Thursday, June 19, 2014


After I was able to convince my OB that I was a good candidate for a trial of labor, and he successfully convinced the other OBs and the hospital to allow it, I rested easier knowing that I would at least have a chance at having a VBA2C.  I was not against a C_section, IF it was medically indicated, and there were a few things that came up during the pregnancy that could have led to a C-section.  Aside from my past history of needing to be induced early for pre-eclampsia, I also developed gestational diabetes during this pregnancy, which also could have led to an early induction.  Part of getting the OBs to agree to my trial of labor, was that there could be no chemical induction.  I asked if the need for an induction arose and if I was dilated enough, could they just break my water and I was told that they did not expect me to make it that long.  However, I did not come down with pre-eclampsia this time and I was able to manage the diabetes with diet alone.  None-the-less, my OB and I were very happy to discover that I was 3 cm and 80% effaced at my 34 week check-up.  However, the baby was also breech at that time and I was told if they could not get him flipped back around (he had been head down until that point), I would be looking at surgery.  By 36 weeks, he had turned back to the proper position and I was up to 4 cm.

Over the next 4 weeks, I did not dilate any more and I did not go into labor on my own.  My OB was very concerned about the risk of uterine rupture and was not comfortable allowing me to go past 40 weeks gestation.  Two days before my due date, we decided to try a non-chemical induction (having my OB break my water).  He had stripped my membranes several times in the last 2 weeks of the pregnancy and I had tried drinking raspberry leaf tea and also castor oil, none of which had started labor.  Sex and walking had not helped either, so I felt that this was the safest option at that point, if I wanted my trial of labor.  I also had begun to suspect that something was going on with the baby's umbilical cord because throughout that last month, he would "drop", but then go back up, repeatedly.  On the morning of the induction, I had accepted that it might end in a C-section, but still wanted to try for the VBA2C.

I was told to come into the hospital at 10:30 in the morning, however once I arrived, I learned they did not have a labor nurse for me and there were other moms who had arrived in active labor.  I was admitted anyway and hooked up to the monitors while I waited for a labor nurse.  My OB was the OB on call until 8AM the following morning, so I knew I would be taken care of.  Finally, at 7 PM, a labor nurse was assigned to me, and it happened to be the same one I had with my 3rd daughter.  My OB came in at 7:30 and broke my water.  Over the next several hours, nothing exciting happened, although my contractions were slowly getting stronger and somewhat closer together, they were still not "regular".  Around 12:45AM, we had decided that my mom would take my girls (they were going to watch the delivery) home, since we were all pretty sure that nothing would happen until the morning.  After they left the room, my mom decided she did not want to leave until she knew how far dilated I was, so they decided to walk around the hospital instead.  At that time, my OB also had said he was ok with me getting up and moving around the room as long as they could still monitor the baby.  The baby had a few decelerations of his heart rate earlier in the night, but when they gave me some IV fluids, they stabilized again. However, due to that being a sign of uterine rupture, it was important to them to keep me monitored.  I decided to get up and use the bathroom before moving to the rocking chair.  As I was using the bathroom, I had a contraction where I felt pressure from the baby.  I decided I did not want the girls to leave yet and asked that my husband call my mom to tell her to stay.  He decided to go get her instead. 

After I left the bathroom, I sat in the rocking chair.  My mom had returned to the room to see what was going on and my husband remained in the hospital walking with the girls.  I had a couple more contractions and asked my mom to go get my husband.  Just after she left, I had another contraction and I stopped thinking clearly.  As the contraction ended, I noted that the monitor said the baby's heart rate was in the 60s (versus his normal 140s).  As I looked at the monitor, I also saw the Nurse's call button and thought I should push it.  When I realized I couldn't move to reach it, I thought I should ask my doula and friend to push it, but then realized I wasn't really up to talking either and I knew the nurse would be right in anyway since they were monitoring it from the nurse's station.  Just as I thought, the nurse came in right after and told me that I needed to get back in the bed so that they could figure out what was going on.  As I moved back to the bed, I again accepted that it was going to end in a C-section and I was truly ok with it.  More than anything, I wanted a healthy baby and I knew that he was in trouble.  The PA entered the room and attempted to put in an internal monitor, but she was unable to do so.  My OB quickly followed her and when he realized I was only 7 cm, he quietly told the nurses to open the OR.  He later told me that he was genuinely worried that I was rupturing and that he did not want to upset me.  He then proceeded to tell me that a moment later, I made a noise that indicated I needed to push.  He went to check me again and the baby's head was there.  I do remember him telling me to grab my legs and push, and I remember being unable to physically grab my left leg and telling him that I couldn't grab my legs.  Then I looked up to my right arm and realized that I was gripping the bed with it and that he probably wanted me to grab BOTH my legs.  Everything happened SOOOO fast, that I barely remember it.  I went from having contractions about every 5 minutes to delivery, in about 10 minute.  The baby was born at 1:18AM.  His heart rate decelerations were due to the fact that he had wrapped his cord around his neck 4 times tightly.  However, he still scored an 8 and a 9 on his APGARs, so he was good.   He weighed a healthy 7 lb 11oz and was 21" long (though he later measured to be closer to 20").  He does have some heart deformities, one of which we were aware of before birth, but they also are not causing him any problems.  They will need to be watched, but so far, he is doing great. 

Fighting for a VBA2C

If you have been reading The Happy Wife for a few years now, you might remember that my fifth baby was an emergency C-section, due to him tying his umbilical cord into a true knot.  What you might not have known, was that it was my 2nd C-section.  My first-born had also been a C-section due to my water breaking spontaneously, but my body failing to go into labor, despite several interventions to try to get labor started.  I was fortunate to have hospitals in my area and OBs that were favorable to VBACs and the 3 babies in between were all born via VBAC.  That included a 10+ pound baby, and 2 babies that were induced early due to pre-eclampsia (1 was severe pre-eclampsia with HELLP syndrome).  I know in many areas it is difficult to find hospitals and/or OBs that are willing to allow a VBAC, so I was very grateful to live in this area.  However, I also know that there are even fewer areas that have hospitals and OBs that are willing to attend a vaginal delivery when there has been more than 1 C-section. 

I also want to say that the OB I started going to when I was pregnant with #3, is someone that I have a lot of respect for and truly trust.  I also really like the hospital that he is affiliated with and wanted to deliver there as long as it was medically feasible.  The other hospitals in our area are good hospitals, but I have had much better birth experiences at my preferred hospital.  When I learned I was pregnant, I dreaded the upcoming conversation with my OB, as I was afraid that I was going to have to choose between finding a new doctor and my wish of being allowed a "trial of labor" in the hopes of having another successful VBAC.  I started by doing my research regarding VBA2Cs (vaginal birth after 2 C-sections) and the risks involved.  I learned that a successful VBAC had a better outcome than a repeat C-section, but a failed trial of labor , often had a worse outcome than a repeat C-section.  I also learned that in 2010 both ACOG (American College of Obstetricians and Gynecologists) and the NIH (National Institute of Health) had issued statements regarding VBACs, including VBA2Cs.  ACOG's statement specifically states, "Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans."  The statement by the NIH discusses the risks and benefits of VBACs and what factors influence the success or failure of a trial of labor. 

I gathered my research and prepared myself for my first prenatal appointment with my OB.  My OB starts every primary prenatal appointment in his personal office before having you go to a room for the physical exam.  This gave me the opportunity to discuss my concerns with him.  When our meeting started, he stated that he had already heard that I wanted to try a VBAC (I had talked about it with the Nurse Practitioner when I came in to confirm the pregnancy.)  I stated that I did and steeled myself for a fight.  As I sat in his office, with tears streaming down my face, I tried to assure him that my decision was an educated one and not merely an emotional one. I left his office with the same fears I had entered with, but with a flicker of hope that he had promised to talk to the other doctors and to the hospital to see what could be done.  At my next appointment, he apologized because there had not been enough time at their meeting to bring up the VBA2C, but he promised he would do it.  A few nights later, he called me and told me that he had spoken with everyone who might be involved in my birth. I held my breath as I waited for him to tell me what they had decided.  I was beyond thrilled when he said that all of them were willing to support my decision to have a trial of labor.  He told me that he did not want to admit it the day we met in his office, but that I had been right about my risks being equal either way and that he used that information when he presented the situation to the other doctors.  He also stated that my successful VBACs in between the C-sections played a large role in the decision.

Sooooo...........did I end up with a successful VBA2C or did the pregnancy result in another C-section?  Stay tuned., the birth story will be the next post.

Sunday, June 15, 2014

The past 8 months

It has been exactly 8 months since my last blog post.  During that time, I was working on a little project, and while I always intended to share along the way, time got away from me.  So what was the little project I was working on?  Here he is:
Meet baby #6 :)  He was born 2 weeks ago and weighed 7 lbs 11 ozs.  I will share his amazing birth story in another post soon.  The pregnancy itself was a little difficult, and brought new experiences to me, but overall, was a good and healthy pregnancy.  Landon himself, appears healthy overall, but does have some minor heart differences that we are keeping an eye on.  They are not causing him any physical issues at this point, so they just look yucky on paper and we are hopeful that they will either "heal" on their own or at least, continue to not cause any issues.

Now that Landon is here and the majority of his "extra" appointments are over, I am hopeful that I will be able to get back to blogging again.  I have missed it greatly and have tons of post ideas.