Thursday, March 04, 2010

Vaginal Birth After 3 C-sections


I met John and Christy about 4 and a half years ago. Their family lived across the street and our kids were instant friends. We both homeschool our kids, eat healthy, love the Lord and love being with our family! Our family has been blessed by these dear friends.

Christy had her first baby by cesarean section, after she "failed to progress" in labor. Her second baby, an attempted VBAC, was induced and although Christy labored to 9 cm, she was given another cesarean. She was also only given a single-layer stitch in her uterus, thus complicating any hope of the next baby being a vaginal birth after c-section.
With her third baby, Christy could not find a supportive attendant for her to VBAC. She had a repeat cesarean section.

6 years after her third child was born, Christy was thrilled to be expecting another child! The Lord was blessing their family with another precious life.

One could say that Christy's VBAC research spanned the course of 10+ years. She was well versed on VBACs and planned to seek out a supportive OBGYN as well as a midwife for this birth. It took a while to interview, scratch off the list and re-interview potential doctors and midwives; but Christy persisted and finally found an OBGYN who believed she could VBAC safely...AND a homebirth midwife with VBAMC experience. Things were coming together!
Despite all the "your going to die..." and "your baby will die..." encouraging words, John and Christy kept their faith. God made her body to birth this baby. She can do it...safely. Their continuing research and education lasted throughout the pregnancy and even into labor. They based their decision on solid facts instead of fear and liability concerns.

I have included many photos from the pregnancy and birth. Some of the pictures I took and some were taken by my cousin Dawn, a fabulous photographer. (i.e. All the really good ones she took!)
Please read the comments from Christy's perspective directly after all the pictures.


The home visit!!!


My two littles loved feeling the baby move.




All the kids wanted to hear the baby's heartbeat.





One of the midwives feeling the baby's position.




John givin Christy some LOVE :)



The day before her due date, Christy started labor.



Early labor on day 1.




A quick family photo in between contractions!!!







The last few hours with a baby belly.






YES. We are all playing Wii :)
What better way to help labor along?!


After a few hours of Wii and hanging out, I went home. Things were slowing down and I was hoping John and Christy could get some sleep.



Day 2, after contractions through the night. They would pick up in time and intensity for a few hours and then slow back down again. Christy (well, ALL of us) ate quite well during labor, thanks to her fabulous mother-in-law who was in the kitchen cooking delicious, authentic Chinese food for days on end!





The bedroom ready for a birth. Beautiful.




Maddie helping get the pool ready.





Things are beginning to get more intense.






Between these two pictures, two and a half days passed. Contractions continued during the night, very intense, and spaced out during the daytime hours.


Day 5 of a start and stop labor.






























The first internal exam was on day 5. It revealed a very thin cervix but only about 2cm dilation. There was scar tissue that prevented the cervix from opening. The midwife massaged the tissue and Christy immediately went to 5 cm.





So we turned on some 70s party music ("Dancing Queen") and climbed/danced up and down the stairs.






Christy was AWESOME.




The contractions got very strong and one on top of the other. YEAH.



The midwife checked the cervix again and found that it was still having trouble getting past that scar tissue. After some more massage, Christy hit 7 and then 8cm...and transition.



Ah. The water. Perfect for times such as these.

















After several hours in the pool, the midwife checked the cervix again. It had gone down to 5cm. Back on the birth stool for more massage and cervix holding. The contractions during these hours were very long and strong, and Christy was relaxing well.










Hard labor.


Several more hours past. The midwife had Christy begin pushing when her cervix was complete. She was on the birthstool, then in the pool for about 2+hours pushing with all her might.



The midwife had Christy get back on the stool to check her progress. Her cervix had again gone back down to 7 cm.

At this point, Christy had been up laboring for almost 6 days. Although well nourished, she was exhausted. Transition was coming yet again (this would be her THIRD transition during the birth). It was suggested she go into the hospital to her OB and get an epidural. Then she could sleep before having to push again. After some deliberation, this was decided as the plan of action needed. I went with her and John to the hospital, as did the assistant midwife.

A heart wrenching choice to make, even in such circumstances. She had gone WAY beyond the call of duty and her body needed some relief. Pain in labor is one thing, but the suffering of a complicated birth is another


At the hospital we got the BEST nurse. She was so excited for Christy and her VBA3C! The nurse helped get fluids in ASAP so Christy could get an epidural. I must say, she had the best epi I have ever seen. She could move around and feel pressure, but no pain.
Christy's doctor was out of town and the doctor on call was an older gentleman who "never allows VBACs"...he sat at the monitor continuously, giving us such jewels as, "I have to watch every contraction because your uterus could blow at any moment and someone will die". Thankfully, John and Christy are well educated enough to blow off such comments and focus on the task at hand. To the doctors credit, he did "allow" Christy to labor for a while instead of immediately going to the OR. He was far out of his comfort zone.


Transition #3. Back to 91/2 cm! This was right before the epidural.



Aaahhh. Such sweet relief! Just what she needed!

Things went fast from this moment on. Christy was fully dilated and pushing. She could push so well with her contractions and we could see her baby's head!!! The awesome nurse was cheering her on as she pushed with all her might.
She pushed this way for about 20-25 minutes.
At this point the OB came back in the room and checked her cervix. He said she has made zero progress...the baby has not moved down. He said he would give her a few minutes, go get the forceps, and try and get this baby out.
Otherwise, to the OR she will go.
Christy pushed and PUSHED. She was strong and stoic, determined to have this baby vaginally. The baby had moved down to a +1 station!
Dr. Wonderful (I use extreme dripping sarcasm here) walks in with the forceps. He says that this is the last chance...if he cannot get the baby out with forceps, the baby is not coming out. Although not in the birth plan, a vaginal forceps birth is better than a c-section; so John and Christy agree.
The doctor tries to deliver the baby, to no avail.
He takes the forceps out and says that it is time to go to the OR. Nurses that had been in the front of the room flood in to prep Christy. There was little time to digest this turn of events. Just moments before, Christy was being told we could see her baby's head.


They left through the big double doors, headed to the OR for her 4th cesarean. I retreated to the waiting room to process.



Beckett Daniel. A beautiful, healthy baby boy!!!






Christy in recovery, meeting her precious baby boy that she worked so hard for!





John holding Beckett.
I'm thinking he wants Mama :)


Several weeks later, Dawn came over to do some newborn/family pictures:



The girls!












One happy family!!!






Big sis.






Welcome, Baby Beckett.


There is just so much to emotionally and psychologically process after this birth. Here it is, 5 months later, and I still have so many questions, thoughts, and feelings.

What if's abound.

This I know:
Christy made an unpopular choice, but a brave and educated one. She stood for her beliefs and her choices in the face of adversity. She is one of the strongest women I have ever had the pleasure of knowing and it was an honor to attend her birth. She proved the safety of attempting a vaginal birth after multiple cesareans. After 6 days her uterus was still strong and the baby was perfect.
Being "allowed" a trial of labor after multiple cesareans should be commonplace in our hospitals and homes.


The birth from Christy's perspective.....

“When I look back on my most recent birth experience, I have a lot of mixed emotion. I was desperate to be given the chance to VBAC after three previous cesareans, all of which I was convinced were unnecessary. After the first unnecessary section, a failed VBAC, and then a forced scheduled section, I was determined to be given an opportunity to try again. Unfortunately, I was deemed crazy by the medical community, and ironically, “untouchable” by the homebirth community, based on laws in my state dictating HBACs. Miraculously, my prenatal midwife finally agreed to attend my birth at home. You cannot imagine how thrilled I was to be given an opportunity I had been told was virtually impossible. My hope skyrocketed, and I began dreaming of the wonderful, peaceful birth I would have in my birthpool in my own bedroom. I planned down to the last detail and couldn’t wait for labor to begin.

I will not go into detail about my labor, which was more grueling than I ever imagined (all SIX days of it). To my great disappointment, after so many days of labor, more than 24 hours of which were very intense, I was ultimately transported to the hospital at the suggestion of my midwives. I was incredibly torn about this decision, as it signaled utter defeat and failure in my mind. I was given the chance to labor a bit more in the hospital, pushing for an hour or two (thanks to an angel of a nurse, and despite fierce protestation by the on-call OB), but ultimately gave birth by the cesarean I so desperately wanted to avoid.

My primary struggle is whether or not this fourth cesarean was necessary, and what would have happened had I stayed at home. It brings up questions all over again about the necessity of the first three. While my dear friend (and doula) along with both midwives assure me the decision to transport was the right one, I remain unsure in my own heart. I fear I will always wonder if I gave up, or was once again robbed by the hospital of my dream to deliver a baby vaginally. I still feel pain when I hear stories about other women having successful homebirths. The bottom line, however, is this: Would I trade my labor experience if I had known the outcome ahead of time? Not a chance! Regardless of the outcome and my ensuing struggle, I am so thankful I was given another chance to try.

My message to any woman wondering if she should try to VBAC or HBAC is a resounding YES! I realized from the beginning that I was never guaranteed the outcome I wanted. I am just grateful I had the experience and would encourage anyone else to fight for their right to labor the way they want. Despite the fear tactics you will undoubtedly encounter, and potential overwhelming “odds” against finding a practitioner willing to let you have this experience, don’t give up! It was worth every minute of pain and I would do it all again. “