Hospital VBAC After a Month of Prodromal Labor

I had been having prodromal labor for about month straight so when I noticed contractions starting on Sunday evening, I didn’t really think much of it. I went about my evening like normal, put my toddler to bed, watched a little TV, and around 9pm I decided to head to bed. I’m not one to ever have trouble falling asleep but I laid there for about an hour and just could not fall asleep. I noticed my contractions getting a little stronger, but nothing alarming. I mentioned to my husband, Steve, that my contractions were getting stronger and that I thought this might be it. He decided to get in bed and try to sleep in case this was the real deal. I texted my doula, Amber, to keep her updated on how I was feeling. 

I laid in bed with the TV on and tried to ignore the contractions for a while. They were about every 7-9 minutes apart by now and I had to deep breathe to get through them. I tossed and turned in bed until about 1:00am when I decided to hop in the shower in the hopes to relax. I woke up my husband before I got in to tell him I thought this was for real this time. The shower was anything but relaxing. My contractions just got stronger and stronger the longer I was in there. When I got out, I told Steve he needed to call my mother-in-law to come watch our daughter. She lives in Lincoln, so I knew it would be at least an hour before she would get to our house. 

The waves of contractions were getting much more intense now and I found myself leaning over whatever was in reach and moaning when a wave would come over me. Around 1:30am, I told Amber that I needed her to come over. At this point, my husband had gone into hyper-focus mode and decided deep cleaning our entire house was necessary, (he doesn’t cope with labor very well) so I really needed Amber’s support. Before she arrived, the nausea kicked in and I started to throw up. I didn’t have nausea with my first labor, and I can say it was one of the most unpleasant parts of the whole experience. When Amber arrived, my contractions were about 3-5 minutes apart and I was still getting sick. I continued to labor at home for a couple more hours. 

Around 5am, I decided I wanted to head to the hospital. We arrived around 5:30am and I was checked into my room. I had great communication with my midwives during my prenatal care so I knew what types of standard things would be coming my way when I got to the hospital, ie an IV lock and continuous fetal monitoring. They also wanted a urine sample, which was fine with me, but I had no idea how intense my contractions would get from sitting on the toilet! No wonder people always rave about how great it is to labor on the toilet! After that little experience, the nurses got my IV going and put baby on the monitor. The on-call OB came in and introduced herself. She asked to check me and I was pleasantly surprised to hear I was already 9.5cm. 

At this point, my labor stalled a bit. My contractions got a little further apart, probably due to my nerves. Around 7:30am, the nurses came in my room to do their change of shift. I remember asking for an epidural while they were talking. I hadn’t specifically planned for a natural labor but I knew being able to move would give me the best chances for a VBAC, so in the back of my mind, I was always reminding myself of that. The nurses told me to wait until the contraction was over and if I still wanted it, we would discuss it again. After the wave passed, I caught my breath and decided against the epidural. 

Soon after the nurses ended their report, the in-house midwife for the day, Kate, came in. She checked me and again I was very pleasantly surprised. I was 9.5cm! I was almost fully dilated without an epidural! That excitement was quickly diminished when Kate told me that baby was still at a -3 station. The problem with baby being so high while I was almost fully dilated is the risk of cord prolapse if my water breaks. Kate and I had a lengthy discussion about my options in this situation. It was a difficult decision to make but after giving it a lot of thought, I decided to get an epidural and let Kate break my water. This allowed the membrane rupture to be a little more controlled, and also allowed Kate to feel if the cord needed to be moved to prevent a prolapse. After three tries to place the epidural, it was finally finished. That was by far the worst part of my labor experience. 

When I was nice and numb, Kate broke my water and did end up needing to move the cord around baby’s head to prevent a prolapse. Baby dropped to a -2 station after the membrane rupture, which was not as much of a drop as we were hoping for. There was also meconium in my waters. Again, Kate discussed my options with me and I decided to continue laboring. Both baby and I were doing just fine, so I wanted to give my body more time. 

For the next several hours, I alternated laying on my left side, to my right side, to sitting up every 20 minutes. Kate continued to monitor baby and I but baby still was not dropping. I was getting more and more emotional as it seemed a cesarean was in my future but I wasn’t ready to give up yet. My nurse and Amber helped me sit up again but this time it was getting uncomfortable. I asked Amber to grab the birth ball and put it in front of me so I could lean over it. I remember hearing baby’s heart rate drop a little on the monitor. I asked the nurse about it and she said that it can happen during a contraction but as long as the heart rate goes back up after the contraction, it’s fine. We were having trouble-keeping baby on the monitor and I thought it was just due to how I was sitting. This happened a couple more times and then Kate came in. This is when things got a little crazy.

Kate had me lay back down and checked me. Baby was now at a +3! Things get a little fuzzy for me here because it all happened so fast. It seemed like I blinked and my whole room was filled with people. The one thing I distinctly remember is Kate looking up after checking me, and telling me that I was going to have to find my strength and get my baby out. That I was going to have to push with everything I had because my baby needed to get out now. Baby had dropped so fast that her head was transverse in my pelvis. With the very next contraction I was pushing. I continued pushing with every contraction and Kate was able to turn baby’s head into the correct position. I could hear everyone in the room cheering me on. That was one of the most meaningful parts of my whole experience. At 2:22pm after only 22 minutes of pushing, Kate successfully maneuvered her shoulder dystocia and I delivered my beautiful baby girl. She was placed on my belly briefly but was not responding as quickly as the doctors and nurses like to see. Daddy cut the cord and the NICU nurses whisked her away. I’m told she was only gone for about 15 minutes but it felt like hours to me. 

I did it! I am so thankful for Kate, Amber, Steve, and all the nurses and doctors who helped me achieve my VBAC. I am thankful that I had the courage to stay patient and thankful that I was given space and time to make my own decisions. This birth story is so different from my first, and I am so grateful to have been able to have such an incredible experience.

Birth experience and photograph submitted by Samantha Wall.