Updated: May 17, 2019
A few years ago, I met Megan and Gregory Tipton. At the time, they were very excited and expecting their first baby. The couple resides in Athens, Ga. They enrolled in my childbirth class and trained twelve weeks in The Bradley Method® to best prepare her body for labor and train dad to understand his role in helping coach her through contractions. The couple also wanted to be educated on how to best prevent, overcome or navigate through the many complications one might encounter to give birth. Despite a near perfect pregnancy, the last few weeks Megan struggled to maintain proper nutritional needs. It was hot, she would find herself on the couch and having missed a meal or two, because she just didn't feel like eating. This can be a struggle for even very healthy moms near term. The stomach is in very tight quarters, the baby has taken over our body and before you know it, things can change very quickly in the last few weeks of pregnancy. She phoned with a bad headache, I suggested she hydrate, check her blood pressure and check in with her medical providers. Her first baby was born via C-section for metabolic toxemia of late pregnancy.
This time around, Megan was even more careful to maintain her well balanced meals, proper hydration and regular daily exercise for the increased stamina needed to endure however many hours her second labor would bring. Her blood pressure readings had been great and she was adamant in following the recommended Brewer nutritional plan (studied and proven at Harvard University to eradicate toxemia pregnancy in one week of correcting nutritional deficiencies). Sadly, few if any doctors offices share this important preventative nutritional plan to this day.
Her good nutrition pays off and she carries full term with no complications! She and Gregory facetime phoned me just after 6pm Saturday, May 11th. Her early labor had began 4pm the day before and regular contractions had commenced that were commanding her attention. When a mom is trying to accomplish a vaginal birth after C-section, a different set of rules apply for departing for your birth place. For most moms, it is usually suggested to use the 6-1-1 for determining departure. Meaning 6 minute apart or less frequency, contractions lasting over 1 minute for over an hour. In Megan's second labor, Gregory had timed her active labor contractions for over an hour and they were rapidly changing and growing stronger and closer together as shown here.
The contractions with a (D) noted beside it were double peaking contractions. Clearly, her body was working extremely hard to move the baby down and line her up for departure. The couple made the decision to head over to get checked out in triage at St. Mary's hospital. Being of Catholic faith, the couple found peace in their decision to give birth there.
That peace was short lived as shortly after arrival they were saddened to hear the midwife on duty mention repeat surgery to them after her very first exam. The couple was aware of evidence based birth options, aka repeat surgery, as well as, the various challenges that lay ahead of them (similar to first labor hurdles). They held out hope for an increased level of support from their medical team, since both mom and baby were both fine.
Thankfully Megan was not aware of her internal exam results, (only 1cm) however, Gregory shared they would go ahead and admit her to monitor her slightly elevated blood pressure which was 144/98. They immediately phoned me to head over to join them to help support them and assist in natural ways to overcome obstacles during what would become just shy of a 24 hour VBAC journey. For people of faith, I often call this their personal John 16:21 birth marathon. Labor is rarely a short sprint, no marathon clearly depicts what most women experience to bring forth life.
It seemed to take an eternity before their room was ready. The hospital had a staffing issue in housekeeping and Megan could not get into the tub quick enough. She needed relief quickly from back and hip pain. Her IV was placed after several failed attempts.
Note: VBAC clients are usually subjected to constant fetal monitoring after 6cm dilated in our best hospitals. Megan, was subjected to constant fetal monitoring upon arrival despite baby and mom doing well. Upon my arrival to triage, the wireless monitor had been placed, but was later removed and normal EFM beside followed until birth.
Her uterus performed beautifully- super strong!
Her baby cooperated beautifully- super strong throughout!
We began in the tub for comfort as soon as her room was ready. She relaxed and managed her contractions well in the tub.
Their night nurse, Kristen, first assigned to them upon admission, could not have been more wonderful and supportive! Both found her demeanor refreshing and greatly appreciated her support of their birth plan. Medical staff that put their personal opinions of how labor and birth go aside, and go out of their way to not just "go along with their birth plan", but actually "encourage the couple to meet their personal birthing goals", are quite rare, but greatly appreciated!
Hours after admittance, the couple utilized epidural to help overcome her slow to dilate cervix. We changed positions every 30 minutes or so to assist her progress. Megan had an anterior rim of cervix that was being stubborn and it wasn't changing despite side lie with peanut ball. Since Megan had maintained some mobility in her legs, we even tried a frequently utilized position known to help overcome this issue, assisted hands and knees position, in a last ditch effort to try to put the weight of baby on the anterior cervix to help create change.
Unknown to Megan, her internal exams continued to reflect no cervical change, however, the station "decent of baby's head" continued to progress so we were pleased with that progress. In the natural realm of the labor process this is commonly known as natural alignment plateau. Commonly known as "failure to progress" in a hospital setting. Sometimes, it's best to keep mom focused on her job not a cervical number, because in the end baby comes out.
Amanda and I, were attempting to help Megan flip sides and surprise her water broke spontaneously! This helped Megan avoid routine use of Pitocin until the last few hours of labor, in which her uterus completed the job. The next day, a friend stopped by to encourage Megan and bring Gregory some Real Coffee - now that’s a good friend!
Their priest also came by to pray over her and baby and perform bedside communion on Sunday afternoon.
Megan was super tired from now two days of contractions as you can imagine, but her body continued to labor efficiently and medically, both she and baby were great. We could not have been more pleased with Megan's blood pressure, throughout, as well.
Dad took his coaching role very seriously and rarely left mom‘s side. Shown here giving mom a well deserved neck and jaw massage.
Ultimately, her uterus would decide to expel the baby despite the lip of cervix that remained present. That was made evident on the monitor reflected as heart rate decelerations, in response to her expulsion contractions. This commonly occurs when the head is being compressed as push phase commences. This continued despite the nurses efforts to resolve with position and monitor placement changes. It was at that time her day nurse, Emily, phoned for the midwife Alexa to return to the hospital. We continued to labor down and take deep breaths to help baby recover after contractions.
I advised the couple not to worry that the decels can be quite normal in push phase and most likely her midwife could try to lift the cervix or see if she could push past it, but we would continue to use singing or low register noises to avoid pushing if all possible to protect her cervix.
Upon arrival, her midwife Alexa shared she believed her body was ready to give birth and despite the anterior cervix she could try pushing through a few contractions to see if the cervix would go away. That is exactly what happened and Megan was an absolute champ utilizing the pushing techniques from her Bradley Method® training.
With Gregory helping hold one leg, and I holding the other, we assisted Megan in curling around her baby. Megan used her abs, pulled back on her legs and pushed very effectively as Gregory counted to ten seconds with each push. She began second stage in side lie, after several pushes, her midwife suggested she fully engage with use of the classic position and with each push she was closer and closer to her baby.
Gregory would announce the surprise gender and with the last push Megan opened her eyes to see her baby emerge!
Baby was placed on her abdomen and then lifted by the midwife revealing the front of baby , as Gregory announced, "Its a boy!" Cheering commenced and Megan shared his name, "Leo!"
Welcome to your amazing Your Birth Helper Birth Family baby Leo! You did good locating the exit! Ms. Pam is very proud of you. Thank you for allowing me to be part of your amazing “birth” day and for holding my finger and warming my heart!
Your Birth Helper & team were thrilled to help the Tipton family prepare for their VBAC marathon and we appreciate you allowing us to be your doula team helping you execute and navigate through all the unknowns along the way! It was our pleasure! Special thanks to Amanda Allen, (YBH doula apprentice) for capturing this special journey in photos and her assistance throughout our near 20 hours laboring at the hospital.
Lastly, special thanks to all the medical team at St. Mary's Athens and the Women's Healthcare Associates staff. We appreciate your continued support to couples who desire low intervention Symbiotic Birth!
For more information/ course outline on The Bradley Method® birth prep visit: www.bradleybirth.com/pamelasauls
For info on future intensive 2 hour labor workshops: yourbirthhelper@gmail or text 678-614-5604 to rsvp
Next Ga workshop held @ #M2bFamilyFarm in Colbert, Sunday, May 26th 3-5pm
Charlotte, Nc Sunday, June 23rd 3-5p
All welcome! You can't ever go wrong being better informed, staying healthy and low risk and avoiding medical intervention whenever possible.