Rhiannon (Renna) was born at home this morning, June 9th, at 12:29 am weighing 8lbs 6ozs and measuring 21.5" long. This is the story of her birth.The seeds of vbac are planted.
The foundations of her birth actually began with her brother's birth. With Jamie, we naively went to the hospital trusting the doctors would give us good advice. After that things went terribly wrong and we were both subjected to unnecessary risks and complications. I had a very long and hard recovery. I began researching birth and vbac almost immediately. A friend was due to deliver her baby 6 months after Jamie's birth, and another friend was training to be a doula for her birth, and I began training to be a doula as well. My education in labor and birth was very liberating, infuriating, shocking, and healing. I learned how badly my labor had been "managed" and how everything they told me to do and asked me to do were exactly wrong. Most eye opening was realizing how selfish and horrible my doctor had been. Realizing she lied to me, making me fear for the life of my son just to get my consent for the c-section, was something that both liberated me from my guilt and caused me new grief at having been so violated. That July, as I attended my friend's labor as one of her 2 doulas, I tried to forget my own labor. As she labored and her labor mirrored mine, I tried to forget. As she was pushed into the same result as I had been, I tried to forget. I wanted to believe that her being in the hospital didn't necessarily mean she had to have a bad experience, especially with the two of us there to help her. Then during her c-section, the doctor changed her mind as to the reason for the operation. Before, she said it was fetal distress. During she decided and put onto permanent record that it was - CPD or cephalopelvic disproportion. CPD, the most recent fad to use as an excuse for c-sections which is a genuine problem, but extraordinarily rare and usually the result of profound trauma to the pelvis or rickets (malnutrition causing fusing of the pelvic bones). I was enraged. I was guilty. I failed to help my friend avoid being cut open simply because the doctors didn't want to wait to let nature take it's course and bring about a healthy baby. Thankfully my friend didn't blame me, and understands, as I do now finally, that our hands were tied. When the doctor says your baby could die, you let them do what they want to ensure the survival of the person who means more to you than your own life. This made me even more resolved to have a vbac successfully and refuse to be manipulated. Michael and I started talking about trying for the next baby, and planned on trying in December so that if it took a few months they would still be around 2 years apart in age. Things changed drastically 2 months later.
The seeds of hope are planted.
In September, Jamie was diagnosed with a congenital diaphragmatic hernia. He had a hole in his diaphragm and his abdominal organs were in his chest cavity compromising his heart and lungs and would die without immediate surgery. He was flown to Riley Children's Hospital in Indianapolis where he received the best care available from experts in his condition. I've blogged in detail about this, so I won't go into it again. But as we lived through this nightmare, we decided not to refrain from comforting each other, and since we were planning on trying for another baby in December, if I got pregnant a few months earlier it wasn't a big deal. And I did. Hence, out of the pits of despair came our next bundle of joy and hope. He's our miracle, she's our hope.
Preparations and deciding on home birth.
After coming home and watching Jamie recover at light speed, I began the search for a doc who would let me try for a vbac. I couldn't find even one in my area who would consider it without a "proven pelvis". Meaning, unless I had given birth vaginally before, they wouldn't let me try. I talked to my doula instructor, and got the name of a doc near her, 1.5 hours away from me, who did them. I started seeing her for my prenatal appointments. At this point, I had decided on a hospital birth just in case I needed an emergency c-section, and because I didn't think we could afford to pay for a home birth out of pocket, since the insurance wouldn't pay a cent. Things with the doc were okay, and she said all the right things. We had our 20 week level 2 ultrasound and learned our baby was a girl and that she had no CDH issues like Jamie had, and we were happy. Then, after entering the 3rd trimester, the doc changed her mind about being non-interventionist, and said some things that were very insulting and totally contrary to what we had discussed before. So after crying all the way home from the last prenatal with her, we discussed home birth again. It was what we both really wanted, and Michael was anry with me for letting money be the deciding factor in our health care choices. So I began to look for a home birth midwife, and I found one, Marlyce. And add to that, my doula instructor, Louise, was willing to still be my doula despite it being such a long drive for her. And so the wait for labor began.
Early Labor.
And on June 6th at 10pm, I started having rhythmic contractions about every 5 minutes. This had happened the previous 3 nights and they had stopped when I went to bed, and expected they would again. But they didn't. At 3am, I couldn't sleep any longer so I got up and started timing them. They were 3 minutes apart lasting 45 seconds. Around 4am, I got Michael up to time them with me, and they were more like 5 minutes apart lasting a minute. So we called Marlyce and Louise. I felt like things weren't going to stop, so Louise decided to come out, but we decided we'd call Marlyce back when things got closer and stronger. I labored all day with the contractions varying from 5 minutes apart to 3 minutes apart randomly throughout the day. We felt like things were definitely going to continue to go forward, but that birth was not imminent. So Louise went home after 5pm, and I had instructions from Marlyce to take a Tylenol PM and sleep as much as I could to conserve my strength. At 3am on Monday June 8th, I awoke after sleeping for about 5 hours, because I couldn't sleep through the contractions anymore. They were again about 3 minutes apart. I had a normal appointment with Marlyce scheduled for 10am, so I just waited to see her. We were supposed to go to our fellowship orientation, but of course I wasn't going, but Michael went in to get something for his research and to let them know we weren't going to be there for our meetings. Mama stayed home from work, too. Just before Marlyce arrived, labor began in ernest.
Active labor and birth of Renna.
10 minutes before Marlyce arrived, my water broke in a trickle. Once Marlyce arrived, we had our appointment as normal, but I felt the contractions were beginning to get a bit more painful. At the end, we discussed whether she should just stay, or come back later, since it was clear labor wasn't going to back off. As I sat on the birthing ball trying to decide, my water started gushing out. So she decided to stay. I got in the tub to clean off and then called Louise to tell her to come out again. This was just around 11am. I labored by bouncing on the birthing ball and walking around the house. We watched a movie (Big Trouble in Little China), and Louise arrived around 1pm. That's pretty much the last time I was aware of the time. The contractions were very painful, and still somewhat erratic. We had lunch, then Louise "suggested" that I walk around the house to try to get things more regular. Then she had me do knee-chest for a while, thinking Renna might need a bit of help making one of the turns through the pelvis. While in knee-chest, I was able to relax some and the contractions slowed. Then I was up again on the ball, and in the shower, and on the toilet. I really hated being on the toilet because it was horribly painful, which of course means it was very productive. Then Marlyce and her assistant got the bedroom ready for the last stages of labor. We did a hanging position where Michael held me under the arms and I hung there. That was the worst pain EVER. Even worse than the toilet. I started feeling like I was in transition, but it lasted a long time. Transition is only supposed to last at most 15 minutes, and I was like that for over an hour. Finally, Louise suggested knee-chest again. And again I was able to relax for about a half hour, resting between contractions, which spaced out to about every 10 minutes or so. I got up and got on the toilet again, and again went into transition. And I started feeling the urge to push, so they let me. I wasn't productive in it, but it gave me something to do and put my energy into rather than just the pain. Up to this point, everyone was taking turns taking care of me and staying with me and coaching me. Louise, Marlyce, Michael, Mama. Jamie was around from time to time, and I did my best to reassure him. He looked a bit nervous, but was calm and let Louise and Marlyce hold him and take care of him, which seemed to help him. But from time to time, I could hear him say "Mama!" and he sounded unsure and afraid. Three times, I lost focus and I seriously thought about just saying I wanted to go the hospital, and that even another c-section would be okay, but I never actually said it out loud. Of course, Michael would never have let me go. I love that man. He knew I didn't really want that, regardless of what thoughts came to my pain-clouded mind. Twice I said I didn't know if I could do this, and my support team rallied around me and gave me the emotional boost I needed, and brought my focus back to what I was doing. The third time the thought crossed my mind, I knew I couldn't do that. I knew I couldn't put Renna (and me) at greater risks just to end my pain sooner. I was in a lot of pain (a LOT of pain), but everything was okay, Renna was fine and the labor was progressing normally. If women for thousands of years could do this, so could I. Once the urge to push started, those thoughts were completely gone. I was almost there and I knew it. And I was doing it. After pushing lightly a bit, and with the urge getting stronger, I was informed that I wasn't actually pushing and got some coaching on it. I was a bit frustrated, to say the least. When we got back on the bed, knee-chest again, I found I was able to actually push sometimes, but it wasn't consistent. You know how all the prenatal classes tell you to "curl around your belly" to push and make the pushing more productive? Total crap. I found if I arched my back a bit I was able to use the exact muscles needed. It was like a straight line down my body and "out", so to speak. As soon as I figured that out, pushing was a snap and very very productive. However, I couldn't push through the entire "contraction" and would have to do clusters of pushes, moaning the whole way, and that worked really well. At this point, now that I figured out how to push, Marlyce checked me to see if I was fully dilated and therefore ready to go. Well, I had a lip of cervix left. Apparently, women who've had a c-section will often have a lip on the front of the cervix because the scar prevents full pulling of the uterus on the cervix to make it dilate. So I had to not push through a total of 4 "clusters", and that was probably the hardest thing I've ever had to do. Once the urge to push, and the knowledge of how to push were there, it was impossible to not push. In order to not push, they led me through puff breathing, and a few times I still did push but it was lighter. Marlyce checked again and pushed the cervix back, and after another 2 clusters she said I could push again. I later learned that it was around llpm at this point, and Jamie was finally asleep on his mattress in the living room, after refusing all night to go to sleep (or have a nap all day). So Mama came in and helped me. Michael was pacing the bedroom, and I saw him a few times and he looked like he wanted to pass out, but he didn't. I switched to laying on my left side for the rest of pushing. With every push, Mama would support my right leg up in the air, I'd grab the belt loop on her jeans and pull, and moan loudly. I swear I was really screaming, but everyone swears it was a low moan. Once Renna started to crown, I had to push more gently. The way I did that was to do what had been ineffective before, curling around my belly. And I stretched. No tearing. And then I could push full on again. And then Marlyce released one shoulder, the left one, and as the right one came out and she was born, I could feel the tearing. All through labor, I was telling everyone that she was punching me right where her head was, which didn't seem right. But I was right. Her right hand was on her left shoulder, and her elbow was straight out and tore me on the way out. It was too late to slow things down at that point since there was nothing stopping her. So I had 2nd degree tears down, and a slight tear up. We think she had her hand (or hands) on her face during most of labor, and that's why she needed help making those turns. Then at the last minute, pulled her hand down onto her shoulder. So, 50.5 hours after prodomal labor began (and didn't stop), 14.5 hours after my water broke, and after 1.5 hours of pushing, my Renna was in my arms.
Me with Renna, Mama, and Marlyce.
She required a lot of rubbing to get her to start breathing, but she finally did. She didn't need any oxygen. Then Michael was laying next to me, and we held our little girl.
Proud Parents with the newborn Renna
She breast fed right away, and really went to town.Renna and her first meal.
Mama brought Jamie in to see his sister. He was too tired and asleep to really be that aware, but he looked at me and was a little freaked out by me holding her. He did go straight back to sleep however, so he must not have been that freaked out. The placenta came out with one push about a half hour later, and Marlyce checked it out and it was fine and healthy. I guess at one point, Michael had agreed to "catch" and after seeing me crowning said he didn't want to (I did hear him say that at the time and asked about it later), so when it came time for the cord they asked if he wanted to but he let Mama do it (after it stopped pulsing, of course). She was thrilled. Marlyce waited to see if I needed stitches, but the "backward" tear wouldn't stop bleeding so she stitched it, but the "front" tear didn't need any. Then they made me get up and pee, which was lots of fun, let me tell you.Renna getting measured.
Mama held Renna while Marlyce was taking care of me (after taking Renna's measurements), and Alex the Bichon, laid next to her and kept sniffing Renna and laying his head next to her in a protective posture. He knew right away when I got pregnant with her (and with Jamie) and loved laying his head on my belly, listening. And once she was here, he was thrilled. All throughout labor, he paced like he knew something was going on. He was a happy boy. The other dogs were locked up in the garage to keep them out of the way. Kelsey the Border Collie because we didn't have enough time to get her used to the new people so she wouldn't nip them, and because she'd bark continuously if locked up her usual place in the house. Tigger the Dachshund because she'd bark non stop if in the house, as well. And Murphy the Golden because his huge self would just be in the way. Once Marlyce and Louise left around 3:30am, Mama let the dogs in, but we didn't have Murphy and Kelsey sleep with us as normal since they hadn't been introduced to Renna yet.Life with Renna
Our First Day
I slept as long as I could, but I didn't really sleep in. I felt great! Renna was a beauty, she fed really well, and she needed to meet her family. The dogs were totally blase, except for Alex who was still thrilled. Murphy did wag his tail, so I think he was happy to have her here, too.Renna in handknits
I made the appointment with the pediatrician for the next day, and we settled in for the day. Julie had arrived earlier to put up a sign with balloons, and later she and Bridget came over to visit. They were amazed I was doing so well. In fact, they did say that I really seemed myself, while after the c-section with Jamie it seemed to take several months before I was "back" and they had missed me. I was amazed by how good I felt, too. Renna continued to sleep most of the day away, feeding every 3-4 hours. In the days that followed, we developed a routine, and she slept well, and fed even better. She lost 7oz the first day, one the day after, but by 9 days old had gone up to 8lbs 12oz! When Marlyce came to do the Newborn Screen, after cutting Renna's heal and Renna starting to cry piteously, Jamie started crying and grabbed me and kept saying "Mama!" while looking at his sister sadly and at Marlyce like she was a monster. He started loving his sister right away. It took him a while to be reassured that I was still there for him and that our relationship hadn't changed, but he is now calmer and happier. It helped him to see Renna go to the pediatrician's office and he didn't get any shots, and his visit several days later went much better than normal. My sister-in-law Kristin arrived a week later, and she has been a big help. Jamie has come to adore her and loves to play with her. I had to go back to work when Renna was 6 days old, which has been really hard. But now my schedule has settled down, and we've made sure Renna gets breast fed on demand, and I'm not so upset about it. My bottom hurt like the dickens for 2 weeks but feels better now. I did over do it twice and started bleeding really heavily and passing larger than is safe clots, but after resting I was fine. So I'm just taking it easy still, while trying to get back to normal. It seems the main trigger for overdoing it is lifting things that are too heavy, or lifting something heavy-ish too high, so I can't carry Renna in her carrier, or lift the stroller, or put Jamie in his carseat. Otherwise, I'm fine to resume normalcy. And Renna is a great sleeper, so I have to wake her to get her to eat. She also sleeps through any household noise, including Jamie's tantrums from when he's overly tired. Jamie is even learning to sleep more heavily and doesn't necessarily wake up when she cries. We've started getting used to being a larger family now, and it's wonderful!
In retrospect
I'm very glad we decided on the home birth. While it was a long hard labor (even Louise and Marlyce said it was hard, so it's not just my opinion), it was very rewarding and healing and so much better than a repeat c/s. The long labor I had, along with the pattern of stopping and starting, would have made the OB's want to intervene to "keep things progressing" and probably would have pressured me into a c-section in the end. In fact, both Marlyce and Louise said just that. And while Marlyce is definitely biased toward home birth, Louise works in a hospital of which she's very proud, including their vbac stats. If I'd had to fight about it, the stress alone would have made labor longer and harder, and I might have caved on an epidural, and would have caved on another c-section if they'd hinted at her being in distress, which is actually pretty likely because they would have required constant external electronic fetal monitoring, which has a 90% false positive rate especially when the baby's actually in the birth canal. All of this would have made a vbac at a hospital almost impossible, and I don't think I can quantify or describe how important it was to me that I have a vbac. I thank God that everything happened the way it did, when it did. I surrounded myself with a great support team, and they didn't let me down. I didn't let myself down, either. Had Renna shown any distress, we'd have been in the hospital in about 8 minutes, but thankfully she was just as happy in labor as Jamie had been. Constant heart rate, and constantly moving. I am a bit embarassed by how loud I was. I moaned the whole time. In fact, sometimes, I moaned as loudly as I could because it "drowned out" the pain. I tried praying, but I'd forget where I was mid-word. Michael said that's okay because he was praying for me. Sweet man. I couldn't use my normal zen dissociation when I neared transition, let alone in it. Now I know what my "normal" pattern for labor is, so next time I know what to expect. And hopefully I won't have a lip then now that my cervix knows how to dilate fully. Yes, there will be a next time. I do still remember the pain, and I think I always will, but it was worth it to have Renna and I would be willing to do it again for another child.
