It's kinda long, sorry
Cassandra’s Birth Story
I had an appointment on Thursday, September 8th with the midwives. Everything looked ok except that I had quite a bit of protein in my urine, but not enough to qualify as anything “official”. Blood pressure was ok. Diabetes control was ok. Pelvic pain was a bit much. Since Dr Massengill likes for the VBACing moms to have planned for delivery before the end of the 39th week, I discussed plans for that with Gloria.
She checked me and I was at 1 and 50%, so she was able to strip my membranes. We decided to do that again the next day and also on Monday to try to encourage labor without resorting to harsher methods. I went to the park that afternoon and had some good conractions. Friday, I saw Candis and had made no progress, and she stripped my membranes a second time. I went to STRIKE! class that night and had some more good contractions.
Saturday, I took Brayden to his gym class, but noticed that Cassandra wasn’t moving very much. I tried changing activity level, eating, etc, but she still wasn’t moving much, so we went in to L&D to be checked. She was fine on the monitors, but my blood pressure was 141/85. Gloria was on call and did a BPP, which was fine. She also stripped my membranes again (still 1/50%/-2)
Sunday, she was moving well, and I rested on the couch most of the day.
Monday, I went in for my appointment with Tonia, and saw both Tonia and Candis. I still had made no more progress. We decided that between the gestational diabetes, borderline protein, and slightly increasing blood pressure (and with the pain from the SPD) that induction would be a good idea. We booked it for 7 pm Monday night. Since this was a VBAC attempt, we planned a mechanical induction with a Cooks catheter instead of using medications.
We finished up a few things around the house and headed in that night.
The Cooks catheter (2 balloons) was placed and I immediately started having pretty intense contractions about 2 minutes apart. John and I dealt with them pretty well, and a bit later on, I took an Ambien and tried to get some sleep while the catheter did its work.
The next morning, the contractions had died down pretty significantly. My chiropractor came to the hospital to make sure that my pelvis was in optimal alignment for labor, then Tonia came in and took the catheter out, and I was at 5/90%/-2. Since this was a good improvement, we agreed that the next step was to break my water to get things going.
She did that, and we did a 30 minute strip, and then I was free to walk around and cope however I liked, including in the tub (which I HATED. I had liked it the night before but not that day). I did need continuous monitoring since she was so high, and they tried to set up telemetry, but it wasn’t working. We compromised on Doppler checks every 15 minutes with a strip every couple of hours.
Contractions got intense pretty fast, and my doula came to help. After about 3 hours, the contractions were coming right on top of each other and I was having a lot of trouble coping, felt like I wanted to push, and was seriously contemplating an epidural. Im pretty sure that my nurse, doula and husband thought I was in transition, but I was pretty far gone in labor lala land. Tonia came and checked me and I hadn’t made any progress. Still at 5/90%/-2. That was incredibly discouraging, and thinking that maybe I needed to relax more than I was able, I asked for an epidural. That got placed about 1.5 hours later (the LONGEST 1.5 hours of my life). The CRNA that placed it was wonderful. It did end up needing to be “topped off” to be fully effective, but I could still move my legs and help out with position changes and stuff. We agreed to give it 2 hours (with position changes) and check again.
At the next check, nothing had changed again. So, with my agreement, Tonia placed an IUPC to check adequacy of contractions. They had spaced out a little with the epidural, so we agreed to start a SMALL amount of pitocin. We started with 0.5 mu, and increased it from there to 3 mu, where things looked perfect. We agreed to give it 2 more hours and recheck. If that didn’t work, then something obviously wasn’t going right.
The 2 hours passed, and nothing had changed on exam again. Tonia left it up to me to decide whether or not to continue trying labor or to call it and go for the csection.
At that point, I knew something wasn’t right, and I wasn’t willing to risk infection, exhaustion, etc, so I opted for the c-section.
She was born at 7:09 pm, about 24 hours after our arrival at the hospital, and the c-section was actually a good experience. The CRNAs made absolutely sure that I couldn’t feel anything, the OB told me what was going on, Tonia (the CNM) deferred first assist to a family medicine doctor so that she could take pictures for us (we got pictures of her actually being born from the uterus!), and they allowed both my husband and the doula back in the OR with me, which was great, so DH could stick to Cassandra and my doula could stay with me.
I asked the OB to see if he could find a reason for the failure to descend/progress while he was in there(thinking that it might have been a cord wrapping issue or something) and he said that she wasn’t malpositioned, or asynclitic, no issues that he could see, but that I have a very oddly shaped pelvis – it’s not any one true “type”, but it’s obviously not gynecoid – more android than anything, but not exactly that either. He said that he thought that MAYBE I could have succeeded in VBACing but only after a very long labor with more pit that most would be comfortable giving. So, Im glad I opted for the c-section, honestly.
DH had to hold her in the OR, but I got to hold her all the way back to the room and for the entire recovery period , and I got help getting her latched from the (wonderful) nurse. (I did let her get passed around to the family for a bit since they all came to see her born).
We were moved up to postpartum about 2 hours later, and they did all of the bath, medicines, vitals, etc right in the room.
Everyone the entire stay was incredibly nice, great about talking to me, and very focused on letting me feel like I had some control over the situation at every point in time. I even got sent home with actual pain medication this time – both motrin AND ultram. (!!!!)
I have to go on Monday, as they left a drain in the incision to be sure that it didn’t come apart or accumulate too much fluid.
All in all, this really was healing for me. Even though it was basically the same story as with Brayden (minus the malpositioning and wonky head), it was SUCH a different experience that I really do think I can count myself over the fear and trauma that I had for so long after Brayden’s birth. I KNOW that my body CAN go into labor and make things happen, and I know that I cant do anything about a wonky pelvis – I mean, I went to the chiro frequently due to the SPD and she was working like crazy on getting/keeping my pelvis in the right position. Had this been 200 years ago, I very well could have been one of the women that died in childbirth.
If I ever get pregnant again (not planning on it), I will not be trying to VBAC again. I don’t want to go through labor knowing that it will most likely end up a c-section again, I’d rather just go for the csection and know that it’s best for me.