Guest Post: "Overcoming Fear in Order to Heal"

The Fear of the past…

Is something that came to light when I decided to get pregnant again. I never really thought about my first labor experience, until I started thinking about having another baby. I would just look at the pictures of my daughter’s birth, and recall my baby girl being born healthy and becoming a mother for the first time. But when I got pregnant for a second time, all the memories of the labor came rushing back. The physical pain of an unnecessary pitocin induction just because I was 3 days "over due" coupled with a half way working epidural and no preparation on how to cope with contraction pain that was intense with pitocin , had created a negative and traumatic memory. The feeling that really hit me was I went against my one and only instinct I had during my labor, I took intravenous narcotic pain medicines twice, which hardly helped anyways. I had not prepared. I just thought well I will just go to the hospital and have my baby like everyone else. I had known nothing of labor, medications, inductions, and delivery methods. I should have known something before I had my first baby, but I was scared of the pain, had fear of the unknown and the whole experience of labor and delivery at 20 years of age. That first birth was out of control chaos that I didn't want to repeat.

I chose to have a birth without fear…

because this time it HAD to be different. You learn from experience and don’t repeat mistakes, right? I started researching everything I could and gathered knowledge. Most of my research was through the American Congress of Obstetrics and Gynecology and the American Pregnancy Association. My research confirmed why my instinct told me not to take the pain meds. It also told me why my unnecessary induction experience was so painful and just overall negative, besides my daughter being born well. And I was lucky for my baby to have done well through labor and be born healthy and alert. I suffered a very painful 1^st or 2^nd degree episiotomy as well. I discovered that I was now personally uncomfortable with unnecessary inductions because it can easily lead to unnecessary risk and suffering for baby and mother. I asked myself, why can't labor and delivery be a happy experience? Why has everyone I known got induced, are we unable to go into labor anymore, or is just inconvenient? Is it possible to look back on your labor and think wow what a great memory? Why not? Why can't labor be a positive memory? Why not? I am a bit of a control freak and perfectionist and the thought of my negative, painful, and out of control first labor was upsetting. I needed to control my body and my labor. This was likely to be my last baby, so I wanted a positive and healing memory this time. So I decided I wanted to try to have a natural unmedicated natural child birth, but I never had full trust in myself to make it without the epidural, although it had only worked on half my stomach last time. I couldn’t let go all the way of my harbored fears from my first labor, my fear of the pain making me want an epidural, fear of getting repeat episiotomy due to scar tissue, and fear of something happening to my baby drove me to a hospital birth again. I was on a budget and read a book called Birth Made Easy by Paola Bagnall and listened to the hypnobirth Mp3 from it every night during my last trimester. I practiced positive affirmations and hypnosis with breathing to counts of four, all in hopes that I could labor all naturally. All the while I was learning to trust my instinct and trust my body, and letting go of all my harbored fears.

Then some problems arose…

At just 24 weeks of pregnancy my OB diagnosed me with low amniotic fluid and monitored me weekly with ridiculously expensive bio physical profiles. I didn't worry after finding out my levels (6-9) weren't worrisome if the baby was healthy. She did tell me to work part time and take it easy the rest of my pregnancy. I started to drink a gallon of water a day and the only caffeine I had was 1-2 sodas per week. Then I found out I was positive for group B strep. So I was glad that I chose a natural hospital birth so I could get the antibiotics for my baby. At my 38 week appointment my blood pressure went up to 130’s/85-95s, which was a little bit high for me considering I had been having low blood pressure (80/45 to 100/70) with symptoms. My doctor told me I was soft and 1-2cm dilated with baby up high, so not much going on. It started looking like an induction was in my future, because my OB was pressuring me already with the three reasons I stated above as her basis. I told her No, I am not inducing until 41 weeks, although she had tried to set up my elective induction for me for 39 weeks. Those three reasons started tricking me into thinking an induction may be needed to. I desperately wanted to labor naturally. For my baby’s health. For my perfect birth experience.

Early labor starts…

At 36.5 weeks I had started walking an hour and bouncing on a yoga ball half an hour, both every night. During these activities I would practice techniques I had learned on my hypnobirth mp3 to relax my muscles so my pelvic floor would not be tense and the walking and bouncing would actually produce progress. I also took evening primrose oil and ate pineapples. I was due with my son November 21st, 2012. On Wednesday evening November 14th after my walk and ball bouncing, I started urinating very frequently with several Braxton hicks contractions. Then I had a sharp uncomfortable contraction, then another 2 minutes later. The contractions continued at 2 mins apart lasting 30sec each. I hopped in the bath tub and relaxed to my hypnobirth mp3 while excitedly pondering if this was it! My Husband packed our hospital bags and timed my contractions…and then they quit after an hour. The next day, Thursday November 15th, I felt like I was having a menstrual period. I had continual dull uterus cramps and low back ache all day with the occasional Braxton hicks contraction. Then the next morning at work, Friday November 16th, I passed bloody mucous. I knew it, I was in early labor! I was excited. I monitored my blood pressure and when I was up and about it was 135/95. It made me nervous because I knew my OB would put the pressure on at my upcoming appointment Tuesday/due date day. So I took out my book Birth Made Easy and looked up natural induction methods in the book to get those wonderful contractions going again. I had already been doing what it said. The ball bouncing, walking, sex, primrose oil, and eating pineapple daily. I continued to read and there it was, castor oil. It said for past due babies though. So I hopped on my birth club online and found the posts about girls taking castor oil. I started counting because I am a number and statistical person and found a success rate of about 30 out of 45 girls who had tried it. With no negative outcomes from any of the girls and baby’s. I had read several birth stories previously that week in which castor oil had been used and actually recommended by midwives and their babies were born healthy. I googled castor oil and came across many blogs with opinions on it and even midwives chiming in on the discussions. I found that it wasn’t studied and the common risk was meconium waters, and most of those cases were over due babies so it was hard to blame that occurrence on the castor oil alone since over due babies tend to have a risk of meconium waters anyways. I needed to have a bowel movement anyways so I decided what the heck, why not try it? It's all natural and I bet its way better than dreadful pitocin as far as the babies and my health is concerned, escpecially since I found it in my hypnobirth book and it had been used by midwifes. So I did it. I took the max recommended dosage around 2pm and did everything else I possibly could to get my contractions started. I walked, ball bounced, etc….And I waited, and got nothing but a few runny bowel movements that were not uncomfortable. I drank a gallon of water (over a couple hours time) and started sweeping the floor. I got in a foul mood suddenly and snapped at everyone around me which was my husband, brother, mother, and daughter. I started crying suddenly. I realized this may be the hormone let down before labor and yet I couldn’t control my level of simultaneous madness and sadness. So my mother and brother took my daughter to my grandmothers for dinner and I went on another long walk alone in the dark and cleared my mind . I thought about my labor and envisioned it all going as planned. I had a feeling this would be one of my last moments alone with myself and my mind and peace. And I was correct. I came in around 8pm, kissed my daughter good night and pondered looking at her as an only child one last time. I went to sleep at 10pm. 

At 12am Friday November 17th at 39 weeks & 3 days I was awoke by a sharp uncomfortable contraction, 2 minutes later another came. I woke up my husband who had just laid down a few minutes prior and he began to track the contractions with a handy android app called contraction calculator. I started playing my hypnobirth mp3 by Paola Bagnall and went into my deep meditative state, while controlling my breathing to a 4 count. In hypnosis, you do not think. This is a reason why it is so effective and why I mastered it with her book and mp3 my last trimester of pregnancy. The only thing your mind is focusing on is the voice of your hypnosis guide, your breathing techniques, and the occasional check that your muscles are relaxed. Without thinking, negativity and tenseness cannot creep into your mind. I could feel right before the contraction was coming and catch it by starting my breathing. I would visualize it coming in like a wave because it actually felt like that. When I breathed in, I would push out my stomach using my diaphragm and it would naturally stretch my uterus making the contraction feel better. When I would breathe out I would drop my shoulders for deeper relaxation and release any tense feeling in my pelvic floor. My mp3 track gave me positive affirmations and visualizations of my cervix easily opening like a flower bud. The contractions were strong and 2 mins apart every time and lasting a minute every time. After an hour, we called my parents and the hospital. I took a shower and did my hair and make-up in a quiet and peaceful state of mind. My dad was to stay with my daughter at my house because she was asleep, and my mom was coming with me and my husband to hospital to video tape the birth. I gave my husband and mother specific instructions on maintaining a quiet peaceful environment and how to be my birth coach a few weeks prior. We were not telling anyone I was in labor to keep it that way, peaceful and quiet with no break in my concentration of hypnosis. I paced the house and listened to my Mp3, I was so excited because with each contraction I was getting closer to meeting my baby! I was so happy I was in control of my body and handling everything so well and went into labor naturally. I called the hospital and told them the about my contractions being regular for an hour and half at 2 mins apart and they told me to come in to get me and Christians IV antibiotics before he arrived because they take a few hours to administer. I would of labored longer at home if I had not had the group b strep.

We arrived to hospital….

around 3am with contractions steadily 2 mins apart still and strong. I never turned off my mp3 but for a few minutes. They hooked me to the dreadful outer monitors and told me I was a -2 station and 2.5cm. Baby Christian was happy as a clam in my belly on the monitors. I rocked back and forth on the edge of the bed for a while then laid down since it was almost 4am and I was with no sleep. I was in deep meditation which allowed me to doze off between the contractions for a whole 2 mins at a time! My mom and husband took turns dozing off, mainly my husband. They checked me again in an hour and I was the same. This brought me out of my deep meditation and I started pacing back in forth in a 6 foot line and got a little tense. Was this a false alarm? Or do I need to get to walking and relaxing again? They came back in an hour and half and I was the same again, and offered pain meds which I of course said no to easily. So I told the nurse, “I need to get off these monitors so I can walk.” She told my Dr, who hadn’t even popped her head in yet and but was there, and the nurse came back and said “We are going to let you go home.” I thought well ok that is what I want, but I am in about 8/10 pain with the contraction, they are lasting one minute each and two minutes apart, and I am positive for group B and have been in labor almost 7 hours now with consistent contractions, so is this a good idea, to go home like this? My mind answered yes it is, because if you stay hooked up to the monitors you won’t dilate and they will give you the awful pitocin which is bad for baby. If I want to progress naturally, I need to get out of here.

We headed back home…

around 7am. The only time I ever looked at the clocks was when I went into labor at midnight and these two times in the car. In my state of hypnosis there was basically no time. The car ride intensified my contractions. When I got home I was exhausted without having slept and my contractions were very hard so I had to lie down. I was nauseous with every contraction. I had drunk another half gallon of water and was hungry, but couldn’t eat the chicken broth soup and toast my mom brought me. My husband went back to sleep and my mom sat right by my side as I laid in the bed. I was hypnotized to my hypnobirth mp3. Paola Bagnall's voice carried me through every single contraction. I visualized napping in the sun on the beach at Lake Tahoe, and I fell asleep for 2 minutes, then a wave was rolling into the shore, it was the contractions which I woke up for the duration of 1 minute to handle. This process of sleeping on the beach and then waking up to a wave continued for almost 2 hours. I was curled up in the fetal position as best as a full term pregnancy woman could. My mother eventually left when my daughter woke up to feed her breakfast. It was just me and Christian now, my son, working together. A quiet mind will wander, but a focused one will not. All my thinking mind needed to shut off was that constant soothing voice of hypnosis. I didn’t fight the contractions, I never tensed up. I breathed through every contraction to a 4 count, sleeping in between, so relaxed , it was an out of body experience. After those 2 hours in bed, I started moaning quietly through the contractions and I had to get up because the pain was very sharp in my uterus now. My heart raced and I had butterflies. I wanted to get in the bath tub instinctively. Half way there, a contraction came and I fell to my hands and knees. I remained like that till it passed. Falling down like that broke me out of hypnosis for a second and the pain was intense. I yelled for my husband and he helped me get in the bath tub. I knew getting in the bath would help me relax and relieve some pain. It was just me and him now and he kicked in to birth partner gear. He gave me positive affirmations and followed my lead. I noticed during the contractions I was peeing a little in the bath tub. I repeated the contraction section on my mp3, over and over again to concentrate on getting through just the next contraction. Just keep breathing. During this labor my life had taken on a different meaning, to just get through the next contraction. The bath was like a haze as the contractions got stronger and I started losing control of my 4 count breathing. I would exhale by blowing out a long whimper so I wouldn’t have to breathe in very much. My husband was timing it all and said the contractions were now nearly 2 minutes long. I said “Well when should we go back to hospital, it’s from an 8/10 to 9/10 pain, is that good enough to go back to hospital? Do you think it’s time, or maybe I haven’t made any progress? ” The next contraction I felt a sudden heavy pressure press down on my pelvic floor and anus. I peed a little more. I had my husband help me out of the bath tub. I sat down in a squatting position on the edge of a chair and had another contraction with intense pressure , it felt like my anus was turning inside out it was so intense. I got a spurt of nervous energy and paced the room before the next contraction and when it hit I sat down in a spread legged position again on the toilet this time and peed a little more in spurts, and I totally relaxed my muscles and let the pressure press down with all it had. I said “Ok it’s time to go back to the hospital because there is intense pressure coming down and seemingly out of my anus.” It was 10:30am (my husband later told me), only 3 ½ hours after we had first returned home. So my husband dressed me because I suddenly started feeling weak, limp, and shaky. He helped me to the car. The drive was horrible, I moaned loudly with very long exhales and a bucket in my lap in case I got sick. I could feel every little bump in the road. I never opened my eyes. My mp3 finally was off for the first time. I started thinking finally, previously I had only had thought when I was at the hospital and when I was in the bath tub. I was still (barely!) in control of myself. I started thinking out loud to my husband. “What if I still haven’t made any progress? If I haven’t made any progress then I will get the epidural because I am losing control! This hurts. What if this pressure and intense pain is transition? I am shaking and weak and nauseous, I think this is transition…I am scared to do this without an epidural. I understand how those girls on I didn’t know I was pregnant thought they were having a bowel movement because this pressure is all coming out of my anus” In that car ride, I became one with my body. Although I was not in hypnosis, I was still relaxing and meditating. When the contraction would hit, my breathing would become shallow and my body would become completely limp. It was like my body would take every ounce of energy from every other muscle and give it all to my uterus, and I didn’t fight it. My legs were rubber and flopped open. When the pressure would start coming down all I could feel were my lungs trying to breath correctly and the muscles of my pelvic floor, uterus and anus, and I would feel them all try to tense up and fight the pressures pain. I focused in on those muscles and I released them, I let the pressure come down as far as it wanted to without resistance. I was truly becoming one with my body and letting it do what it was designed to do. It was amazing. It was empowering. I was strong.

We got back to the hospital…

Around 11am (my husband told me later) Here is the scene: Me in my red pajama pants with black dogs on them, pink and silver tennis shoes, belly hard as a rock In a tight black tee shirt, huge black sunglasses on, messy hair, moaning out loud but quietly, whispering when I spoke, my poor husband helping me into a wheel chair in front of the emergency room. He left me with the check in attendant to park the car, my mom was parking her car at the same time. The ER attendant rudely said “What’s your name and date of birth mam?” I just quietly moaned/whimpered through another contraction and ignored her. My husband came running up and answered all her check in questions. They wheeled me up the elevator and to a labor room. My nurse and husband had to put me in the bed and take my clothes off. I felt too weak to stand and the bath tub and bed had been my best friends this labor (and my hypnotherapist of course) so I happily obliged to the bed. The nurse strapped on the monitors and Christian was still performing excellent on them. The nurse tried to check me immediately and I slammed my legs shut saying “Wait till my contractions over.” She said “Well I have to check you hunny!” I said ”I know just wait”. The contraction was so intense and the pressure made me shake uncontrollably. The nurse checked me for a long uncomfortable time in which her hand was almost going in a circle and I said “What is that? Ouch! What are you doing? Please stop.” And she said “That is your baby’s head , you are fully dilated and ready to go. You already lost your bag of waters?” I said “I don’t know.” I must have left it in the bath tub and toilet right before I left and had close to none since I had low amniotic fluid throughout pregnancy. It was 11 am just 4 hours from when I left the hospital earlier. In 4 hours at home and in the car I went from 2.5cm to 10cm. But here comes the fear in my mind; is my baby going get strep? Well I can’t control that. Onto the next fear, something I can control, my previous episiotomy hurt like crazy after my epidural wore off with my first daughter, I mean I cried it was so horrible. That fear hit me like a ton of bricks. And the fear of a ring of fire during crowning my best friend had described to me as a blowtorch after her natural birth. I said to the nurse “Ok I need an epidural first because I don’t want to feel that ring of fire thing or any cutting or tearing. It’s gonna hurt.” And she said “Oh no hunny I am so sorry it is too late for that.” and she ran out of the room. I yelled after her “But no I really need an epidural first!” My beloved mp3 was gone, my meditation was gone now, and the chaos started. My husband held my hand tight, looked me in the eyes, smiling with a tear in the corner of his eye and said “You are gonna be ok baby you can do it. I love you.” I said “Where is my mom?” She had been told to go in the waiting room while they checked me I later learned. I started to panic; I let the fear come over me like a wave as the wave of nurses started running into the room and another wave of a contraction hit me. I moaned loudly in a low pitch. I said again “Seriously I need an epidural. I drank a lot of water I promise.” They said no again. My mind told me it would hurt, but I didn’t know that for sure. It was fear of the unknown and fear of the past gripping my mind. I said “Ok, well what about some pain meds, I had those with my daughter and she was perfectly fine. I really don’t want to feel that ring of fire thing.” And a nursery nurse with her back turned to me and my husband said while unfolding the babies blanket, “We can’t give you that this late or your baby would have to be resuscitated.” My husband said no out loud and I said no in my mind. I shook my head back In forth as a response and went into my mind Why did you even ask for that, you were adamantly against that anyways because of that very fact, sedated babies and hardly any pain relief. People swarmed about the room setting up the delivery table and baby table. My nurse came over and said “I’m sorry hunny, but look you have made it through the hardest part already, all the labor!” That sentence started to settle, and started stirring something up inside me, my strength. A male Dr came in and said my Dr was delivering another baby right now and he introduced himself. I introduced myself and looked straight at him and said, “Is there anything you can do to help me?” He said “I am going to give you a local anesthetic over your scar here and start your antibiotics” I watched his hands draw the needle and felt the sting on my old scar. The Dr said “You’ll feel this sting. Ok it’s almost time, just 2 good pushes and we’ll have this baby!” My mom had just entered a few minutes ago and excitedly and nervously said “You hear that Melanie, just 2 good pushes and you’re gonna let er rip! When should she start pushing?” The room was very quiet and my eyes were closed, head tilted back. I heard people saying “You’re doing great” Then, another contraction came over me and as I moaned I felt an uncontrolled push happening with a whole lot of shaking and crazy breathing, thinking no I can’t I can’t , but my body was trying to push. The nurse told me hold my breath and started to count out loud for me. I didn’t do it like I should of, I said “I can’t”. Everyone said, "You can do it, just push hard" When that contraction stopped the room got quiet again. I felt a sharp unnatural feeling on my urethra and said “What is that?” The Dr said “I’m sorry but I have to drain your bladder real quick with this catheter because your urethra is beginning to tear from your pushing so hard” He did it fast and took it out within his 2 minute window before I was to push again. The sentences of encouragement where still stirring around inside of my mind , I had done it? I had done it. I labored naturally and controlled my pain up until this crazy transition pressure pain, anyways, just when I thought I couldn’t take anymore, it was delivery time. The nurse had said the hardest part was over already, was she right? Pushing with my daughter was a piece of cake, so this should be easy too right? My perineum was numb so I won’t feel it if its injured again. I turned to the nurse and said “But what about that ring of fire? I’m starting to feel a burning sensation.” Her and the Dr replied “Just push through the pain when you feel it” I said ok, and I thought I’m going to do this this time, I am strong. I got what I wanted, a natural child birth. The sentence reawakened the strength that had only gone away momentarily. I said “Here it comes” and there it was, a huge contraction with a huge amount of pain and pressure. The nurse started her instructions. I breathed in, held it, and pushed as hard as I could, and as soon as I started to push, that contraction pain completely vanished. Like magic. So I pushed harder, and there was absolutely no pain. My mind was relieved, it was like a breath of fresh air as I only felt a huge amount of pressure and a slight burning sensation now and not the contraction anymore. When I got to the count of 6 I started moaning out my held breath, like a relief moan, I knew I probably shouldn’t have but it felt right. I felt my baby moving through the birth canal and it didn’t hurt. The feedback of feeling successful movement of my baby helped me focus on my pushing. I took another breath and I pushed again two more times for long 10 counts and then the contraction ended. The Dr said the head was nearly out and with the next contraction I could meet my baby. This statement, coupled with a nonexistent ring of fire, a numbed perineum, and the super awesome newly discovered fact that when I pushed my pain actually went away, gave me so much excitement! A huge smile came across my face. I asked the nurse “Can we let my bed up higher?” , so I’d be like sitting and she said no, and before I could argue here came my contraction. I took that huge breath in and held it and pushed as hard as I could, I really used every ounce of strength I had in my pushing. I started to moan as I exhaled again through the last couple of seconds of each breath, I thought about that nurse telling me no and my moan got loud. The Dr said “Ok stop, his head is out” I excitedly demanded “I want to hold him!” They said hold on, and ok now push again, and I did with a higher pitch moan, and whooosh, out he came! The Dr put my son on stomach and I was over taken with emotion and joy crying “My baby, my baby! " My baby boy quietly opened his eyes and squinted up trying to find me and my voice, I was in awe as he looked at me. I don’t know if he had started to breath yet, I don’t think he had, but the Dr gave him a little rub and he started to cry. I said “He's so little! It’s ok sweet baby ” Dr clamped the cord and daddy cut it while he was on my chest still. I was so overtaken with emotion! Then they took him to his little bed a few feet away and cleaned him up and weighed him and he stopped crying and started looking around calmly. The Dr said he did have to give me a very small episiotomy, just a few stitches, because the scar tissue was not stretching although he had was trying to stretch the perineum for me. The Dr massaged out my placenta and sutured me quickly; he kept saying that I had done a great job, and an amazing job pushing. I closed my eyes and sighed in relief. I said “It really wasn’t as bad as I thought it would be” My son was born Saturday November 21st 2012 at 11:26 am, only 26 minutes after arriving to the hospital at 11am. I labored 4.5hrs at the hospital and 6.5hrs at home. I lost control and let that fear creep in right before delivery for about 10 minutes during my 11 and half hour long labor. Christian Lee Willis was perfectly healthy and was 7lbs 2oz and 21 inches in length at 39weeks and 3days gestation. He had no cone head shaping at all and no puffy eye lids and was born fairly clean. After about 20 minutes of cleaning him up and measuring him in the same room as me, they gave him back to me and left us all alone. He nursed for 20 minutes with ease, just quietly staring with squinty eyes at me and his new food source, just like my daughter did after her birth. My brother and daughter came in and I let my husband and daughter hold our baby boy. Then I fed him again. I hoped up with ease a little less than an hour after delivery. Recovery was so much easier than the first time, although my urethra and bladder were sore for months from being stretched. The contractions were much easier to handle because I could catch them as they came on like wave, building up to a peak, and they were focused on my uterus, with a max total of 9/10 pain in transition. Compared to 10/10 pain with pitocin contractions for several hours with my first birth and they were so hard to handle because they took over my entire stomach and came on out of nowhere immediately strong. My body created a natural epidural due to adrenaline and other hormones that were left undisturbed throughout labor also due to the vagina being stretched so much after crowning that it just goes numb from nerve compression, I started to reflect on what just happened. I had my healing experience that I so desperately needed after my first birth experience. I trusted my body and just let go. I just gave birth without fear. I am strong.

After my experience I discovered Birth Without Fear blog and decided to write my story so I wouldn't forget the details, to inspire women, and to show my children when their first children are one the way. I also found this quote that spoke to me, and it is my hopes that my story and this quote will find someone who is pregnant and inspire them to believe that they are strong.

“We gain strength, and courage, and confidence by each experience in which we really stop to look fear in the face... we must do that which we think we cannot” – Eleanor Roosevelt


Please follow Melanie on Instagram @Mama_Mel_Mel to learn more about her and her family!

Factors for VBAC success, Part 1/2

In this post, I will discuss why each of the following factors are important in VBAC success:

*reasons for previous c-sections
*arriving at the hospital as late into labor as possible
*not having continuous fetal monitoring
*epidural as late as possible into the labor, if at all
*no induction or acceleration
*previous vaginal birth

*Reasons for previous cesareans
If previous cesareans happened because of something unlikely to reoccur, like the baby being breech (which is a whole other topic, and I will be featuring both facts on breech babies and a couple of guest post on the topic next month), you have a pretty good chance of a successful VBAC. Something like CPD (a medical condition where one's pelvis is actually too small to allow a baby to pass) can make a VBAC more difficult, but it is still not impossible. According to The VBAC Handbook, as many as 2/3 of women with CPD that attempt VBACs are successful!

*Arriving at the hospital as late into labor as possible
The reason for this is simple. The longer you labor at home, the less opportunity the hospital/doctors/nurses have to "help" you with a cascade of interventions that could just lead to a RCS.

*Not having continuous fetal monitoring
Continuous monitoring restricts your mobility, which is a huge problem because being able to move around in labor is a necessity to help labor progress. You might also experience more pain/discomfort constantly laying on your back because you're stuck in bed, hooked up to a monitor. 15 minutes an hour is more than sufficient to give care providers an idea of how baby is doing, and then momma can focus the other 45 minutes of the hour on LABORING how she's most comfortable. Another reason to avoid monitoring if you can help it is that results are often misread, which leads to more cesareans unnecessarily.

*Epidural as late as possible into the labor, if at all
Epidurals usually require continuous fetal monitoring so that the laboring moms lowered blood pressure (a side effect of the epidural) can be checked regularly, along with it's effect on the baby. Because you don't want CFM (see above), you should wait as late as you can to get the epidural, if you get one at all. Epidurals have also been shown to stall labor.

*No induction or acceleration
Any sort of induction or acceleration of labor, including artificial rupture of membranes (AROM, or having your water broken) can raise the risk of the previous cesarean scar "unzipping". Some doctors might want to administer pitocin once a labor really gets going to speed things up, but be aware of the risks before you consent to ANY sort of augmentation!!!

*Previous vaginal birth
If you have had a vaginal birth before your cesarean, you are likelier to have a successful VBAC. You are also likelier to have a successful VBAC if you've already had a VBAC! Crazy, huh? ;) Not much help for mommas like me, that had an unnecesarean right out of the gate, but perhaps good news for other mommas out there!


The next post will finish up the list of factors and the reasons behind them. I'd love to hear your thoughts on the list so far!

Guest Post: "A Story of Strength: Know Your Options"

Hello, my name is Brittney Horn and this is my birth story.

I am a 27 year old stay at home mother to one amazingly smart 3 year old little girl. I am married to the love of my life, TJ. We have been together for nine years, married for five. One year into our marriage, we decided to try for our first child. First time was a charm for us. We got pregnant right off the bat but my first trimester was extremely hard on me due to the nausea. Was in and out of the hospital getting iv fluids to maintain hydration. I couldn't hold water down. Second trimester was amazing! Loved it! Then the third trimester hit.

I had just started my 34th week of pregnancy, on our way home from the hospital tour and as we approached a green light, the car in front of us locked his brakes. We had to do the same resulting in my seatbelt tightening around my stomach.  Later that night I felt pain, didn't think anything of it. 

During the night, the pain got worse. I got up the next morning, got ready for work and went about my normal day, with continued pain. After four hours at work, I drove myself across town to the hospital where they said I was in preterm labor with contractions less than two minutes apart. I was dilated to one cm. After what seemed like forever, I was sent home on bed rest. The next five days were just a repeat. Labor starting and being stopped. 

Fast forward almost six weeks to five days before my due date. At exactly midnight my water broke. I didn't want to be sent home from the hospital again so I allowed my husband to sleep while I paced the house and sat on my birthing ball for five and a half hours. I then woke him up and off to the hospital we went. Once there, the rest of my water broke. At 3 cm I was taken to get an epidural. My contractions were about one minute apart. The anesthesiologist missed the first epidural. Second one was a success until the pump they had me on died. I started feeling my legs, third epidural on its way along with pitocin. Neither worked because by that time I was stuck at 8cm, my daughter flipped her head and was stuck in the birth canal. My temperature starting skyrocketing and I couldn't stop shaking. The doctor said emergency c section and I saw 5 nurses and 3 doctors running in. 

It was such a rush to the operating room. Once placed on the table and drape was up, I was crying for my husband whom they said was getting in his coverups. After a few minutes of prep, the doctor informed me that they couldn't wait and were going to do the first cut. He did so and I about flew off the table. It was like I had absolutely no pain meds or anything on board. I screamed and the last thing I remember was the doctor yelling stop, she feels it, she needs to go under. 

At 6:55 pm on February 21st 2010 our beautiful daughter, Audrey Lynn was born weighing in at 7lbs 5oz, 20 and a quarter inches in length. She was pulled out by her right foot due to being stuck in my birth canal. I woke up eight hours later on a sleep apnea machine. I never heard my girls first cries, I never got to feed her her first meal or change her first diaper. Thank God my husband was there to do all of that. Having my daughter was a true blessing, just wish I could remember the most important parts of it. I refuse to go back to that hospital and I am now researching midwives and doulas. My husband and I are trying for our second child and I want nothing more than to have her/him naturally. With C-Sections growing by the day, we all need to know what our options are. I now know that I have other options and I hope to be able to use a better one for our second child. 

 

Thank you for reading my long story. Its not easy for me to talk about.

Guest Post: "My long, long, long story."

I've been overweight my entire life. At the beginning of this journey, I was 300lbs. I'm 5'2, so that's quite big. I was diagnosed with PCOS when I was 13. I was immediately put on birth control to control the symptoms of PCOS, as well as metformin. As time went on, I stopped the metformin because I wasn't trying to conceive as a teenager and thought it was dumb to try.  So at the time I became pregnant, I had been dealing with PCOS for 13 years. Most of those 13 years I was on birth control. About 6 months before I became pregnant, I was tested for PCOS again and it came back that I very obviously had mild to severe PCOS. I was put on metformin and aldactone. A few months later, I moved from Tennessee back to PA and stopped taking the metformin, aldactone, and birth control because I wasn't in a relationship at the time and wasn't able to get my medication because I no longer had insurance.

 I met the father of my baby in July of 2012 and we became a full blown couple in August of 2012. We used condoms, but weren't extremely careful. I wasn't worried because of my history of PCOS.  We broke up September 15th, 2012. Two weeks later (after he moved back to California to be with his family - I live in Pennsylvania. That's 2000+ miles) I found out I was pregnant. For about a week, I had been feeling tired and nauseous, but I just assumed it was from the stress of the breakup and PMS. My mom asked me if I could be pregnant and I told her "Well, technically, yes. But I highly doubt it". She asked when I was supposed to get my period and I told her it would be about a week before I could test, but I was sure my period was coming.

Fast forward to 4 days past when my period was due to start. I worked my 3-11 shift and decided to go to the drug store after work to get a test. I bought a two pack of digital tests because I didn't want any question about the lines. I didn't want to think I was seeing things when it was really negative. I got the tests and went home. Ate something as I always did and went to bed. Around 7am, I got up to use the bathroom and decided to take the first pregnancy test since it would be first morning urine. I sat the test on the sink and went about finishing up. I glanced down at the test less than a minute after taking it and it said "Pregnant". I closed my eyes for a few seconds and looked at it again. Still "Pregnant" I picked up the test and held it close to my face, staring at it. It didn't change. I turned the test every which way, still the same. Still "Pregnant". I took the second test out of the package and tested again. Same thing. "Pregnant" came up before a minute had passed. I started shaking and crying. I went to my bedroom and called my mom. At first I couldn't speak. She became panicked, thinking there was an accident or I was hurt. I squeaked out "I'm pregnant" through my gasps for air. All she said was "You're pregnant? That's not a bad thing!". She's always wanted me to have kids.

So, there I was: 26, 300lbs, major history of PCOS, just broke up with the father of the baby I was apparently carrying, living alone 2 hours from my family, working a full time, physically demanding job. It took me a little while to wrap my head around it. I took pictures of the test and looked at them because I was still in disbelief. A couple hours after taking the test, I called the baby's dad. We had still been in touch since we broke up, so it wasn't terribly weird talking to him. I basically told him to sit down where ever he was. I explained that I took two tests and that we were having a baby. He was in shock, as any man would be in his situation. He didn't talk for a little while. I was crying. I told him he didn't have to come back and that he didn't have to have anything to do with the baby if he didn't want to. I just wanted him to be able to make the decision. He decided he wanted to come back to help me out and be a part of his baby's life. He was back in Pennsylvania 2 weeks later. We decided at that point to work on our friendship because we wanted a healthy relationship (whether it be friendship or romantic) for the baby.

He came with me to my first real appointment at 8 weeks pregnant. The first thing I asked the nurse was "Do women as big as me often have healthy pregnancies and healthy babies?" She let out a little chuckle and said "I see women bigger than you every day that have healthy pregnancies and healthy babies. Don't even worry about that!" I knew then that I was at the right office with the right people. The doctor didn't mention it, she only suggested that I have an early glucose test because of my PCOS history. They tracked my weight like they would any other pregnant woman. They didn't treat me any differently. I ended up losing 10lbs in my first trimester due to my morning sickness. At 10 weeks, they found my baby's heartbeat and I cried. It sounded so perfect. I had my first ultrasound at 13 weeks and my baby looked perfect. I was worried that they would have a hard time seeing the baby because of my weight, but the ultrasound tech didn't seem to even notice.

Everything carried on as normal for a few months.  I wanted to have an all natural birth, but I also knew that things can happen so I decided not to get too used to the idea. The baby's dad and I re-developed feelings for each other and decided to make a go of a romantic relationship with the understanding that we need to make it work. If it ends, it ends for good. Either way, we needed to be mature and civil for the baby. We decided to move closer to my family for support and for childcare after the baby was born. I worked up until the day before we moved (I was 28 weeks), but wasn't able to get a job after we moved. The worst part was switching doctors.

I went to a women's clinic in town and was severely disappointed. The female doctor I saw was horrible. She looked right through me. She ignored my worries about my blood pressure. She did mention my weight and I simply said "I've only gained (this much) and that isn't a problem." After two appointments like this, I decided to find a doctor in my hometown that is an hour from where I live. I'm so glad I did. I went to a new practice that had an OBGYN and a midwife. They were both so wonderful. Never mentioned my weight, but did address my blood pressure. It was only slightly elevated, but they didn’t want to take any chances. I was put on Labetalol twice a day to manage my blood pressure starting at 34 weeks. I had no real side effects from the medication, but it didn’t completely control my blood pressure. At 38 weeks, my doctor decided that inducing me no later than 40 weeks was the best option. This was because of my blood pressure, my family’s history of pre-eclampsia, and also because baby was measuring weeks ahead on every ultrasound since 33 weeks. Luckily, I didn’t develop pre-eclampsia.

I kept trying to bring labor on naturally. Walking, bouncing on a yoga ball, walking up and down the steps, and increasing intercourse (the boyfriend loved that!). I had a few contractions off and on, but nothing significant. So, at 39 weeks and 4 days, I began the induction process. They decided on Prepidil because I was already 1cm dilated and 75% effaced.  The worst part was that I had to stay in bed for 90 minutes after they inserted the Prepidil. It causes spontaneous contractions that, at times, are very painful. I was able to get out of bed and into a jacuzzi after the first round of Prepidil and it was heaven. My contractions evened out and I was handling them well. Sadly, they stopped a couple hours later. I kept walking and trying to bring the contractions back on, but nothing. I did this all day long with very little progression. At about 10pm, they offered to break my water and try another round of Prepidil. I opted for sleep because we had been up since 3am.  They gave me a shot of pain killers to help me rest.

The next morning, they checked me and I was still the same. We did another round of Prepidil. Same thing, eventually my contractions stopped again. I got to 4cm and they broke my water (Strangest feeling ever!). They also gave me some Cytotec. Nothing happened. I made it to 5cm and they said that it was time to try Pitocin. The baby was tolerating everything really well, but there wasn’t much we could do besides the Pitocin. At this point I was exhausted. I had been through about 36 hours of medications, contractions that weren’t doing anything, and plenty of cervical checks. I had heard about the effects of Pitocin and how strong the contractions can be and I decided that it was time to get an epidural. The anesthesiologist wasn’t very nice and it took a few minutes to place the epidural, but it was worth it. I got some relief from the spontaneous contractions and was able to rest. It was also worth it because I couldn’t feel the very uncomfortable cervical checks anymore. They placed a monitor on the baby’s scalp to monitor the heartbeat, and also placed an intrauterine monitor to track my contractions. The pitocin ran the rest of the evening and into the next morning. They jacked it up to the highest setting. My contractions still would not regulate. At about 4am, the baby’s heart rate dropped just a little bit, then again an hour later. My midwife and OBGYN told me that, if I hadn’t progressed any, that it was time to start thinking about a c-section. They checked me at 6am and I was still at 5cm. The baby’s dad and I talked with the midwife and OBGYN and because I wasn’t progressing, plus the baby was starting to show signs of distress, it was time for a c-section. What was nice was that it wasn’t an emergency. Yet. Luckily, all the doctors and anesthesiologists had just come in for their shifts and no one was in the operating room yet, so I didn’t have to wait. Within minutes of getting the order, everyone was in my room, calmly preparing me for surgery. My epidural was working well enough that we could use it for the surgery. Within 30 minutes I was being wheeled away. The baby’s dad joined me in the operating room, of course. All dressed up in those scrubs. There was a second anesthesiologist that was helping with getting me prepped. I called him “the nice one” because he was very friendly and was wonderful at keeping my attention. While he helped wheel me into the OR, he looked at me and said “I think you’re the calmest c-section I’ve seen in a long time!” My reply was simply “I’ve been at this for 48 hours. I’m ready to meet my baby.” He was great. He talked to me the whole time and kept the baby’s dad from looking over the curtain. It felt like an eternity, but eventually he said to me “She’s on her way out! She was very far down into birth canal.”

There was a lot of tugging and pulling and then there she was. They held her up and she looked so mad! They rubbed her a little bit because she didn’t want to cry, but she did a few seconds later. I lost it. I just started crying. They cleaned her up enough that she could open her eyes and made sure she was breathing okay, and then they laid her on my chest. I was so excited to be able to have skin-to-skin contact like that. She laid there in my arms for about 10 minutes and then I began feeling nauseous so I had her dad take her. I watched while they weighed her and finished cleaning her up. The doctor gave me some nausea medication and I actually dozed off on my own. I heard a nurse ask if they had to sedate me and the doctor replied “No, she’s just dozing off on her own! After 48 hours, I’m sure she’s exhausted.” I had to ask for pain medication because my shoulders were killing me. They told me that sometimes gas gets trapped and it’s a pretty common side effect. After that, we were wheeled to my room. We weren’t allowed visitors for an hour. It was just me, my baby and the baby’s dad. Luckily, the pain medication worked well enough that my shoulders quit hurting before we got visitors.

My midwife came to check on me shortly after I got to my room. I was holding my baby and asked her what the red lump on the side of her  head was – if it was from one of the monitors or what. She smiled and said “No one told you? That’s where your baby was trying to come down into your birth canal. Her head was tilted. That’s why she couldn’t move any further down and that’s why you only dilated to 5cm. She was never coming naturally with her head tilted that way. She tried, though. She was pretty far in there!” So, in the end, there was nothing wrong with my body at all. It was simply that my baby girl got a little confused and tilted her head just enough that she simply couldn’t move any further into the birth canal.

My boyfriend had to take care of the baby most of that day because I didn’t get out of bed until later that evening. He was great. Changed all the diapers and would bring her to me any time she looked hungry as I was trying to breastfeed. My pain was being managed well, but I was still exhausted. I basically demanded that they get me out of bed that evening into the chair. They told me that most women don’t get out of bed until the next day, but I was determined.

The next day was pretty rough since my epidural had completely worn off and I could feel my incision. I got up and was walking around, the nurses and my doctor were all surprised I was up. The baby was doing great, latching on like a pro. I went home 5 days after I was admitted.

The first night the baby was home, she screamed and screamed. The hospital had arranged for a home health nurse to come see us because the baby had lost quite a bit of weight in the hospital. Well, she lost even more in the 18 hours that we were home. I had to start supplementing with formula. My milk never came in. I cried and cried, but still tried to breastfeed her in hopes that my milk would come in. Once she started formula, she was a happy camper. She started gaining weight and all was well. My milk never did come in and she’s fully a formula fed baby now.

Two days after we got home from the hospital, I had increased pain and tenderness in my incision site. I called my doctor. It was infected. I don’t want to go into the gory details, but I had some very painful doctors appointments and three rounds of antibiotics. I also had to have home health come in to take care of the wound once a week while my boyfriend took care of it every day. This went on for a month.  I couldn’t see it, thank goodness! I didn’t look at the scar until it was completely healed. It’s nothing. You can barely tell anything is there. My boyfriend was amazing with the whole thing. He diligently took care of my wound, helping me heal physically and emotionally.  He’s also been a great dad. He loves his baby girl and I can see it in his eyes.

Through all of this - every painful and scary minute, having a baby was worth it. I’d go through it all again in a heartbeat. Anna Sophia is beautiful, healthy, and happy.






Guest Post written by Elise Shute, 27 year old momma to Anna, who is named after Elise's grandmother. Elise resides in Pennsylvania, is a pet mommy to a dog and two cats, and enjoys crocheting when she's not playing with Anna