, my nurse anesthetist, asked me who my favorite band was and put on a Pandora playlist. I was able to just enjoy some music and let myself relax and not panic, using some self-hypnosis techniques to calm my nerves. They pulled Evan out and he immediately started crying. I was so excited to hear him! Mike went to get pictures of them cleaning him off, and we learned he was 9lbs 4 oz and 23 inches long!

At this point I told Roger I was feeling like I was going to have a panic attack, because during the closing is when things went bad last time. He immediately ran some meds in my line and I felt awesome. Not too doped up, just less panicky. I heard them say Evan’s Apgar’s were 7 and 9 and the NICU team checked him out and made sure he had no issues with the meconium. They swaddled him and let Mike bring him back to me. I didn’t have to have my hands tied down, so they let Mike lay him on my shoulder and I could wrap my arms around him and touch him. It was amazing! Roger took some pictures of us all.

The OB came to see me off in recovery right away, and she informed me that when she opened me up I had begun to rupture along my scar. It was a small rupture, technically called a dehiscence, but amniotic fluid had begun to leak out. I just felt a huge wash of fear at that news. I’m so glad nothing happened and we made the choice to have the surgery! It made me wonder if all the sharp, tearing pains of my contractions weren’t normal after all and were in fact signs that I was beginning to rupture. It also made me wonder if this was the reason why Evan would not descend. I felt so grateful I didn’t try pushing him out with a rupture. It could have been disastrous!

So though I had been really hoping for a VBAC, I feel this was an incredibly positive birth experience. I felt true healing from my previous trauma for the first time. Everything went step by step according to my birth plan because I had been sure to cover every eventuality, and the entire team I worked with respected my feelings and tried to make me feel comfortable. This was the surgery experience I wish I had had the first time around. I felt in charge of every decision and listened to every step of the way. It wasn’t the birth of my dreams, but it was a powerful and moving birth that healed some very deep wounds for me.

{Holding Evan for the first time}

{First family photo}

{Skin to Skin}

{Brothers}