Little Brother’s Birth Story {the long version with pictures and video}

Little Brother arrived Thursday, September 3rd, 2015 at 5:58PM. He weighed in at 10 lb 1 oz, 22 inches long.

I went past my “due date.” This was not all that concerning to me, although my husband and son were quite ansy.

{Read my 40 week update here.}

I continued having prodromal labor, soft bowels, mucus, and a lot of other signs that labor was imminent. I remained active by walking Ezra to school every morning (1.5 mile round trip), doing pelvis opening exercises and belly floating in the pool, and attending prenatal yoga once a week. I also started seeing my chiropractor three times a week.

I saw one of my midwives at 40 weeks 5 days for a repeat NST, blood sugar test, and AFI (amniotic fluid measurement). My high fluid had come down some but was still high, I had lost a pound, (both signs labor was imminent), and the NST and sugar tests were beautiful.

I agreed to my first cervical check, (but declined a membrane strip), mostly because I was really struggling with discouragement throughout the weekend and felt that some information would help. I was 3cm, 50% effaced, and baby was at -3 station. My midwife recommended an induction to be scheduled for 41 weeks. I did not feel ready to take such drastic measures and asked her for a compromise:

I would come back on Wednesday at 41 weeks for a repeat NST and a visit with one of the obstetricians (as the midwives only work in clinic Mondays and Fridays). She was favorable to this.

I spoke with my chiropractor, my doula, and my husband in great length that day. I reviewed the evidence on induction for going passed your due date and looked carefully at the risks that increase at 41 weeks, especially in regard to stillbirth and uterine rupture. I asked myself how much risk I was willing to assume as a parent. We talked over what a -3 station position meant, especially in regard to my previous cesarean of a big baby partially credited with “failure to descend.”

We also talked over factors such as the anxiety levels in our home, my husband’s work schedule, the Labor Day holiday weekend impending and Ezra’s birthday, which would fall on Labor Day.

Lastly, we looked at the relationship we had with our care provider, knowing that the road to VBAC would most likely be a long one for me. We wanted to start things off as non-combative as possible to have more leverage later on in the process for the overall experience that I needed.

Putting it all together, we agreed as a couple that at my 41 week appointment, I would consent to a strip of my membranes and ask to be scheduled for a Friday morning induction at 41 weeks, 2 days. I upped my chiropractic adjustments to daily, started doing more walking – including curb walking (during which I would chant “push push, move down”), and focused much on relaxation and positive thinking. All of this in hopes of encouraging my baby to descend and trigger spontaneous labor.

On Wednesday, I woke up at 4:30 AM feeling panicky about the coming appointment and the decision to induce. I questioned the decision over and over in my mind, but still felt like it was the right one.

I walked Ezra to school and then prepared for my day of appointments.

I saw my chiropractor at 9 AM, grabbed some juice and cheese at a gas station afterward, and then went to the clinic at 10AM. My NST was beautiful, and I was incredibly surprised at the hands-off attitude of the obstetrician. She was jovial and made me feel even LESS pressure to induce than had the midwife, saying, “It’s America, you can do whatever you want!” I was so taken aback by this that I again started second-guessing the decision we had made toward induction, but my phone didn’t have signal so I couldn’t really text my husband to talk to him about it. I went ahead with our plan and asked her to see if they had a Friday morning opening, who was on the schedule, and to book it. She came back and told me the midwife on call for that day and it was a midwife who I liked and who my doula had worked with before.

Then we moved to another room for the cervical exam and strip where I was hoping to receive good news about baby’s progress. The OB said she was going to give me “a really good strip” to which I replied, “Good. Just don’t break my water!” She joked back that amniotic fluid on her all-white clothes was NOT in her plan for the day.

The check revealed that I was 4 1/2 cm and the baby had moved down from -3 station to -1 (deeper into the pelvis). She stripped my membranes. Then I heard, “Wait, is that? No…please tell me that’s not…”

And sure enough, my water had broken during the strip! The OB said that this had only happened to her twice in 25 years of practice, so I took this as proof that God’s plans are bigger than ours. I started crying happy tears and told the nurse, “I’m having a baby!”

It was a little chaotic because I started gushing fluid like Niagara falls (even the diapers they gave me wouldn’t hold it), but I had no cell service to get ahold of my husband and mother-in-law (I could contact my doula and chiropractor via iMessage via wifi). I finally waddled and dribbled out to my car where I sat on a towel in the front seat and arranged details with my husband.

The nurse and receptionist at the clinic were already headed to the hospital for a meeting, so they agreed that one of them would drive me in my car. My husband was already on his way.

We stopped at McDonalds where the nurse ran in and grabbed me lunch because I was NOT going into labor without eating. The timing worked out perfectly that Russ was able to catch up to our vehicle on our way to the hospital and follow us the rest of the way there, arriving with me.

In Triage, I had a chance to clean up a bit, although they did make me put on a nasty hospital gown. My doula met me there in Triage and I was in a room just before 1PM. I changed into my labor clothes and had my doula help me hang up my affirmations, start diffusing lavender, and get things set up the way I wanted. I was totally not in a very relaxed headspace at all – rather I felt unfocused and hyper. Everything had happened so quickly and I couldn’t calm down.

There wasn’t a midwife coming on until 8PM. They said that they could call one up from being on call, but the MD who introduced herself to me was amazing. She had had a birth-center birth herself and whispered to me that she had even done placenta encapsulation as a way to show me that she really got the whole “low intervention birth” thing. I felt like I was in good hands for the next few hours.

She did mention that we might have to augment labor if things didn’t get going. I asked for some time and her response was, “Sure, how bout I come back at 7? Does that sound okay?”  I was thrilled to have that much time before having to face interventions!

Knowing I had been awake since 4:30AM, they offered me a shot of something to give me a chance to sleep, and I happily agreed. I got the shot at 2:13. I also turned on yoga music to try to help me relax. My chiropractor was planning on showing up around 3:30.

I really wasn’t able to rest that well because of the contractions that were already coming, so somewhere around 2:30, I got up and started MOVING trying to get contractions going stronger. Lots of dancing, pelvic tilts, squats, and by 2:40 I was running to the bathroom after every contraction. I was being monitored intermittently so I had a lot of freedom of movement, and was snacking and drinking whenever I could. At 3:20, I moved to sit in the rocking chair and that slowed the contractions down enough for me to relax a bit. Just before 4PM, they placed an IV lock, but I didn’t have to be hooked up to an actual IV.

Contractions really started picking up around 5PM. Around 7 PM, the MD came back. I don’t remember if she checked me or not. Because things were moving along, she again offered me more time, offering to check back in around 10PM. I burst into tears, again grateful to have more time and no pressure to accept intervention.

A midwife also came on shift at 8PM, and by then I was having to vocalize and moan to get through contractions.

I continued doing a lot of squats and lunges (putting 1 leg up on the stool in the shower), and also had two runs of laboring in the shower with water running over my lower back. They were coming very hard.

Around 10, I started feeling like I was totally losing control over the contractions. It was harder for me to keep my voice low, find my breath, and just cope in general.

I wanted to be checked by the midwife (who was in the room for a while watching me labor), but was in so much pain that it was hard for me to even get into position. I believe I was checked sometime around 11:15 and I was at about 6 1/2 cm.

In the 11:00 hour, I asked for a narcotic, which I received at 11:42 PM. This helped me relax for all of about one contraction, and then I was back to some really hard labor. It was NOT back labor, and my chiropractor continued to check and make sure my body was in alignment. Baby appeared to remain in a good position. I did a lot of laboring on my knees leaning over the top of the bed.

I quickly realized that the narcotic really wasn’t helping, and at 12:30 AM I asked for the epidural. Before going into labor, I was already MUCH more open to the epidural because I wished that I had at least tried it with Ezra. I knew that I still had a LONG way to go, and that I couldn’t go on for hours in this state. The time between asking for the epidural and receiving it seemed to last a lifetime, and was – by far – the most emotionally and physically difficult part of the entire labor. I was in agony. The epidural was placed by 1:25 AM.

Once it set in, I felt amazing, but just wanted to sleep. I laid down on my side with the peanut ball between my legs to open everything up while I rested. I also sent my chiropractor home to get some rest.

I started shaking, partially due to the epidural, partially due to the fact that by 3 AM I was running a temperature – a sign of infection. I found that I could NOT sleep because of the shakes which were causing tension in my upper back. I turned on my baby lullaby station on Pandora and found that if I focused in on the music, fingering the baseline with my fingers, it helped with the shaking.

Getting the epidural was one of the best decisions I ever made in my life. The epidural I received took away my pain and made me tingly. However, it did not interfere with my mobility. I had complete control over my lower body, even though I was “confined” to the bed. I could lift my legs up while side-lying, sit in tailor pose and seated squats, do seated pelvic rocks and hip circles, and sway back and forth – all completely unassisted. I kept moving like this through the wee hours of the morning because it helped with the shaking, and I knew it would help the baby move down.

The baby’s heartrate started going up around 3 AM, and my temperature continued to climb. I had an infection called chorioamnionitis. They started me on antibiotics around 4:15 AM. At some point they gave me Tylenol which helped to bring the temperature down, temper the shakes, and allowed me the chance to doze between contractions for an hour or two.

The midwives were very hands off in general, out of the room most of the time. My checks were limited. At 6:30 AM I was checked, and I was 9 1/2 cm, but the baby was still at a -1 station. Both of us had high heart rates.

The shift changed at 8am, we opened up the blinds, started a new day, and my chiropractor returned.

The new midwife (who “just happened” to be the midwife I saw the most during my pregnancy) didn’t come in until 10AM.

Another check revealed no change in baby’s station and she recommended augmenting labor to help move the baby down. While I was much more open to Pitocin because I had an epidural now, I asked to try breast pump stimulation first. She placed a pressure catheter to monitor contractions internally and agreed. I pumped for nearly an hour, during which my chiropractor sat right there with me. She ran the pump, turning it off every time the contractions came, and helped me keep track of what side I was on. The pressure went up from 50 to maybe 70 at the most, but they wanted to see pressure closer to 200. We started the Pitocin around noon.

Baby and I were both hanging out in what the midwife called “middle ground” as far as my fever and our heartrates. Definitely not beautiful, but not too risky yet.

I went back to resting and at some point while side-lying I literally felt my pelvis open and the baby move down!

My next check, around 2PM, revealed that I was right! Baby had moved from -1 to +1 station! They started setting up for delivery!!

I started having symptoms of transition: speaking in monosyllables and sign language, hot and cold flashes, feeling fuzzy-headed, asking people to stop talking, crying a lot, and being very emotional.

My midwife asked me if I was willing to try some practice pushing. I wasn’t feeling the urge, so was a little hesitant to start trying to push. But ultimately, I was glad for the practice because it took several contractions to get into a pushing groove. By that point, I was feeling the urge, and began pushing in earnest. I used the squat bar a lot and my support team helped me move my legs up onto the bar and around into some other great pushing positions.

After an hour of pushing, the baby still hadn’t descended and his heart rate continued to remain high. At this point, they called in the OB on call and asked him to check. He tried to feel the baby’s progress during multiple contractions. He and the midwife both said that I was doing an amazingly effective job of pushing, (in fact they said that they had never seen someone with an epidural push so effectively) but the baby simply wasn’t descending with the pushes and his head was not molding, at all. By this point, they were concerned about the baby’s health and told me that I needed a c-section.

I asked for more time, and started pushing quite angrily – vocalizing, yelling at my body to “OPEN” and the baby to “MOVE DOWN,” even occasionally cursing. This went on for maybe 2, 3, 4 contractions, with no change, and then I was done.

I had known what was needed, and my husband called it for me. He said, “It’s my decision, I’m making for my family,” after talking to the doctor personally. I had known he was right, just needed a little time to be angry about it, and work through acceptance of it.

The nice thing about having an epidural is that, once the decision was made, I was able to rest some more. I still had several contractions I had to vocalize through, but I was able to process what was happening in ways that I never got to with Ezra.

I cried a lot, talked to the midwife about my fears, got lots of hugs from my support team, and my chiropractor prayed with me.

I also was completely in control when signing the consent and even specifically asked for a picture to be taken of me signing it.

I was wheeled off to the OR. When I entered, I was very frustrated about how bright it was and remember asking if they could dim the lights. They just kept saying, “You want us to see what we are doing!” At that point I made a joke about watching too much Grey’s Anatomy because they always have dark ORs!

I was also scared and frustrated when I started going numb because my arms were tingly and I was afraid I wasn’t going to be able to hold him. I kept saying over and over, “My arms are numb. I don’t like this!”  (This ended up not being an issue at all!)

Only one of my arms was strapped down, the other they left free.

Little Brother was born at 5:58 PM, nearly 31 hours after my water breaking.

The surgery went so quickly, that I was shocked. I hadn’t felt any pulling and tugging and thought I was still being prepped…when I literally felt him being lifted out of me and heard him crying. They showed him to me then moved him into a little room off to the side, fully in my line of sight (although I wasn’t wearing my glasses), for Apgars.

They cleaned him off and SIX minutes later, he was placed on my chest for skin-to-skin time, where he remained until they had to move me to recovery.

He was placed back on my chest in recovery, and at 7:01, just an hour and 3 minutes after birth, he was latched on and we nursed for 45 minutes.

The entire ordeal was excruciatingly beautiful. It was healing. It was freeing. It was empowering. It was exactly what I needed to go through.

Am I disappointed I did not have a VBAC? Yes, but only a little. This experience taught me so much about myself, about both of my children and their births, about my husband, and about God. I think having a repeat cesarean for “failure to descend” and cephalopelvic disproportion (CPD) actually brought me much more closure to my first cesarean than had I had a VBAC.

With Ezra’s birth, there were so many questions unanswered. What if I had exercised more, eaten better, and gained less weight? What if he hadn’t been malpositioned? What if I had experienced natural contractions instead of Pitocin contractions? What if I had asked for the epidural and given my body a chance to rest? What if I had simply been given more time?

All of these questions were answered in Little Brother’s birth. I was in GREAT shape when I went into labor and had a very active pregnancy. He was positioned perfectly. I went through hours of natural, unmedicated labor until it got too hard to handle. I utilized the epidural effectively to help me rest and recover during a long labor. I was given LOADS of time, both in the labor and pushing phase.

The outcome was the same: a big baby with a big, HARD head that refused to mold who simply could not descend through my pelvis no matter how hard I tried to aid him in the process – exactly what happened with Ezra. Little Brother has a soft spot the size of the tip of my finger – that’s it! His head bones are so solid!

Genetics are not on my side. My husband was a 10 lb, 12 oz baby and big babies run on his side of the family back at least one generation beyond him.

The internet is rife with comments and articles about how cephalopelvic disproportion (CPD) is a myth – that the body won’t make a baby so big it can’t birth. And for the last five years, I have believed that the fault of my primary cesarean lay with fetal malpositioning, poor diet, no exercise, or with the time constraints of my first labor.

I no longer believe that. I believe that CPD is an accurate diagnosis for my labors and, after Little Brother’s birth, I believe it to be a darn good reason to have a cesarean.

I am so proud and privileged to have had this experience to have a TOLAC. I feel no shame. I feel no defeat. I feel no failure.

The hospital was amazing. They followed my birth plan as much as they possibly could, giving me a lot of time and space to make some very hard decisions, while still being honest with me and putting my health and my baby’s health above all. While I had nearly every intervention possible, I never felt that it was a “cascade of interventions.” I never felt like things were happening to me that were out of my control. My decisions were my decisions, and I made them carefully and with informed consent.

Kristen Burgess over at Natural Birth and Baby Care emphasizes over and over on her website and podcast that, “Working with your baby is the focus of giving birth.” 

The necklace you see me wearing during my labor has the word “Together” engraved on it. {More on the necklace here.} I wore it as a reminder of the wisdom that Kristen shared.

During my labor, I remained very connected to baby and felt like I accomplished this. We worked hard. We worked together.

I’ve now made two gorgeous big babies. I’ve worked my butt off to push them both out. They both needed help. And I’m okay with that. I’m so proud to be their mother.

—–

Embedded below is a 20-minute video I made that goes into more detail about Little Brother’s birth and includes video footage of the labor and our skin-to-skin time in the OR. It’s set to a few of my favorite songs that I listened to while I was pregnant with him, capturing the emotions of what I was feeling throughout the process. {Thanks to my video editing software, photos and videos were easily cropped so this is not too graphic of a production!}