Katherine's Birth Story
Saturday morning, February 2, I began passing small bits of mucous plug. I was 36w1d at the time. Throughout the day, I continued seeing mucous, usually just clear tinted pink.
It was moving day. It's possible I had over-exerted myself the previous day with moving some things over to the new apartment, even though I hadn't done a whole lot, so I really tried to take it easy. But at about 2:30 or so, I had a very small gush of fluid (about a tablespoon, maybe a little more) that just felt different. I went to the bathroom to check, and it was VERY watery--it had soaked right into the pad I was wearing.
So I texted a friend of mine who is even more of a birth junkie than I am, asking her opinion. She called her mom who was an L&D nurse for years. Based on what her mom said, their general opinion was that I probably hadn't sprung a leak, but I wasn't completely convinced, so I decided that if it happened again I'd check with my doctor. My gut was just telling me I shouldn't dismiss it.
It did happen again, about ten minutes later. I didn't call my doctor for another hour or so, though. I was hungry and wanted to get something to eat, plus I was putting it off because of "it's just my imagination" type doubts Even so, I was still passing mucous.
When I talked to my doctor, he was really wanting me to be checked, just in case. Also, my anti-c antibody levels had quadrupled in just a month's time, and he figured we could kill two birds with one stone and do an ultrasound while I was here. Since the hospital was an hour away, we had to find a ride and arrangements for Naomi. Once all that was settled, we headed out to the hospital and arrived at around 7pm. I checked in through the ER, not really knowing what the procedure was, and they got me all registered and sent me to L&D.
They tested my fluid, and it was in fact my water. So then it was decided that it was time to get baby out. Unfortunately, I wasn't dilated AT ALL.
I was there for a few hours before they really got the show on the road. There was a lot of discussion going on between the nurses and my doctor, but I didn't see him for a long time. I guess I didn't really get that we were going into full "induction" mode, because when they started talking about pitocin, I was less than thrilled. It all boiled down to me being a bit out of the loop and not really understanding things, but after I got to talk to my doctor, it made more sense. They wanted to use a foley catheter to help my cervix dilate, but I needed to be having contractions as well for it to work right, and that's why the pitocin was needed. Ok, gotcha. I asked if we could try to wean me off pitocin later, and it was agreed that if I was progressing well, they could try it, but I ended up staying on the pit until the end. Again, I didn't really get that this was an actual induction.
I really don't remember at which point the contractions began to be enough to need to focus and breathe through. Sometime during the night is all I know. I got up at some point to pace/rock/whatever, and soon found that was better for the pain than just lying in bed and breathing. My fluid leaking had really picked up since the nurse had checked my cervix, and I ended up needing to stand on towels.
Walking was tricky, and not just because I was tethered to a bunch of wires. The fetal heartbeat monitor didn't like to pick up Katie's heart rate when I wasn't being still and positioned just right. I soon figured out that if I could hold it tighter against my belly, it worked better, and that I was pretty much limited to just standing and rocking/swaying my hips side to side. If I attempted to lean over forwards against the bed, the heart monitor would lose her pulse again. I tried getting on all fours on the bed (felt GREAT for my contractions and back), but even that was a no-go. So for hours I would basically stand in one spot, rock with contractions, and occasionally get back in bed to rest.
They began to get strong enough for me to need to vocalize, I think sometime in the early morning hours. Not too loudly though. For the first few hours of the day, I could get away with just sorta moaning lightly, kinda breathy. Later on, they got more intense and I found myself having to vocalize more forcefully, especially if I was lying down. The rocking and moaning combo worked best for a good long while.
I was contracting with the pit and the foley for hours. They had started out feeling just like period cramps, and were no big deal. The internal exams and the insertion of the catheter and all that were the most painful thing at that point. I actually got annoyed at my doctor because he always says, "Okay, real gentle" before he does it, but it's NEVER gentle. I teased him about it at one point, but in all seriousness I'd rather be told, "This might hurt, brace yourself" than be led to believe it won't and then be caught off guard by OMGOODNESSTHATHURTSMORETHANANYTHING!
Well I'm getting off track. I think it was something like 5:30 or so when the foley finally came out. They'd been waiting to see if it would fall out, but the doctor ended up pulling it out. It came out easily and without pain, so it was ready. I was 4cm at that point.
Since I was induced, my contractions were never more than five minutes apart. What they wanted to see was 2-3 minutes apart, ideally. So I never did have that mild early labor where you'd have fifteen minutes or more between pains. I was up all night.
For the first part of Sunday, though, I progressed really well. I was dilating, effacing, things were looking good. Katherine was head down and LOA--the most ideal position for birth. I spent the first part of the day being really happy that things were going so well. I even liked being continuously monitored because I could always see the contractions starting up before I could feel them, and that gave me just enough time to focus and brace myself to ride them out. If I let one catch me off guard, I had a harder time dealing with them. Also, I was only feeling pain for maybe 15 seconds at a time, not the full minute that you usually hear about. I don't know if that's a natural vs. pitocin thing, though.
But at some point, maybe in the afternoon sometime, they checked me and I was basically stuck at 5-6cm. So they upped the pitocin some more. They'd check, I hadn't progressed, they'd up it some more.
The problem became that, for some reason, my body kinda hit a wall. It wasn't responding to the increasing dose of pit--I'd get a few really strong contractions, but then they'd ease off and they weren't dilating me at all. Then my cervix started to swell and lose effacement. Katie had been engaging, but had gone back up some. I was regressing even though my contractions were nearing the unbearable point. They sure didn't FEEL like they weren't doing anything!
At one point the nurse suggested I let her give me some stadol to take the edge off the pain for a while and put me to sleep so I cold get some much-needed rest, I think sometime between 5 and 6pm. The idea was that if I could sleep for a bit, my cervix might relax and start dilating again. At that point, after spending some time on the birth ball to rest my legs from walking, I was essentially falling asleep between contractions, but of course couldn't sleep through them. So I agreed to take some temporary pain relief and a nap. That stuff did make me VERY sleepy (really what it did was knock me flat out between contractions!) AND it made the pain more bearable, but very soon after she gave it to me, there was a period of time where everyone was just busy about me. They were trying to get me to lie on my side to help things progress, and then the doctor wanted to check my cervix again, which of course hadn't progressed. For about half an hour there was just "stuff" going on, and I wasn't able to get my nap.
Then the doctor began recommending I get an epidural.
He had good reason, actually. The epidural could help the cervix relax, and I would be pain-free, able to sleep a while, AND I'd be able to withstand a higher dose of pit which he hoped would get things rolling again. He asked us to think about it and left the room.
Then I asked the nurse if I could first do one more round of stadol. I expressed that I felt that I hadn't had a chance to nap with the first dose they'd given me because that's when everyone got busy with me. So she brought me one more dose, and I said I'd discuss the epidural after I'd had some rest. I had gone into this being open to pain relief if I became too exhausted to really deal with the labor, anyway.
I think I slept... maybe an hour or hour and a half? I remember being awakened by contractions a couple times. When I started to wake up some more, my husband and friend who was there to take pictures said I'd actually slept through a couple contractions. I think I woke up at around 8:30 or so.
So by now I was really considering the epidural. What the doctor had said made sense. I considered that I'd spent all night and all day in labor and these really painful contractions weren't even doing anything, and if an epidural was my best shot at a vaginal delivery, I figured it could be worth it. I thought about it for a little bit, talked about it with those in the room with me, and decided we'd give it a try.
That. HURT.
The anesthesiologist was... well, not very personable. He had some trouble getting it in the right spot, plus I needed two shots of local so it didn't REALLY hurt going in--enough to make me shriek in a high pitch, and of course they were all telling me to try to relax. Yeah, right! My husband was standing in front of me, holding my hands while I leaned over with my head buried in his chest. It helped to have his hands to squeeze.
Even after the second shot of local, it still felt VERY uncomfortable. The whole process took a few minutes and was rough, but we got it done and just a few minutes later my belly was numb, even though the nurse had said it would take a little bit to completely work, so I was glad it worked so quickly. My legs went sorta numb, but I could still move them around on the bed, which was really nice because that allowed me to sit up as best I could to help keep my pelvis open.
A few hours went by, and progress was still very slow. The 24-hour mark (since water had broken) had long passed, and my doctor hadn't even mentioned c-section very much. He was trying everything to get Katie out of me the old-fashioned way. At about 12:30am, My doctor told the nurses to turn up the pitocin by two points every 20 minutes and that I would be checked every hour for three hours, and if I wasn't progressing then we'd be probably doing a c-section. He explained to me that what needed to happen was stronger contractions to push the baby's head onto the cervix and apply more pressure, and that's why I hadn't been dilating past 6cm. At this point the swelling had gone down, though, so it wasn't a lost cause just yet.
So that's what we did. The first time I was checked, I think I'd gone to 7cm. I'd been feeling a mild urge to push, and had been kinda lightly pushing a few times, but not much. I noticed it showed on the monitor, too (they'd put in an internal tube to more accurately measure my contractions). So when I was told I was 7cm, I decided I'd start pushing more. I knew the nurse wouldn't like it if she found out, but I also knew it might just be the thing to help apply that pressure needed, along with sitting straight up.
I didn't push very hard, because I didn't want to overdo it. I knew if I wasn't careful I could make things worse. But based on what I've read, it's not really all that necessary to wait until 10cm, and if I was feeling an urge to push, especially through an epidural, my body was doing that for a reason. I had also been feeling the baby's head putting pressure on my cervix whenever I had a good strong contraction.
Well after a little while the nurse came in, looked at the monitor and said, "Looks like you've been pushing, have you?" I just told her that I'd been feeling the urge and that I probably did push subconsciously a few times--and that was true, I just left out the part where I was also pushing intentionally, LoL. She then gave me the usual "don't push yet, just try to breathe if you feel you need to, your cervix will swell again if you push" spiel. I nodded, played compliant until she left the room, then went back to pushing, LoL. I tried to hide it better after that, though.
(For anyone interested, this is why I ignored the nurse and pushed when I felt the urge. Also, the doctor had told me that he wanted to see contractions strong enough to cause the baby's head to put more pressure on my cervix, and so it seemed logical that some light pushing would achieve the same result.)
I honestly think it did some good. My next check I was 8 or 9cm, though I didn't find that out until a little later. When my doctor checked me, he started prodding around and then told me to push HARD. He didn't explain what he was doing exactly, but he told me later that what he wanted to see was whether my pushing would move her head down at all. Once he saw that it did, he just kept telling me to push while helping my cervix stretch with his fingers. OH IT HURT, even with the epidural.
This is basically what we did from that point on. When one of the nurses came in, he had her start getting me ready to deliver the baby. She grabbed a couple other nurses, lights were turned on, my husband was awakened, my legs were propped up, my bed was leaned back, the works. It was time to have the baby!
Honestly it all happened so fast I didn't process it much at the time. In fact, when he'd come in to check me, I had just decided to take a break from obsessively watching the monitor and pushing with contractions to try to get another nap. I think I was still kinda loopy from the stadol, too, and had been really having a hard time staying awake. But I put all I had into pushing anyway.
At one point, I suddenly got very nauseous, my mouth was watering, and so the nurse grabbed a sick bag for me, and I threw up into it right away. I think I had a contraction while I was throwing up too, hehe. I remember the nurses saying, "That's okay, throwing up counts as pushing!" Not sure why, but it struck me as rather amusing.
Pushing really HURT when they had me going at it full-force. Then at some point, the epidural started to wear off on my right side. There is a spot on my right side from my c-section that gets sore now and then, a very sharp pain kind of sore. I think the surgery hit a nerve or something on that side. My doctor had also triggered that sore spot while he was prodding around, so now when I started to feel contractions, I was feeling them in that one spot. IT HURT. I was also being instructed to push as hard as I could for ten seconds at a time, and barely time to breathe in between pushes. They were having me push four times with each contraction. My mouth was unbearably dry every time I was done. My husband had been standing near the bed with a cup of water and a straw which he'd use to drop a couple teaspoons of water in my mouth between contractions. My friend was taking lots of pictures.
Progress was being made with every contraction. I couldn't feel too much besides the pain of my sore spot and of the doctor's prodding. During some pushes I couldn't help but cry out because of the pain. Then at one point the doctor said I almost had her hair out (a fun way he likes to describe crowning). And then after the next contraction he said I could reach down and feel her head if I wanted to, and I did. It was such a neat feeling! They were all saying that she had a lot of dark hair.
I most definitely felt when her head started coming out and stretching my skin, but the funny thing is that pain was not all that bad compared to what I'd already been through, and I knew it wouldn't last long. It was one or two contractions between crowning and being born! She cried right away and they placed her, gooey and bloody and all, on a cloth on my chest. I'd wanted skin-to-skin, but I was too tired to bother asking. I just put my hands on her and had contact with her that way. It was great to actually be able to see her and touch her in that state, all covered in mess, before any of it was gone. Not getting that the first time around was one of the things that really bothered me about my c-section.
Katie was on my chest for just a few minutes. She was crying, kind of blue, but I was DONE and so happy to finally see her, although I was so incredibly EXHAUSTED that I really wasn't all that emotional at all when I was actually in the moment. My husband actually cut the cord this time, too. He had said he wasn't too interested in it. He was really just indifferent, didn't care one way or the other, but since my friend was there taking pictures and all, the doctor quickly talked him into it for the "kodak moment" LoL.
The placenta came right out, all on its own--no pushing needed (on reflection, the doctor might have pulled it out, but he didn't say anything)! I felt it just slide right out of me a minute or two after the baby was out and said, "Well that was easy!"
I got a few tears, so the doctor had to put in some stitches. He did this while the nurses took the baby and weighed her and all that. They ended up doing the eye ointment and vitamin k before I even thought to ask them not to, but that was my fault because I'd just completely forgotten to bring it up ahead of time. In fact, it wasn't until I'd started pushing that I remembered to mention that I wasn't interested in an episiotomy, LoL. Fortunately, my doctor doesn't do them unless they're actually needed.
After it was all over, there was one more internal check he wanted to do, and that was to check the scar for a rupture. He did that and then happily announced that it was still intact, and that was a relief to me. I had been worried that the pain I'd been feeling earlier had been a small tear. He said, "Well you did it, you've successfully VBACed!" Not with much enthusiasm since it was the wee hours of the morning and he was pretty tired himself, poor guy. When he said that, I raised up my fists in the air and smiled. I'd have said something like "Woohoo!" but I was just too exhausted to say much at all.
Overall, I'm very satisfied with the experience. It definitely wasn't the amazing, emotional, "this makes up for everything" experience I was hoping for, at least not at this point, but I think that the "emotional natural birth" thing kinda went out the window as soon as my water broke. I didn't realize that right away, but in a way I'm glad I didn't realize it, because that's partly what kept me going as long as I did through the really tough contractions. I really feel like I gave it a really good try. I wouldn't say I gave it "my all" but I think if I'd have completely used up all my strength, I wouldn't have had any left to push out the baby and I'd have ended up with a c-section. That was one reason the doctor wanted me on an epidural, so I could save the little energy I had left. I'd been without sleep for around 36 hours, and in actual labor for well over 20 hours when I consented to it (although it really didn't seem nearly that long!). I really was out of juice. I think if I'd have tried to keep going, I'd have ended up with another surgery.
I have to say that my doctor completely surprised me and I am just blown away at how he fought for my VBAC, albeit mostly very quietly. I knew about the "24 hour" rule, and I had also heard him say he wasn't really strict about it, but I honestly didn't know he was willing to wait as long as he did. It was right around 37 hours from when I felt the first gush to when Katie was born, and that says a lot. It was well past the 24-hour mark when he brought up the suggestion for the epidural, too. It was almost like he wanted it more than I did, and I feel like I owe a lot of my success to him. It's amazing.
I have to give credit to Katie, too. She was SUCH a trooper the whole time. Her heart rate never faltered, she never showed any signs of distress whatsoever, and she was in the PERFECT birth position. She didn't get stuck or anything. I know she didn't really control any of that, but I couldn't help but be so very proud of her. I guess I'm just really grateful to have such a strong, healthy baby in this process who could handle all that the situation threw at her.
I feel like this whole experience has been very worthwhile. I have learned a lot about myself--not only do I now know what labor really feels like, but I know how much I can handle, and when I actually counted the hours that I'd been in labor, I was honestly surprised at myself. I feel like I'm just that much better prepared for next time, and I am SO glad that next time will be even less risk than this time. And this time I don't have to deal with any major, lingering emotional stress about the birth itself, and I can focus on my new daughter and our relationship, as well as the transition to being a mother of two now. As it is, the little one and I are having some breastfeeding issues, but I honestly feel like I can handle it a lot better BECAUSE the birth hasn't left any lingering emotional drama.
TL; DR: Very medicated preterm birth wasn't what I wanted, but was still an awesome, positive experience and I am thrilled to have not only pushed out my own baby, but I have also defeated the "once a c-section, always a c-section" trend that is pretty much still in place. I feel incredibly privileged to have had this opportunity AND to have succeeded.
My body is not broken!
It was moving day. It's possible I had over-exerted myself the previous day with moving some things over to the new apartment, even though I hadn't done a whole lot, so I really tried to take it easy. But at about 2:30 or so, I had a very small gush of fluid (about a tablespoon, maybe a little more) that just felt different. I went to the bathroom to check, and it was VERY watery--it had soaked right into the pad I was wearing.
So I texted a friend of mine who is even more of a birth junkie than I am, asking her opinion. She called her mom who was an L&D nurse for years. Based on what her mom said, their general opinion was that I probably hadn't sprung a leak, but I wasn't completely convinced, so I decided that if it happened again I'd check with my doctor. My gut was just telling me I shouldn't dismiss it.
It did happen again, about ten minutes later. I didn't call my doctor for another hour or so, though. I was hungry and wanted to get something to eat, plus I was putting it off because of "it's just my imagination" type doubts Even so, I was still passing mucous.
When I talked to my doctor, he was really wanting me to be checked, just in case. Also, my anti-c antibody levels had quadrupled in just a month's time, and he figured we could kill two birds with one stone and do an ultrasound while I was here. Since the hospital was an hour away, we had to find a ride and arrangements for Naomi. Once all that was settled, we headed out to the hospital and arrived at around 7pm. I checked in through the ER, not really knowing what the procedure was, and they got me all registered and sent me to L&D.
They tested my fluid, and it was in fact my water. So then it was decided that it was time to get baby out. Unfortunately, I wasn't dilated AT ALL.
I was there for a few hours before they really got the show on the road. There was a lot of discussion going on between the nurses and my doctor, but I didn't see him for a long time. I guess I didn't really get that we were going into full "induction" mode, because when they started talking about pitocin, I was less than thrilled. It all boiled down to me being a bit out of the loop and not really understanding things, but after I got to talk to my doctor, it made more sense. They wanted to use a foley catheter to help my cervix dilate, but I needed to be having contractions as well for it to work right, and that's why the pitocin was needed. Ok, gotcha. I asked if we could try to wean me off pitocin later, and it was agreed that if I was progressing well, they could try it, but I ended up staying on the pit until the end. Again, I didn't really get that this was an actual induction.
I really don't remember at which point the contractions began to be enough to need to focus and breathe through. Sometime during the night is all I know. I got up at some point to pace/rock/whatever, and soon found that was better for the pain than just lying in bed and breathing. My fluid leaking had really picked up since the nurse had checked my cervix, and I ended up needing to stand on towels.
Walking was tricky, and not just because I was tethered to a bunch of wires. The fetal heartbeat monitor didn't like to pick up Katie's heart rate when I wasn't being still and positioned just right. I soon figured out that if I could hold it tighter against my belly, it worked better, and that I was pretty much limited to just standing and rocking/swaying my hips side to side. If I attempted to lean over forwards against the bed, the heart monitor would lose her pulse again. I tried getting on all fours on the bed (felt GREAT for my contractions and back), but even that was a no-go. So for hours I would basically stand in one spot, rock with contractions, and occasionally get back in bed to rest.
They began to get strong enough for me to need to vocalize, I think sometime in the early morning hours. Not too loudly though. For the first few hours of the day, I could get away with just sorta moaning lightly, kinda breathy. Later on, they got more intense and I found myself having to vocalize more forcefully, especially if I was lying down. The rocking and moaning combo worked best for a good long while.
I was contracting with the pit and the foley for hours. They had started out feeling just like period cramps, and were no big deal. The internal exams and the insertion of the catheter and all that were the most painful thing at that point. I actually got annoyed at my doctor because he always says, "Okay, real gentle" before he does it, but it's NEVER gentle. I teased him about it at one point, but in all seriousness I'd rather be told, "This might hurt, brace yourself" than be led to believe it won't and then be caught off guard by OMGOODNESSTHATHURTSMORETHANANYTHING!
Well I'm getting off track. I think it was something like 5:30 or so when the foley finally came out. They'd been waiting to see if it would fall out, but the doctor ended up pulling it out. It came out easily and without pain, so it was ready. I was 4cm at that point.
Since I was induced, my contractions were never more than five minutes apart. What they wanted to see was 2-3 minutes apart, ideally. So I never did have that mild early labor where you'd have fifteen minutes or more between pains. I was up all night.
For the first part of Sunday, though, I progressed really well. I was dilating, effacing, things were looking good. Katherine was head down and LOA--the most ideal position for birth. I spent the first part of the day being really happy that things were going so well. I even liked being continuously monitored because I could always see the contractions starting up before I could feel them, and that gave me just enough time to focus and brace myself to ride them out. If I let one catch me off guard, I had a harder time dealing with them. Also, I was only feeling pain for maybe 15 seconds at a time, not the full minute that you usually hear about. I don't know if that's a natural vs. pitocin thing, though.
But at some point, maybe in the afternoon sometime, they checked me and I was basically stuck at 5-6cm. So they upped the pitocin some more. They'd check, I hadn't progressed, they'd up it some more.
The problem became that, for some reason, my body kinda hit a wall. It wasn't responding to the increasing dose of pit--I'd get a few really strong contractions, but then they'd ease off and they weren't dilating me at all. Then my cervix started to swell and lose effacement. Katie had been engaging, but had gone back up some. I was regressing even though my contractions were nearing the unbearable point. They sure didn't FEEL like they weren't doing anything!
At one point the nurse suggested I let her give me some stadol to take the edge off the pain for a while and put me to sleep so I cold get some much-needed rest, I think sometime between 5 and 6pm. The idea was that if I could sleep for a bit, my cervix might relax and start dilating again. At that point, after spending some time on the birth ball to rest my legs from walking, I was essentially falling asleep between contractions, but of course couldn't sleep through them. So I agreed to take some temporary pain relief and a nap. That stuff did make me VERY sleepy (really what it did was knock me flat out between contractions!) AND it made the pain more bearable, but very soon after she gave it to me, there was a period of time where everyone was just busy about me. They were trying to get me to lie on my side to help things progress, and then the doctor wanted to check my cervix again, which of course hadn't progressed. For about half an hour there was just "stuff" going on, and I wasn't able to get my nap.
Then the doctor began recommending I get an epidural.
He had good reason, actually. The epidural could help the cervix relax, and I would be pain-free, able to sleep a while, AND I'd be able to withstand a higher dose of pit which he hoped would get things rolling again. He asked us to think about it and left the room.
Then I asked the nurse if I could first do one more round of stadol. I expressed that I felt that I hadn't had a chance to nap with the first dose they'd given me because that's when everyone got busy with me. So she brought me one more dose, and I said I'd discuss the epidural after I'd had some rest. I had gone into this being open to pain relief if I became too exhausted to really deal with the labor, anyway.
I think I slept... maybe an hour or hour and a half? I remember being awakened by contractions a couple times. When I started to wake up some more, my husband and friend who was there to take pictures said I'd actually slept through a couple contractions. I think I woke up at around 8:30 or so.
So by now I was really considering the epidural. What the doctor had said made sense. I considered that I'd spent all night and all day in labor and these really painful contractions weren't even doing anything, and if an epidural was my best shot at a vaginal delivery, I figured it could be worth it. I thought about it for a little bit, talked about it with those in the room with me, and decided we'd give it a try.
That. HURT.
The anesthesiologist was... well, not very personable. He had some trouble getting it in the right spot, plus I needed two shots of local so it didn't REALLY hurt going in--enough to make me shriek in a high pitch, and of course they were all telling me to try to relax. Yeah, right! My husband was standing in front of me, holding my hands while I leaned over with my head buried in his chest. It helped to have his hands to squeeze.
Even after the second shot of local, it still felt VERY uncomfortable. The whole process took a few minutes and was rough, but we got it done and just a few minutes later my belly was numb, even though the nurse had said it would take a little bit to completely work, so I was glad it worked so quickly. My legs went sorta numb, but I could still move them around on the bed, which was really nice because that allowed me to sit up as best I could to help keep my pelvis open.
A few hours went by, and progress was still very slow. The 24-hour mark (since water had broken) had long passed, and my doctor hadn't even mentioned c-section very much. He was trying everything to get Katie out of me the old-fashioned way. At about 12:30am, My doctor told the nurses to turn up the pitocin by two points every 20 minutes and that I would be checked every hour for three hours, and if I wasn't progressing then we'd be probably doing a c-section. He explained to me that what needed to happen was stronger contractions to push the baby's head onto the cervix and apply more pressure, and that's why I hadn't been dilating past 6cm. At this point the swelling had gone down, though, so it wasn't a lost cause just yet.
So that's what we did. The first time I was checked, I think I'd gone to 7cm. I'd been feeling a mild urge to push, and had been kinda lightly pushing a few times, but not much. I noticed it showed on the monitor, too (they'd put in an internal tube to more accurately measure my contractions). So when I was told I was 7cm, I decided I'd start pushing more. I knew the nurse wouldn't like it if she found out, but I also knew it might just be the thing to help apply that pressure needed, along with sitting straight up.
I didn't push very hard, because I didn't want to overdo it. I knew if I wasn't careful I could make things worse. But based on what I've read, it's not really all that necessary to wait until 10cm, and if I was feeling an urge to push, especially through an epidural, my body was doing that for a reason. I had also been feeling the baby's head putting pressure on my cervix whenever I had a good strong contraction.
Well after a little while the nurse came in, looked at the monitor and said, "Looks like you've been pushing, have you?" I just told her that I'd been feeling the urge and that I probably did push subconsciously a few times--and that was true, I just left out the part where I was also pushing intentionally, LoL. She then gave me the usual "don't push yet, just try to breathe if you feel you need to, your cervix will swell again if you push" spiel. I nodded, played compliant until she left the room, then went back to pushing, LoL. I tried to hide it better after that, though.
(For anyone interested, this is why I ignored the nurse and pushed when I felt the urge. Also, the doctor had told me that he wanted to see contractions strong enough to cause the baby's head to put more pressure on my cervix, and so it seemed logical that some light pushing would achieve the same result.)
I honestly think it did some good. My next check I was 8 or 9cm, though I didn't find that out until a little later. When my doctor checked me, he started prodding around and then told me to push HARD. He didn't explain what he was doing exactly, but he told me later that what he wanted to see was whether my pushing would move her head down at all. Once he saw that it did, he just kept telling me to push while helping my cervix stretch with his fingers. OH IT HURT, even with the epidural.
This is basically what we did from that point on. When one of the nurses came in, he had her start getting me ready to deliver the baby. She grabbed a couple other nurses, lights were turned on, my husband was awakened, my legs were propped up, my bed was leaned back, the works. It was time to have the baby!
Honestly it all happened so fast I didn't process it much at the time. In fact, when he'd come in to check me, I had just decided to take a break from obsessively watching the monitor and pushing with contractions to try to get another nap. I think I was still kinda loopy from the stadol, too, and had been really having a hard time staying awake. But I put all I had into pushing anyway.
At one point, I suddenly got very nauseous, my mouth was watering, and so the nurse grabbed a sick bag for me, and I threw up into it right away. I think I had a contraction while I was throwing up too, hehe. I remember the nurses saying, "That's okay, throwing up counts as pushing!" Not sure why, but it struck me as rather amusing.
Pushing really HURT when they had me going at it full-force. Then at some point, the epidural started to wear off on my right side. There is a spot on my right side from my c-section that gets sore now and then, a very sharp pain kind of sore. I think the surgery hit a nerve or something on that side. My doctor had also triggered that sore spot while he was prodding around, so now when I started to feel contractions, I was feeling them in that one spot. IT HURT. I was also being instructed to push as hard as I could for ten seconds at a time, and barely time to breathe in between pushes. They were having me push four times with each contraction. My mouth was unbearably dry every time I was done. My husband had been standing near the bed with a cup of water and a straw which he'd use to drop a couple teaspoons of water in my mouth between contractions. My friend was taking lots of pictures.
Progress was being made with every contraction. I couldn't feel too much besides the pain of my sore spot and of the doctor's prodding. During some pushes I couldn't help but cry out because of the pain. Then at one point the doctor said I almost had her hair out (a fun way he likes to describe crowning). And then after the next contraction he said I could reach down and feel her head if I wanted to, and I did. It was such a neat feeling! They were all saying that she had a lot of dark hair.
I most definitely felt when her head started coming out and stretching my skin, but the funny thing is that pain was not all that bad compared to what I'd already been through, and I knew it wouldn't last long. It was one or two contractions between crowning and being born! She cried right away and they placed her, gooey and bloody and all, on a cloth on my chest. I'd wanted skin-to-skin, but I was too tired to bother asking. I just put my hands on her and had contact with her that way. It was great to actually be able to see her and touch her in that state, all covered in mess, before any of it was gone. Not getting that the first time around was one of the things that really bothered me about my c-section.
Katie was on my chest for just a few minutes. She was crying, kind of blue, but I was DONE and so happy to finally see her, although I was so incredibly EXHAUSTED that I really wasn't all that emotional at all when I was actually in the moment. My husband actually cut the cord this time, too. He had said he wasn't too interested in it. He was really just indifferent, didn't care one way or the other, but since my friend was there taking pictures and all, the doctor quickly talked him into it for the "kodak moment" LoL.
The placenta came right out, all on its own--no pushing needed (on reflection, the doctor might have pulled it out, but he didn't say anything)! I felt it just slide right out of me a minute or two after the baby was out and said, "Well that was easy!"
I got a few tears, so the doctor had to put in some stitches. He did this while the nurses took the baby and weighed her and all that. They ended up doing the eye ointment and vitamin k before I even thought to ask them not to, but that was my fault because I'd just completely forgotten to bring it up ahead of time. In fact, it wasn't until I'd started pushing that I remembered to mention that I wasn't interested in an episiotomy, LoL. Fortunately, my doctor doesn't do them unless they're actually needed.
After it was all over, there was one more internal check he wanted to do, and that was to check the scar for a rupture. He did that and then happily announced that it was still intact, and that was a relief to me. I had been worried that the pain I'd been feeling earlier had been a small tear. He said, "Well you did it, you've successfully VBACed!" Not with much enthusiasm since it was the wee hours of the morning and he was pretty tired himself, poor guy. When he said that, I raised up my fists in the air and smiled. I'd have said something like "Woohoo!" but I was just too exhausted to say much at all.
Overall, I'm very satisfied with the experience. It definitely wasn't the amazing, emotional, "this makes up for everything" experience I was hoping for, at least not at this point, but I think that the "emotional natural birth" thing kinda went out the window as soon as my water broke. I didn't realize that right away, but in a way I'm glad I didn't realize it, because that's partly what kept me going as long as I did through the really tough contractions. I really feel like I gave it a really good try. I wouldn't say I gave it "my all" but I think if I'd have completely used up all my strength, I wouldn't have had any left to push out the baby and I'd have ended up with a c-section. That was one reason the doctor wanted me on an epidural, so I could save the little energy I had left. I'd been without sleep for around 36 hours, and in actual labor for well over 20 hours when I consented to it (although it really didn't seem nearly that long!). I really was out of juice. I think if I'd have tried to keep going, I'd have ended up with another surgery.
I have to say that my doctor completely surprised me and I am just blown away at how he fought for my VBAC, albeit mostly very quietly. I knew about the "24 hour" rule, and I had also heard him say he wasn't really strict about it, but I honestly didn't know he was willing to wait as long as he did. It was right around 37 hours from when I felt the first gush to when Katie was born, and that says a lot. It was well past the 24-hour mark when he brought up the suggestion for the epidural, too. It was almost like he wanted it more than I did, and I feel like I owe a lot of my success to him. It's amazing.
I have to give credit to Katie, too. She was SUCH a trooper the whole time. Her heart rate never faltered, she never showed any signs of distress whatsoever, and she was in the PERFECT birth position. She didn't get stuck or anything. I know she didn't really control any of that, but I couldn't help but be so very proud of her. I guess I'm just really grateful to have such a strong, healthy baby in this process who could handle all that the situation threw at her.
I feel like this whole experience has been very worthwhile. I have learned a lot about myself--not only do I now know what labor really feels like, but I know how much I can handle, and when I actually counted the hours that I'd been in labor, I was honestly surprised at myself. I feel like I'm just that much better prepared for next time, and I am SO glad that next time will be even less risk than this time. And this time I don't have to deal with any major, lingering emotional stress about the birth itself, and I can focus on my new daughter and our relationship, as well as the transition to being a mother of two now. As it is, the little one and I are having some breastfeeding issues, but I honestly feel like I can handle it a lot better BECAUSE the birth hasn't left any lingering emotional drama.
TL; DR: Very medicated preterm birth wasn't what I wanted, but was still an awesome, positive experience and I am thrilled to have not only pushed out my own baby, but I have also defeated the "once a c-section, always a c-section" trend that is pretty much still in place. I feel incredibly privileged to have had this opportunity AND to have succeeded.
My body is not broken!