Saturday, September 7, 2013

A Birth Center VBAC to C-section for Chorioamnionitis

E's Birth Story, submitted anonymously by request.


Let me just start this by reminiscing on those lovely weeks of what I called prodromal labor, which may or may not have been, but was certainly hard to handle. Especially from 36 weeks on, I had contractions for hours and hours and most would become regular and then end up fizzling out.

We thought it was truly labor once or twice, and I was really concerned I wouldn't know when it was time. I'd been planning a birth center birth and all of the midwives kept telling me, "Trust me! You'll KNOW!" ...They were right! I continued drinking my RRL tea and taking Evening Primrose Oil capsules daily, in hopes that it, along with my prodromal labor, would make for a smooth, easy, quick labor.

We live 45 minutes away from the birth center, so I had my fair share of worries about not making it on time. Boy, was I worried for nothing! On the evening of June 20th, I started having bloody show. It was coming only a little bit at a time, but consistently. I'd lost some of my mucus plug weeks earlier, but it would only be like one piece here and there, and not bloody. I got a little excited, but decided to just calm the hell down because I'd been there, done that too many times so far.

Husband came home and I shared the news, told him to get some good rest because I may need him soon. I was still hoping inside that contractions would start coming on, but I fell asleep and didn't wake to anything unusual during the night. Sometime in the morning of June 21st, contractions DID start, and I wasn't sure they were that regular, but I texted my doula and told her I thought it might be time.

By 10:30 AM, I was sure it was time! The contractions started in at 6-7 minutes apart, lasting about a minute, and so I called the midwife. Since I lived so far away and we worried about a quick labor, they told me to come on in. We got there around 12:30 and the doula was going to meet us in town. I think they checked me upon arrival, but I'm not really sure.

I know the first check I was 4cm, so I think that's where we were at about that time. The midwife suggested that I go get some lunch, and meet my doula somewhere in town. They were going to fill the tub up for me and have it ready by the time we got back there. Contractions were pretty easy at this point, but I practiced swaying and focusing through them so I'd be prepared later. Definitely different than the Braxton Hicks ones, though.

We got some food, met the doula, and decided to go walk around and help bring baby down and make the contractions more effective. We started timing them in the store and they were still 6ish minutes apart. Around 3pm, we went back to the birth center and I labored on the bed and on the birthing ball for awhile before getting in the tub. I did all kinds of position changes, rocking, etc. The tub was just calling my name and I couldn't help but think how awesome it was going to feel since the intensity of my contractions was picking up. I deserved a little break. I think I remember getting checked before the tub and I was about at a 5 then?

The water felt amazing and I thought to myself, "If I can just stay in here, and my labor progresses, I will absolutely get through this!" I kept moving, squatting, and doing what I could to progress things in there. The contractions were coming at 4-5 minutes apart and stayed that way for many hours. I kept getting out periodically when I'd get too hot, or when I needed to pee.

I swear I traveled back and forth between the tub and the bathroom 100 times during the whole course of my labor. Used an entire toilet paper roll and then some. LOL We left to go get dinner in the evening, and laboring in Subway for awhile, I had to really start to breathe and moan through them. I felt like someone was stabbing me, but I tried to keep my mouth open, and envision my cervix opening like a beautiful flower.

When we got back to the center, I saw a picture on the wall above the tub of a flower in bloom with some beautiful statement about 'opening up', which I promptly called bullsh*% during one of my contractions. I didn't feel beautiful, but I felt powerful. I was wondering when the contractions would get closer, though, and if I was really progressing.

Baby didn't feel lower, and all that felt different was that things were getting more painful. We turned some music on to try to lighten my mood. My doula says we listened to Cake, Norah Jones, and Tupac. Sounds just like my tastes. All I remember about the music is it being late in the night, my doula by my side at the tub, rubbing a cool cloth on my face, and Stevie Nicks singing "Landslide". It was the most peaceful moment of my entire labor. I will always be able to look back on that song and feel the joy, the love, the endurance, the power of what my body was trying to do.

Around 3am on June 22nd, my "due date", they checked me and I was at 7cm. We kept laboring in and out of the tub, doing all we could to keep things moving along. Contractions weren't any closer really, that I remember, but still growing in intensity. I needed rest very badly, especially if I were to be pushing soon.

I was starting to feel like I couldn't manage very well, and after vomiting numerous times already, I accepted some phenergan for nausea and to help me sleep. I had restless, painful sleep until around 7am. Everyone around me was so tired and sleeping so peacefully so I waited a bit to really wake anyone up, but it wasn't long before I felt I needed some support. I tried to feel like this would be the day, and be excited, and pumped up to bring my baby down, but this is where I started to feel like something may be wrong.

The midwife checked me and I had regressed down to 5cm. She reminded me this was normal and that maybe some more walking and fresh air would help. We went to breakfast, but I didn't want to eat. I felt so nauseated. I choked down a breakfast burrito and water. Then, we went to Walmart and walked around, but it was too much. Too many bright lights, people, and other distractions.

The contractions HAD started coming closer-like every 3 minutes-but they were dying down in such a busy place. So, we went to the library where it was more quiet. I walked around with my husband and sobbed quietly into him during some of the more painful contractions. It was becoming incredibly hard for me to manage and after being away from the birth center, I wanted to go back and labor there.

At about 1pm, the midwife suggested I go back home since I wasn't any more dilated and after the outing in public, contractions slowed back down to 5 minutes apart. It felt like a kick in the face. I was working so hard, and it was SO incredibly painful, but I tried to keep my faith that a natural birth, and a VBAC, was still possible for me. I reiterated all my birth affirmations, and agreed.

My doula went home for some rest, and I tried hard to rest at home. I took a phenergan pill and it didn't help me sleep. Instead, I woke very quickly to absolutely unbearable contractions, uncontrollable shaking, and I threw up. I called the midwife back and she told me to come right in because it sounded like I was in transition. I met the doula back there at 11pm and the midwife checked me. I was at 4cm, but very loose and soft. About 95% effaced. Baby was at -2 station, which he had stayed at thus far.

The rest of the night is incredibly fuzzy to me because I was focusing so hard on getting through each contraction. Coming very hard, lasting a long time, and close together at 2-3 minutes apart. I labored mostly in the tub, doing some counter pressure and tons of position changes. I could not shake the feeling that something was wrong with my body. I chalked it up to it being my first real labor, and letting some fear in.



I kept rejecting the notion that I was afraid of labor because I had been very prepared and educated regarding birth since my first birth (a failed induction that resulted in an unnecessary cesarean and birth trauma afterwards). I kept my worries quiet since I was battling with myself if it truly was FEAR or instincts telling me there would be bad news.

6am. Midwife comes in to check me and see where I'm at. Contractions still 2-3 minutes apart. Lasting 2 minutes. Extremely hard, intense. I hadn't had even a moment of real rest in many hours. She checks my cervix and I'm still at a 4, with heavily bulging waters baby still at -2 station. Then she said the words I had been SO afraid of hearing. For years, I was afraid my next birth would come to this... She suggested that I either go home and wait for something else to happen or to transfer to the hospital for a repeat c-section.

(NOTE: Here, the hospitals have VBAC bans, so that wasn't really an option to go labor over there.)  I couldn't stomach the idea of going home, the contractions not letting up, and having to go through even another hour of it. I asked for some time to discuss my options with my husband alone. They gave us privacy and I told him that I wanted to go ahead with the c-section.

I honestly felt relieved...the opposite of how I expected to feel. He cried. He told me about how scared he was that I was going to be traumatized over losing my birth experience, and how heartbroken he felt that all the knowledge I'd gained and preparation I had done for a VBAC was all in vain. He was scared about the surgery and what risks there were with that. We embraced each other and I told him I really felt inside like something was wrong and that I didn't feel I was losing my birth experience because I had just been through 45 hours of natural labor and I was such a warrior!

I consoled him and said we would be in good hands since the midwife and doula would come with me. I felt like I had just been waiting for a sign that something really was wrong, and while we didn't know it at this point, there was a complication and my consent to a repeat cesarean was probably the best choice for us. This is where things kind of went downhill. I arrived at the hospital, completely miserable, waiting for them to get me prepped for surgery. I screamed through the cervix check at the hospital, having to be laid down on my back, and I realized this is exactly why labor fails to progress sometimes in hospitals where you're bed-ridden. Mad props to moms who labor like that.

The nurses were rushing around like there was some sort of emergency or like I'd pop my baby out any second. That made me feel really uncomfortable and I jumped in the commotion as much as possible through the pain, stating my wishes for my c-section. The nurses kept assuring me I would be able to watch my baby be born, I would have my husband there, the baby would stay with us at all times, etc. The doctor arrived and finally it was time for surgery. I was incredibly nervous about getting through those contractions while getting my spinal block in.

There was a sweet nurse who held me in the proper position and told me how strong and amazing I was. I still remember the calm, peaceful look in her eyes. Instant relief with the spinal block. They laid me down and I waited for them to get ready to start. They put the curtain up and I kept asking where my husband was and they said he was getting dressed to come in. From this point on, no one acted as if they heard me.

I was talking, yelling, asking for answers and no one responded to me. I kept reminding them of what was most important to me...I wanted to see my baby come out of my body. They had initially agreed they would lower the curtain. They never did. I won't go on about the disrespect I received and how much they really killed my joy in that moment, but it was really awful.

My husband came in as they were cutting me open. He watched over the screen and saw our baby as he came out. E was born at 8:21AM, on June 23rd, 2012 at 40w1d gestation. He was 8lbs, 4oz and 22inches long. They came over to me and said that our baby boy would be going to the NICU, as I had severe chorioamnionitis, an infection, and there was heavy meconium... I told them, "NO. HE CAN'T. You can't take him!", but they explained that he just needed to receive IV antibiotics for 48 hours and that I would still be able to breastfeed him.

I kept asking what type of infection that was, but stopped asking when I saw a glimpse of my baby to my right side. He was across the room and I couldn't make out any details, but I hadn't heard his cry yet. I asked, in a panic, why he wasn't crying. The nurse said they were keeping a finger in his mouth to keep him from inhaling the meconium. I told my husband to go over to him, to be with him. I watched from afar as they stuck a suction tube down to empty his stomach contents. I heard gagging and choking, and then a sweet cry and the tears began to stream down my face.

My husband said he was fine and that he was pinking up. He then left with the NICU team to stay with our son. Once I got into recovery, my husband came to tell me how awesome he was doing and said that our son was right behind him. They'd been trying to get his IV in and give him some sugar water, but he was a hard stick and he was acting so hungry that they were going to let me breastfeed him instead. (Which should have been their first option anyways!)

So, I met my baby boy... I instantly latched him on and it was such an imperfect latch but I didn't care. I just wanted to be near him and get as much time as possible with him before they took him off to the NICU again to get his IV started. It was a beautiful time with my midwife, doula, and husband there. The doula and midwife stayed back to give us some privacy, but I was very thankful for their presence.

Soon after, they left. And they took E. I really wanted my husband to go be with him and so he did. I got a little cat nap in here and there. They brought him to me to nurse a few times, and then at 3pm, they came and said he had been doing so well and since there was so little room in the NICU, he would get to room in with me that day until the end of our stay! We were so thrilled!!!

I've been reflecting on how things turned upside down and how my attempt at a VBAC failed. I have come to realize that I was, indeed, a warrior! Also, if the hospital hadn't had a ban on VBACs, things might have gone much differently. I could have stayed there and labored, with pain medication, and perhaps things would have progressed and he could have been born vaginally, even with the infection. This would have been the time for intervention on my birth. But I won't dwell on the what ifs, could've, should'ves.

I'm healing from my birth by pushing myself into activism so that women like me, can have healthy options for their birth, no matter what happens. I remind myself daily that, "When you know better, you do better", and that going into my pregnancy and birth as an educated woman in charge of her care, ready to birth without fear, gave us the best possible outcome and because of that, I do not regret my decision. I feel empowered and beautiful just by being educated and in charge.

Update: E was born in June 2012 and we're happy to announce our pregnancy with #3 and that we are planning a HBA2C with a fantastic midwife in February! To follow our journey, I started a Facebook page.




What is chorioamnionitis? 

This is a severe infection during labor that can have tragic outcomes including stillbirth. Pathogens from the lower area travel up to the baby, taking hold in the membranes, placenta and cord. It's dangerous to the mother and baby, and is considered one of the more common yet ignored plights during childbirth. The number one way to prevent this infection is to keep a healthy vaginal flora, limit vaginal exams and avoid placing anything else in the canal (e.g. douching, internal exams) while laboring. With severe adverse outcomes for mother and baby, this is not an infection to take lightly, but the initial symptoms can be vague, making it harder to address. Symptoms include things such as low maternal fever, foul odor and tender or painful contractions. Learn more here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008318/

1 comment:

  1. Beautiful story! I also had chorioamnionitis during labour, but I did not have the same luck. My baby boy Samuel never cried and never took a breath. Very hard to accept and move on. I did not have any signs, and for this reason they did not give me antibiotics. I am so glad your baby E made it!

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