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Overcoming fear: A VBAC Story

Jennifer had called me a few months back and wasn't sure if she wanted to try to have a VBAC (vaginal birth after cesarean) or plan for a repeat cesarean section. We agreed to meet and discuss her options.

I presented her with statistics, explained my birth philosophy, and after a hour or so, she decided that she would like to plan for a VBAC. Her last baby came via belly birth, after an induction, and a long pushing phase. I could tell that while this was what she wanted, she was still quite reserved about the entire idea.

Jennifer and I had met multiple times through out her pregnancy, including a meeting with her mother, who was with her at the hospital when she had her first child. Her mother was also afraid for Jennifer. There was a lot of fear about having something similar happen again, as what happened at her last birth. I once again went through all of the positive stats about VBAC and assured them, that their OB would not be onboard with her attempt, unless it was safe.

Jennifer was due in the beginning of May, but starting in the middle of April, there were signs that Jennifer's body was readying itself for birth. Jennifer joked that her and the baby had made a deal and the baby promised not to arrive until at least it's birth month. I always just replied with a neutral statement. None of us really know when these babies are going to come.

On Monday, April 23rd, Jennifer messaged me that she was having some light cramping and what seemed like the beginning of bloody show. She thought that she was having braxton hicks. I did tell her that I believed they were real contractions and to pay attention to them, but that she didn't need to track them and she could go about her day. Some moms need to go home and focus, while others need a good distraction. Jennifer needed distraction. She is a teacher, and there is nothing better than a bunch of kids to keep you distracted! We chatted some more through out the day, but eventually Jennifer went quiet.

On Tuesday, April 24th, again around noon, Jennifer texted me that she was at work and she was having more bloody show as well as some random cramping very low. I once again told her I didn't think these were braxton hicks. This time, based on what she was telling me, I knew that she was in early labor. At 12:20pm she did ask me what day I thought she would be having a baby. I didn't want to cause any fear. I wanted to be with her when I confirmed that I thought she was in labor and so I again gave a neutral answer.

Remember, Jennifer had never started labor on her own before. She hadn't experienced any of this part of labor. So while she is a mom, this was all new territory for her.

I texted Jennifer every 15-30 minutes. I suggested that maybe she head home after a bit more of information, but she decided to stay at work at that point. At 2:00pm she suggested leaving work. I told her that I thought it was a good idea. I then organized my childcare and family.

At 2:48pm, Jennifer texted me that she was home and that she was scared. I told her that I was going to come and chat with her about what was going on.

I arrived to Jennifer's home at 3:12pm. She was overwhelmed with emotions. She wasn't in a true active labor pattern yet. She didn't feel safe, and while we don't always acknowledge this part of the birthing process, our minds are in greater control of our bodies than we realize.

I helped Jennifer to cope with her fear. She was afraid that she was choosing a VBAC selfishly. That this was for her and not for the benefit of her baby, and how guilty she would feel if something went wrong. Jennifer had also not felt the baby in awhile. She had a juice box, laid on her left side, and her baby started dancing in there. Jennifer began to smile. We talked and told each other stories. She was distracted from her fear, she felt confident that her baby was ok, and was happy to have a support person in her presence.

Her contractions began to come at 3 minutes apart around 3:45. At 4:03 I could see that the contractions were coming with a different intensity than before. At 4:20 pm, after a walk to the toilet, Jennifer and I were then on the floor. Staring intensely into each other's eyes, and me telling her how strong she was and guiding her through the start, the peak, and the end of each one. I became Jennifer's focal point.

It was 4:38pm. The room around us was a blur for each contraction, and chaos in between. I was trying to gently encourage her family, without ensuing panic, that it was time to head to the hospital.

At 4:56, we began to crawl towards the front door. Grandma had arrived to care for their son, and Visda was gathering their things. There was a knock and Visda opened the door. Jennifer was actually sitting right behind it, so we could only crack the door. The neighbor had crashed into my parked car, in front of their house. Visda said, "Um, my wife is about to have a baby." I peaked around the door and told her it didn't matter and I would come talk to her later. Her eyes were so insanely big! She said "Oh my gosh! I'm sorry!", and basically sprinted back across the street,.

We all got into their vehicle and headed to the hospital at 5:02pm. Jen had 4 contractions while in their vehicle. She couldn't stare into my eyes, but we came up with an unspoken system to help her focus during each one.

We arrived at the hospital at 5:13pm. I had Visda drop us off at the entrance, rather than parking the car and walking. Jennifer had one last contraction in the car and we entered the hospital. The security guard buzzed us into the ER, where there is an elevator up to labor and delivery. Jennifer sat down in an ER chair in the hallway as the next contraction started. She managed it just as beautifully as she had done all of the others and then she stayed put. She looked up at me and the fear was back. I asked her if she wanted to have a baby in the ER, which of course she didn't, and she began to walk again. One more contraction, and we got into the elevator.

When we arrived on the L&D floor, her doctor had not informed them that we were on our way and they were a bit puzzled. I don't actually think they ever called back to be honest, to find out she was in labor, but that certainly didn't matter now!

I knew two of the nurses at the front desk. I whispered to them that I didn't think we had time to go through the entire check-in process, while Jennifer had another contraction in the waiting room chair behind me. One of the nurses yells, "Oh god! This is the second baby! We don't have time. Put her in room 1!" Not exactly the laid back environment I was trying to create.

We went into triage, they wanted to put her in a gown and have her empty her bladder. I encouraged them to just check her and Jennifer gave me consent to remove her pants. The midwives eyes bugged out of her head, "She's fully!!!!" Visda knocks on the door and enters, a room of panic. The midwife and the nurse began to run down the hall to the other side of the hospital with Jennifer on a triage bed. I then decided to say, "Oh and she's a vbac." The same nurse as earlier was yelling, "She's fully! Where is she going?! This baby is coming!? She's a VBACCCCCC!!!!" Please note that Jennifer had not expressed any urge to push. She was calmly breathing through every single contraction and her practice was very supportive of her having a VBAC.

At 5:28pm Jennifer was wheeled into a room in L&D. They were very busy that day, and so they were resetting this room asap. There was 11 people in this room, and it was as noisy as a rave. Jennifer looked at me, again with a face of fear. I told her that there was nothing wrong. This was not an emergency. They were not there because they were worried. They were there just trying to set the room up for her to be comfortable as soon as possible. One of my favorite nurses, also named Melissa, concurred and we both just talked to her while everyone worked quickly.

Within a few minutes, the room emptied. Dr. P, checked Jennifer and noted that although Jennifer was fully dilated, the baby was still very high up.

This was the reason why Jennifer hadn't had the urge to push yet. The Doctor asked if she wanted an epidural. While Jennifer had asked for it many time before that, when presented with the option, she wasn't sure. Another contraction came and again Jennifer managed it beautifully. Her nurse and Dr. P, were so impressed with her. Dr. P left the room to give Jennifer some space. Jennifer than decided that she would wait on the epidural, until she couldn't anymore. She didn't want to turn it down quite yet and was afraid of there being hours of pushing to come. Most women don't realize that you can actually get an epidural even when fully dilated, as long as you still feel in control and can follow instructions. Jennifer was still in AMAZING control.

Jennifer's contractions were still coming about 3 minutes apart. Another check and baby was still a bit high. Dr. P suggested pushing. I saw that look come back into Jennifer's eyes. She looked at me and I told her she didn't have to. The nurse told her it will feel better, and I again told Jennifer, she didn't have to.

At 6:03pm, there was a loud pop and then a waterfall sound. Her water had broken on it's own. The next contraction was a bit more intense. Often times the water acts like a bit of a pillow and helps to keep the babies bones from applying a ton of pressure to the pelvic bones. Once the water is gone, it's a different sensation all together.

Jennifer worked through the next contraction, ignoring the nurse and the doctor's pushing suggestions. Dr. P, then put her hand on my shoulder and as I looked back at her, she nodded. The nurse realized too, that this was the hurdle for Jennifer. The pushing. This was the fear. This was the trigger that was with her from the last time.

Visda had been sitting back, nervous the entire time, but attempting to brush it off each time a nurse asked him if he was ok. I could see it on him though. He was afraid too. He then said, "Ya know the last time, this part was really hard."

The nurse and the doctor were now onboard. We were going to wait. I talked Jennifer through every contraction, with our hands in the tightest, sweatiest grip. I had her close her eyes and take calm breaths during the breaks. Each time, the nurse had to move the baby's heart rate monitor down about a 1/2 inch. We began to see the baby's heart rate dip with each contraction. The baby was coming down the canal, with the uterus doing the work, and Jennifer doing the most amazing job coping with every single squeeze.

At 6:26pm, the body began to push on it's own. I reminded Jennifer to trust her body and let her body do the work. Her contractions were coming about 90 seconds apart. With each one, she followed her body. Dr. P asked permission to check where the baby was to see if she should call the other nurse and Jennifer consented. Dr. P said, "Oh the baby is about an inch in." Jennifer then decided that she would like to actively push. I called Visda over and he stood by my side, rubbing Jennifer's head.

At 6:33pm Jennifer gave her first active push and we saw the babies forehead. They asked her to breathe through the next contraction, which she did with ease.

They began to break down the bed and Jennifer said, "What's happening?" (In conversation the next day, Jennifer told me that she thought they were wheeling her to the OR, for a cesarean section when she started to hear the metal of the bed.).

I whispered, "I can see her hair." As I'm typing this sentence, my eyes are welled up. This was the first time I knew, that Jennifer knew, she was going to have a VBAC. All of this time, she still wasn't sure of herself. I promise you though, that not one other person in that space ever doubted her.

With the next push, we all saw a full head of hair and Jennifer smiled from ear to ear. Visda looked at me and said, "Oh I'm so glad we hired you!"

90 seconds later and one more push, little miss Vivian, came earthside and let out the biggest and best cry. Vivian's cord was super short, but Dr. P, still delayed the clamping, and told Jennifer that it was best to wait a bit even though she knew Jennifer wanted Vivian up higher on her chest.

Visda cut the cord and as they tucked Vivian up and under Jennifer's shirt and onto her chest, I moved myself to the couch and I began to cry just a little bit. I was so proud of her. She had overcome her fear. SHE DID IT!!!

Just a little while later, big brother Logan, came to check out his new baby sister. Jennifer is an exceptional mother and that little boy loves her so much.

Jennifer your strength and willingness to trust, will forever stay with me. You are wildly powerful.

Jennifer and Visda thank you so much for letting me be a part of this very special experience. It was a honor.

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