A VBAC Birth Story

amanda vbac2.jpgThe following birth story comes to us from our very own Lamaze International staff member, Amanda O'Kane, who shares the experience of her second birth after a first cesarean birth. We celebrate her story in particular during the month of April, which is Cesarean Awareness Month

During my second pregnancy, my mom loved to tell me that I was born in the emergency room without time for an epidural; she hoped (that for my sake) I would deliver my baby just as quickly. Neighbors shared their concern that I designated a friend who lived 45 minutes away to watch my toddler during the birth, wondering if she would arrive in time for me to make it to the hospital. I’ve heard many birth stories and knew I would have time. I had PLENTY of time.

I went to my scheduled OB appointment at 39-weeks, secretly hoping it would be my last weekly visit since I was growing tired of the routine. My anticipation to find out if my second baby was a boy or a girl was also increasing since we chose not to find out the baby’s sex in advance. My doctor promptly offered to schedule a C-section, saying that I had not started to dilate yet, nor was the baby’s head engaged. I was impatient, but not quite that hurried.

After having a scheduled C-section with my first baby because of his breech position, I discussed a trial of labor after cesarean (TOLAC) with my doctor when my second pregnancy was confirmed. I had a healthy pregnancy and my baby had been head down at every appointment check (starting around 28-weeks), so I grew confident that I would have a successful VBAC (vaginal birth after cesarean).

At my 39-week appointment, I found out that that my group of doctors do not induce for previous cesareans because of increased risks*. Since they would typically schedule an induction date, my doctor was instead offering to schedule a C-section at 41 ½ weeks. He told me that he did not think that I would go into labor on my own before that point.

I was devastated. We had not previously discussed needing to schedule C-section under any circumstances. My doctor agreed that I would be back in his office the following week for my 40-week appointment, and we could wait to schedule a date at that time.

I went home and read everything I could about VBAC births. After looking at the American College of Obstetricians and Gynecologists (ACOG) recommendations, I learned that a vaginal birth after a cesarean is more likely to be successful if a woman goes into labor spontaneously prior to 40 weeks. I immediately realized that I could not control these factors. While I was not scared of having a C-section since I had already experienced the surgery once, I felt defeated by the idea that I may need to schedule one.

At the end of the week on Saturday, although I was tired from pregnancy, I decided to put up my family’s artificial Christmas tree. Christmas was still a full month away, but I wanted to make sure it was finished since I was expecting the baby in a couple of weeks. Unbeknownst to me at the time, the following day I would begin labor and learn that I had been nesting. If only I had had the urge to clean!

Sunday, 7:30 a.m. – At 39 weeks and three days pregnant, I woke up and noticed I had lower back pain. I knew this was an early labor sign and thought that it might be near, but since my doctor had said he did not think I would go into labor before 41 ½ weeks, still 12 days away, I did not take the discomfort too seriously. My husband didn’t take it too seriously either since I had been complaining for weeks!

Sunday, 11:00 a.m. – That morning, I offered to take my toddler out for a walk and we ended up going to the park. I was feeling uncomfortable, but questioned if I was experiencing false labor, especially since my doctor’s prediction was still looming in the back of my mind.

Sunday, 1:30 p.m. – After our outing, I went home, had a bite to eat, and decided to finalize a few items for work just in case. I still wasn’t feeling any better, so I chose to get some rest and took a short nap while I had a chance.

Sunday, 3:00 p.m. – I woke up after about a half hour and decided to go for a walk to get things moving. I hoped contractions would pick up. I had technically been in early labor for eight hours at this point, but I had heard too many stories of women experiencing false labor to be hopeful that it was the big day.

Since I needed my friend to come over and stay with my toddler, I wanted to be extra cautious and make sure I was really going to deliver my baby a week and a half earlier than my doctor had predicted. The last thing I wanted was to be sent home from the hospital and inform my friend that I didn’t need her help after all.

Sunday, 6:00 p.m. – That evening, I made dinner and as I plated the meal, I experienced my first painful contraction that stopped me in my tracks. Even at this point, I reminded myself to be patient.

Sunday, 10:45 p.m. – The contractions continued coming more frequently and stronger throughout the evening. When I tried to go to bed, I realized that I would not be getting any sleep, and my husband was more than ready to call our friend and get to the hospital. I asked him to wait a bit longer and decided to take a shower for some relief.

Monday, 1:00 a.m. – My dear friend came over in the middle of the night, and the feeling of exhaustion consumed me. I quickly experienced a boost of adrenaline since it was time to head to the hospital! Even as I continued to experience the pain of intense contractions on our short drive and while checking in, I was still fearful that I might be sent home.

Monday, 1:30 a.m. – I initially went to the triage room, and felt confident about laboring so long at home when the labor nurse declared that I was in active labor and dilated at 4 cm**. It was enough that I immediately qualified for my own room.

I still had the option to eat, but began to feel nauseous as I was overcome by the intensity of each contraction, and only wanted ice chips. My husband had a hard time keeping enough cups of ice ready because I ate them so quickly.

I had been in early labor for about 18 hours with minimal rest by the time I was admitted. With each contraction bringing me to a standstill for the past seven hours, I requested an epidural.

Monday, 3:30 a.m. – Surprisingly, the hospital wasn’t busy, but it ended up taking nearly two hours before the anesthesiologist administered the epidural. My contractions had continued to progress and were very strong at this point, making the epidural more complicated than I expected.

I needed to be very still so the anesthesiologist could insert the needle. Because my contractions were so close together, I had two while he was trying to stick the long needle in my lower back. I panicked a bit at this point because it hurt so much more than I had expected.

The anesthesiologist and nurse were very patient with me though and the third time was the charm. Relief came quickly, and my pain from the contractions subsided within about 10 minutes.

Monday, 4:30 a.m. – I was checked soon after the epidural and had progressed to around 6 or 7 cm. The nurse told me to rest at this point, but I was much too excited for our pending arrival to sleep.

Sunday, 7:00 a.m. – A new doctor started her shift and encouraged me to keep resting (as much as possible). My husband took the opportunity to grab a snack and then a nap at this point too, which was helpful since I felt like we were operating as a team. I was doing the physical work through labor, but continued to rely heavily on his support.

Monday, 9:00 a.m. – The doctor who had recently started her shift checked my progression a couple of hours later and I had dilated almost fully. She said she would come back at 9:30 a.m. and I should plan to start pushing soon. I was nervous and exhausted, but eager to meet our baby girl or boy.

Monday, 10:15 a.m. – It was 45 minutes later than promised, but a nurse came and was ready to monitor while I pushed. I really felt the urge to push at this point, and knew it was time.

I had heard that first time laboring mothers often push for up to two hours, so I mentally prepared myself and admittedly had my eye on the clock. Because my epidural was not strong, I still felt the most intense pain I have ever had, which made me determined.

I would tell the nurse when my next contraction was starting versus reading it off the monitor. Pushing was as mentally demanding as it was physically. The nurse instructed me to use an oxygen mask between each contraction so I could have a short recovery period.

Monday, 12:00 p.m. –Almost two hours later at noon, I was consumed by sheer exhaustion and told my husband that I wasn’t sure if I could keep going. He was my biggest supporter and reminded me that the finish line (our new baby!) was near.

amanda vbac.jpgMonday, 12:15 p.m. – I could not resist the urge to watch the time pass and knew I had been pushing for two full hours. My nurse, doctor, and spouse told me that I was getting close. I honestly wasn’t sure if that meant two more pushes or two more hours. I asked them to be more specific, but they avoided any false promises.

Monday, 12:24 p.m. – Our healthy baby BOY was born just nine minutes later. Relief washed over me as the labor nurse immediately placed my baby on my chest for skin to skin. There is truly no feeling in the world like the satisfaction of meeting the little human that will forever be your child for the very first time.

 

Amanda O’Kane welcomed charming sons in 2014 and 2017. She is passionate about working full time in marketing communications, loves being an avid runner when she has the chance, likes traveling with her family, and enjoys acting as an amateur chef for her household most weeknights. She lives in Arlington, VA, with her family.

 

Editor's Notes

*Induction can be an option with VBAC. Learn more at VBACfacts.

**6cm is now considered the beginning of active labor, according to ACOG.

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