Our second birth story - August 2015

His birth was not what I expected.  None of which that happened during the journey to meet this kid was what I visualized.  Except, of course, I am alive and well (under the circumstances) typing this entry while my baby sleeps peacefully beside me.

Our littlest man was due to arrive some time at the end of August. By the end of July, I was anxious to experience labour and birth.  Because of my previous Cesarean section, I wasn't sure that I'd be able to successfully have a vaginal birth after Cesarean.  Even though I was in a healthy position to have a vbac, the slightly increased risk of having an uterine rupture due to contractions was terrifying.  A rupture can be fatal to baby or mother.  It was a long time of praying and relying on God's sovereignty to bring us to a place of confidence in trying to labour.  We did *not* relish the recovery after a major abdominal surgery.  I really, really, really wanted to participate in September routines beginning for our firstborn - it's such an exciting time for us all! Under these circumstances, armed with hope and unknown possibilities - we decided to try for a vbac.

All through the end of July to August, I did all. the. things. to help my body prepare for labour and potentially bring on labour - things such as foods to consume, activities to do, and treatments such as acupuncture... And nothing.  But still we were hopeful.  If nothing else, perhaps all these things just prepared my body to labour quickly, smoothly, safely.

A few days prior to my waters breaking, I'd an internal check done along with a membrane sweep.  Maybe it worked... maybe it was the full moon...

When my water ruptured on my original due date (calculated by my last period), I wasn't even sure it was amniotic fluid as it came in small gushes.  But as the day progressed, I started to suspect that perhaps it was my water.  We phoned the labour and delivery ward and they had me come in to check and monitor (I'd already been warned that there'd be a lot of monitoring due to my vbac attempt).

Sure enough, my membranes had ruptured (one of the few spontaneous things that actually happened in the course of all the spontaneous things that should...) but I'd not felt even the slightest twinge of a contraction.  I'd had braxton hicks tightening for months so I didn't think anything of them at all.  It didn't cause any pain - barely uncomfortable.

Since we weren't entirely sure when my water actually broke (in the morning when I noticed increased discharge?  in the night?  in the afternoon when there were bigger gushes?), the doctor on call was super "conservative" and wanted to start me on oxytocin right away.  I wasn't buying it as they just told me baby's heartbeat was good, he was still moving lots, etc.  I also knew that the majority of women's labour begins within 24 hours of water breaking.  So we asked the appropriate questions and since the L&D were very busy, they let us go home for the night.

We went to get some supper, phoned my acupuncturist to make a house call, and prayed that contractions would start that night.

It didn't.

In the morning, we went to the hospital.  Things were the same.  No contractions, regular small gushes of fluid, baby heart rate fine.  Got an internal check before starting and was *still* the same as my internal check from earlier that week.  I was disappointed but I thought, hey - doesn't mean labour won't progress fast!  Still hopeful.  I was hooked up to IV for fluids, sugar water (couldn't eat), and oxytocin.  The fetal monitor was strapped to my stomach.  And so began my official labour.

The doctor on call (whom we love and was *amazing*.  She delivered 4 of the babies in mine and brad's family combined) told us that this early phase could take a really long time.  For some, getting to active labour is just slow.  And this was totally the case for me.  After 8 hours of being on a low and increasing amount of oxytocin, my body had done NOTHING.  I was still the same as when we started: 1 cm dilated, 2 cm long, high up.  My contractions were not strong, painful or regular- they weren't even uncomfortable.  All through this, when I could I'd move around the bed and room, and also bounce on an exercise ball to help baby get things going.

The doctor gave the order to increase oxytocin as needed and to call if there were any irregularities.  Another 4-5 hours of this and I was beginning to feel stronger tightenings, but still nothing painful or regular.  The doctor checked me again after 12 hours of oxytocin and still only 1 cm, but fully effaced!  Finally - progress.

She noticed that there was a small sac of waters at my cervix.  She said that sometimes that slows down contractions.  Asked if I wanted it broken.  I said yes - I want to feel like something more is happening.  I had totally expected to have had this baby by this time.  It was about 10 PM.

After this breaking the small sac of waters and increasing oxytocin, I started to feel stronger tightenings.  Those stronger tightenings quickly became painful contractions.  Some were longer; some were shorter. There was definitely still no regularity to the contractions.  To my disappointment, I did not have enough time to find my rhythm or even try out strategies.  I remember at one point feeling like I needed to sit on the toilet.  As I tried to get out of bed, I had a contraction.  I remember my mind scrambling to use a coping mechanism.  By the time my brain got ahold of it, the peak had passed.  As I sat down on the toilet, another contraction hit.  Same thing.  As I stood up to go back out another contraction would hit.  Same thing.

Previously, I'd already decided that if my body didn't take over naturally (which would've likely given me a chance to work up to the strength of these contractions with coping strategies and a pain management "rhythm"), I would have an epidural.  I knew that if my body was tense and stressed, it would be counterproductive to my muscles dilating enough for baby to come out.  So we called for the anesthesiologist.

It took him 3 attempts to get that epidural catheter into me.  It felt like forever but it was maybe 20-30 minutes max.  Afterwards, I was much more comfortable and could rest.  Fortunately, I could still feel the contractions and tightening.  I could feel changes taking place in my body.  I was thinking it might really happen!!  I rested for a few hours hoping, praying, going with the flow... At some points, it felt like the baby was going to fall out.  The nurse coached me to relax with that feeling.  It's just the baby getting himself ready.

A nurse checked me at about 5 AM.  I had made some progress again, though the strength of  contractions still hadn't dilated me more than 6-ish cm and still no regular pattern of contraction. She also noticed that baby's head and back was tilted.  Not an optimal birthing position.  Baby's heartbeat was also dropping with each contraction - which is normal - but they weren't sure whether it was because of normal contractions or because of the sudden increase of contraction strength (due to increasing oxytocin) that was dropping his heart rate.

She must've called the doctor to come check.  While the doctor made her way, the nurse commented gently and sympathetically that she wasn't sure we'd be able to have our vbac.  She is an experienced nurse (she was K's delivery nurse!) so she must've known something about the progress of our labour... Brad and I knew that this was a possibility.  But we were still sad and disappointed to be so close, yet so far.  When the doctor came, she confirmed what the nurse had checked.

The doctor then explained the situation.  She was completely supportive of us continuing to try to labour if we desired.  She said that it could take a long time still, including pushing time, to meet baby.  She also said that if there was any sign of distress to baby, we would for certain be looking at surgery.  In the meantime, she was totally fine with us continuing on.  They were watching baby sooooooo carefully.  The only unknown really, was whether the strength of contractions produced by oxytocin to get me to 10cm in the amount of time that it could, would be harmful for baby.  The other factor was that my uterus was not completely relaxing between each contraction.  I often had contractions that only went away partially before going back up.  This gives my muscles no time to recover and isn't ideal for a vbac attempt.

Doctor then left to give us a chance to talk it out.

My first thought was... I am tired of waiting.  I want to meet my little guy.  But I didn't want to make a decision based on my own tiredness of waiting.  As we talked it out, we realized that we were getting closer and closer to a section.  We knew what to expect with a section.  And we knew that we wanted to be of sound mind and in a place of safety if we had to face surgery.  We did not want there to be immediate danger to me or baby if we had to be wheeled into surgery.  So we decided it was time.

When the doctor returned, we told her our decision.  She had been very composed and professional the whole 24 hours of her shift with us.  But at that moment, I saw surprise and a bit of relief in her face.  I think she thought we were going to soldier on.  She was compassionate of our decision, as were the nurses.  They said that they do want women to have the births that they desire, but sometimes circumstances are not what we expect.

I was prepared for surgery.  My surgery was around the time when the doctor on call would change over (to my own doctor, actually...)  So the doctor wasn't sure who would perform the surgery.  Turns out to be the doctor who'd been with us the past 24 hours.  I was glad.  It seemed appropriate that she'd get to meet our baby after keeping such close tabs on us.

Surgery this time around was so different from my first section.  My first section was comfortable.  I was in a calm state of mind.  The operating room was actually jovial and easy-going.  The sensations I felt were odd but didn't cause any discomfort until the anesthetic side effects hit me.

This time, I was So.  Uncomfortable.  during the actual surgery.  I didn't feel pain, but the sensations just felt... odd.  My side effects were also painful versus just uncomfortable.  The anesthesiologist (same one who tried 3 times to get my epidural in...) was not exactly a comforting presence.  Trust me when I say that you want an anesthesiologist who is a comforting presence when you go for major surgery while conscious!!!!  My friend tells me that my epidural (which was topped up for surgery) likely wasn't in an optimal position for comfort and relief.  I believe it.

When they pulled AJ out of me, we heard him sputter/choke out fluid twice before belting out his loud cry.  I remember looking over to my right, just as the first time, and carefully listening to the paediatrician give the okay that he was fine, before letting my mind admire my son.  My first thought was: He is so BIG!  I wanted to push him out...??!!??  Hahaha  AJ turned out to be a whole pound and half heavier than K.

We stayed in the hospital 2 nights after my surgery this time around.  I'm so glad that I'm generally unafraid of the hospital.  I know some people are ultra uncomfortable at the hospital and would rather not be there.  But I've had good experiences at the hospital and feel well cared for when I'm there.  We were at the hospital for a long time including the labour induction time...

Recovery though, has been much smoother.  I've felt way stronger and less "out of it," feeling like I can do much more -- maybe sometimes too much more!  I wasn't even in recovery for an hour before they thought I was ready for my own room.  Or maybe I was... I can't recall.  I was so pleased that this time Brad was able to go into recovery with me.  He brought our little AJ to nurse and baby latched like a pro.  All the things that I need to do to recover well came quickly and easier than the first time.  We had a lot of family and some friends visit us at the hospital.  It was super surreal being at the hospital, especially on the first two nights.  For one, I couldn't believe that AJ was finally here.  And another, we'd never been away from our firstborn before.  And now we'd been away from him for a few nights in a row.

In the past 3 weeks, we've had some breastfeeding challenges as is norm for many.  But he's getting what he needs as gained and surpassed his birth weight in a week.

I am beginning to feel more like myself again.  It's as if AJ has always been a part of our family.  Having already experienced a newborn who is now a toddler, we know that some of what we see in our little dude is actually his personality appearing!  It's been really great getting to know him and who he is created to be. We are relishing our time together.

Big bro K is loving his little brother.  He wants to give him cuddles and see him all the time.  The challenges that come with transitioning into a family of 4 is mainly with big bro and me -- I feel so incapacitated much of the time when it comes to loving on and training my (almost) 3 year old.  It's been a rough go.  I know it's a phase and temporary.  I know that it's worth it.  But it sure is difficult with a persistent and strong-willed firstborn personality.

Our first birth story is linked here and here (it's written in two parts).