Monday, October 10, 2011

An OB and I work Together: Tracy has the VBAC of her Dreams

    Tracy had the birth of her dreams on Friday.  She did this at our local hospital where such a birth, a VBAC, is banned!   She came up with an amazing plan, and it worked out magnificently.  This plan included hiring both myself and an OB.   The result was an unprecedented collaboration between myself and someone who has been hostile towards me in the past.   Let me fill you in on the details!

     First, a little of Tracy's story...   Tracy's first birth was the typical hospital induction that went awry and ended in cesarean section.   Baby was posterior.  She was induced with pitocin.  She needed an epidural.  The baby never rotated.  She pushed for five or six hours, numb from the waist down and  on her back.  Not feeling the contractions, her team had to scream "Push!" for her when contractions showed up on the monitor.  Rolled into surgery finally.  The drugs from surgery gronked her little system so the first hours with her baby were just a blur, she can't even remember them.  The first weeks were a misery of  surgical pain, drug-induced fog, depression, and breastfeeding problems.  She was shocked this had happened to her - her mother, grandma, and aunt all had easy natural births!  She felt betrayed by her doctor, and upset with her husband and mother for not protecting her from this.  She felt guilty for having such emotional turmoil around her birth experience, even though she got her healthy, beautiful baby.  "My first birth was the worst experience of my life." She wanted her second to be the best.



    When Tracy became pregnant again, she was determined to avoid another cesarean.  She lives out in the rice fields, almost an hour from the closest hospital.  She and her husband decided homebirth was out of the question due to the distance to the hospital.    But  VBACs are officially banned at our local hospitals!  Despite this fact,  OB docs occasionally tell very determined women that they CAN refuse surgery.   To everyone else, they say sorry, their hands are tied!  They don't want to get in trouble!  Tracy's OB doc Dr L agreed that she had the right to refuse surgery. He told her that if everything was "perfect" and she showed up in advanced labor, he would attend her as a VBAC.  Tracy hired me to help her do that.  She planned to take a hotel room in downtown Chico to labor in.  We would have her labor there, just two minutes from the hospital, We would go to the hospital somewhere between 8cms and complete and Dr L would take it from there.
    Second, some back story on me and Dr. L:   This particular OB has been very communicative about his disapproval of me.  He happened to be on call for my two most medically intense transports from home, and let me and my clients "have it" in those cases. My clients and myself have experienced his communication style as intimidating and inappropriate at times.  He tells his patients "they are crazy"  if they decide to have a homebirth, or if they have had a homebirth. Tracy let him know that she had hired me to monitor and support her first stage of labor out of hospital, and come with her to the hospital as her doula for the delivery.  I was shocked that he agreed to the plan!  
   Third, the lead-up:  .  I gave Tracy my best holistic prenatal care.  We met several times over the months.  She cried at every visit as we gave time and attention to her emotions and fears.  We processed the trauma of her first birth with EFT and a supportive, listening ear.  We did guided visualizations of what this birth could look like.    She did acupuncture and chiropractic, and poured over the spinning babies website, www.spinningbabies.com   doing the recommended exercises religiously.  She prayed and meditated and practiced relaxation.  She chatted on Baby Center's VBAC listserve and paid attention to what worked and what didn't work for other mamas.  Dr L saw her for routine prenatal care and would ask her if he could talk her out of it.  When she said "no", he said  " All right then."
   The Last Week:   On Tuesday, she came in for what would be her last her prenatal.  Her baby was STILL posterior, and she was discouraged.  I checked her and found her 2cms, 80% effaced and the head low in the pelvis.  Very good sign!  I noticed that her pelvis did have a narrow arch at the outlet, and at 5 feet tall, her belly looked huge.  Not good sign.  She asked me, can I do this?  I looked deep within myself, remembering that you JUST NEVER KNOW who can or cannot birth.  Everyone deserves a chance!  "Absolutely."  I said calmly, smiling, and gave her a big hug.  "You CAN."  She wiped tears from her eyes for the zillionth time . "And your baby will rotate, if not before, then during labor.  So stop worrying about it now, relax and soon we will have a baby." I said.
    The Grand Finale:  Two nights later the Call woke me up at 2:30 am.  It was Jay, Tracy's hubby, telling me her contractions were 2 to 3 minutes apart, lasting a minute long.  They were getting into the car and would be in Chico in 45 minutes.  2 to 3 minutes!  That sounded like labor was already well underway.  I called him 20 min later and he said now they were two minutes apart.  Let's just go straight to the hospital, we decided.   We met in the parking lot at the hospital, where I was prepared to examine her in her car to make sure it was time to go in.
     Tracy got out of the car in the dark parking lot, and I took one look at her and thought, "She is completely dilated!"  "Don't touch me" she growled at Jay.  Then she grabbed him and bent over, putting her hand over her crotch for the contraction.  I smiled at Jay.  "This is great, really great.  Tracy is almost done!"  Over about 20 minutes, we crossed the street to the hospital.  They brought out a wheelchair but she refused it.  Then she climbed onto it so she was kneeling backwards on it, her bum in the air.  She was brilliant, letting her body guide her and not letting anyone get in the way of that!
   When we finally arrived in the labor room, she was checked by the nurse - completely dilated just as I thought, and the baby's heart sounded great.  "Tracy"  I said, "Why don't you get up and go to the bathroom.  You probably need to do that."  So we got her off the bed after only about 10 minutes and she went into the dark closet-like bathroom with me.  We spent the next hour in there so she could find her own way with pushing.  "Just let your body guide you" I whispered.  "Push if it feels right with the contraction. For some women it feels GOOD to push".  Slowly, slowly she began feeling into pushing.  And over the hour she pushed with more and more gusto until finally she made those sounds that let us know the baby is moving through the pelvis.  The nurses were respectful of our process. So was Dr L!  He popped his head in, said "Oh , you're in the bathroom!" and disappeared for another 40 minutes.   When her pushes were the roaring, baby-ejecting kind, she went onto the bed and Dr L. came in.  He looked at her bulging yoni and said "Oh, the baby is coming out this way." 
     A few minutes later she was crowning.  Dr L cut a tiny episiotomy and then looked at me and said "I only cut her a small one." "Thank you."  I said, "I am sure she appreciates that."  Then, the baby was born.  Tracy was on the moon!  "Wow!  That was SO MUCH EASIER THAN I THOUGHT! I can't believe that was it!!!!!!"  

Here is how she looked:




   Afterwards, Dr L admitted to Tracy, "I didn't think it was possible for you to do this.  I was just humoring you."  "I know", Tracy replied,"That is why I hired Dena."  He and I had a friendly exchange at the nurse's station, acknowledging that this was a nice collaboration of available resources, and how well it worked out.  He expressed again, how with her narrow pelvis,short stature,  history of a stuck baby, and the size of this baby, he had been sure she wouldn't be able to birth.  I told him that I have seen VBACS like this before, and that you just never know who can do it and who can't.  Everyone deserves a chance.  The nurses listened, smiling to themselves. On his way out, Dr L stopped in the room one more time.  "I am surprised, impressed, and proud."  he told us. 
    I left soon after.  Tracy was still flying high, raving about her experience.  The baby was nursing away.  My heart was full of joy.  This birth has changed Tracy's life.  She wanted to experience natural birth more than she has ever wanted anything.  She got to experience a fierce, primal, undisturbed birth where her body just found its way!    This birth also helped to bridge some of the abyss that had grown between myself and the hospital staff.  I was treated like a valued member of the team.  And that, dear readers, is progress for all birthing women in our community.

24 comments:

Lynda Halliger-Otvos said...

What a huge victory for all women and their births. I love this story and all that it implies, concerns and describes.

thank you so much for sharing Tracy’s birth.

Jamie said...

This made me cry. Tracey is my internetty friend and so many of us have been on this journey with her. I'm soooo happy that everything worked out!! Thank you for supporting my friend.

Dena Moes said...

Wow Jamie! Small world...I know she gained so much confidence from her internet friends. You all were a huge support for her journey.

Unknown said...

Wow. That is such an amazing story and I'm so proud of both of you (Mama and midwife) for making that happen. I'm also happy to see that the hospital staff witnessed that this is possible and might now acknowledge that there isn't just one recipe for every birth. Good one.

Dena Moes said...

I know that the nursing staff does love it when they have the opportunity to support natural birth at this hospital. They nurses there are wonderful.

Dena Moes said...

But we all, myself, Dr L, and the nurses were given the reminder that there is something in birth - magical, mysterious, spiritual, psycho-emotional, call it what you will, that cannot be quantified or scientifically assessed. Thus she overcome all these "risk factors" and had a quick, straightforward birth.

traceyjay said...

Thank you again Dena.

My gratitude knows no bounds. I'll let you know when I sit down to write out our story.

Cat said...

Dena, THANK YOU - xxx - Tracey is also an internet/bloggy friend I've met through quilting.
I am in New Zealand, whilst VBAC's aren't 'banned' it can be difficult to find a midwife to support you.
Tracey and I have spent many emails crying with each other over our 'c-section's', and I sent so many encouraging emails regarding my healing birth, my VBAC. Her story IS my story, the drug hazed first few days, the b*feeding issues, the lack of bonding in the early hours/days. And now THANK-YOU I can say again Tracey's story IS my story - the healing VBAC!
I've just celebrated my son's 6th birthday - it was the FIRST birthday I didn't cry because I hadn't 'given birth' to him . . .

elisa024 said...

So happy for you and proud of you Tracey!!!

This made me cry too!

Kerry said...

What a beautiful account, can't say more but very moved

L.Kiehn said...

Yeah!!! Whoot-Whoot!Congradulations Tracy for believing so deeply in yourself and congradulations my sister girl, for believing so deeply in these beautiful women!! What an amazing and beautiful story. It filled my heart.

♥Duff said...

wow! I have been so excited for Tracey and hopeful that a VBAC was in her future. I'm elated to see it's a girl!! I thought for sure it would be another boy. How thrilling!!
Thank you for your side of this wonderful story--it's a step in the direction of more natural births and doctors believing that they're possible!

CJ said...

Great telling of Tracey's story! I came over from her blog. Such a precious baby she has too. :)

Samantha said...

Oh Tracy I'm so happy for you! This has tears streaming down my face. I'm so glad you got the VBAC you dreamed of!

Sarah Kin said...

I feel a little bit like I have a promising career as an internet stalker that I found this :) This brought tears to my eyes. I'm so, so proud of Tracey. There are two incredible stories here: the amazing story of Tracey's labor and delivery, and the collaboration between midwife and OB. Beautiful. Love to all.

Sarah said...

You all rock!!!

Bess Donley L.Ac said...

Such an inspiring story, thank you for sharing. I too had a c-section first time around-due to breech. I am 15 weeks pregnant and planning a home birth vbac-the more positive stories I hear the more positive I feel!!!

TerrieCNM said...

I love the story! It can be done, but women have to be informed and determined. I am so happy for Tracy and her family, and so pleased to hear of the collaboration by the medical team. Good job all!!

Mikelle said...

WOW! I only know Tracey through her quilting blog, and then I happened to stumble on this birth story and knew the two matched up! So glad she could have this experience.

Doula Brandi said...

How absolutely wonderful for BOTH of you! Thanks for sharing!

Meg said...

That is so similar to a birth I attended recently as a doula. Thankfully, minus the traumatic first c/s - just a routine breech c/s. But, I got to her house and she was obviously deep into labor, we got to the hospital and she was complete. The doc on call was clearly uninterested and put off and didn't really believe she could do it. Fortunately, a CNM was on hand and wanted to take over. She had a beautiful second stage and a gorgeous, good sized baby. Everyone was in awe - she's not a large woman. I knew she could do it, though. We're made for this and when women believe they can and have someone to believe in them it almost always works. What a great opportunity for you and that hospital.

Manda said...

This is almost the same story I am dreaming of (and I'm a short woman, too). It brought tears to my eyes.

I've always wanted an unmedicated birth but I have had two c-sections that were probably not necessary. I'd "failed to progress," I let them do AROM, and nothing we did (the second time I had a CNM as well as a doula and my husband) was making my contractions effective. I'm due just after Christmas Day and we found a fantastic hospital this time. :) Even still, our plan is to not leave home until my cervix is close to complete.

AJ said...

Congratulations Tracy! Fantastic birth. Thank you for sharing it with us.

Ashley said...

UGH I wish you were a little closer... but California to Indiana... bit of a drive during labor ;) I am GOING to vbac after a rupture I see high risk MD and he is KNOWN for not letting vbacs happen. I am hoping for a story like this! He hasn't denied me yet and isn't discouraging me :) and he is also know for being straight to the point and rather blunt. So I am pretty sure he isn't giving me false hope- back story 1st preg 32 weeks, 5000 u heparin bid + administering CPR + awful rail road tracks @ 45 mph (i was not driving) = 12 hrs easy labor @ home while sleeping thinking I was having braxton hicks = small rupture @ 6cm 70% and C-sec...