Monday, April 29, 2013

Our Birth Story: A natural VBAC at 41 weeks, 1 day

Our birth story with Amelia really began with the birth of her big brother Grant.  As some of you know, we had intended on having a natural hypnobirth with Grant but because of his being frank breech we had a c-section at 39 weeks.  I knew before he was even born that I wanted a natural VBAC with our next and that is exactly what we had with Amelia.  If you didn't have the chance to read more about our attempts to turn Grant and his birth story you can read that here.

For me this birth was exactly what I wanted and needed.   It was healing and empowering, beautiful and enlightening.  I had heard from women in my shoes and with similar experiences that there was no greater feeling than birthing your baby the way it was intended and I wanted that experience more than I can even put into words.

How it began:
Leading up to labor and delivery, I had what I would call an active uterus. It was nothing for me to have a couple days in a row where my Braxton Hick's (BH's) were like clockwork anywhere between 5-7 minutes apart and then have them taper off a bit and have them every 20 minutes or so.  Even with all that action, I never dilated beyond 1 cm at any of my appointments.   

At 40 weeks, 2 days I lost my mucous plug.  I finally felt like things were progressing in the right direction and I had some indication that my body was beginning to do what it was made to do.  The next couple of days my BH's continued as normal but occasionally I had some mild cramping and back aches associated with them.  It wasn't until I was sleeping Wednesday night (40 weeks, 6 days) that I had contractions that actually woke me up because of the cramping and back pain associated with each wave.  Still they were nothing regular or unbearable so I went back to sleep comfortably. 

The next morning at 41 weeks I woke up as normal and went to work.  I was still having what I would now deem as "real" contractions every 10-20 minutes but never focused on them too much.  I knew that I and my body would know when it was time to dial in and really focus on how it was all making me feel and to leave work if need be.  Well, I made it through the day with no problem and no change and headed to my 41 week appointment.  I was at 2 cm and 70% effaced.  She stripped my membranes and off I went.  Dr. Dennis had us schedule a biophysical profile (BPP) for the next day just to check on Amelia and make sure we were still safe to go to at least 42 weeks if needed but we both felt confident that wouldn't be the case. 

Labor at home:
By the end of the day my contractions still were not regular but they were more uncomfortable.  I attributed some of that to stripping my membranes.  I gave Kamala (our doula) my update before bed and put my relaxation music on knowing that even at this point with irregular (6-11 minutes apart) but uncomfortable, not painful contractions I would need help relaxing between them so I could get some sleep.

The music worked wonderfully and I was able to doze easily between contractions that by 11 pm were now regular and coming every 10-11 minutes. This same trend of 10-11 minutes continued all night and though I didn't time them all night I would periodically do so to make sure they weren't getting closer because everytime I had one it would wake me and I had to actively breath through them.  I was pretty tired going into Friday morning.  Once I woke and got moving, they became somewhat irregular depending on what I was doing so I honestly wrote it off again as noting.  As the day continued they settled in to about 6-9 minutes apart and lasting anywhere from 45 secs if I was moving to 1 min 15 secs if sitting still.

We still went in for our BPP and she scored 6/8 because she was being lazy and didn't want to move so they sent me to labor and delivery to do a non stress test (NST).  I was a little frustrated at this point because she was moving like crazy leading up to the BPP and I thought the NST was a waste of our time.  Well she was looking great on the monitor during the NST and they were just about to let me go when I felt a pretty big contraction and gush.  My water broke at 11:45 am.  My contractions were about 5-6 minutes apart at that point and I was still at 2 cm but 80-90% effaced.  That is when reality set in that what I had been feeling over the last 24 hours were indeed "real" contractions although like I mentioned they weren't always regular but different than my very active Braxton Hick's.


Labor at the hospital:
After admission to the hospital, we got settled in.  Matt got the call to leave work, my mom had been with me all along, and Kamala came shortly after.  I was hooked up to a hep lock and not confined to having an IV the entire time.  I had my next vaginal check at around 4 pm and I was at a 4 cm and still about same effaced.  My biggest fear with my water breaking at the hospital and being admitted right away at only 2 cm was that we had a very long road ahead of us and I know I would be much more comfortable at home.  I am happy to say that things progressed rather quickly and it was perfectly ok laboring at the hospital in my case.  I was unhooked from the baby/contraction monitor at anytime I wanted.  I labored in the tub, on a birth ball, on a birth stool, in bed, on my hands and knees.  Basically whatever position felt best for me, body and baby at the time that is what we did.   

After my check at 4 pm my contractions began coming very close together.  I was lucky if I was getting a 1 to 1 1/2  minute break between them.  I was feeling pretty run down and tired.  The nurse came in at 6:50 pm and I asked when Dr. Dennis would be in for another check.  She told me 8 and asked if I wanted her to come in sooner.  I knew if I said yes and I was only at say a 6 I would feel let down but if I were further it would give me a boost of confidence.  I took my chances and asked the nurse to have Dr. Dennis come in and check me.  Well I am glad she did because I was then at 8 cm.   That of course explains the intense contractions I had been having.  After another check at 8:00, I was at 9-10 cm with a slight amount of cervix "between 9 and 12 o'clock that wasn't fully effaced."  The order was given to prep the room and I was given the go ahead to continue to gently breath her down and work with my body.  I was feeling the urge to bare down during contractions at this point, not labor pushes just pushing to get her further down the birth path. 

Delivery:
We were doing well, I was at a full 10 and fully effaced but at about 9 pm we were noticing some dips in her heart rate with each contraction.  Dr. Dennis let me continue to breath Amelia down and push on my own until 9:30 and then she decided the dips were getting too big and we needed to work a bit harder to get her out.  I began pushing and she tolerated well for a little bit but her heart rate began taking some bigger dips (as low at 70 bpm at some points and not having enough time to recover because my contractions were coming so quickly).  They decided to give me oxygen in between contractions to help get her heart rate up and Dr. Dennis was also massaging her head in between contractions.

After some hard work of pushing for about 30-40 minutes her head emerged but her shoulder was stuck so that took another push or two and some help from Dr. Dennis to deliver the rest of her.  

After Delivery:
Amelia arrived into this world a little shell shocked and slightly distressed.  Dr. Dennis had to unloop a single wrap of the cord from around her neck.  She respected our wishes for delaying the clamping of her umbilical cord and was giving her a good rub down then brought her to my tummy all the while leaving her cord in tact.  She still wasn't responding the way we had hoped so Dr. Dennis made the call to cut her cord (which had stopped pulsating already) so the nurses could do some quick work on her.  In less than 5 minutes, she was back in our arms and left completely undisturbed until we were ready.   

I delivered the placenta and Dr. Dennis repaired a 2nd degree tear I experienced.  All the while we were allowed to nurse at our leisure (she latched on like a pro from the beginning), bond, cuddle, take pictures.  It was truly amazing.  Overall, Amelia's APGAR scores were 6 and 8.  I experienced some post partum hemorrhaging that they first used pitocin to try to slow down which didn't work so they had to give me an injection methergine which did the trick.

Amelia's official stats were as follows
Birthday: April 26, 2013
Weight:  9 lbs 0 oz
Length:  20"
Head Circumference:  35.5 cm   

She is actually considered "large" for her gestational age (which I found surprising because she was born at 41 weeks, 1 day afterall) so we had to do 2 blood sugar checks for diabetes before 2 of her feedings.  She tested just fine so there are no further concerns there.

Thus far at 2 days old she is doing amazingly well.  I have been having to wake her to feed her but she is very alert when she is awake.  Eyes wide open looking around and she already has a little personality.  Grant is so in love with her and so attentive.  If she cries, he is immediately concerned and wants so badly for her to play.  We are very much looking forward to the time ahead and we are continually reminded how blessed we are.

Thank you to all of our family and friends for your thoughts and prayers.       


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