The Intown Doula crew were elated to serve Drs. Rachel Patzer and Justin Schrager with their second pregnancy and birth, a VBAC. Rachel was told that she had only a 13% chance of achieving her goal, but anyone who's met Rachel must know that that just sounded like a challenge to her! ;) Read Owen Michael's triumphant VBAC birth story here. We are so honored to be able to share it with you.
Almost two years ago I was pregnant with my daughter, Lillian. With an emergency medicine doctor as a husband, I felt pretty cavalier about planning for the birth. I had no qualms about entrusting the doctors and medical system with what was one of the most important events of my life. I ended up skipping my prenatal education class, and I came in with no birth plan. I didn’t even THINK about hiring a doula, or writing a birth plan. All I had overheard was all of my husband’s medical friends criticizing the people who come in with 5+ page birth plans and examples of doulas who would interfere with medical care and the end result was some kind of problem with the baby. I was totally relaxed (or so I thought!).
At 39 weeks+ 3 days I had to be induced due to gestational diabetes. This was the standard of care for gestational diabetes, and my baby was measuring 2 weeks ahead and I was really worried about the ability of a large baby to fit through my pelvis. The induction was awful to endure - my body was not ready (0 cm dilated), and the induction methods were painful (Cervadil, then foley balloon). After 14+ hours of labor, I couldn’t take it anymore and wanted an epidural. I did make it to 10 cm after about 24 hours, and then I pushed for 2 hours. I was on oxygen and the baby's heart rate was dropping then rising again for more than an hour during this pushing phase. Despite crowning, my sweet girl’s head apparently would not fit through my pelvis and the doctor called for a c-section. I remember feeling so stunned at this point. The finish line was in view and I was so close! Though I know the c-section was ultimately a good idea (she had swallowed meconium, came out blue with an Apgar of 1, and had to be intubated, but then was fine), I couldn’t help but wonder if there was something else I could have done differently that would have led to a more natural (vaginal) birth. The recovery from the c-section was miserable and I felt deeply disappointed in myself. I suffered from post-partum depression for several months and felt like no one understood my loss since I had a healthy baby girl.
Fast forward to present day - I had a much better pregnancy this time and no gestational diabetes (yay!!). My doctor from my first birth had told me specifically NOT to attempt a vaginal birth with my second child because my pelvis was just too small. But I didn’t think this was likely and I knew I wanted a VBAC and I wanted to do things differently this time. First, I had to convince my husband this was the way to go. His work life is filled with emergencies that are rare in every day life but common in the emergency room, and he has seen VBACs and home births go horribly wrong, and he did not want to take a chance with his own family. I had to present it to him with facts – a VBAC is safer than a major abdominal surgery. The risk of uterine rupture is <1%. He was supportive if the doctors were supportive, and they were, although the doctors said I had a 13% chance of a successful VBAC (based on a risk calculator) since I had made it to 10 cm last time and she didn't fit out of my pelvis. But because I was young and healthy, they said “go for it!”.
This time I was going to be better prepared. I interviewed doulas, I read Ima May’s Guide to Natural Childbirth, I trained myself in hynobirthing, and I convinced my husband to do a private (in-home) childbirth education class. And I came up with a birth plan! I really wanted to try to have a natural birth with no epidural this time, because I was convinced that any intervention I had would lead to more interventions and ultimately a c-section. With the help of my Intown Doulas (MMT and Richee were my team), I came up with a super short and simple birth plan (primarily instructing the medical staff that I was attempting a natural VBAC and to please not offer medications or interventions unless medical necessary). I only hoped that I would not have to be induced this time…during our prenatal education, we learned that it was not mandatory to have cervical exams at my weekly checkups in the last month of pregnancy. It didn’t matter whether I was dilated or effaced, since these can change in a matter of hours and knowing I was at 0cm would probably only stress me out!
From week 20, I had Braxton Hicks contractions and these steadily picked up the last month of pregnancy. At 40 weeks + 3 days, I had a doctor’s appointment and I requested my first cervical check. I prayed I was not at 0 cm…and I was 2cm dilated and 50% effaced (-2 station)! I asked my Dr to strip my membranes (after reading a LOT of articles in the medical literature on the risks/benefits), primarily because I wanted to do everything I could do avoid a scheduled induction with pitocin. Within an hour of the appointment, I started having regular but not painful contractions (this was at about 1pm in the afternoon). I went for a 3.5 mile walk, and contractions continued throughout the afternoon and evening. They felt similar to the Braxton-Hicks contractions I had been having the entire pregnancy, but I timed them and they were consistently 5-7 minutes apart. I thought “this is it!”. I phoned my brother, who was the designated person to watch our daughter while we were in the hospital, and told him I thought that I would go into labor soon. He wondered if he should come over right then, and I said “No, it will be some time still. It will probably be more like 3am!”.
That night was the NCAA basketball championship and I just hung out bouncing on the birthing ball and cheering for my Alma Mater (On Wisconsin!). I went to bed around midnight and slept for about 3 hours. Then I woke up at exactly 2:59 AM to three painful contractions in a row. I was in labor!! I called MMT, who was my on-call doula that night, and gave her the heads up, and my husband called my brother to have him come over. My plan was to try to labor at home as long as possible, but my contractions were 2-3 minutes apart and I kept nearly fainting at the end of each contraction (I have low blood pressure to begin with and am a fainter!) and my teeth were chattering like crazy, so we left for the hospital after only an hour of home labor.
I got to the hospital at 4:30am and was at 6cm (90% effaced and still -2 station) and I thought it would be quick!! MMT arrived at the hospital around 6am, just after we moved from triage to our hospital room. At 9am, they checked me again and I was STILL at 6cm (though station was 0). For the next few hours MMT and my super supportive husband helped me through the painful contractions. I walked up and down the hospital hallways, I tried different positions (the “Captain Morgan” was the worst!) and kept playing my hypnobirthing tracks and breathing through the contractions. I ate Cliff “shot blocks” for energy – they really helped! At about 11:00 am I was at 8 cm. I was thinking “this is taking FOREVER!!” and multiple times I thought (and said out loud) “I can’t do this anymore.” MMT kept saying “Yes you can! You are doing it!”. I said multiple times I wanted an epidural, but I had warned my husband and doulas that I would do this, but that they were not allowed to get me one. I knew this, but it still felt good to think about!
At 1pm I asked the doctor’s to break my water to help move things along because my contractions were slowing down and I wasn’t making as much progress. They broke my water, but then my contractions got SUPER strong and more painful. I kept having double and even a couple of triple contractions, and just could not catch a break from the pain. They checked me at some point in the afternoon again and told me I was at 9cm, but apparently I was STILL at 8cm (the docs told me they fibbed to me later since they didn’t think I could mentally handle this!). After hours (around 4pm), I decided I was seriously going to give up. When the doctor came in to check on me to say that my contractions were slowing down and that I may want to consider Pitocin, I asked her for an epidural. She said okay, but I needed to have a bag of IV fluid first since I was dehyrdated at this point. I went back to the bed to lie down, feeling utterly defeated. I had given in! About 25 minutes later, the team of anesthesiologists rolled their cart in and at that moment I felt the urge to push! I couldn’t believe the timing – I thought “Oh wow, I ALMOST just got an epidural!”. Turns out that EVERYONE but me knew that this was just a mental ploy to move me forward. They don’t give epidurals this late in the game! But this mental trick did it for me. They checked me again and I was at 9.5 cm – still had an anterior and posterior cervical lip around the baby’s head. But the doctor helped the first 10 minutes of pushing to manually dilate me (ouch! Yes, this was the most painful part!).
Once I figured out how to push and where to push, I rocked the pushing! Finally, something I can do to get this baby out! I did not believe the baby was actually going to come out until MMT told me that they were calling the pediatric team to come in and she explained that meant the baby was close! Really? No c-section?? YES!! I pushed for 49 minutes and out came my whopping 8 lb 10 oz baby Owen Michael! Incredibly, I felt no pain, just utter elation at the amazing feeling of my own baby being delivered vaginally. He was instantly placed on me – skin to skin- and started nursing like a champ within just a few minutes. Dad cut the cord, and then we named him – Owen Michael. I got to hold him skin-to-skin for more than an hour before they took him briefly from me to get weight/height, etc.
I cannot describe how empowered I felt after this. Even more than a month later, I am so incredibly proud of myself. I did it! I followed my birth plan and the medical staff did too. They were amazingly supportive. Both my husband and I were surprised but so thrilled that all the hospital staff were super supportive of my birth plan. No one ever offered me pain medication (it was me that asked the doctor for that epidural), and even when I did ask, they wanted so badly for me to have the birth I planned that they pretended to get me an epidural! My husband and I have a new respect for all the women championing natural births, and the medical staff who are so supportive.