VBA2C at 42+6 Weeks

“You’ve got to give a little, take a little,
And let your poor heart break a little.
That’s the story of, that’s the glory of love.”

To tell the story of Bunni Larue, I have to give a little background.  The stories of Sylvia Joleigh and Justus Brooks are condensed but will give an idea of how I approached Bunni’s birth.  My husband and I met in a Yahoo chat room in January 2005. He was an Army soldier in Korea at the time, and I was in college in NC. We spent months talking on the phone mainly, and then I drove to meet him for the first time in June 2005. It was like we had always been together. We got married in May of 2006. He has done a year in Korea, two years in Iraq, and a year in Afghanistan. We have been stationed at Ft. Hood, TX and Ft. Richardson, AK.

Somehow in there, we have been able to conceive 3 precious babies. It took us about a year and a half to have Sylvia. There was a point in time that we thought we might not be able to have children.  So we were ecstatic to find out we were pregnant with her.  He was deployed and made it home on mid-tour leave just before my labor started. She was born 3:18 a.m., December 18, 2008 at exactly 39 weeks gestation; 8 lbs. and 19 inches long. I had an infection called chorioamnionitis, which led to a very necessary emergency cesarean under general anesthesia, and a week stay for her in the NICU. John was under the assumption that he would be going back with me for the cesarean, and was in shock when they brought our baby to him just a few minutes later.  He was not able to go back for her birth because of the general anesthesia.  The day after she got home, he had to report back to Iraq, and did not see her again until she was six months old.  Sylvia was named after his grandmother.  Sylvia was also a Goddess of the Forest and mother to the founders of Rome; Romulus and Remus.  Jo and Leigh are our mother’s middle names.

Within 6 months of John coming home, I got pregnant again!! I’m pretty sure the magical moment happened the night of Sylvia’s first birthday… he.he.he.  The next 9 months were extremely stressful. We moved several times and John left for Afghanistan exactly a year after he had gotten home from Iraq.  Justus came at 12:59 a.m., September 17, 2010 at 42 weeks gestation; 7 lbs. 12 oz. and 19.75 in. long. I planned a HBAC (homebirth after cesarean) in NC and labored at home for 48 hours. I can’t remember the exact times, but I think I was nearly complete for 7 hours. My cervix began to swell at 9.5 cm with an anterior lip.  When my midwife broke my water at 9 cm there was meconium, and based on several factors I made the decision to transfer. I also ultimately made the decision to go to cesarean. He had been posterior and asynclitic, and my mom said the cord was wrapped 3 times. John was in a terrible spot in Afghanistan and missed Justus’ birth entirely. He came home a week later due to the cesarean and me needing help, and then did not see his son again for 10 months.  Justus is a very old Latin name and Brooks is John’s middle name.

“You’ve got to laugh a little, cry a little,
Until the clouds roll by a little.
That’s the story of, that’s the glory of love.”

We knew we wanted another baby, but had no idea how fast it would happen.  Within a few weeks of John’s homecoming from Afghanistan, we conceived again.  There was never any doubt in my mind that I would go for a VBA2C (vaginal birth after 2 cesareans).  I knew I would not try another homebirth for a couple of different reasons, and mostly because I had a provider in mind who I knew would support me.  I went back to work to occupy my mind, and I focused on not really focusing on anything.

As usual, my pregnancy was easy.  The only difference was that I had a variety of skin rashes and weird things like itching under my ring, and an allergic reaction to mango.  I have always been blessed with perfect blood pressure, no gestational diabetes and no complications.  I had very little morning sickness and even that was just nausea.  I did not take a standard prenatal but took Vitamin C, D, and B-Complex, as well as a magnesium supplement.  The one thing I did do is go to the chiropractor religiously.  I knew in my prior births that the baby’s positions had really worked against me, and not only that, but all the aches and pains I had felt before had disappeared once I began seeing Dr. Jen.  By the end of the pregnancy I had gained about 12 lbs. and I was GBS negative.  Then the sicknesses began!

At 40 weeks pregnant I got a nasty stomach bug that really depleted me.  I was out of work for several days.  I went back for one day with a little tickle in my throat and thought I was getting a cold.  Come to find out, at nearly 41 weeks pregnant I had the flu!  Influenza A.  It was terrible and I was very, very sick.  Thankfully I started taking Tamiflu almost immediately which made it slightly shorter-lived than usual.  I prayed for her to wait a few more days so that I could regain my strength.  It was around this time that I started losing my mucus plug.  At my 41 week appointment I was 2 cm and 50% effaced, but I was having no contractions whatsoever.  Everything was oddly quiet down there.  I was elated as this was where I was after being up all night the first night I labored with Justus, but after a couple of days I started to get down on myself.  We were doing non-stress tests about every other day, and the baby always looked fantastic.  My OB mentioned trying a Foley bulb a day before 42 weeks if I wanted.

That Friday rolled around and still… nothing!  I went in for my appointment and agreed to the bulb.  It was actually a nifty little contraption called the Cook Cervical Ripening Balloon.  There were two balloons, one on the inside of my cervix and one on the outside.  He filled them each with 80 ml of saline and sent me on my way.  I could not believe that he let me go home!  The insertion was not painful at all, but sitting upright was not very comfortable.  After a visit to Wal-Mart, once I got home, contractions were coming hard at 10 minutes apart.  I also started a cotton root bark, blue, and black cohosh regimen.  The balloon stayed in for 12 hours and then I removed about 20 ml of saline and it came out fairly easily.  I knew this meant that I was at least 3-4 cm dilated.  As soon as it was out I felt instant relief and realized just how miserable I had been all day.  I continued contracting through the night on my own, and then by morning, we were back to nothing once again.

Happy 42 weeks to me.  This was probably the hardest day of the whole pregnancy.  This was officially the most I had ever been pregnant.  I kept thinking that statistically my chances of successful VBAC had dropped.  I countered that thought by acknowledging that I am not a statistic and that I bake my babies longer, but I was really down on myself.  I reached out to my doula.  What was the latest she ever had a mom go to?  43.5 weeks with my OB and after 36 hours of labor she birthed her 11 lb. baby vaginally; also a VBA2C.  I suddenly did not feel so bad for myself.  Then I reached out to another ICAN friend who had gone past 42 weeks.  She had gone on to have a HBAC after 55 hours of labor.  What an inspiration!  If she could do it, so could I.  I had my pity party for the day, and by that Sunday I was in a good place.  I felt good physically and emotionally and it almost turned into, “Let’s see how long this baby really is going to cook!”  I stopped all the herbs, rested a ton, and decided I was not going to do anything for a few days.

Monday I had a non-stress test at the hospital.  She looked beautiful on it, and I did not get checked.  I did not have one contraction the whole time. There was no other mention of any sort of induction, and my OB had left the ball in my court as far as going as long as we needed.  For once I felt totally in control of the choices for my body and baby.  Tuesday I had contractions all day long that were about 15 minutes apart.  They started to increase in intensity, and by evening were 5-6 minutes apart but nothing unbearable.  I woke up in the middle of the night starving and still contracting, and then by morning, everything stopped.

On Wednesday we had a biophysical profile.  I think that is what held up my contractions.  I got nervous, and hoped all was well with the baby.  We scored 10 out of 10.  My fluids were not fantastic but not bad either.  The placenta was showing some slight signs of aging, but nothing too concerning.  The ultrasound tech estimated her weight at 7 lbs. 6 oz.  At my 39 week consult with the other doctor (the hospital made me consult with a different OB because I was declining continuous fetal monitoring and they implied that my OB was not scaring me enough about the risks), they had estimated 7 lbs. 7 oz.  She looked great and we went in for another OB appointment.  This time when he checked I was 4.5 cm and about 75% effaced!  Yes!  I knew it would not be much longer and it was likely that my next round of contractions would not stop.  Dr. Elrod brought up castor oil.  We went and got some afterwards and I let it sit ominously on the kitchen counter hoping that seeing it there would send me into labor.  I knew deep down that once contractions started again, they were not going to stop.

The next morning, John and I went and had a big breakfast at IHOP.  We did some shopping and by the time we got home it was about 10:30.  I decided to give the castor oil a try.  I mixed 2 oz. with 2 oz. of orange juice and chugged it down.  This is where everything starts to go fast.  I waited 30 minutes and started my herbal regimen; one dropper of cotton root bark, one of black cohosh, wait 15 minutes, another dropper of cotton root bark, and a dropper of blue cohosh.  I did this for an hour.  I started pooping almost immediately from the castor oil.  By 12:30 pm contractions were coming lightly about 5 minutes apart.  Deep down I knew this was it.  Suddenly they started to intensify.  Then by 1:30 they were 3 minutes apart.  Some were even lasting 2 minutes long!  But I was confused.  I could walk and talk just fine through them.  Everything time wise was moving fast, but the intensity was workable.  I decided to call our babysitter just in case.  John went to get Sylvia and Justus from school, and Skylar got to the house at about 3:30 pm.  John was gathering last minute stuff, and I was sitting on the edge of the bed.  I’m still talking and joking through contractions hating to leave so early but instinctively knowing that go time was near.

At 3:45 I heard and felt the pop deep within me.  There was no doubt in my mind about it; my water had broken.  But there was no water.  I stood up and felt a tiny dribble.  What I did see, thank the powers above, was clear!!  I had prayed for clear fluid.  When I sat down on the toilet there was lots of mucus and bloody show, but very little fluid.  It was pretty clear why very shortly after when another contraction hit.  She was down deep in my pelvis.  It rocked my world!  And from there they kept coming fast and hard.  There was no more talking or walking.  I was moaning through every one and trying to make my way to the car.

That was the worst car ride of my entire life.  John was driving fast.  Traffic was heavy as usual for 4:00 pm on a Thursday coming out of Anchorage.  I had a hard time relaxing.  At 4:30 pm we got to the hospital and were told to wait in the lobby.  I went to the lobby bathroom and started puking.  I was sweating and shaking.  From that point until around 10:00 pm everything was a blur.  We had the worst nurse ever in the beginning, and John promptly fired her.  I cannot remember who said it, but it always stuck in my mind, “Chances are if you don’t like your nurse, she doesn’t like you either.  The difference is, she can’t fire you as a patient, so go ahead and do her the favor of firing her.”  She kept harping on the monitors, which I wasn’t refusing at this point!  I had agreed to the initial strip.  The only thing I refused was lying in the bed to be monitored.  Luckily, baby girl was cooperating and we could get her heart rate beautifully while I was standing.

Dr. Elrod came in and checked me and I was 5 cm and 90% effaced.  Oddly enough, the information did not bother me.  I did not have time to think of it.  In hindsight, when I think of Ina May Gaskin and her talk of the Sphincter Reflex, I think that is what we had going on.  I was scared, I could not get into a groove in triage, and I felt like I was on display.  There was a point where her heart rate was dropping into the 70s and 80s during a contraction.  He did not say anything but I saw a brief look of concern on his face.  Luckily it popped right back up as soon as the contraction was over.  I knew she was fine the entire time, but we did see that it happened when I bent over during the contraction so I tried to stand up straight after that.  My doula also had me talk to my baby and connect with her telling her everything was ok.  I have looked back on this moment and I am extremely thankful for Dr. Elrod’s confidence.  I think if it had been anyone else, they would have taken me straight to cesarean, even though decels during contractions can be totally normal.

All I wanted was to hide in the bathroom… alone.  I think my body was further along than what the dilation told.  I could feel the pressure as if I could not sit on my bottom.  Contractions were 2-3 minutes apart, and lasting at least 1.5 minutes long.  I was also doing this funky double-peaking.  The first one would come, it wouldn’t ever let go, and then it would hit again.  Then the second one would be normal.

Finally we got a room.  I got the hep-lock.  Shortly thereafter I started puking again.  When I puked I would get lots of bloody show.  I got the telemetry monitor which is the exact same thing as the other monitors but on a pole so you can move around.  Then I got in the tub.  It did not provide the relief I was hoping for and that I remembered with Justus.  How in the world had I made it 48 hours at home with him?  And I did not feel like I could go another hour with her? I thought hard about it.  I was fighting the contractions and could not let go and work with them.  All I kept thinking is how fast everything was going.  I asked for the epidural.  My doula held me off for a bit.  Then I asked again.  I was sure.  I talked to my doula, then to John.  Then Dr. Elrod came in and asked why the change of plans.  I told him that I knew I was fighting the contractions and if I could just relax I thought she would come.  I knew I did not want narcotic medications.  Everyone was extremely supportive and John said he was with me as long as I would have no regrets.  I was sure.

I had to get fluids first which took FOREVER.  Then the anesthesiologist started with an extremely low dose that did nothing.  It did not take effect for quite a while.  I felt as though I was climbing the bed with the contractions.  They were so intense.  In the meantime I also got a shot of Phenergan for nausea.  I am a puker in labor; it has taken me 3 times to figure that out.  It was just enough to take the edge off.  Finally, after what seemed like an eternity the intensity of the contractions started to ease.

Amazingly, only about an hour after the epidural took effect, I felt a lot of pressure.  At 11:00 pm Dr. Elrod came in to check and I was 10 cm and +2 station!  That was fast!  It made me feel even better about the epidural and in that moment I knew I had done what I needed.  I tried pushing a few times and decided that I should rest.  I was exhausted, and the pushing was not very effective.  She just was not quite ready.  Around 3:00 am, we tried a few more pushes.  Still not quite ready.  I slept and let the epidural wear off.

At 6:00 am it was time.  I was feeling contractions again and a ton of pressure.  Everything was so calm and relaxed, just as I had imagined.  There was just Dr. Elrod, a nurse, my doula, and John in the room.  Nobody counted at me.  There were no bright lights.  I tried holding my legs and pushing, but I got the most from doing tug of war with the nurse.  She got a towel and I pulled as hard as I could with the contractions.  I was also getting a horrible cramping in my back that slowed me up a bit.  It did not seem like I was making much progress.

Finally John said he could see a bit of her head.  They brought the mirror in for me so that I could see too.  Dr. Elrod stepped out of the room and I continued to push with the nurse.  All of a sudden I felt her slipping down and the nurse jumped up and said “Whoa!” and placed her hand over my vagina.  This was oddly amusing to me; what was she going to do, hold the baby in?  Her head was half-way out, and I told them with the next contraction she would come.  I began to cry.  My doula told me not to be afraid, but that was not it.  I was doing it.  She was doing it!  My body was doing it!  I was not even pushing!  Then I felt a pop as I tore.

Dr. Elrod came in and John was trying to put gloves on.  Poor guy, he had one glove on, and Dr. Elrod goes, “It’s your baby man, you better catch her!”  Right at that moment, he threw the other glove down as I felt her wriggly arms, legs, and body slide right through my pelvis, and out in a perfect anterior position.  At 6:49 am, he scooped her up like a football as she pooped all over him and laid her across my belly.  Fifteen hours after my water broke, and nearly 8 hours after I had reached 10 cm, my husband caught our baby girl… our vaginal birth after 2 cesareans.

“As long as there’s the two of us,
We’ve got the world and all it’s charms.
And when the world is through with us,
We’ve got each others arms.”

Time stood still.  That was the most beautiful moment of my entire life.  She was not breathing yet but I knew she was just fine.  Nobody took her.  They placed a blanket over top of the two of us and we rubbed and talked to her.  Another nurse, one of my favorites, came in and was talking to her telling her she needed to cry.  I knew she was fine.  I felt her take her first deep breath, as the outside world filled her body.  It was as if we were still one; her skin to my skin and her cord still attached to me.  She never did cry, and the nurse finally said, “Well, she’s breathing and looks great, oh well!”  I did it.  We did it.  I had prayed many nights that we would do this together.  I could not believe it.

The cord stopped pulsing quickly.  I was surprised by that.  It was totally limp and white and John cut it.  Then slowly my ears began picking up the sounds of the room.  Was that a faucet running?  “Is that my blood?” I asked.  I could hear it pouring off the bed.  Dr. Elrod looked up at me and said, “Yes.  I know you did not want the Pitocin Ariel, but you need it now!  I don’t want to be talking about transfusion in a few minutes.”  I was bleeding a lot, and in my state of bliss I did not care what they did to me.  My uterus was not clamping down.  They ran the Pitocin, vigorously rubbing my belly, and then after a shot of Methergine the flow began to slow down.  Later, we estimated about 4 cups of blood loss.  Dr. Elrod stood up and held his arms up, “Just to give you an idea,” he said.  He was up to his elbows in my blood.  I gave a slight push with the next cramp and felt the warm, softness of her placenta slide out.  I asked to see it.  It was big and healthy looking.  No wonder she was nice and content in there.

I must have held her skin to skin and nursed her for two hours before curiosity got the best of me.  Instinctively I knew that she was my smallest baby so far.  I wanted to know what she weighed.  The nurse took her and weighed and measured her; 7 lbs. 1 oz. and 20 inches long, born at 42 weeks and 6 days gestation.  She was my smallest, but longest baby!  Then the nurse gently bathed her.  She loved having her hair washed, and I loved watching my beautiful girl being cared for so intimately.

Bunni is a short form of the Goddess Berenike, the Bringer of Victory.  Larue is my grandmother’s middle name.

So all in all, it didn’t go exactly as planned, but I was prepared for that.  It went exactly as it was meant to.  I had waited a long time to write a birth plan because I did not know what I wanted.  All I saw was the VBA2C and a healthy baby.  Nothing else mattered, and I have no regrets.  I have asked myself at least once a day, “Regret the epidural?” and every time the answer is, “Nahhhhh, I don’t regret it one bit!”  The only thing I wish I had done was go to the hospital when my mom had told me to (you know when I was still a bit confused about what was happening since I could walk and talk through contractions).  I had this aversion to the hospital, and overall they were awesome!  I wish I had a little more time in the beginning to integrate what was happening in my body and to reconnect inside before everything hit so hard.  The biggest lesson I learned is that it is imperative to have a team that truly supports you.  If it had not been for my OB, I do not know if we would have made it to a VBA2C.  Especially since she waited until 42 weeks and 6 days.  I do not know of anyone else who would have supported me to that extent.  I am one happy mama, and I am excited to see what the future holds for our little bringer of victory.

“You’ve got to win a little, lose a little,
Yes, and always have the blues a little.
That’s the story of, that’s the glory of love.
That’s the story of, that’s the glory of love”

* A big thank you to my husband who caught our third baby at the first birth he had ever attended; Dr. Elrod of Sleeping Lady Women’s Health Care in Wasilla, Alaska; and Stella Lyn, doula and herbalist of Village Birth & Herbals in Palmer, Alaska