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Friday, February 19, 2010

A Mothers Victory: My VBA3C Birth Story


“Boobalumba has arrived!”

After three Caesarean sections, I knew I wanted a natural birth for my fifth child. I had written a detailed birth plan describing how I was to be involved and treated during my labour and birth at the hospital, with as little intervention as possible. My plan notwithstanding, this is my story of the very difficult labour and birth of my son on February 8, 2010.

by Danielle Arnold-McKenny


It all started with a week of annoying, stop and start prodromal labour. There really is nothing quite so frustrating as playing the guessing game every time the contractions start. Is this it…this time?! But after a week of lots of contractions and various other questionable symptoms, early evening on Saturday (February 6, 2010) I was pretty certain that we were onto the countdown.

Contractions continued during the night for the first time. Although they slowed right down and became erratic, they kept getting stronger. Sunday morning they slowed to a halt for about three or four hours. When they started up again, it was like being back at square one.

So I kicked my husband Nick and the kids out of the house to go to a friend’s to watch the Super Bowl. Then I set out to do some serious relaxing: filled the living room with candles, put some of my favourite aromatherapy oils in a burner, put on soothing music, got settled into my super comfy rocking chair, and just…R E L A X E D.

Soon enough the contractions became steady at about 8–10 minutes apart. Nick brought the kids home and tucked them into bed late that night, and we called my best friend Lynda over to be with us.

By 3 AM I was definitely in labour. While still only about 6–8 minutes apart, the contractions were strong enough for me to need to support myself and focus on breathing through them—rocking and swaying. We called our midwife, to put her on alert that the party was definitely on. By 5 AM the contractions were still 6 minutes apart but very strong. I had to decide what to do next.

I knew that the kids would be waking up soon and really didn’t think I could deal with my labour and them. So I made the decision for us to head off to the hospital. It was too early—I knew it was—but I was so tired, having not really slept in two nights. I just wanted to know where I was in my labour, to know how far/fast I was progressing.

I think that this is one of the worst things that most labouring women do—worry about the numbers: how many minutes apart, how many centimetres dilated, how many hours of labour…This turns so easily into a downward spiral.

When we arrived at the hospital, we were met by one of our midwives—and so started that downward spiral. She checked me at 6:30 AM. I was only 3 centimetres…3? Just 3 centimetres?!? Oh gods!!! Immediately I became depressed, completely despondent. Three centimetres was exactly where I’d been when I’d gone to the hospital in labour with my youngest daughter Keira, and exactly where I stayed with that labour, which this one had so far exactly mirrored. Keira’s birth ended up being a Caesarean section…

On my midwife’s advice, Nick and I started walking the hospital hallways, to try to “ramp up the contractions,” as she was convinced that I wasn’t in active labour yet—another very disappointing announcement that brought me down even further. How was I supposed to continue like this? In my opinion, my contractions were damn strong, as strong as they were when I was close to transition with Quinlin, my home-birth, vaginal-birth-after-one-Caesarean (VBA1C) baby.

So we walked the halls, stopping to lean on whatever I had available during contractions. We talked and I cried. I was so despondent, and after two nights of almost no sleep, I was completely exhausted. How was I going to make it through this if the contractions were already this strong and I wasn’t even in “active labour”!?!

Nick was a huge support both physically and emotionally. While we walked, we talked: about my fears, about the “options,” both of us knowing what the “option” was…We returned to our room and talked to our midwife about the jumble of emotions, about the labour and my fears. We decided that we would talk to the obstetrician on call. Even then I knew that we were taking the first step down the road to another Caesarean. But I was so caught up in my anxiety and despondency that I had lost hope.

When the doctor arrived finally at around 9 AM, I was desperate for some relief from the contractions. Luckily I had an OB who wasn’t a pusher. Oh, he definitely wanted me to have the C/S, to remove the “risks” of my trial of labour, and to save the staff from the obvious stress of having a VBA3C on their labour & delivery floor. But he suggested that he see how far along in my labour I was before we made the final decision. For this alone, I have much respect for the man, because at that moment I was so vulnerable that he could have pushed me right down to the operating room himself and knocked me out. I wouldn’t have uttered a peep. But instead he checked me over.

I was 8 centimetres!!!!

From down in the valley of emotional despair so dark and heavy that I could barely breathe, I flew up to the top of the tallest mountain of elation!! 8 centimetres?!? I could do this!!!! Nick’s face lit up in what I knew was a mirror expression of my own. Eight centimetres were unimaginable.

“What do you want to do?” the OB asked. “I want to continue to labour!!!” I almost shouted in excitement.

He then started on the litany of risks, and rules I “had to” follow. He suggested that we break my water to help get things moving along. I readily agreed. Hell, if he’d suggested cartwheels while holding a bottle of nitroglycerine, I’d have eagerly agreed with him!

So he quickly broke my membranes. With a huge rush of lovely, clear amniotic fluid, I instantly felt Baby Boobalumba (as we had nick-named him) drop down a bit farther. Continuing with his sermon, the OB warned me that he’d give me one hour to show some progress, and that we would discuss “the options” when he returned.

For 20 minutes or so, the contractions eased off in severity, while coming closer together. I was laughing between contractions and joking with Nick and my midwife. That break was short-lived, though. Very soon transition fell on me like a lead curtain.

Oh, it was bad.

After an hour, the doctor returned and checked me again. Still 8 centimetres. “Tsk tsk tsk” is what I got, and again he started listing the risks and lecturing me on the dangers of having a uterine rupture if I didn’t hurry up and progress. I argued that Boobalumba moving lower was progress. I immediately lost my high regard for him when he began shushing me and telling me off like a naughty child.

Have I mentioned that I don’t take lightly to someone treating me as an inferior being? Hackles were raised, and Nick quickly set about to calm me down. We were given another hour.

Oh gods!!! Contractions were now never-ending waves that carried away any semblance of humanity I had left. The logical Dani was left behind by the primal Dani, who ruled unchecked over the writhing body that had been human just a few hours before.

Occasionally the logical Dani had flashes of insight that penetrated the haze of transition: thoughts of caged mountain lions screaming in rage at their captors; the lone wolf caught in a trap that gnaws its own leg off to try to escape…for I was the trapped animal, trapped by the hospital staff, policies, doctors, and my midwives. I was hooked up to a fetal monitor that inhibited my ability to move. I was suppressed by people telling me where to go and how to position myself, and reminding me of the clock that continued to tick towards the “deadline.”

Some of what happened that I’m about to relay, I learned later from Nick. At this point my chronological memory that was recording the events as they happened became seriously erratic (resulting in gaping holes big enough to drive a truck through).

At some point during my transition to a blubbering mess, my friend Lynda showed up after taking my kids to her parents’ house. Between Lynda and Nick, I had a small bit of calm to cling to. They took turns talking to me, feeding me sips of water, rubbing my back, and helping me be as comfortable as possible.

Then my second hour was up. The OB arrived and announced that I was still just 8 centimetres and my cervix was inflamed.

I begged for relief. The last piece of human Dani was ready to admit defeat. But I managed to beat back the primal contractions and somewhat coherently tell the doctor that if I could just relax for a minute, just have a moment’s respite to regain control of myself…If I’m heading down the hallway to the operating room anyways, then give me the epidural so that we can try just one last time to finish this dilation thingy that you’re all so hyper about!!

Then the human spark slipped away, having said its final piece, and the primal Dani took over again. Nick discussed it all with the doctor. They arranged to get me an epidural, and Nick bargained a further half hour to see if we could achieve the final 2 centimetres that they wanted.

Immediately the room seemed to fill with people. Two maternity nurses bustled in to set up an IV…I remember biting the head off one for even thinking about putting the IV into the back of my hand…my second midwife was there.…the noise levels rose substantially and I felt like I was in a stadium surrounded by overwhelming crowds. I vaguely recollect my midwife checking me again and saying that she thought the cervical lip could be moved…and she did something down there that wasn’t pleasant.

Then they all decided that I needed to be lying down right now. “Take the pressure off the cervix”…“let the swelling go down”…snippets of directions, with me arguing that I didn’t want to lie down. I can’t lie down, I won’t lie down…yet somehow they had me down flat on the bed, taking away the last vestige of control that I had over this three-ring circus.

More people flooded into the room. The anaesthesiologist came with cartloads of paraphernalia. At some point they kicked Lynda out of the room on some flimsy excuse, leaving me with one fewer island of support to cling to.

At this point I remember feeling “the push.” I told “them” that I needed to push, that I felt that pressure, that I needed to poop…and I remember “them” telling me not to push, that it was too early, that I wasn’t fully dilated to the golden 10. They rolled me to my side to get ready for the epidural, hands on me everywhere, voices ordering me to do this and do that, curl into a ball, hold still, don’t move…I tried to follow orders. The small inner voice of logic screamed at the primal me to listen: “Don’t move, you idiot!! That’s a needle in your spine!!!”

All of a sudden my primal self was engulfed by an all-consuming command to push…Out of the confusion of the moment, standing out from the roaring crowds came the scream: “I have to push!!! I have to push!!!!!”

The crowds yelled back at me: “Don’t move!!” “Don’t push!!!”…

What came next is a moment of clarity that I will remember to my last breath. It came so clearly and so powerfully that it is permanently etched into my brain. I pushed. With every fibre of my being. Every muscle, every tendon, every vital organ. I pushed once, then again. And I felt Baby Boobalumba burst through some invisible barrier and move down into my vagina. I felt every contour, every millimetre of his descent.

A primal growling scream rose out of me that was pure energy. I was filled with a sense of exhilaration as endorphins flooded my system. I CAN DO THIS!!!! I CAN BIRTH MY BABY!!!—only to be cut off by grabbing hands and barking orders from the madding and maddening crowds…“Stop!! Don’t push!! Don’t move!!”

Voices tumbled overtop each other. “Is the baby coming?” “Can you see the head?” “I can see the head!” “Turn her around!” “Lie on your back!” Voices bellowing at me…

The human Dani fought with the primal Dani to take back control. The human Dani knew logically what she needed to do. Knew that she needed to retake control of her body, not just from the primal Dani, but from all of these people who were trying to control her.

I needed to get up. I needed to get off my back and upright. I needed to find my voice and make these people all shut up and listen to me.

Another contraction and another push. This time my midwife cheered me on: “Push!!!!!” and I did, feeling the baby’s head start to crown, the burning that brought with it that all-encompassing need to keep pushing—only to have it all come to a crashing halt. The epidural kicked in, to block all sensation of the contractions.

The voices yelled at me to push, but the urge was simply gone. Along with the realization that my guide had disappeared came the awareness that I couldn’t breathe. “They” kept yelling at me to push, to lie back and grab my legs and pull them back…but I couldn’t find my centre, couldn’t breathe in the air deeply enough to get a full breath, couldn’t feel the contractions to cue me to push…I needed to get up. I had to get up, I tried to tell them to let me up…but they just kept pushing me back down and telling me to grab my legs…

“Tsk tsk tsk we missed another contraction.” “Dani, you have to push, the baby’s head is half way out!!! You have to push!!!”

HELLO?! I’m perfectly aware of exactly where the baby’s head is, thank you very much!!!!

I tried again to tell them that I couldn’t feel the contractions, that I couldn’t breathe…but the crowds drowned me out with their incessant commands and annoying nattering verbal diarrhea.

I reached down and felt the top of my baby’s head, and ran my fingers through the masses of soggy hair. Someone pushed my hand away and forced me to grab the back of my thigh. The human Dani sighed in resignation. They couldn’t hear me, they wouldn’t listen. I had no choice but to do it “their” way. So ignoring the roaring of the masses surrounding me, I breathed in as deeply as I could and P U S H E D.

The relief of his head coming fully out is one that every woman who has given birth can no doubt relate to. Again I reached down. I wanted to birth my baby. I wanted to grasp his slippery body as it came out of me, as we started our journey as two separate beings. I wanted to be the first to hold him. Then someone pushed my hands away again and forced them back to my legs. And so again I pushed as “they” ordered, and Baby Boobalumba was born.

Strange, but as soon as he was delivered onto my belly, the human Dani completely took over. I immediately reminded my midwife not to clamp the umbilical cord, and asked for a warmed blanket to put over both of us.

Once the cord was cut a few minutes later, my midwife asked me to push to deliver the placenta. At that point one of the nurses made a motion to press on my belly. I immediately slapped her hand away and told her No, then told my midwife that I did not want any cord traction applied. As the epidural was now firmly in place and I had no feeling at all, I concentrated on muscle memory and pushed…hard, delivering the placenta in one quick swoosh.

When one of the nurses tried to rub Boobalumba down with a towel, I pushed her away again. After that, no one interfered with me and the baby; no one tried to weigh him or measure him or clean him. They left me alone to be with my baby.

Now that clarity had returned, I could concentrate on him and interact with the people around me as a rational being again. I immediately started asking Nick for details and found out only then that Lynda had been kicked out of the room and he had run out into the hallway as soon as Boobalumba was born to grab her and bring her back in. He also told me that the nurses wouldn’t allow him to take a picture as our son was crowning. That made me so angry.

Oh, I was mad, really mad!!!

But on the surface I was able to enjoy the victory for what it meant to me personally: a validation that I was not broken. Though the birth had not gone even remotely as I had wished, and my birth plan was basically trampled on by galloping hordes, I did it.

Writing this down now, a little over a week later, I am able to verbalize many things that at the moment were just notes stored away for later analysis. The basic need for understanding and support for the VBAC mother. Support and care that are different from what other birthing mothers need.

My personal story is one of vindication of a VBA3C mom. We are not broken. We are perfectly capable of birthing our babies without the surgeon’s knife. My story will, I hope, inspire those that were there—the OB doctor, the labour & delivery nurses, my midwives—to realize that it is possible if only women are given the choice.

I wasn’t given the “choice.” I demanded that they allow it. I didn’t have their support or their understanding. I had to rely solely upon myself and my husband, knowing that if we wavered even for a moment, as we came so close to doing several times, we would be engulfed by the medical machine and processed as yet another number.

Sure, our birth is a number, but a very different and more important one: the first VBA3C in Cambridge Memorial Hospital (Cambridge, Ontario, Canada) and by the Cambridge Midwives Group. I hope that through my experience they will open doors to more VBAC mothers. I hope that my story inspires others to make choices for themselves and to learn from my mistakes and my victories. We can do it. But we have to fight for our rights and continue to fight to make changes so that other women will not have to fight the battle I did.