Hospital Birth | VBA2C | Chapel Hill, NC
***Birth story and images shared with client's permission***
Meagan and Peter decided to hire a birth doula based on the recommendation of their OB. Meagan was pregnant with her third child. She had cesareans on the recommendation of her doctors with both of her first two children. She really wanted to have a vaginal birth this time. She talked to her OB about this, and they basically shamed her for wanting to even try, saying that she would be putting both her life and the baby’s life in danger if she did. She was very discouraged by this, but knew there had to be another option. She had done her research and knew the risks and benefits of trying for a VBA2C (vaginal birth after two cesareans). She was given a recommendation to try a new OB practice at a different hospital. She contacted them, and they were nothing but supportive of her desires for a vaginal birth.
Meagan’s first two children were decent size babies at 39 weeks, so Meagan was somewhat concerned that if she went too far past her due date that this baby would be too large. Her OBs agreed that they could do a “gentle induction” at 39 weeks, only if Meagan’s cervix was favorable. It wasn’t. Both her doctors and I assured her that she was fully capable of delivering a baby vaginally, even if he was big. Meagan’s due date came and went, and she tried everything possible to naturally induce labor. On April 25th, 2016 at Meagan’s 41 week appointment the OB did another cervical exam, and there were still no changes. They scheduled a repeat cesarean for her the following week when she would be 42 weeks and 2 days just to have her “on the books”, but said that as long as the baby and her were doing well they could try inducing instead. That Friday on April 29th, Meagan went in for a non-stress test and biophysical profile. All looked good on the NST, but they noticed on the ultrasound that the baby wasn’t practicing breathing. The OB said that was somewhat concerning, and felt it would be best to go ahead with an induction. Meagan agreed to being induced that evening, but asked if she could go home first to shower and get her things together. The OB said that was no problem.
Around 8:00pm that evening, the OB placed a foley bulb in Meagan’s cervix to begin the induction process. When they placed the foley bulb, they inadvertently broke her water. Meagan was very upset by this. She was afraid that she would then be put on a time limit. The OB assured her that this would not be the case. I recommended that she get a good meal in and try her best to get a good night’s sleep, because the next day would be a busy one. She agreed. She also said she was so impressed with all of the doctors and nurses she had encountered so far. Every single one of them was not only supportive of her, but also excited for her! She knew she was in exactly the right place to give birth.
The next morning, around 6:30am, the doctor came in for a cervical check. The foley bulb had come out, and Meagan was now 4 cm dilated and 50% effaced. She still wasn’t having intense contractions, so they started her on a low dose of pitocin. At 9:30am, Peter called to let me know that Meagan’s contractions had picked up. They were about 4-5 minutes apart, and she had to stop and breathe through them. I told him I would get ready and head their way!
I arrived at the hospital around 11:00am. Meagan was sitting on the ball working through each contraction. She was handling them so well. She would have to stop to breathe through each contraction, but in between contractions she was chatty and happy. I sat beside her and talked. I asked if she had eaten breakfast. She said she had. I asked Peter if he had. He said he had not. I told him he really should get something to eat, as it was going on lunchtime. The nurse came in about that time, and she also encouraged Peter to eat something. He said, he was fine, but we both explained to him that he needed to get something in his system before things got too intense. Many dads will go without eating, and then as soon as the baby arrives and the adrenaline is gone, they get light headed. I offered to go down and get some food for him and bring it back up. He said, that was alright and that he’d go. He asked Meagan if she was alright with him bringing it back, or if the smell would be too much for her. She said it was no problem. While Peter was gone, Meagan and I chatted some about the day before and how supportive everyone was so far. She was so ready to meet her baby and so excited about the process. Contractions began to intensify and get closer together. They were now about 2 -3 minutes apart.
Peter arrived back with his lunch around 11:30am. He ate, and we talked about Passover. Meagan was sure she was going to be able to skip it that year, because the baby would be arriving. Instead, though he waited until the very last day of Passover to make his appearance. Admittedly, I asked a lot of questions in between contractions about the different Jewish holidays, as I am not real knowledgeable about them. Meagan and Peter were great about explaining the traditions during them and the history behind them. At this point, Meagan was still able to talk fairly easily between contractions, but things were beginning to get more intense. She no longer felt comfortable sitting during contractions. I suggested she sit on the ball between contractions, and then stand and lean on the bed or on Peter during, while I applied heat and pressure to her back. This helped for a little while.
Around 12:20pm, Meagan was beginning to feel a little more overwhelmed by the intensity of the contractions. I suggested she try peeing and working through a few contractions on the toilet, and then try the bath or shower. While she was using the bathroom, we called the nurse to get her IV covered. The nurse covered it, and Meagan got in the shower. She labored in the shower for about 45 minutes. At 1:06pm, while she was drying off from the shower, she mentioned that she thought she might want something for pain relief. I suggested she get checked first to see where she was at, and then she could make the decision. She agreed. Meagan had said before labor that she really wanted to try to avoid getting an epidural.
At 1:25pm, the OB came in to check Meagan’s cervix. She was 5-6 cm dilated, 80% effaced, and baby was at a -1 station. This was really great progress, but Meagan still felt like she needed something. I explained to her that typically once a laboring woman hits the 6 cm mark, things go a little bit faster. The nurse explained her options for pain relief. These included an epidural, IV pain meds, and nitrous oxide. Despite the intensity of the contractions, Meagan was still handling each one so beautifully. She told the nurse that she wanted the epidural. The nurse stepped out to call the anesthesiologist. After the nurse left, Meagan and Peter asked me more questions about the other pain relief options. I answered them, and explained the benefits and risks of each. I told her no matter what her choice, I fully supported her decision. She decided to not get the epidural quite yet. She wanted to try the IV pain meds first to see if that could take the edge off long enough for her to either progress a little more or until it was time to push. I walked out and let the nurse know this. During this time, Meagan continued to labor in the bed on her side. She felt this was the best option for her at the time so that she could at least rest in between contractions.
At 1:43pm, the nurse administered a dose of fentanyl in Meagan’s IV. It took a few minutes to kick in. Typically, IV pain meds make most people a little loopy, but not Meagan. She was pretty well aware of everything still. It did take the edge off some, and she was able to rest and doze in between contractions. Meagan continued to work through the contractions lying on her left side. We put the peanut ball in between her legs to help keep her pelvis open. I added heat and pressure to her back and right hip. Peter and I also kept applying ice cold washcloths to her head and neck. Around 2:00pm, Meagan was grunting a little with her contractions, and she said she really felt a lot of pressure. We called the nurse. She checked Meagan’s cervix, and she was already 8 cm dilated and 100% effaced. That was incredible progress in such a short time.
Just 10 minutes later, at 2:10pm, during a contraction, Meagan yelled, “I need to push. This baby feels like it’s coming out of me right now.” The nurse decided to check her cervix again. Meagan rolled over onto her back, and the nurse checked her. She was completely dilated, and ready to push! Meagan did a few “practice pushes” to get the hang of the best way to push. Once, she got the hang of it, the baby came pretty quickly. Teddy was born at 2:43pm, and he was placed immediately on Meagan’s chest. She was in absolute shock, but full of joy. SHE DID IT! SHE GOT HER VBA2C! It was so incredibly amazing to watch Meagan and Peter’s joy as they looked at their baby and marveled at the way he was born. Meagan had never had a new, sticky, slippery baby put immediately on her, and she was beyond excited that she finally got that experience. Peter was in awe of it all too.
Attending Meagan’s birth was truly such a privilege. Both Meagan and Peter were AMAZING. Peter was awesome support to Meagan. And Meagan. Well Meagan rocked EVERY. SINGLE. SECOND. of her pregnancy, labor, and birth. She worked so hard to make sure she was able to give birth to her baby in the best way she thought possible. She made it happen. She’s an amazing, strong, beautiful, powerful woman. She fought for what she wanted, and she made it happen. In the end, all that work paid off. She had a beautiful, empowering birth, where her choices, her decisions were respected and supported. That is something all birthing people should have. I hope she will forever be proud of herself and all the work she put into making her birth an empowering one.
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