How well do you know your expectant wife? Well, Gabe matched almost every one of Lindsay's answers in our workshop! The question to the photo below was, "What is MOM most looking forward to?" Answer: Getting the baby out!! More specifically Lindsay strongly desired a baby naturally. She knew she had her work cut out for her as VBAC carries its own set of challenges, but she knew it could be done. In fact, our YBH teams help couples successfully VBAC regularly and many also achieve it naturally, as well.
Lindsay and Gabe had their initial consult with Doula, Nancy Cook, BSN, YBHD to discuss a plan for VBAC success. Nancy shared, yes it can be done, but very honestly the couple had their work cut out for them. You see, in a VBAC scenario, we must get mom into natural labor as induction is not offered to attempt vaginal birth after cesarean. Also, she would be subject to more constant monitoring after 6cm so freedom to move about and use tub could be challenged. Even with the wireless monitor, there are still limitations. Also with VBAC, comes a higher use of epidural, in which she was not completely opposed. However, she firmly believed the epidural is what created the issue in which she had surgery the first time. Her ultimate goal was Drug-free labor and birth, if all possible. Nancy explained with good nutrition, daily exercise/ staying low risk and preparing her birthing muscles, it was very possible she could do just that! She understood her homework and immediately began preparing both her body and mind.
Together, with her husband, acquiring the knowledge to overcome obstacles they could experience along the way, she gained more and more confidence. They were functioning as a solid team and this newfound determination would soon play a huge part of their success!
When we talk about labor averages and giving birth, statistically speaking, the length of uninterrupted rhythmical contractions for a first time mom in active labor is around 15-17 hours, with the average length of push phase 1-2 hours unmedicated and 3-4 hours with use of epidural. The funny is, labor and birth are so unique, not just for each woman, but also for each individual child they give birth to. In the second birth story of Gabe and Lindsay Beverly, the goal was vaginal birth after cesarean surgery. Her first labor progressed well. She achieved 10cm dilated, but sadly at Gastonia hospital pushing with an epidural was not very supported. Little if any assistance, in fact, what was encouraged was giving up and going into surgery. Unfortunately, we hear these stories all the time. Now, understand we are all grateful for life saving interventions. However, when these same interventions are used simply to shorten labor or push phase, or routinely on the masses when not medically necessary, this is when couples feel very cheated. Particularly, when a near term hormonal woman in the heat of labor is not encouraged... well you see where this ends up. One way to help prevent such outcomes is GET EDUCATED! Shown below, Lindsay and Gabe attended several Your Birth Helper Intensive Labor workshops.
Our YBH workshops are currently held in Charlotte, NC and Athens, GA. Couples invest two hours packed full of specific information, activities and practice to understand basics of labor, how to work with their body, how Dad can help, how to overcome common obstacles/ variations of labor, how to understand and acquire informed consent in the event of complications, positioning, push phase techniques, etc. As you can see, we have a Fun time while cramming as much into workshop as possible.
Then our work was cut out for us keeping mom a viable candidate for VBAC, as around 34 weeks midwife Lisa Nona suspected Lindsay’s fluid level was high. She was sent for ultrasound and everything checked out fine. One hurdle jumped! Also, mom had an internal exam check at 36 weeks when Dr. Alvarez did the strep b swab. Of course, mom was nothing dilated, etc. as few are this early, but since induction is not an option for VBAC candidates, any release of natural prostaglandins can be helpful. Typically, our clients try to delay internal exams to around 39/40 weeks, because most carry 8 days over their due date.
At 38 weeks, Lindsay was 50% effaced. At 39 week appointment, mom chose to not be checked again. The 40 week appointment, midwife, Lisa Nona said she couldn't determine if baby was still head down. This, of course, stressed mom out. She didn't want to have another internal exam (she just wasn’t feeling it), but midwife insisted she thought baby's head wasn't down. Then, mom was informed, the midwife couldn't reach cervix or baby internally and once again Mom was sent for ultrasound. The ultrasound revealed Baby was in fact head down. That same appointment midwife sent Lindsay home with Hibicleanse and a scheduled section date. This is where VBAC clients have to dig down deep and do their best to keep stress down. Stress will not help us get into natural labor in fact it further releases adrenaline in the pregnant body and adrenaline keeps contractions at bay. As anyone can imagine its a tough situation to not become discouraged and disparaged. But again, sometimes you must follow your gut and assume the risks associated with your personal decision making. Mom was not ready to give up and did not feel comfortable with repeat surgery. In fact, she was feeling cheated all over again. She and Gabe were doing everything in their power to get labor going, even scheduled acupuncture with our own Stephanie Crowley (in our #CharlotteBirthFamily) but unfortunately, it started out far from relaxing and helpful as someone backed into her in the parking lot and they had to wait almost an hour for an officer to arrive... more stress. Stephanie was able to work her back in and still see her and even offered relaxing tea while she waited. The other stress was what to do with their two year old white they tried to commence labor, during night try to get full nights sleep and tending to another child when we are trying to get another one out can be far from relaxing.
The day was drawing near and labor was still absent. She had experienced some small bouts of contractions, but they always seem to fizzy out. The surgery date was rapidly approaching and Lindsay had to do some soul searching. She simply was not prepared to have a repeat c-section simply because she was 41 weeks. She canceled her appointment and asked for it to be rescheduled. She also solidified her decision with a visit to Dr. Alvarez to once again verify both she and baby were fine. Everything checked out fine and she went home to work work work and prep her body for labor. Her efforts paid off.
Contractions intensified and Dad was right there assisting and supporting her along the way. Lindsay endured hours of labor
Kudos to Mom and Dad for educating, preparing, executing and achieving such a special all natural journey! It was no doubt, quite a different, much happier outcome, from the first epidural / cesarean experience they had been encouraged to have after 10cm in Gastonia when things got tough. Lindsay and Gabe would like to strongly express; the time, energy and work associated with properly "training and giving birth" may sound overwhelming at times, but the benefits after are so vast and so worth your best efforts! Know this, if mom and baby are okay, you still have options to stay the course both are evidence based choices. Also, consider wisely how medical interventions may serve you in meeting your goals. For example, after four long hours of pushing Lindsay was very exhausted, as pushing in any position is taxing physically. Dr. Lauder suggested the use of the Kiwi vacuum, due to baby's asynclitic head position and longer than normal crowning phase. Mom and Dad weighed the risks and benefits and agreed. Trained in its use, Tammy Reyes, CNM easily applied since head was in full crown and easily with one push, mom helping moved baby right along. I was fortunate to have arrived from Georgia shortly after and with couple more contractions baby emerged and the birthday celebration began! Twelve hours of hard labor - four of which were pushing. Lindsay displayed great strength, power and was such a warrior woman throughout it all and Gabe, never left her side.
Lindsay's recipe for success: "train with Your Birth Helper, switch to supportive practice, (if mom & baby are fine) avoid induction by doing the work to get into labor, have a trained husband coach, Doula support with the #CharlotteDoulaDreamTeam! That's what helped me remain drug free during labor and just keep pushing, pushing, pushing even when tired." As an English teacher and writer herself, she now finds that words could never adequately express her gratitude to all who supported her. I replied, "no worry, the smile on your face after pushing your baby out said it all!"