Despite everything stacking up against my desire for a VBAC (vaginal birth after cesarean) – previous big baby, ultrasound estimating an even bigger baby, being overdue and having gestational diabetes – I was ultimately successful and delivered my second daughter vaginally.
I knew I was having a big baby. My first was 9 lbs, 10 oz, and ultrasounds late in the pregnancy were predicting an 11+ lb second baby. I knew in my heart that she wasn’t quite that big, especially given my strict diet and lack of weight gain (thanks, gestational diabetes!).
The fear of a big baby and an increased risk of shoulder dystocia led my doctor to recommend a repeat C-section. I appreciated her concern and where she was coming from. We carefully considered it, but I knew deep down that I had to at least try laboring. When I expressed my wishes to attempt a VBAC even with a big baby and explained my reasoning, she agreed to support me. I appreciated this respect for my body, my baby and my choice. I also trusted that she would keep a watchful eye and I could rely on her medical expertise should a C-section ultimately become a necessary rather than being an elective, if recommended, procedure.
This baby girl did not want to be born and was happy to stay inside me growing and growing! Ultimately we decided to induce at 41 weeks and 5 days. She was born the next morning, so very close to 42 weeks gestation! I had tried everything possible to jump start labor, from walking to pumping to chiropractic care to supplements to sex. She wasn’t budging unless forced!
My husband and I arrived at Woman’s Hospital bright and early for our induction, and check in at admitting was straightforward. We were surprised by our pastor being there to pray with us before getting started, and I am beyond grateful for the support we had (and continue to have) from our St. John’s United Methodist Church family.
After getting set up and checked – 2 cm dilation but baby still high – the induction began with my doctor placing a Foley bulb. This is a mechanical dilator – basically two connected balloons, one goes inside the cervix and one is on the outside. Each is inflated with water, and the pressure helps get the cervix to open. Because I’d had a cesarean, chemical cervical ripeners were not an option.
Our doula was critical to our success, giving recommendations and advice that really helped labor progress. I was attempting a natural birth, although VBAC was the greater goal. After a brief rest, I started alternating walking and using the breast pump, both of which stimulate contractions to effect cervical change as well. My doctor was also key to my success, as she was very encouraging and even requested a natural birth-friendly nurse for me, something she said she’d never done in the years she’s worked at the hospital. As long as I was OK and the baby was OK, we were going to make it work, and we did.
The Foley bulb can stay in for about 12 hours, and after laboring all day, I had dilated to 5 cm and made great progress in effacement. The breast pump was especially effective to get contractions going. I kept laboring into the night in various positions, including in the Aqua Doula tub, on the bed with and without the peanut ball, on the couch, on the birth ball and even in the family room at the end of the hall. I had a lot of back pain, which scared me thinking that my baby was in a non-optimal position for delivery.
Eventually I found myself “stuck” at 7 cm. It wasn’t the number that was tripping me up or even the amount of time left to go, but the intensity of the pain and knowing things had to get a lot worse before they’d get better. My fear overcame me, including the fear of a big baby that might have been malpositioned. After discussing things with my husband and doula, I said my code word and got the epidural. At this point, I was certain I was headed for a C-section, so it was very emotional and scary for my husband and me.
The epidural placement was kind of a fiasco because it only took on my right side and I was still rocked by contractions on the left. I was desperate for relief at this point since I couldn’t change positions to better manage the contractions. The anesthesiologist pushed some more medicine, but I never got complete pain relief. After the shift change, a new nurse checked me and said to forget having the epidural redone because I was complete and would soon be ready to start pushing. (So much for that C-section I thought was inevitable!)
After laboring down for about an hour with the peanut ball, I started pushing. I didn’t want to do the purple pushing, as I’d had a consultation with a pelvic floor specialist who had taught me how to push effectively and minimize tissue damage by breathing the baby down and letting my uterus work. But the nurses and my doula encouraged me to bear down and hold my breath. I felt like the epidural changed things and I should just do as I was told.
It took about an hour of pushing to get my daughter to come down. And at 8:54 a.m., she was born — huge, screaming and beautiful. I was so happy and in disbelief as my doctor placed her in my arms. There were about 10-12 people in the room in case she did get stuck. Thankfully they weren’t needed, although their collective gasp at the sight of the size of her head is a fun memory for me. I was able to hold my girl immediately after birth. Our wishes for delayed cord clamping and extended skin-on-skin contact were respected.
About an hour later, she was washed and weighed – everyone was anxious to know how much she actually weighed. She came in at 10 lb. 8 oz. So not quite an 11-pound baby, but certainly close.
About two hours after birth, we were transferred to a regular room. I hadn’t eaten real food in more than a day, so I was starving. (I take great exception to the liquids-only labor diet at the hospital, especially with how hard I worked to manage the gestational diabetes and eating every two hours. I think if I’d been able to keep my energy levels higher I might have been able to better manage the pain.) The nurses said I couldn’t eat in recovery but that I’d get food as soon as I made it to my room.
Because so many babies were born that week, we were put on the 5th floor in an overflow room, which led to a food snafu. Vaginal deliveries are supposed to automatically get a tray from dining services, but apparently that doesn’t happen on the overflow 5th floor. It was more than 2 hours after I got in the room before I was given food, meaning 4 hours after delivery and who knows how many hours since I’d eaten anything, liquid or otherwise. At this point I was dizzy, nauseous and starving – I felt awful from the lack of food, lack of sleep, epidural side effects and exhaustion from the work of labor. It took a couple meals before I felt nourished and better, but eventually I did!
Not that it could be changed, but I wasn’t a fan of the bathroom layout, since the trash can was several steps from the toilet and was covered so I couldn’t even toss trash in. (And birth recovery generates a lot of trash from the pads and disposable undies!) The sink was not accessible from the toilet, making filling the peri bottle a challenge with every bathroom trip. It also took forever for the water to heat up, which was surprising to me for such a big hospital.
Our experience on the mother-baby floors was good overall. Although after two days we were moved to the third floor and a “regular” mother-baby room, which was annoying to have to pack up all our stuff but not a real big deal. The nurses were all professional and very good at their jobs. We experienced a variety of personalities, of course, but overall we received excellent care.
Although my VBAC wasn’t natural as I’d hoped, I was able to birth my daughter vaginally, which was healing for me emotionally. I’m grateful to my doctor, labor & delivery nurses, my doula and my husband for supporting me to meet that goal. It was difficult work, but I’d do it again for this girl no problem. And I think as time goes by I’ll better be able to come to terms with my decision for pain management and just focus on the healthy baby who is sleeping in my lap as I write this.