A Mother's Day VBAC

Mother's Day began slowly. A nice long sleep followed by lounging and breakfast-making. Just as I was leaving the house to go to my favorite cafe, my phone rang. It was Tom, husband of Shana, my first May client.

Tom called to tell me that Shana's contractions were about 4-6 minutes apart and he was driving her to the hospital. They lived far away and this was their second baby so they didn't want to risk staying at home too long (Tom was not all about the idea of catching his own baby en route to the hospital).

Shana's first birth experience had been traumatic, a c-section that she felt had been completely unnecessary. She felt as though she had no control over the decisions made during the birth of her first baby and was determined to have a different experience this time around. When I met Shana at the hospital an hour later, she was very controlled through her contractions. She was easily talking in between them and could breathe through every one. I was concerned that she was not very far along and that she would be disappointed when the midwife checked her cervix. In her ideal world she wanted to labor at home until late active labor but her husband was too worried that she would deliver the baby in the home if they waited.

When the midwife checked her, she was 1-2cm. Shana immediately got up and said--ok, I'm going home. The midwife suggested that Shana, Tom and I take a walk outside, grab food, and come back mid-afternoon. We thought that was a great plan but things quickly changed. The nurse took Shana's blood pressure and it was way too high. Darn. Back to the bed, no walking around until the BP went way down.

Although Shana changed positions on the bed, she was really much more comfortable when standing. When we were moved to the official L&D room, her BP had gone down enough so that she was allowed to stand and sway during contractions. I applied firm counterpressure during the contractions and her husband helped to keep the baby's heart rate on the monitor (she had continuous EFM because she was a VBAC and had high BP). This went on for a couple of hours until I suggested she get on the birth ball. After settling down on it, she really found relief from the way it was opening her up. Soon it was mid-afternoon and the midwife wanted to check her again. As the midwife checked Shana's cervix she smiled and said: "guess how many centimeters you are, Shana". Shana said 5-6 and to our delight the midwife informed us that she was 7cm, 100% effaced and the baby was nice and low. Phew. The VBAC was well on its way!

Shana went back and forth between the birthing ball and standing and swaying for the next hour or so. Soon the contractions began to intensify and although Shana was still very focused and breathing beautifully, she was definitely getting more uncomfortable. I suggested she get up onto the bed on her knees. We raised the head of the bed and she draped her arms and rested her head on the top of the bed. She was starting to contort her face during contractions and I tried to get her to relax her facial muscles and gently rubbed her head when she scrunched up.

Maybe an hour later she felt "pressure" for the first time. She said to wait to get the midwife, so we continued with our routine for another forty minutes. The midwife came in and re-checked Shana. Fully dilated! A new midwife was on-call and she was wonderful. She gave Shana great hints on how to breathe during pushing and how to rest between pushes. Shana's husband really got into gear at that point and was so sweet and supportive. He looked into her eyes and held her head gently in his hands. Shana pushed on her side for about thirty minutes until the cutest baby girl entered the world. Mom looked at baby and said "Hi beautiful" and the baby looked longingly up at mom. Soon they were beginning to breastfeed and getting to know each other. I felt so happy knowing that Shana had a wonderful, natural, empowering second birthing experience.